Earlier today the journal PLoS Medicine released the first 3 papers in a series devoted to the health impact of “Big Food” (full disclosure: PLoS Medicine is published by the same folks who run our blog network, and we had
pre-embargo access to the below papers access to the embargoed articles prior to official publication). The purpose of the series is to “examine the activities and influence of the food and beverage industry in the health arena“, with the recent increases in obesity rates as a major focus (although under nutrition is hinted at as well).
This first release included 3 papers – an editorial by the editors of PLoS medicine outlining the series, an essay by series editors David Stuckler and Marion Nestle, and an article by Lori Dorfman and colleagues comparing the Corporate Social Responsibility campaigns of Big Food, with previous similar campaigns by Big Tobacco. All of the articles are available for free here.
I had originally planned to discuss the release in one post, but it quickly became clear that it was going to be a very long post. So instead I’ve decided to break it into 3 parts, published throughout the week.
Today I’ll look at the issue underpinning this whole debate: does Big Food contribute to the increasing body weights of North Americans?
While the series may technically be focused on “Big Food” as a whole, the focus of these first three papers was largely on the beverage industry (e.g. Coca-Cola and PepsiCo). Some may question the role of sugar sweetened beverages (e.g. pop, soda, Kool-Aid, Gatorade, etc) in the recent increases in body weight in Western nations, but my personal reading of the literature leads me to conclude that they play at least a somewhat important role.
Here is what I’ve written previously on this topic in the journal ISRN Pediatrics:
While trends in total [energy intake] over the past 40 years are unclear, there is little ambiguity for trends in sugar-sweetened beverage (SSB) intake, which has increased dramatically in recent decades [58–60]. For example, the average self-reported soft-drink intake in American youth increased from roughly 150 mL/day in 1977 to more than 350 mL/day in 1998 , and recent studies suggest that total SSB intake has continued to increase into the 21st century . Interestingly, while this may be partially due to increased fast food consumption, available evidence suggests that SSB intake has also increased in the home environment in recent decades .
Several recent systematic reviews have also concluded that there is consistent evidence that excess consumption of SSBs is associated with an elevated risk of weight gain [19, 61, 62]. For example, among longitudinal studies, Vartanian and colleagues report significant effect sizes of 0.24 and 0.09 for the relationship of SSB consumption with total EI and body weight, respectively . Similarly, a 19-month prospective study of 548 school children reports that every serving of sugar-sweetened beverages at baseline was associated with a 0.18 kg/m2 increase in BMI at followup .
Finally, it has recently been estimated that removing sugar-sweetened beverages from the diet of American children and youth would reduce caloric intake by an average of 235 calories per day , which has the potential to dramatically reduce the risk of positive energy balance in this age group. Thus, available evidence suggests that excessive consumption of SSBs plays a strong role in the etiology of the childhood obesity epidemic.
Not all evidence supports the role of sugar sweetened beverages in increasing obesity rates (Dr Arya Sharma covered just such a paper on his blog this week), but in my opinion the wealth of evidence suggests that sugar sweetened beverages have played a role in the process.
Come back tomorrow when I will discuss this paper comparing the corporate social responsibility programs of Big Food with previous campaigns by Big Tobacco.