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September 17, 2013

How America is exporting its obesity epidemic

WASHINGTON — With this summer's news from the United Nations that Mexico has surpassed the United States in adult obesity levels - one-third of Mexican adults are now considered extremely overweight - U.S. foreign policy has come into sharper, or perhaps softer, focus. Despite first lady Michelle Obama's continued emphasis on good diet and exercise, the United States seems secretly intent on fattening everyone else on the planet. Apparently, America has adopted the old piece of ursine humor as grand strategy: "You don't have to run faster than the bear to get away. You just have to run faster than the guy next to you."

At first blush, it might seem unfair to blame the United States for the stoutness south of its border. Surely, Mexicans (like Americans) are getting fatter because they are eating more, exercising less and spending too much time watching television. When one digs beneath the surface, however, it quickly becomes apparent that a complex web of American agricultural, trade, marketing and scientific practices together are helping drive a "globesity" epidemic. Many of these policies were designed to give U.S. firms a leg up in international markets, but the domestic economic benefits of this culinary oligarchy are increasingly being outweighed - literally and figuratively - by the toll on international health, particularly among the poor. The American taxpayer is directly underwriting a food-production system in which nutrition has become a distant afterthought.

Perhaps America is ultimately guilty of nothing worse than trying to remake the world in its own hefty image - a case of soft-power influence gone horribly literal. As the global costs of obesity continue to spiral, however, it is time to rethink the changes that the United States has brought to the table.

               

It is no accident that Mexico's weight gain has coincided with increased soft-drink guzzling. The country's national statistics agency estimates that Mexicans drink 43 gallons per capita annually, giving the country the world's highest rate of soda consumption. The Institute for Agriculture and Trade Policy, a Minnesota-based think tank, has shown that the country's sharp spike in obesity and soda consumption correlates with the 1994 passage of the North American Free Trade Agreement (NAFTA), which opened Mexico to a flood of cheap junk food and soda pop: After the agreement took effect, there was a more than 1,200 percent increase in high-fructose corn syrup exports from the United States to Mexico between 1996 and 2012, according to the U.S. Agriculture Department. (At one point, the Mexican government began taxing drinks sweetened with high-fructose corn syrup, but the fierce objections of U.S. corn refiners prompted Washington to complain to the World Trade Organization and the tax was eventually struck down.)

In many ways, Mexico's diet is being devastated by America's perverse economic incentives. The United States has long imposed relatively high tariffs on sugar imports and granted large subsidies for domestic crops such as corn and soybeans. In the 1970s, however, when sugar tariffs rose even further and technological advances from Japan helped perfect high-fructose corn syrup production, agribusinesses' use of the sweetener exploded. Suddenly, it was cheaper to put high-fructose corn syrup in everything from spaghetti sauce to soda. Coke and Pepsi swapped out sugar for high-fructose corn syrup in 1984, and most other U.S. soda and snack companies followed suit. U.S. per capita consumption of high-fructose corn syrup spiked from less than half a pound a year in 1970 to a peak of almost 38 pounds a year in 1999. As it did, American obesity spiked as well.

The problem was not just that shoppers were more willing to buy (and consume) a cheaper product, but also that high-fructose corn syrup actually seems to be less healthy than natural sugar. Despite a multimillion-dollar advertising campaign backed by corn producers, with gauzy pictures of mothers assuring us that "high-fructose corn syrup is simply a form of sugar made from corn," there do seem to be important differences. Yale University researchers released a study this past January suggesting that fructose simply does not trigger the same sense of being satiated as glucose does. This builds on 2010 research from Princeton University scientists who found that rats ingesting high-fructose corn syrup gained significantly more weight than those eating sugar, in addition to experiencing abnormal increases in body fat. Research released this year from Canada's University of Guelph found that a high-fructose corn syrup diet in rats produced addictive behavior similar to that from cocaine use.

 I'll admit that an evil American plan to fatten the world sounds like an outlandish conspiracy theory. But consider the sad saga of Samoa and the American turkey tail. Turkey tails, which can be some 40 percent fat, were long a largely unwanted byproduct of the U.S. poultry industry. James Sumner, president of the USA Poultry & Egg Export Council, acknowledged this year that turkey tails would likely only be used for pet food in the United States. But after World War II, clever marketers began dumping them on Samoa, which enjoyed strong economic ties with the United States - and the tails became an unlikely local delicacy in the Pacific island nation. (Neighboring islands with closer ties to New Zealand have been flooded with a similarly unhealthy fatty food byproduct: mutton flaps.) By 2007, Samoans were each consuming more than 44 pounds of turkey tails every year. Unsurprisingly, Samoan obesity rates skyrocketed from the 1960s onward - reaching 56 percent by 2008 - as the turkey butts and other imported foods squeezed out seafood, a much leaner option, in the local diet. A 2005 study concluded that the "acceptance and/or belief that foreign goods and services are superior" led many Pacific islanders to consume foods of low nutritional quality, which directly correlated with adverse health outcomes. Nine of the world's 10 most obese countries and territories are in Oceania, according to the CIA's World Factbook.

When desperate Samoan officials, facing a mounting public health crisis, banned turkey-tail imports in 2007, U.S. agricultural producers said, "Not so fast." Even as Samoan officials pleaded with the World Health Organization (WHO) for help in combating American poultry companies' food-marketing strategies on the island, the World Trade Organization (WTO) blocked Samoa's application for membership. The turkey-rump dispute bogged down Samoa's WTO bid for years, until it agreed in 2011 to open itself back up to turkey-tail imports. Sumner insisted at the time, "We feel it's the consumers' right to determine what foods they wish to consume, not the government's." The Samoans were rolled into accepting a compromise whereby they can maintain steep tariffs on turkey tails until 2016, when they hope to have better public health education in place.

Meanwhile, nothing has been more American in recent years than exporting fast-food chains. McDonald's boasts that it now has restaurants in 118 countries. KFC is second only to the Golden Arches in global fast-food market share. The fried-chicken chain's parent company, Yum! Brands, which also owns Taco Bell and Pizza Hut, saw $13.6 billion in revenue last year alone and is focusing some 86 percent of its restaurant development in emerging economies.

The results are as depressing as you might expect. A University of Minnesota study published last year found that those flocking to Western-style fast-food chains in Singapore were younger and better educated, exercised more and smoked less - all factors normally associated with lower risk of heart disease. Yet those Singaporeans eating fast food once a week had a 20 percent higher likelihood of dying from coronary heart disease than those eschewing fast food; people eating fast food two or three times a week had a 50 percent higher likelihood; and those wealthy, educated patrons downing fast food four or more times a week were nearly 80 percent more likely to die from heart disease. "The big picture," one of the study's authors said, "is that this [fast food] aspect of globalization and exportation of U.S. and Western culture might not be the best thing to spread to cultures around the world."

               

Why is the United States determined to export fat? In part because button-popping sums of money are at stake. The market research firm Euromonitor International notes that the global sale of packaged foods (everything from potato chips to cereal to pre-prepared meals like Lunchables) has jumped more than 90 percent over the last decade, with 2012 sales topping $2.2 trillion. PepsiCo alone sells more than $10 billion in potato chips annually. Kraft Foods' global snack-food spinoff, Mondelez International - meaning "world delicious," in a blend of Romance languages and corporatespeak - operates in 165 countries and is ramping up investments in the developing world, which already accounts for more than 40 percent of its $35 billion in annual net revenues. Coca-Cola and PepsiCo together control almost 40 percent of the world's $532 billion soft drink market, according to the Economist. Soda sales, meanwhile, have more than doubled in the last 10 years, with much of that growth driven by developing markets. McDonald's investors were disappointed that the company only turned $1.4 billion in profit during the second quarter of 2013, having become used to years of double-digit gains every three months.

But the focus on promoting unhealthy lifestyles abroad has also increased, ironically, because the United States has succeeded in promoting healthier ones at home. Americans are eating less fast food and ingesting fewer calories than they did a decade ago - a trend that should begin to lower U.S. obesity rates, which have largely plateaued. San Francisco actually tried to ban McDonald's Happy Meals because they target kids with fat and sugar, and this summer Taco Bell announced it is dropping food-toy combos for children altogether. As eating patterns have changed, the food industry has looked to new markets.

Take high-fructose corn syrup. U.S. consumption, at around 27 pounds per capita last year, has declined in large part due to mounting concerns that it is an important driver in the obesity epidemic. So American corn producers have looked to export markets to pick up the slack. According to the U.S. Census Bureau, in 2012 the United States exported 1.47 million metric tons of fructose, a 1,450 percent increase from 1995.

This shift abroad mirrors the strategy of the tobacco industry as anti-smoking efforts and cigarette taxes have pushed the U.S. smoking rate down steadily over the past half-century, from 42 to 18 percent. Economists have estimated that every 10 percent rise in the price of a pack of cigarettes reduces cigarette consumption in the United States by as much as 5 percent, helping explain why American tobacco companies are looking more to China and other less regulated and taxed markets for future growth. It does not seem coincidental that America's twin behemoth tobacco companies, R.J. Reynolds and Philip Morris, moved into the food business - buying up or merging with snack companies including General Foods, Kraft, and Nabisco in the 1980s - to diversify their portfolios as domestic tobacco sales came under mounting pressure.

The big players in the U.S. food industry have certainly acted like the tobacco pushers as they have deployed an incredible array of scientific and marketing research designed to get people to eat more, often at the obvious expense of their health. In his book, "Salt Sugar Fat: How the Food Giants Hooked Us," journalist Michael Moss offers a damning portrait of food companies that have entire research wings dedicated to creating the ideal "bliss point" so that brain receptors crave a food without ever triggering a sense of being satiated. More often than not, adding sweetness has been the easiest way to fool the brain, resulting in products like Yoplait yogurt, which tries to project a healthy image but, as Moss notes, has twice as much real sugar per serving as Lucky Charms cereal - the poster child for an unhealthy breakfast when I was growing up.

Taking another page from Big Tobacco's playbook, whenever food companies and high-fructose corn syrup manufacturers talk about obesity, they rely heavily on language stressing "personal responsibility." They argue that kids around the globe just aren't exercising as much anymore and that consumers have every right to eat whatever they want to, using obvious truths to gloss over the fact that they are ruthlessly maximizing science and marketing to get people to embrace unhealthy lifestyles. As the Center for Consumer Freedom exclaims, "Eating a balanced diet and getting plenty of physical activity is crucial. Unfortunately, Americans have been force-fed a diet of bloated statistics hyping the problem of obesity." (The executive director of the Center for Consumer Freedom also happens to run a Beltway PR firm that specializes in defending corporate interests, and he has acknowledged that the center has received significant funding from food and restaurant companies.)

American consumers are wising up a bit - in 2009, Kellogg was forced to drop its claim that Frosted Mini-Wheats were "clinically shown to improve kids' attentiveness by nearly 20 percent" after a public outcry - but the costs of global obesity are enormous and rising sharply. According to the WHO, many low- and middle-income countries are, ironically, facing the twin problems of obesity and undernutrition. More than 30 million overweight children now live in the developing world, and many of them - in a cruel trick of human biology - are more prone to obesity because they were undernourished in the womb and as infants. A 2012 study by University of Southern California and Oxford University researchers found that the prevalence of Type 2 diabetes is 20 percent higher in countries with larger availability of high-fructose corn syrup than in countries where its use is comparatively low, and the study's lead author, Michael Goran, argued that the sweetener "appears to pose a serious public health problem on a global scale." Cardiovascular disease is already the No. 1 global killer, and the WHO notes that more than 80 percent of cardiovascular deaths occur in low- and middle-income countries because those countries are exposed to more risk factors, including unhealthy diet.

Samoan government officials have plans to implement a public health campaign to talk people out of eating turkey tails, but the health minister will be competing with the marketing divisions of major American poultry companies. Mexico's Education Ministry is trying to get schoolchildren to drink fewer soft drinks, but it is fighting an uphill battle against the marketing arms of major American cola companies that have spent years perfecting drinks that are cheap and designed to leave you wanting more. The African Union holds an Africa Food and Nutrition Security Day, but what is it to do when local McDonald's franchises push kids to join the Happy Meal Club and receive "loads of great offers, promotions & competitions every month"?

The United States, meanwhile, seems to be doubling down on the export of fat and fructose. The farm bill that passed the House of Representatives in July not only stripped out food stamps but also made a number of key agricultural subsidies - including for corn, soybeans, and peanuts - self-renewing in perpetuity. Legislation like this, mixed with relentless corporate marketing, means the rest of the world is likely to keep getting heavier - and it's clear whose hand is feeding them.

               

     

 

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