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David Katz, M.D.

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Into the Mouths of Babes: The Case for Minding Our Business!

Posted: 05/ 1/2012 3:13 pm

There was an expression, once commonly used, to describe a situation in which it was easy to exploit people: "like taking candy from a baby." As with all such similes, the illustration itself was meant to be the extreme, self-evident case. Stealing a baby's candy is something so outrageously objectionable that all decent people must oppose it. It would concern anyone, and everyone. It would be everybody's business.

We don't hear that expression much any more for fairly obvious reasons. There is, if anything, far too much "candy" -- and variations on the theme of candy, such as soda, sugary cereals, and so on -- to go around; and too much of it in particular heads right into the mouths of our babes. The new-age problem is selling far too much candy to babies (well, children, really). That, too, is objectionable.

I believe we should regulate food marketing to children far more diligently than we do. You may believe I should mind my business. I agree with you!

There doesn't seem to be much we can agree on these days across the spectrum of ideologies and politics. We are, at this juncture in our history, a very politically polarized society -- where arguments for gun control confront arguments for "Stand Your Ground." Food marketing to children is among the many issues caught in the vice of opposing convictions. There are those who believe this is a clear case for regulation, and others who feel that parental responsibility is the only counter-measure required.

But I trust we can agree, as a general principle, that decent adults look out for the wellbeing of children. "Loving Parents and Grandparents, Inc." could be the most powerful special interest group of all time!

The well being of children is, to varying degrees, the business of every responsible adult. If you are a parent, it's your business. If you are a grandparent, it's your business.

If you are an aunt or uncle, it's your business. If you are a teacher, it's your business. If you know a kid, or have ever been one -- it's your business.

I simply contend it's business we should be minding a whole lot better, and do so not on the basis of ideology -- but of epidemiology.

The evidence that we have failed to mind this business adequately is overwhelming and incontrovertible, and all but common knowledge.

We have, of course, epidemic obesity among our children and adolescents. And this epidemic didn't "happen" to our kids because of some extraterrestrial invasion we were powerless to withstand. We let it happen. We made it happen -- by what we have chosen to condone and prioritize as a culture.

We have made the proliferation and sale of energy-dense, manufactured foods more of a priority than the health of our kids. We have made indulgence of "free" market forces more of a priority than the health of our kids.

And so, predictably, the health of our kids has gone where we sent it: to hell in our handbasket.

Epidemic childhood obesity is just the visible tip of an iceberg of present and pending peril. We have widespread Type 2 diabetes among our children; a generation ago, this was called "adult onset" diabetes. The proliferation of ever more cardiac risk factors in ever younger people is reported in the medical literature at regular intervals. There is actual coronary disease in adolescents. There is ever more bariatric surgery among teenagers. And we have evidence in the last year or so that the rate of stroke has risen 35 percent in children 5 to 14, with epidemic obesity the only smoking gun on the scene to account for it.

Compounding the physical toll of childhood obesity and its many metabolic consequences is the bullying it invites. Even in an age when fat is more common than thin, there is still a potent stigma attached to being the "fat kid." Obese children are ostracized and persecuted -- adding, quite literally, insult to injury. All too often, "comfort food" is the only reliable friend in such a toxic impasse -- and of course, reliance on it only exacerbates all of the underlying problems.

Virtually all of this is preventable with a readily available expediency: better use of feet and forks. We don't need new biomedical advances to eliminate most obesity and 80 percent of chronic disease; we simply need a societal commitment to use what we already know.

We are even beginning to get some hopeful evidence that when we do so, it works. The rate of childhood obesity has dipped slightly in recent years in both the New York City schools, and among young children in Massachusetts. In both cases, a dedicated effort underlies these modest but encouraging results.

Study after study indicates that the foods most assiduously marketed to children are the foods they would be well advised to minimize or avoid. The foods they would be best advised to eat for health promotion are marketed least, not at all, or ineffectively. The modest budget and modest effects of "five a day" and subsequent campaigns to encourage produce intake are infamous in public health circles.

You might like to think your child is immune to this marketing -- and if they aren't, at least you are. If you think this, I would like to sell you a bridge -- and with a little help from Madison Avenue, have no doubt I could do it. Marketing works, and that means we ARE vulnerable to it. It is the art of manipulation, and those who practice it have Ph.D. biologists, psychologists, sociologists, economists, and reams of research on their side.

We know it works because they keep spending money on it. We know it works because of innumerable studies that confirm it. And we know it works because occasionally, someone like Brian Wansink of Cornell brings expert marketing knowledge out of the boardroom and into daylight.

You may accept that marketing works, but feel that the industry should self-regulate. There are lesser and greater problems with this concept.

The lesser problem is that it creates a conflict of interest. How can you do your best job selling what you make when it is also your job not to sell too much of what you make?

The greater problem is that it doesn't work. We have volumes of real-world research showing business doesn't regulate itself effectively. It advertises aggressively the foods most likely to harm our kids, and if some avenue of advertising shuts down, they devise a new and generally better one -- such as "advergaming." Their business is business.

Counter-arguments to regulation have, predictably, proven highly effective in a politically polarized society in which many fear regulation and the heavy hand of government. When the rhetoric heats up, even the First Amendment of the U.S. Constitution is invoked to protect current marketing practices. There is likely little more than ideological appeal in a First Amendment argument, however; most authorities agree it does not immunize advertising against regulatory limitations. But even absent this argument, resistance runs both wide and deep.

Other countries have imposed restrictions on food marketing to children, and have used objective measures of nutritional quality to guide such practices. We have recourse to such metrics, and might do the same. But thus far, the United States has left the foxes to guard this particular henhouse -- with our kids incubating inside.

We can, of course, immunize ourselves and our children against pernicious effects of marketing, to some degree, with the right kind of knowledge. If we know in advance where marketing distortions (if not outright deceptions) reside, we are less vulnerable to them. We have seen just this effect with our Nutrition Detectives program, which is available for free. If you would like your 8-year-old to go from pleading for the item advertised on the Cartoon Network to advising you to put back the cereal with sugar as the first ingredient -- Nutrition Detectives is for you!

With the right kind of knowledge, and responsible use of it, we can indeed take matters into our own hands. We also have potential recourse to safe havens, where both the persecution of peers and the persuasion of Madison Avenue can be avoided. We don't need to keep waitin' on the world to change.

But healthful eating should be the default, not the exception. It should not require special skills or knowledge, or a world apart. And parents are amply taxed by the demands on their responsibility every day -- why make it harder than it has to be to get our kids to eat well? We have no evidence that the current generation of parents is any less responsible than any prior generation; and yet we have epidemic childhood obesity. There are other forces to account for it! And there are, quite simply, times when the best defense of the human body resides with the body politic.

The wellbeing of children is everybody's business, and everybody should mind that children are staring down the barrel of a glow-in-the-dark cheese doodle or sugar-laden cereal loop at foreshadowed health and foreshortened lives. In an age when the average child is more likely to suffer chronic disease and/or premature death due to poor diet and lack of physical activity than the cumulative toll of tobacco, drugs, and alcohol, the case for reigning in such practices would seem to be conclusive -- driven by data, not diatribe.

So yes, I should mind my business. I'm a parent; this is my business!

As for the businesses that profit from selling excesses of new-age candies to babies, we should be minding them a whole lot better than we do.

-fin

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefounation.org

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