Sugar-Sweetened Beverages - Voluntary and Regulatory...

Sugar-Sweetened Beverages - Voluntary and Regulatory Industry Approaches

National Academies of Science Workshop:

Strategies to Limit SSB Consumption in Young Children

Richard Black, PhD June 22, 2017 Quadrant D Consulting Tufts University, Friedman School of Nutrition Science and Policy

Disclosures Past employers • University of Toronto • Kellogg Co. • Nestlé Canada • Novartis, SA • ILSI North America • Kraft / Mondelez • PepsiCo

Current contracts • Bill & Melinda Gates Foundation • Tufts University • Nutrition Impact, LLC • Pilot Lite Ventures • Q:Quest, LLC • Care4ward, LLC • Janji, LLC • American Egg Board • Pulse Canada

Current boards / councils • Tufts Nutrition Council • Cornell Division of Nutrition Sciences

Advisory Council • Pulse Science Research Cluster

Scientific Advisory Board, Canada • University of Toronto Child Centre for

Nutrition and Health Advisory Board

Building Bridges • Establishing Trust

• Statistics, damn statistics…

• Building on success, acknowledging failure

• What is holding us back?





If they like you and they trust you, your facts don’t matter. If they don’t like you or don’t trust you, your facts don’t matter. Jack A. Bobo

Building Trust Amongst all Stakeholders is Key for the Industry

Trust is not all or nothing, rather it is a spectrum: • On one end is blind trust, in an individual or institution,

that if betrayed nonetheless persists. Blind trust requires a certain amount of self-deception.

• Next is simple trust, devoid of suspicion, taken for granted and very difficult to recover if betrayed.

• The far end is cordial hypocrisy: a fac ̧ade of good will and congeniality that hides distrust. It is very destructive and prevents honest communication.

• In the middle, is authentic trust. Authentic trust is not trust that can be taken for granted. Rather, it is based on recognition of the possibility of betrayal and disappointment and the need for continuous cultivation. (Solomon and Flores, 2001).

Seven Features of Successful Partnerships

• A sense of authentic trust • Mutuality (working toward a common goal, with the

benefits of achieving that goal being different for different partners)

• The feasibility of achieving the desired outcome • Joint planning • The formulation of clear procedural steps for risk

mitigation • The establishment of general project management

processes • Complementarity (all partners contributing unique but

complementary resources)

We must recognize and deal with our own biases, recognizing that everyone brings something

worthwhile to the table.

We must recognize and deal with our own biases, recognizing that everyone brings something

to the table





How do we track success and keep everyone accountable?

Daily Per Capita Calories from Sugared

Beverages

% Adults Obese

180

193

205

218

230

25%

28%

31%

33%

36%

39%

1999 2001 2003 2005 2007 2009

% Adults Obese

Daily Per Capita Calories from Sugared Beverages

Source: CDC’s National Center for Health Statistics; Beverage Marketing Corporation

Give me good data and interpret it well

or

Give me bad policy decisions

What’s my point?





Voluntary Efforts having Impact • Over 10 years ago, working with the Clinton Foundation,

the beverage industry voluntarily removed full calorie soft drinks and other beverages from U.S. schools, which led to a 90% reduction of beverage calories shipped to schools.

• Under the voluntary guidelines, 100% juice, low-fat milk and water are allowed in elementary and middle schools, while in high schools students also have access to diet beverages, calorie capped sports drinks, flavored waters and teas.

• Beverage companies have all publicly committed to not advertise their soft drinks to children under 12, but debates continue on what constitutes advertising.

• The Healthy Weight Commitment Foundation exceeded targeted goals of calorie reduction by a factor of 3 or 4.

Healthy Weight Commitment Foundation

• Initial target was to remove 1.5 trillion kcal from the diet on an annual basis, by 2015.

• Member companies succeeded in removing over 6 trillion kcal on an annual basis.

• Nevertheless, many challenged the interpretation of the outcome.

Data courtesy of Barry Popkin, UNC

The Interpretation Challenge: Healthy Weight Commitment

• The counterfactual model (darker blue dash)is a negatively

accelerating model, leading to a prediction of ~70% reduction after 10 years (essentially impossible). Linear trend model may be problematic as well.

Voluntary Efforts having Impact

• For several years (after some coaxing) calorie information has been placed on the front of every product, to give consumers clear information.

• New products are developed with lower calorie content from the outset – there is no consumer expectation to be matched, rather this sets the consumer expectation (Mountain Dew Kickstart is one example)

• Some products are quietly being reformulated to contain fewer calories, but the challenge of consumer acceptance remains.

• Consider what is generally referred to as the “Don’t mess with my Coke” phenomenon.

Not everything works as expected

• “New Coke” beat Pepsi by 6% to 8%, and was preferred over Classic Coke 55% to 45%, in blind taste tests.

• For Coke consumers, they preferred New Coke 53% to 47% in blind taste tests, and in unblinded tests, New Coke was preferred 69% to 31%.

• Reports state that the Coca-Cola Co. spent over $4,000,000 (in 1984 – 85) to test acceptance of the new formulation, interviewing (with taste tests) over 200,000 consumers.

• Initial sales results were positive, even better than expected. Then the news stories started to appear about those who preferred the original recipe, and of protests organized against New Coke.

• By June, less than two months after launch, only 30% of people said they preferred New Coke. People wouldn’t accept changing Coke: “It was like saying you are going to make the flag prettier.”

R. Schindler, Marketing Research, 1992

Not everything works as expected

• There have been attempts to reformulate SSBs to have a lower calorie content. The challenge continues to be similar to that of New Coke

• Reformulating a favorite to 100 kcal may be an issue – it seems as though there might be an immediate impression that something has changed in a significant manner, going from 160 kcal to 100 kcal.

• This may limit what the consumer is willing to accept – a drop to 120 kcal seemed not as striking

• Another key consideration is the notion of consumer segments: how they differ; their receptivity to a health message; the trust in the messenger; etc.

• In other words, there is simply no “one size fits all” solution.

Not everything works as expected • Taxing SSB has received a lot of attention, especially in

light of the results reported from the tax in Mexico. • At $1 Mexican peso per litre, the tax was positioned as a

simple flat tax because it was felt that implementing a graduated tax (likely based on sugar content) was too difficult to implement.

• However, the Mexican tax as implemented is a graduated tax, but based on grams of liquid rather than grams of sugar – it is $0.01 peso per 10g liquid.

• Placing a tax on the grams of the beverage (which of course is equivalent to the ml of a beverage) removes any incentive on the part of the beverage producer to reduce sugar content in a beverage. No matter the sugar content in the drink, the tax is the same.

• However, a graduated tax based on grams of sugar in the beverages (and not the grams of liquid) incentivizes both consumers and the beverage industry.

• Interestingly, although overall SSB intake significantly declined in Mexico, consumption of colas declined by only about 1.5 kcal per day (per capita).





Failure to understand and leverage the digital world

• Today, roughly 3.3 x 109 people have internet access, with about 1 million more added each day

• In 2016 ~60 % of the global population had access to a personal mobile device that sends and receives

• We send well over 3.3 million emails every second • Over 85% of those are spam, viruses or advertising • Social media is over 28% of time spent online • There are 2.8 billion YouTube views/min and ~10 hours of

new video uploaded every second • We send 4,000 Tweets a second, and do 187.5 billion

Facebook likes every hour • In fact, if Facebook were a country, at 1.53 billion active

users it would be the largest on the planet, beating China (1.38 billion), and India (1.25 billion).

Updated from Charlie Arnott

• How fast is all of this changing? • 13 years ago Skype, Facebook, YouTube, Twitter,

Tumblr, Dropbox, and Instagram didn't exist. • 23 years ago there were only 130 websites total,

Google wasn't even around yet, and you had to pay for an email account through an ISP (go watch the movie “You’ve Got Mail”); Today there are about 250 new websites added every minute.

• 26 years ago there was no internet (World Wide Web Project launched Aug 1, 1991)

Updated from Charlie Arnott

Failure to understand and leverage the digital world

What happens when you ignore the digital world?

• A recent survey from the Oklahoma State University Department of Agricultural Economics found that 80.44% of respondents supported a government policy mandating labels on foods containing DNA.

• Not GMOs, but DNA, the genetic material contained in every living thing known to science and practically every food, GMO or otherwise

• ~82% support mandatory labels on GMOs

• WARNING: This product contains deoxyribonucleic acid (DNA). The World Health Organization has determined that DNA is linked to a variety of diseases in both animals and humans. In some configurations, it is a risk factor for cancer and heart disease. Pregnant women are at very high risk of passing on DNA to their children. DNA can be transmitted in body fluids.

Capitalizing on public misunderstanding serves no one’s interests in the long run.

In fact, it can be terribly detrimental.

What’s my point?

But there are those willing to do so, and they will succeed if there is not a countervailing voice.

What can we do?

• Be aware of, and seek to solve, the problems that each partner faces.

• Hold everyone accountable – for establishing well grounded targets that can be measured and interpreted, and for meeting those targets.

• All of us need to be active supporters of such efforts, meeting criticism with facts, improving the approach where possible, and not passively watching as others seek to tear down what has been built or what must be built.

27

Thank you

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