U.S. sets off furor in anti-obesity fight

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Tue, 20 Jan 2004 15:01:19 -0500

U.S. sets off furor in anti-obesity fight

 

Bush officials hit WHO's focus on sugar, junk foods

 

By Judith Graham

Tribune staff reporter

Published January 20, 2004

 

The U.S. is challenging a draft plan by the World Health Organization to combat

the growing worldwide epidemic of obesity, provoking strong international

criticism and charges that the food industry is influencing the policy.

 

The Bush administration alleges that the WHO plan, under development for three

years, relies too heavily on questionable science to recommend that people limit

their intake of sugar and other refined foods, among other measures.

The administration's position has caught international public health officials

by surprise and sent shock waves through the WHO governing board, which is

meeting in Geneva. The board is set to decide Tuesday whether to endorse the new

obesity plan.

 

" People are appalled and, frankly, extremely dismayed, " Neville Rigby, director

of policy for the London-based International Obesity Task Force, said Monday in

Geneva.

 

The WHO plan would lay out policy recommendations that nations could adopt to

stem a rising tide of obesity. Some 300 million people are thought to be obese

worldwide.

 

The WHO seeks to create an international blueprint for promoting healthy

lifestyles and reducing the costs of chronic diseases related to obesity, such

as heart disease and diabetes.

 

The draft plan suggests nations consider advising people to limit sugar and

refined foods, restricting junk food marketing, improving food labeling and

raising prices on unhealthy foods.

 

Rigby and others suggest that U.S. criticism of the plan is being driven by the

sugar industry, grocers and other U.S. multinational food companies that want to

forestall emerging international efforts to regulate food marketing, pricing,

production and trade.

 

The U.S. position came to light in a Jan. 5 letter by William Steiger, special

assistant for international affairs at the Department of Health and Human

Services, to Dr. J.W. Lee, director general of the WHO.

 

In the 28-page letter, the U.S. repeatedly suggested that the quality of the

science used by the WHO to support its policy recommendations was questionable.

 

Among the concerns articulated in the letter, the U.S. said rigorous scientific

studies do not clearly show that marketing fast foods or high calorie foods to

consumers increases their risk of becoming obese. Nor do scientific studies

definitively link particular foods, such as soft drinks or juices, or foods high

in fat or sugar, to a higher risk of obesity.

 

Evidence does not support the conclusion that TV advertising for food can be

tied to rising rates of childhood obesity, the letter asserted.

 

On Friday, Steiger told the Washington Post the U.S. would demand significant

changes to the WHO obesity initiative based on the concerns outlined in his

letter. The U.S. wants to see more emphasis on the role of " personal

responsibility " for obesity and less emphasis on government regulation, Steiger

said.

 

Steiger could not be reached for comment Monday.

 

On Friday, Kaare Norum, the senior scientist leading the WHO's anti-obesity

effort, sent an angry letter to HHS Secretary Tommy Thompson charging that the

U.S. was putting business interests above public health.

 

" I am deeply concerned about the course the U.S. is pursuing, " Norum said Monday

during a telephone interview from Geneva. " I am very disappointed and very

astonished.

 

" I hope the U.S. will stand alone and the [WHO] strategy will go ahead, " said

Norum, a professor at the Institute for Nutrition Research at the University of

Oslo.

 

Dr. Walter Tsou, president-elect of the American Public Health Association, said

the WHO's emphasis on encouraging people to eat less processed food laden with

fat and sugar and more fruits and vegetables is exactly what U.S. consumers are

being told.

 

" Any mother with any common sense knows that you don't feed your kids cookies

and ice cream every day unless you want to see them gain weight, " he said. " This

appears on its surface like what happened with tobacco: an attempt to raise

scientific questions to draw attention away from actions that could stem an

escalating public health problem. "

 

Several critics of the U.S. position noted its similarity to industry statements

over the past year opposing the WHO's obesity initiative.

 

For instance, at a meeting last May, Mari Stull, a top official at Grocery

Manufacturers of America, called the WHO report " troubling " because it " severely

understates the role of the individual in managing his or her diet and weight,

while it overstates the role government could or should play. "

 

Consumers in wealthy countries like the U.S. may be able to choose what they

eat, but that is often not the case in poorer countries where obesity is

exploding, said professor Bill Leonard, chairman of the anthropology department

at Northwestern University, who has studied obesity in Latin America and

Siberia.

 

Healthier foods are often simply unaffordable for impoverished families in these

countries. " Expecting the rest of the world to follow the U.S. model of personal

responsibility is very shortsighted, " Leonard said. " This is an area where it is

reasonable to ask governments abroad to act to look at what their policy options

are. "

 

The data the WHO has assembled on obesity, while not the most rigorous possible,

does offer " compelling evidence " that the problem is expanding and merits

attention even before definitive scientific studies are completed, he said.

 

The U.S. Sugar Association threatened last year to ask congressional allies to

eliminate U.S. funding for the WHO unless it canceled the release of its report

on obesity, diet and chronic disease.

 

Sugar companies were irate over a WHO recommendation included in the report that

urged people to get no more than 10 percent of their daily calories from sugar

and other sweeteners.

 

Rather than focusing on specific types of food, the U.S. believes the WHO should

be focusing on people's overall caloric content and the degree to which they

exercise, said Dr. Van Hubbard, director of the National Institutes of Health's

division of nutrition research coordination.

 

It is the totality of people's food choices that is important, not individual

food choices which will vary by country and culture, Hubbard said. Furthermore,

hard evidence proving that specific foods contribute to obesity for the most

part does not exist, he noted.

 

The U.S.'s overarching goal of stemming the rising tide of obesity is entirely

aligned with the WHO, Hubbard insisted. The major disagreement is over tactics,

he said.

 

Professor Shiriki Kumanyika, who teaches epidemiology and biostatistics at the

University of Pennsylvania's School of Medicine and who was vice chair of the

panel that drafted the WHO's report, isn't impressed by that argument. Most of

the dietary suggestions included in the WHO report are " extremely compatible

with the U.S. dietary guidelines, " she said.

 

U.S. guidelines on what people should eat have not been based on irrefutable

scientific evidence; like the WHO guidelines, they are crafted using " reasonable

evidence and sound judgment, " said Kumanyika, who helped prepare U.S.

guidelines.

 

2004, Chicago Tribune

 

 

 

 

 

 

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[Guest guest]

Bush officials hit WHO's focus on sugar, junk foods

By Judith Graham

Tribune staff reporter

Published January 20, 2004

The U.S. is challenging a draft plan by the World Health Organization to

combat the growing worldwide epidemic of obesity, provoking strong

international criticism and charges that the food industry is influencing

the policy.

The Bush administration alleges that the WHO plan, under development for

three years, relies too heavily on questionable science to recommend that

people limit their intake of sugar and other refined foods, among other

measures.

The administration's position has caught international public health

officials by surprise and sent shock waves through the WHO governing

board, which is meeting in Geneva. The board is set to decide Tuesday

whether to endorse the new obesity plan.

" People are appalled and, frankly, extremely dismayed, " Neville

Rigby, director of policy for the London-based International Obesity Task

Force, said Monday in Geneva.

The WHO plan would lay out policy recommendations that nations could

adopt to stem a rising tide of obesity. Some 300 million people are

thought to be obese worldwide.

The WHO seeks to create an international blueprint for promoting healthy

lifestyles and reducing the costs of chronic diseases related to obesity,

such as heart disease and diabetes.

The draft plan suggests nations consider advising people to limit sugar

and refined foods, restricting junk food marketing, improving food

labeling and raising prices on unhealthy foods.

Rigby and others suggest that U.S. criticism of the plan is being driven

by the sugar industry, grocers and other U.S. multinational food

companies that want to forestall emerging international efforts to

regulate food marketing, pricing, production and trade.

The U.S. position came to light in a Jan. 5 letter by William Steiger,

special assistant for international affairs at the Department of Health

and Human Services, to Dr. J.W. Lee, director general of the

WHO.

In the 28-page letter, the U.S. repeatedly suggested that the quality of

the science used by the WHO to support its policy recommendations was

questionable.

Among the concerns articulated in the letter, the U.S. said rigorous

scientific studies do not clearly show that marketing fast foods or high

calorie foods to consumers increases their risk of becoming obese. Nor do

scientific studies definitively link particular foods, such as soft

drinks or juices, or foods high in fat or sugar, to a higher risk of

obesity.

Evidence does not support the conclusion that TV advertising for food can

be tied to rising rates of childhood obesity, the letter

asserted.

On Friday, Steiger told the Washington Post the U.S. would demand

significant changes to the WHO obesity initiative based on the concerns

outlined in his letter. The U.S. wants to see more emphasis on the role

of " personal responsibility " for obesity and less emphasis on

government regulation, Steiger said.

Steiger could not be reached for comment Monday.

On Friday, Kaare Norum, the senior scientist leading the WHO's

anti-obesity effort, sent an angry letter to HHS Secretary Tommy Thompson

charging that the U.S. was putting business interests above public

health.

" I am deeply concerned about the course the U.S. is pursuing, "

Norum said Monday during a telephone interview from Geneva. " I am

very disappointed and very astonished.

" I hope the U.S. will stand alone and the [WHO] strategy will go

ahead, " said Norum, a professor at the Institute for Nutrition

Research at the University of Oslo.

Dr. Walter Tsou, president-elect of the American Public Health

Association, said the WHO's emphasis on encouraging people to eat less

processed food laden with fat and sugar and more fruits and vegetables is

exactly what U.S. consumers are being told.

" Any mother with any common sense knows that you don't feed your

kids cookies and ice cream every day unless you want to see them gain

weight, " he said. " This appears on its surface like what

happened with tobacco: an attempt to raise scientific questions to draw

attention away from actions that could stem an escalating public health

problem. "

Several critics of the U.S. position noted its similarity to industry

statements over the past year opposing the WHO's obesity

initiative.

For instance, at a meeting last May, Mari Stull, a top official at

Grocery Manufacturers of America, called the WHO report

" troubling " because it " severely understates the role of

the individual in managing his or her diet and weight, while it

overstates the role government could or should play. "

Consumers in wealthy countries like the U.S. may be able to choose what

they eat, but that is often not the case in poorer countries where

obesity is exploding, said professor Bill Leonard, chairman of the

anthropology department at Northwestern University, who has studied

obesity in Latin America and Siberia.

Healthier foods are often simply unaffordable for impoverished families

in these countries. " Expecting the rest of the world to follow the

U.S. model of personal responsibility is very shortsighted, " Leonard

said. " This is an area where it is reasonable to ask governments

abroad to act to look at what their policy options are. "

The data the WHO has assembled on obesity, while not the most rigorous

possible, does offer " compelling evidence " that the problem is

expanding and merits attention even before definitive scientific studies

are completed, he said.

The U.S. Sugar Association threatened last year to ask congressional

allies to eliminate U.S. funding for the WHO unless it canceled the

release of its report on obesity, diet and chronic disease.

Sugar companies were irate over a WHO recommendation included in the

report that urged people to get no more than 10 percent of their daily

calories from sugar and other sweeteners.

Rather than focusing on specific types of food, the U.S. believes the WHO

should be focusing on people's overall caloric content and the degree to

which they exercise, said Dr. Van Hubbard, director of the National

Institutes of Health's division of nutrition research

coordination.

It is the totality of people's food choices that is important, not

individual food choices which will vary by country and culture, Hubbard

said. Furthermore, hard evidence proving that specific foods contribute

to obesity for the most part does not exist, he noted.

The U.S.'s overarching goal of stemming the rising tide of obesity is

entirely aligned with the WHO, Hubbard insisted. The major disagreement

is over tactics, he said.

Professor Shiriki Kumanyika, who teaches epidemiology and biostatistics

at the University of Pennsylvania's School of Medicine and who was vice

chair of the panel that drafted the WHO's report, isn't impressed by that

argument. Most of the dietary suggestions included in the WHO report are

" extremely compatible with the U.S. dietary guidelines, " she

said.

U.S. guidelines on what people should eat have not been based on

irrefutable scientific evidence; like the WHO guidelines, they are

crafted using " reasonable evidence and sound judgment, " said

Kumanyika, who helped prepare U.S. guidelines.

2004, Chicago

Tribune