 Thank you So everyone can hear me with the mic So I'm the director of legal initiatives at the Rudd Center for food policy and obesity We're a non-profit at Yale and we're a multi-disciplinary center. I think it's the only one of its kind We have economists, policy people, psychologists, they run studies. I'm a lawyer Then we try to come up with Promising ways to change the modern food environment basically to address obesity and we also work on weight stigma issues So I'll be talking about the modern food environment and tell you some marketing practices that the processed food companies Do especially a lot of parents don't realize what their children see on TV What what happens in the supermarket and then I'll talk about the regulatory authority of some of the agencies and their lack thereof and Some state and local ways to address food and I'm gonna tell you about some of the policy options that are all all in the news now like mayor Bloomberg serving size restriction and sugary beverage taxes and then removing sugary beverages from the snap which is formerly called food stamps So that that's basically my talk, but Just to start out There are about 300,000 Process food items on store shelves today and every year 12,000 new products are introduced These products benefit from the corn and soy subsidies, but economists don't think that's the sole reason for their Their cheapness. It's more about the high production ability of modern technology and modern machines but nonetheless we have We're inundated in this country with just processed food that are primarily made of corn soy and sugar and you could see this from From in stores and in fast food restaurants and convenience stores and the red center has done Three reports this it's called cereal facts sugary beverage facts and fast food facts So if you want any of the information or more information about what I'm talking about you could find it on our website So the fascinating thing are studies after studies and after studies show that the same group of food is Problematic for several reasons. They're most associated with weight gain. They're the most Purchased at fast food restaurants The most snacked on by us adults and they are very high sugar and sodium content and it's the same list Candy's not always on every list, but it's on the high sugar snack food list and The and as you could see it's processed foods the french fries chips sugary beverages Processed meats like the kind that are at the McDonald's that I showed you Sweet desserts refined grains, which are like the sugary cereals and juice drinks And so these are the products that are have basically inundated society and unfortunately, they're also the most marketed to children So these the FTC did a study. They're actually supposed to come out with a new study. That's a federal trade commission the same group of foods are the same that are most marketed to children and in many venues television if they measured this by expenditure, but if you look at it Digital even though digital is the fourth on the list The impact is quite high for how small the amount that they have to pay for so The digital marketing on the internet and now mobile phones That's the new horizon where there are banner ads on children's websites And then of course lots of children's Websites that are actually just dedicated to the brand and the product and children play with the product And it becomes a game and they don't realize that they're actually being marketed to while being on the websites So a lot study after study also shows that the the impact is that it's teaching our kids that it's it's cool and fun to eat unhealthy food anywhere anytime and That's a message that's definitely coming through and there's no repercussion the kids on the commercials are not obese They're not sick. They don't have cavities. They're the happy young kids running around And they promote exercise as their their way to say you can eat anything you want if you exercise And we all know that this is not true So I would like to show you some marketing practices But first I do want to give you like a one second background on why in the US we allow marketing to children Other countries have tried to restrict it the World Health Organization the Institute of Medicine American Academy of Pediatrics and the Psychological Associations They all recommend limiting marketing of unhealthy food to children But the US we focus on self-regulation and for the non-lawyers in the room It's because we have a first amendment and other countries don't and our first amendment It says the Congress shall make no law bridging the freedom of speech and the original purpose for this was to protect political speech political discourse Religious peace so you were really could participate in the marketplace of ideas There was nothing no wrong ideas and everyone could debate but in the 1970s the Supreme Court determined that the first amendment protect a commercial speech which is advertising and Unfortunately since then the Supreme Court has been interpreting this much more strictly to protect more and more commercial speech It's very hard for the government to restrict commercial speech except in schools, which I'll talk about So so this is why it's hard for our government to restrict marketing to children False and deceptive commercial speech is not protected by the first amendment So this is where our agencies come in to protect consumers And I'll show you an example of that but we will be talking about commercial speech here, so We we just came out with a serial fact study that showed that the number one packaged food kids see is cereals the kids are seeing 1.6 almost two ads a day for cereal and this is a great photo from CSPI just showing that the 30 grams of cookies are identical to 31 grams of this cookie crisps and In fact, it turns out that over 90 90 percent of the ads that kids see for cereals are comprised of 26 percent sugar or more and it's not that the companies don't have other products because they market healthy products to adults and The family range like Cheerios But they really market the most unhealthy products to children and this is this is the great slide that my marketing team put Together they had studied whether there had been a change from 2008 to 2010 because the companies are all telling us that they're self Regulating where we don't need to have any government intervention. We're taking care of it And so these were the top 10 cereals marketed to children in 2008 and in 2010 this was the change So here they tell us they're doing their job government doesn't need to regulate and these are still the top 10 mark were Serials marketed to children and these are all the cereals that the company say meet. They're better for you standards These are healthy. I mean and I just have to point out Reese's puffs and They're and also, please note that so for Reese's puffs is a great example There's health claims on the top of that and if when you go into the store, you'll see it And here's where it gets really tricky This is these are the cereals that they tell you are they're okay to market to your children on TV When you go into a supermarket There's not like you know now which is the one that's better for you compared to the one that's not better for you The kid request one you you know, they've seen a commercial for it So when once you get into the retail environment, it's really irrelevant What they've decided to say is better for you and not better for you And if you'll note again, there are health claims on both of these cereals Now the fast food companies are using a new strategy to tell us that they're not marketing to our children on healthy food Instead of showing hamburgers and french fries. They're branding their companies and the products and tell us about the toys So now it's actually turns out it's probably a better marketing method By getting kids just wanting to go to McDonald's. They don't care what the food is It's about the toy and the the branding of McDonald's And then sugary beverages are the other product Kids are seeing more ads for sugary beverages than they did in 2008 Unfortunately, these are products that have unhealthy amounts of caffeine for young children to be consuming and and kids are seeing ads for energy drinks and energy shots To the same rate as adults are so this is becoming a real big problem There are now emergency room visits of energy drink overdoses in young in teenagers and not being combined with alcohol But literally caffeine toxicity And then they have high sugar content as well And also one thing that was shocking that we found was that some of the regular drinks that don't label that anything they had Artificial sweeteners in them also, so I think that would be surprising to parents that would normally think it would say diet or light So the other problem is they at these drinks are marketed with healthy features and 68% of parents and one of the surveys we did said that they want healthy features such as Vitamin C and the term all-natural And they look for this and they'll purchase it for the children We have no vitamin C deficiency in the country and in fact so many things are fortified with vitamin C It's it's impossible not to be getting enough vitamin C and Even you if you eat whole foods you're getting enough vitamin C and then interestingly this all-natural term has really no meaning The FDA has declined to have a definition for all-natural The only thing it's FDA has said that's the Food and Drug Administration They're responsible for package labeling which I'll talk about in a minute The only thing they've said is that it shouldn't have added color synthetic substances or flavors But then there are a lot lawsuits all over what the term all-natural means Consumers suing Snapple your product at high foods close corn syrup. That's not all-natural. Well, there really is no definition So when parents are and consumers are looking at the all-natural label it means nothing, so don't be tricked by that And then the last thing is schools 90% of all the ads that the kids are seeing in schools are for sugary beverages There are many venues within the school environment And the one good news in this whole bad news scenario I just gave you is that if you are interested in working in your community. It's the one area you can restrict marketing Schools are a government property. I'm talking about public schools only So that's called a non-public forum in First Amendment terms and the government can regulate schools It's recognized that children are a captive audience in schools and that they Understand that what's being told to them at school is is different than just in the community. They take it for a learning So you so schools can contract away for ads if they have a vending contract with say Pepsi They can tell the Pepsi That's fine if you bring your water up into our schools But you can't advertise for anything else and the other way is you can actually enact guidelines it's called viewpoint neutral guidelines and And the whole purpose is to reserve the property for its lawfully dedicated use Unfortunately a new practice is springing up where schools are now selling marketing space on their school buses This is all over the country If you are interested in trying to restrict that in your school I have a paper that just came out American Journal of Public Health That is really a practical tool to tell people what to do to get get that out of their schools So when we talk about Addressing this environment the food and drug administration is in charge of labels They they they have the regulations for the nutrition facts panel ingredient lists and health health claims And the one thing there's a lot of things missing in the regulations They have a disqualifying level for health claims for fat Saturate fat cholesterol and sodium, but there are no disqualifying levels for sugar and added sugar So remember all those health claims. I was telling you we're on those sugary beverages and on the cereals This is why it's the only product. These are the only products that now can keep having health claims Unfortunately our studies have shown that parents are really swayed by these and consumers in general are swayed by health claims and They do purchase products They might not otherwise purchase if they had known the that there's no disqualifying level of sugar Also, there's no required caffeine disclosure. So energy drinks can have as much caffeine and not tell consumers how much is in there The one bright spot is the FDA is researching right now They just put a call for Comments about whether they should research adding added sugar on the nutrition facts panel So that's that's a bright spot and hopefully that'll be true. So as everyone knows you the beverages get a nutrition facts panel But what's going on with these energy drinks? There's a lot of energy drinks that are saying they're supplements They have and they have dietary supplement labels. Well, that's illegal. They do it. Anyway, the FDA sends them letters and They don't have much recourse What miss branding is illegal under the regulations, but the FDA doesn't have so much authority to address this They can see they send warning labels and they basically say we're seeking assurance that you're going to change your label But they can't if issue civil monetary fines They can't obtain Substantiation documents. So if a company puts some false claim the FDA does not actually have the authority to say can give us your Documents to support this claim which to me is is crazy So if they want to go after a claim they actually have to do their own studies now They don't have all the money in the world to do the studies to prove that a company's claim is not Valid and there's no pre-approval for structure function claims And so what this means is even though health claims and nutrient content claims have to be pre-approved or they go through They're have to abide by certain regulations the structure function claims can basically say anything as long as it's truthful And so there's where we run into a problem. So FTA has had had rights letters to companies. These are two examples of of letters of company I'm sorry of products that have gotten letters because of their labeling diet coke Plus is in direct Contradiction to a regulation that says you're not allowed to fortify a soda and they have lawyers at coke So they knew what they were doing and they got a letter being told to stop with this and Juicy juice is a really interesting Juicy juice is intended for children under two but the regulations say you can't have certain claims for children under two yet They did it yet. If you notice there says brain development on there Well, the f that's considered a structure function claim So even though the FDA wrote this long letter to Juicy juice about their no sugar added claims and their fruit claims They don't even mention brain development, which is obviously the worst claim on this packaging because it's a structure function claim So what we're a little lucky the FTC has better authority and they've been able to fill some of the gaps FTC is in charge of marketing while the FDA was labels. This is marketing. So TV internet radio They can issue civil monetary penalties for certain Practices they can obtain substantiation documents and they can go after structure function claims. So When Coco Krispies had these immunity claims during the swine flu scare and parents were apparently buying this thing They would keep their kids from getting regular colds and swine flu the FTC was able to go after them told them to stop These these practices So that's the a quick background of the regulatory environment that's going on at the federal level And I want to talk a little about the local level and then tell you about some of the news the stories You've heard about regulation that's going on So local level is basically retail food service establishments local jurisdictions meaning state and local governments have authority over public health safety and welfare they They would where I'm talking now about not not restricting advertising but regulating conduct, which is Not protected by the First Amendment governments can regulate conduct easier than speech in the US So what happens is a lot of times a government will try to restrict the marketing of an unhealthy product to protect children one of the most famous Supreme Court cases came out of Massachusetts there was a restriction on the ad for tobacco products, so Near schools the Supreme Court struck down most of the restrictions and this happens a lot for alcohol tobacco But often that when the Supreme Court strikes down a restriction it offers ideas of what the government could have done instead if they would Regulate conduct and we can learn from these ideas and implement them for food They had suggested limiting per capita purchases of products banning or limiting harmful ingredients age limits to purchase possessor use products restrict location Increase information About the products and then raise the price and so we've seen this these are things that are enacted all the time in the Fedron containing cold medicine is a per capita restriction You can't buy many at a time to sign it out in many states You can't just buy it because it's used to make meth Some states have banned the product called for local which is a caffeinated alcohol drink Actually, I live in New York and New York banned it quite a while ago And I just saw it in the bodega down the street for me So I don't know how effective that pan was but it is banned as you know minors can't purchase alcohol and tobacco and Tobacco can be placed requires to be placed behind the counter That was something that did come out of the Massachusetts case that Retailers can be required to place tobacco behind the counter so kids can't just get cigarettes with and The California enacted a law saying that Tobacco can't be sold out of pharmacies and the Ninth Circuit upheld this and so this is a just a direct regulation of conduct And it has nothing to do with Marketing menu labeling laws if your state doesn't have them or your city doesn't have them. It's a national law Our understanding is that the Obama administration is waiting till the next election to actually enforce the law But that it has been implemented in many places where their calorie counts are on them on the fast-food menu and then Every state in the country and the federal government has an excise tax on tobacco products So these are all in practice and now we could see it apply to sugary beverages and this is starting to go on I've done this talk this as this part of the talk for years And I've had to add and add and add to the list which is exciting news because local governments are starting to get on board I haven't heard of any Virmins trying to limit per capita purchase that doesn't sound very politically feasible But we have seen serving size limits, which I do have a whole slide on New York City But New York City is trying to enact a serving size limit on sugary beverages Cambridge, Massachusetts actually talking about it and also considering just Trying to work with the vendors to only have a certain serving size An Oregon had a bill that failed You can restrict the sale of certain drinks in Connecticut The Attorney General didn't want the energy drink drink called cocaine to be sold in the state because they felt like it was marketing Drugs and they talked to the company said you're not you can't come in our state and they're not but you could also do this through legislation There was a there was a local Politician in New York who tried to enact a age limit So nobody under 19 could purchase a energy drink that it didn't pass and Then there is there was a bill in New York about junk food free checkout aisles This is one that we've we talked about a lot at the Rudd Center It would be very easy to enact that in the checkout aisle You can't have it inundated with all that candy and junk But then the pharmacy ban is another idea And then factual signs at the checkout Boston I guess I you know, I haven't even seen it here, but apparently they have signs at certain checkout And but you could do creative you could say how many calories or caffeine is in a product or how much exercise Time it would take to burn off the calories, which I'm not in love with just because I don't think that is really of the compensation But this was an idea floated by one of the commissioners at the FTC And then of course degree beverage taxes. So just here's one of the signs from Boston I haven't seen these two as we've seen that anyway, it's mostly in some retail establishments um, and so then serving size restrictions, so this is a Really interesting idea. Mayor Bloomberg announced it in New York City that no Food service establishment could sell sugary beverages that were Larger than 16 ounces and the in New York City The health department has a lot of regulatory authority and not every health department in the state or In state health departments or city health departments have as much authority as they do Massachusetts health department has a lot of authority and you see a lot of great regulations coming out of these places because they have the authority to enact them so because this is a health department regulation it only applies to the Vendors that they have jurisdiction over and in New York City that are food service establishment So the news has picked up this story is saying This is going to apply to fast food restaurants, but not 7-eleven big gulp And that's all you hear is that New York City is why are they enacting this and no 7-eleven big gulp? Well, it's because that the health department doesn't actually have authority over 7-elevens. That's actually a state Run the state us the state agriculture department has authority over those types of stores So it's just that it's a that's their authority And so what's been very interesting in New York is that they have the the beverage industry are sending out people Pretending to be grassroots movements saying let we pick our own drink I'm on the day that they were voting on this. I saw men in white t-shirts. I picked my own drink walking around These are paid people. They're not actually grassroots movements So the new term is has come out called astroturfing which is when you fake a grassroots movement And that's what was going on. It's happening all around the country every time a sugary beverage tax The there's astroturf movements of pretend grassroots movement trying to convince people that they're taking away your liberty Interests in being able to purchase a large beverage basically whatever you think of this proposal legally, there's not a problem the major complaints are that The major legal complaint that could potentially be valid is that the health department has overstepped its bounds But that's a real very New York City Centric argument based on the case law But legally any jurisdiction could really enact this if they had the authority to do it And one of the great arguments that the movie theater industry does not like this at all because people tend to buy large beverages and share them Which I spoke to the head of the company of the movie industry company and I said well Just won't you make more money that people have to buy two and he's all I don't yet. You're right so anyway But then they all y'all about the slippery slope argument of what about popcorn is the big one that was talked about The reason why none of us are worried about the slippery slope argument is because there's absolutely no product that every study Consistently shows is problematic for health. It's associated with waking diabetes mellow metabolic syndrome And the very different thing about sugary beverages is that your body does not compensate for the for the calories You consume through sugary beverages, which means you don't eat less so if you eat eat the same amount of calories in food form you would eat less In your meal But if you're drinking it through sugary beverages the studies show that you actually don't eat any less and the studies also Showed this to be the same for fruit juice Just as an FYI even though that's not covered by the law And so the sugary beverage taxes there have been bills all over the city all over the country Cities and states all over trying to pass sugary beverage taxes The federal government and all the states have the power to pass excise taxes and some local governments can as well the in the two years after the US Constitution was ratified the country passed the first excise tax on whiskey and They've been passing excise taxes ever since there's excise taxes on Tons of stuff in this country and then as I told you every state and the federal government also taxes tobacco The the benefit of an excise tax is that you can you alter the price at the base So it's not a sales tax that you would later find out when you got to the register But it actually changes the base price of the product and also you can earmark it Which means that you can dedicate the revenue stream to a specific cause and those of us who work in public health Our whole goal is to dedicate it to public health put the money back in communities that do suffer health disparities maybe or maybe do have consistent users of sugary beverages and It would it would basically make a tax to help the communities And then you would have to learn from the tobacco world when tobacco taxes were first instituted all the tobacco companies started doing trade discounts and You would you have to prohibit that in order to make the tax work But this is something that our office talks about a lot Kelly Brown L our director is kind of one of the most famous proponents of the sugary beverage tax And then my final slide is about the snap program. So snap is formerly known as food stamps and Right now we have the largest amount of people on snap than ever before one in seven people in the country received snap And study are no in our office someone did a study. There's there's one There's one Estimate that people spend four bill that I'm sorry the government spells four billion dollars a year buying sugary beverages for snap recipients and Some the economists in our office did a study that showed it was Two point six billion in the new in the New England states not including stores like Walmart and those stock stores So the four billion does sound kind of right if you're if you're only talking about a small proportion of the sugary beverages so the argument is that Snap is basically snap recipients can use their money for anything except for pre-prepared food alcohol tobacco pet food stuff like that But they can buy anything and so The wick program, which is the women infant children program, which is also a food help program They have restrictions very strict restrictions on what recipients can purchase and they actually it's the strict Nutritional criteria are pretty strong And we found that the retail environments of the stores that accept quick actually improved because of this And so not only are people buying healthier food, but the retail environments got healthier So New York, Texas and Minnesota tried to ask the USDA if they could pilot a study Where they would withdraw sugary beverages from snap recipients the USDA said no the USDA is very Concerned about hunger their end stigma So the USDA's main argument is that it's stigmatizing to snap recipients to not be able to purchase everything that they want We had to represent it from the USDA actually at our office last week who said this argument but it doesn't it doesn't seem to connect with the fact that Snap recipients do have their own money and also it's the government purchasing the products It's not actually the snap recipients So nobody wants to stigmatize anybody but our goal would be to have a study and not try to cut The benefits for snap recipients which is one problem some of the conservative groups are latching on to this as a reason A cut snap which is not really the greatest idea, especially when so many people are receiving it in light and a lot of people need it But rather to study whether this is stigmatizing because that's a testable question and see it because It's there is a pretty good case that maybe the government shouldn't be purchasing such a harmful product You know, we now know this is harmful Maybe it's not something to purchase just like tobacco is So anyway, if you I would love to answer any questions and our website has a ton of information and All the studies I talked about so thank you First I'd point out that children don't have a lot of disposable income So I would think that this is ultimately a problem with what the parents are buying Second can you quantify how much of this demand for unhealthy food is driven by the advertising versus bad information in general? Versus the health claims that food companies are able to make because of the USD is okay And so I wonder if you're putting the cart before the horse if you're trying to limit advertising If we've just got all this widespread bad information in the first place. Oh I don't think limiting advertising is the solution to obesity or the food problem I simply think it's important that people know what children are seeing when they're when they're watching TV I what we found is parents have no idea what kids are seeing and a lot of parents Say that children request the foods that they've seen on TV when they're in their sores they're constantly begging for food and I'm not saying that the parents don't have a responsibility, but I think as a Society we might have a responsibility to our children to have an environment that doesn't foster Such an unhealthy relationship with food and only the desire for unhealthy food I think it's a challenge for parents to get their kids to eat healthy when They're being inundated with these kind of commercials But for sure and there's no way that we would solve all obesity or food problems by just marketing alone And no, I can't quantify that. I'm I have a JD. I can't barely add so Hi, I just have an observation regarding snap and food stamps and wick It's my understanding that wick allows women infants and children to have access to things such as milk and bread and cereal so it's It's still I mean from a from the people here perspective. It's still not a Preferred approach, but then also I've seen at least in Seattle We've got food stamp programs that are accessible through our farmers market So I would take issue with it being wick being better than food stamps from that perspective anyway Oh, yeah, that's it's a great program that the farmers markets are accepting ABT I Think that it's a better Program to have restrictions on not buying bad things not telling people what to buy on the good list is not really where I'm at but I would say restricting the most unhealthy products and also I'm not really sure it's that listen I'm as liberal as they come But I don't know if it's the government's role to buy sugary beverages Which we now know are really harmful for people the the thing I said about not come about people not Compensating I think is really important if you're hungry and you drink sugary beverages It's not satiating you whereas we're we're trying to get food to people that are hungry so they can be sustained and Healthy whereas sugary beverages not only make you sick, but they don't actually make you feel that you've eaten or that you're sustained so it's a pretty bad item and by the way energy drinks are also purchased so purchase a bowl and These are not products that we would that I feel that government should be buying for hungry people Has the red Center looked at the way Europe handles it. It seems like they have a they they just group sugar with tobacco and alcohol and and tax tax it like crazy Seems like a good model for them. I've been over there and people really think about buying sugar because it's really expensive Our sugary product. Yeah, there's some great economists I think in Iowa who had just modeled out taxing sugar itself instead of sugary beverages I love that that model I think Europe's got it a lot better in a lot of ways, but Kelly Brownell came up with this idea of taxing sugary beverages like 20 years ago. So he's really into it. So they The economists in the group that do the studies They are really looking at sugary beverages Although there are other economists in other places looking at tax and if you email me I could send you their studies because they're great studies I don't agree with Mary Nessel on much of anything, but she's Proposed this idea that when you just remove health claims from food labels all together And I've talked about that with people who do policy and and some of them have been like well What about the first amendments, you know freedom of speech that that? Producers have the right to make these health claims if they can Substantiate them according to whatever the policy level is and I'm I know that it's complicated and people are You know that the legis that the laws behind that are you know, whether you're claiming this versus claiming that but I'm just wondering what you think about just no No health claims on label. I agree But I do that the first amendment is a barrier here So I think it would be better if we didn't have health claims because of what's happened now But what happened was the FDA tried to restrict certain claims and the district of Columbia's court of appeals Said that they couldn't and that's the highest Court that's looked at the issue, but they were looking at something called They were looking at health claims that were qualified and they had all and they were they weren't meeting the strict standard and The court said that they couldn't restrict them that they all they could do and this is consistent with the first amendment is included disclaimer or Planetary language, so now there's something called qualified health claims They're like two sentences long and not that many people not that many companies use it But it's they're very long ways of saying that we don't really have that much proof But this is what we think and so I would argue that that's confusing and misleading and deceptive right there So we should be able to ban that and I think that if you that we need to have studies showing Consumers are misled these are deceptive then you can restrict them if it's just saying this has is high in vitamin C It's it would be very it's impossible under the first amendment and the current conception of the first amendment to restrict it because Especially this court feels that corporations have the right to say a lot And so if but what we could do is get studies to show that they're confusing because deceptive speech is not protected So that's the route that we could take So I agreed with her I saw her her article on that and then I wrote an article something after it's saying Well, if you could prove it's deceptive then then we can we can get them get rid of them So what kind of barriers are there to doing these studies and I'm interested in the barriers like what are the barriers and what Can we do to try to get rid of them? The barriers is that we don't know that public health doesn't have any money So we have to get we have to get grants to run studies and so there are some great groups Robert Johnson The NIH they do give grants to groups to do these types of studies there, but that's the that's the barrier and so The other thing is the lawyers know this the about the deceptive and then this the people who run studies might not so we got a So the one beauty of our office is that we can join those two things, but we would have to get a grant to run the study Thanks, Jennifer. Thank you