At Civil Eats, nutrition policy reformer Andy Bellatti included a kind word for Food Policy in the United States: An Introduction (Routledge/Earthscan) as part of his year-end review for 2013.

Let’s wrap up this look back at 2013 by remembering just a small selection of the many great books that saw the light of day. When it came to an inside look at the world of processed foods, two journalists masterfully pulled back the curtain: Melanie Warner in Pandora’s Lunchbox and Michael Moss in Salt Sugar Fat. Food politics were front and center in Dr. Gyorgy Scrinis’–a lecturer in food and nutrition politics and policy in the Department of Agriculture and Food Systems in the Melbourne School of Land and Environmen–Nutritionism, and literally illustrated in Marion Nestle’s Eat, Drink, Vote.

The plight of restaurant workers was well-detailed in Saru Jayamaran’s Behind the Kitchen Door, while New York Times writer Mark Bittman made a solid case for eating a plant-based diet before 6 PM in VB6. In the textbook realm, Parke Wilde, Associate Professor at Tufts’ Friedman School of Nutrition Science and Policy, released Food Policy in the United States: An Introduction to much acclaim from his peers.

Okay, 2014, now it’s your turn. Impress us and give the “good food” movement something to cheer about, please!

Recent activities of Dietitians for Professional Integrity

Andy Bellatti last month summarized in a column for Civil Eats the recent activities of Dietitians for Professional Integrity, an initiative to encourage the leading dietetics professional association, the Academy of Nutrition and Dietetics, to distance itself more clearly from its food and beverage industry sponsors.

For years, many of my colleagues and I have voiced our discontent that the professional organization that represents us takes money from and partners with the likes of Coca-Cola, PepsiCo, McDonald’s, and Hershey’s, supposedly to foster dialogue with the industry and help Americans get healthier. In reality, Big Food gets free press for feigning concern, while going about its usual business, and the registered dietitian credential gets dragged through the mud.

“Too often I’ve lost the trust of potential clients because, despite my rigorous education in nutrition, they only see the dietetics field as corrupted by big businesses,” says Matt Ruscigno, MPH, RD, one of Dietitians for Professional Integrity’s co-founders.

Over the past four months, Dietitians for Professional Integrity has shared many statements of concern from registered dietitians on its Facebook page, and helped raise awareness of Big Food’s influence on the Academy (from the world’s largest aspartame producer helping to fund the organization’s evidence analysis team on the artificial sweetener to Coca-Cola’s Academy-approved continuing education webinars which  teach dietitians that soda is unfairly vilified).

A key point is that Dietitians for Professional Integrity is not a "nanny state" initiative.  There are good reasons why it is sometimes difficult for government agencies to take strong public interest positions on key challenges to the healthfulness of the food and beverage industry.  Government institutions in a democracy frequently must represent the mainstream of public opinion.  They explicitly must be concerned both with public health and with encouraging a thriving economy.  When government agencies push too hard or are insufficiently deferential to individual preferences in guiding people toward healthy nutritional choices, the public worries about government overreach.

Because of these constraints on government activism, it is especially important that non-profit public interest organizations such as the Academy of Nutrition and Dietetics speak clearly, boldly, and without bias on the nutrition issues of the day.  I think Bellatti and Dietitians for Professional Integrity have a good point in encouraging this private-sector nutrition organization to be more independent from its corporate sponsors.  Sometimes, the Academy should have more courage to criticize food and beverage industry products and marketing practices that really do contribute to an unhealthy nutrition environment.

Disclosure, corporate sponsorship, and the Academy of Nutrition and Dietetics (AND)

Ethan Bergman, president of the Academy of Nutrition and Dietetics (AND), responded in a press release on Jan. 23 to Michele Simon's critical report about corporate sponsorship at the national dietetics group (which U.S. Food Policy covered last week).

A key part of Bergman's response was his statement that AND has its own independent and "statistically sound" sample survey demonstrating "continued support" from dietitians for the Academy's current corporate sponsorship practices and policies:

Each year, the Academy utilizes Performance Research, an independent, third-party research company, to examine a random selection of members that is a statistically sound representation of the Academy membership as a whole. The results from these representative surveys have shown an increased awareness and continued support of the sponsorship program.

Since last week, I have been asking AND's media office to send the questions, results, and sampling methods.  I wanted to share this information with my statistics students, because it shows how discussions of sampling methods can matter for real-world high-profile policy debates, and I wanted to do a blog post noting the survey's key results.  Today, the media office confirmed that they will not disclose this information:

I apologize, but we do not share the survey or its results with outside professionals. I appreciate your interest in the issue, especially with regard to your students, and apologize for the inconvenience.

The response is polite and professional, but it still seems to me quite unsatisfactory.  If the Performance Research survey is so reassuring and statistically sound, it seems quite odd not to share it with the public.

Also this week, because this debate heightens people's awareness that funding sources are connected to the perceived credibility of public interest research and writing, I asked Michele Simon who funded her report.  She responded that, at the request of the funder, she could not disclose this information.

I feel considerable admiration for all people trying to make a living doing good work in the public interest.  Each in their own way, Michele Simon and AND make hard choices about research funding in order to make possible the work they do to promote a healthier and more nutritious food system.

Still, let me speak up in favor of more disclosure all around.  The public is not stupid.  We can handle this information without overreacting.

Dietitians discuss appropriate policies to govern corporate sponsorship at the Academy of Nutrition and Dietetics (AND)

The Hunger and Environmental Nutrition (HEN) practice group within the Academy of Nutrition and Dietetics (AND) has long been encouraging greater transparency about corporate sponsorship issues.  The AND (formerly known as the American Dietetic Association) serves as an influential advocate in U.S. nutrition policy and also as the professional association for registered dietitians.

My students and former students who are registered dietitians have worried about AND corporate sponsorships.  They send me a steady stream of awkward examples of ill-chosen sponsorships, for example with sugar sweetened beverage companies and meat checkoff programs.  One Friedman School graduate student, Ashley Colpaart (who for some years co-blogged here at U.S. Food Policy), has been proposing reforms for AND's corporate sponsorship practices for many years.

Other Friedman School graduate students conducted analyzed a survey of dietitians last year, noting that many dietitians share at least some of these concerns [small edit Feb. 3].  The article was an important source for Michele Simon's hard-hitting and highly critical report this week on AND corporate sponsorship.  The students, Lauren Adler, Alyssa Koomas, and Catherine Wright, wrote:

ADA’s corporate sponsorship program has become a topic of public discussion in recent years. A total of 370 HEN members were surveyed to shed light on member opinions of the corporate sponsorship program and whether our DPG approves or disapproves of the program. The majority of survey respondents appear to disapprove of the corporate sponsorship program, indicating that it negatively impacts their public image as food and nutrition professionals. Additionally, 61% of respondents were willing to pay higher ADA membership fees in order to decrease reliance on corporate sponsors.

In a letter to AND leadership last year (.pdf), some Hunger and Environmental Nutrition practice group members recounted the common experience of having their own independence called into question by others who were aware of the Academy's corporate sponsorship relationships:

[R]egardless if they are real or perceived, the influence of Academy corporate  sponsors has not only sparked scrutiny among journalists, but has led to several conversations in which members have had to defend these relationships and the profession at national conferences and forums. These confrontations have led to rising humiliation and a growing discomfort while fulfilling the role as Delegates. In some instances, this has led to long-­‐time members leaving the organization. We urge the Academy to uphold more transparent and stricter guidelines on access of corporate  sponsors to Academy leadership and to remove their presence at meetings, such as HOD [the AND House of Delegates], in which decisions about the profession and/or the organization are made. This will avoid conflict of interest, advance transparency, maintain professional and organizational integrity, and establish a more credible national presence.

It is difficult for any professional association to find a business model that works, providing needed support for association activities without conflicts of interests.  For example, the HEN practice group itself last year sought to develop its own policies for sponsorships (.pdf), describing the ideal potential sponsors as companies with a combination of nutrition and environmental virtues. I wish them well finding such terrific sponsors, but, realistically, we should admit that giving up compromised sponsorships may imply accepting a smaller scale of operation and revenue for a professional association.

Even recognizing those difficulties, it would have been wise for AND to listen to the input from its own internal rank and file.  As an outsider to AND, nutrition policy advocate Michele Simon offers much harsher criticism of the Academy in her report this week. With hindsight AND leaders might wish they had listened more sympathetically to internal concerns before matters came to this point.

When Marion Nestle blogged about this issue yesterday, generally agreeing with Simon's report, some of the open comments from dietitians were defensive, while others agreed with the concerns about corporate sponsorship.  Nestle has a very good follow-up post today, responding to the discussion so far.  The New York Times also covered this issue, which is unlikely to just fade away any time soon.