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Hofmann LC, Strauss S, Shpigel M, Guttman L, Stengel DB, Rebours C, Gjorgovska N, Turan G, Balina K, Zammit G, Adams JMM, Ahsan U, Bartolo AG, Bolton JJ, Domingues R, Dürrani Ö, Eroldogan OT, Freitas A, Golberg A, Kremer KI, Marques F, Milia M, Steinhagen S, Sucu E, Vargas-Murga L, Zemah-Shamir S, Zemah-Shamir Z, Meléndez-Martínez AJ. The green seaweed Ulva: tomorrow's "wheat of the sea" in foods, feeds, nutrition, and biomaterials. Crit Rev Food Sci Nutr 2024:1-36. [PMID: 38979936 DOI: 10.1080/10408398.2024.2370489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Ulva, a genus of green macroalgae commonly known as sea lettuce, has long been recognized for its nutritional benefits for food and feed. As the demand for sustainable food and feed sources continues to grow, so does the interest in alternative, plant-based protein sources. With its abundance along coastal waters and high protein content, Ulva spp. have emerged as promising candidates. While the use of Ulva in food and feed has its challenges, the utilization of Ulva in other industries, including in biomaterials, biostimulants, and biorefineries, has been growing. This review aims to provide a comprehensive overview of the current status, challenges and opportunities associated with using Ulva in food, feed, and beyond. Drawing on the expertise of leading researchers and industry professionals, it explores the latest knowledge on Ulva's nutritional value, processing methods, and potential benefits for human nutrition, aquaculture feeds, terrestrial feeds, biomaterials, biostimulants and biorefineries. In addition, it examines the economic feasibility of incorporating Ulva into aquafeed. Through its comprehensive and insightful analysis, including a critical review of the challenges and future research needs, this review will be a valuable resource for anyone interested in sustainable aquaculture and Ulva's role in food, feed, biomaterials, biostimulants and beyond.
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Affiliation(s)
- Laurie C Hofmann
- Alfred Wegener Institute, Helmholtz Center for Polar and Marine Research, Bremerhaven, Germany
- Bremerhaven University of Applied Sciences, Bremerhaven, Germany
| | | | - Muki Shpigel
- Morris Kahn Marine Research Station, The Leon H. Charney School of Marine Sciences, University of Haifa, Haifa, Israel
| | - Lior Guttman
- The National Center for Mariculture, Israel Oceanographic & Limnological Research, Eilat, Israel
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dagmar B Stengel
- Botany and Plant Science, School of Natural Sciences, University of Galway, Galway, Ireland
| | | | - Natasha Gjorgovska
- Institute of Animal Science and Fishery, University Ss Ciril and Methodius in Skopje, Skopje, North Macedonia
| | - Gamze Turan
- Aquaculture Department, Fisheries Faculty, Ege University, Bornova, Izmir, Türkiye
| | - Karina Balina
- Institute of Microbiology and Biotechnology, University of Latvia, Riga, Latvia
- Institute of Science and Innovative Technologies, Liepaja University, Liepaja, Latvia
| | - Gabrielle Zammit
- Department of Biology, Faculty of Science, University of Malta, Msida, Malta
| | - Jessica M M Adams
- Institute of Biological, Environmental and Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, UK
| | - Umair Ahsan
- Department of Plant and Animal Production, Burdur Vocational School of Food, Agriculture and Livestock, Burdur Mehmet Akif Ersoy University, Burdur, Turkiye
- Center for Agriculture, Livestock and Food Research, Burdur Mehmet Akif Ersoy University, Burdur, Turkiye
| | | | - John J Bolton
- Department of Biological Sciences, University of Cape Town, Rondebosch, South Africa
| | - Rosário Domingues
- Department of Chemistry, Lipidomics Laboratory, Mass Spectrometry Centre, University of Aveiro, Santiago University Campus, Aveiro, Portugal
- Department of Chemistry, CESAM - Centre for Environmental and Marine Studies, University of Aveiro, Santiago University Campus, Aveiro, Portugal
| | - Ömerhan Dürrani
- Department of Fisheries Technology Engineering, Faculty of Marine Science, Karadeniz Technical University, Trabzon, Türkiye
| | - Orhan Tufan Eroldogan
- Department of Aquaculture, Faculty of Fisheries, Cukurova University, Adana, Türkiye
- Biotechnology Research and Application Center, Cukurova University, Adana, Türkiye
| | - Andreia Freitas
- National Institute for Agricultural and Veterinary Research (INIAV), Rua dos Lágidos, Lugar da Madalena, Vila do Conde, Portugal
- REQUIMTE/LAQV, R. D. Manuel II, Oporto, Portugal
| | - Alexander Golberg
- Department of Environmental Studies, Faculty of Exact Sciences, Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Kira I Kremer
- Marine Biology, University of Bremen, Bremen, Germany
| | - Francisca Marques
- Department of Chemistry, Lipidomics Laboratory, Mass Spectrometry Centre, University of Aveiro, Santiago University Campus, Aveiro, Portugal
- Department of Chemistry, CESAM - Centre for Environmental and Marine Studies, University of Aveiro, Santiago University Campus, Aveiro, Portugal
| | - Massimo Milia
- Department of Life and Environmental Science, University of Cagliari, Cagliari, Italy
| | - Sophie Steinhagen
- Department of Marine Sciences, Tjärnö Marine Laboratory, University of Gothenburg, Strömstad, Sweden
| | - Ekin Sucu
- Department of Animal Science, Agricultural Faculty, Bursa Uludag University, Bursa, Turkey
| | - Liliana Vargas-Murga
- Department of Chemical and Agricultural Engineering and Agrifood Technology, Polytechnic School, Universitat de Girona, Girona, Spain
| | - Shiri Zemah-Shamir
- School of Sustainability, Reichman University (IDC Herzliya), Herzliya, Israel
| | - Ziv Zemah-Shamir
- Department of Marine Biology, Leon H. Charney School of Marine Sciences, University of Haifa, Haifa, Israel
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Marshall K, Beaden P, Durrani H, Tang K, Mogilevskii R, Bhutta Z. The role of the private sector in noncommunicable disease prevention and management in low- and middle-income countries: a series of systematic reviews and thematic syntheses. Int J Qual Stud Health Well-being 2023; 18:2156099. [PMID: 36591948 PMCID: PMC9815432 DOI: 10.1080/17482631.2022.2156099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Conduct six systematic reviews investigating for-profit private sector roles in NCD prevention and management in low- and middle-income countries (LMICs) through our a priori framework's pillars. METHODS Six systematic reviews and thematic syntheses were performed between March-August 2021, Six databases, websites of relevant organizations, and references lists of included studies were comprehensively searched. Studies published in English from 2000 onwards involving the pillar of interest, for-profit private sector, NCD prevention/management, and LMIC context were included. Results were synthesized using an inductive thematic synthesis approach. RESULTS Ultimately, 25 articles were included in the PPP review, 33 in Governance and Policy, 22 in Healthcare Provision, 15 in Innovation, 14 in Knowledge Educator, and 42 in Investment and Finance. The following themes emerged: PPPs (coordination; financial resources; provision; health promotion; capacity building; innovation; policy); Governance/Policy (lobbying; industry perception; regulation); Healthcare Provision (diagnosis/treatment; infrastructure; availability/accessibility/affordability); Innovation (product innovation; process innovation; marketing innovation; research; innovation dissemination); Knowledge Educator (training; health promotion; industry framework/guideline formation); Investment and Finance (treatment cost; regulation; private insurance; subsidization; direct investment; collaborative financing; innovative financing; research). CONCLUSION These findings will be instrumental for LMICs considering private sector engagement. Potential conflicts of interest must be considered when implementing private sector involvement.
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Affiliation(s)
- Keiko Marshall
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada,CONTACT Keiko Marshall University of Toronto
| | - Philippa Beaden
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Hammad Durrani
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Roman Mogilevskii
- Institute of Public Policy and Administration, University of Central Asia, Bishkek, Kyrgyzstan
| | - Zulfiqar Bhutta
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada,Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada,Centre for Excellence in Women and Child Health and Institute of Global Health and Development, The Aga Khan University, Karachi, Pakistan,Zulfiqar Bhutta Zulfiqar BhuttaCentre for Global Child Health Hospital, Sick Children 686 Bay Street, 11th Floor, Suite 11.9805 Toronto, ON M5G 0A4 Canada ext. 328532 Aga Khan University
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Huse O, Reeve E, Zambrano P, Bell C, Peeters A, Sacks G, Baker P, Backholer K. Understanding the corporate political activity of the ultra - processed food industry in East Asia: a Philippines case study. Global Health 2023; 19:16. [PMID: 36879312 PMCID: PMC9986662 DOI: 10.1186/s12992-023-00916-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Evidence is mounting that the ultra - processed food industry seeks to influence food and nutrition policies in ways that support market growth and protect against regulatory threats, often at the expense of public health. However, few studies have explored how this occurs in lower - middle income countries. We aimed to explore if and how the ultra - processed food industry seeks to influence food- and nutrition - related policy processes in the Philippines, a lower - middle income country in East Asia. METHODS Semi - structured key informant interviews were conducted with ten representatives from the Philippines government and non - government organisations closely involved with nutrition policy making in the Philippines. Interview schedules and data analysis were guided by the policy dystopia model, which we used to identify the instrumental and discursive strategies used by corporate actors to influence policy outcomes. RESULTS Informants were of the view that ultra - processed food companies in the Philippines sought to delay, prevent, water - down and circumvent implementation of globally recommended food and nutrition policies by engaging in a range of strategies. Discursive strategies included various tactics in which globally recommended policies were framed as being ineffective or highlighting potential unintended negative impacts. Instrumental strategies included: directly engaging with policymakers; promoting policies, such as industry - led codes and practices, as substitutes for mandatory regulations; presenting evidence and data that industry has generated themselves; and offering gifts and financial incentives to government individuals and agencies. CONCLUSIONS In the Philippines, the ultra - processed food industry engaged in overt activities designed to influence food and nutrition policy processes in their favour. A range of measures to minimise industry influence on policy processes should be introduced, to ensure that implemented food and nutrition policies align with best practice recommendations.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Erica Reeve
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Paul Zambrano
- Alive & Thrive Southeast Asia, FHI 360, Manila, Philippines
| | - Colin Bell
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Phillip Baker
- Faculty of Health, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventative Health and Nutrition, Faculty of Health, Institute for Health Transformation, Deakin University, Geelong, Australia
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Cervantes G, Pérez-Ferrer C, Thow AM, Villarreal E, Durán-Arenas L. The Way Forward on Nutrition in Food Systems Transformation: A Response to the Recent Commentaries. Int J Health Policy Manag 2022; 11:3155-3156. [PMID: 37579352 PMCID: PMC10105171 DOI: 10.34172/ijhpm.2022.7797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 11/02/2022] [Indexed: 08/16/2023] Open
Affiliation(s)
- Gloria Cervantes
- Master´s and Doctorate Program in Medical and Health Sciences, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Carolina Pérez-Ferrer
- Center for Research in Nutrition and Health, National Institute of Public Health, Mexico City, Mexico
- National Council for Science and Technology (CONACYT), Mexico City, Mexico
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Eduardo Villarreal
- Public Administration Division, Center for Research and Teaching in Economics, Mexico City, Mexico
| | - Luis Durán-Arenas
- Public Health Department, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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Carriedo A, Walls H, Brown KA. Acknowledge the Elephant in the Room: The Role of Power Dynamics in Transforming Food Systems Comment on "What Opportunities Exist for Making the Food Supply Nutrition Friendly? A Policy Space Analysis in Mexico". Int J Health Policy Manag 2022; 11:3137-3140. [PMID: 35964162 PMCID: PMC10105191 DOI: 10.34172/ijhpm.2022.7382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/11/2022] [Indexed: 11/09/2022] Open
Abstract
A paradigm shift is required to transform food systems, so they are more equitable, environmentally friendly, and healthy. This requires acknowledging which factors change or maintain the status quo. In this commentary, we reflect upon the Cervantes et al study findings and discuss the role of power dynamics in transforming food systems. This is directly relevant to Mexico in terms of (i) relationships between food system actors; (ii) the role of socio-economic political context; and (iii) opportunities for policy coherence and transformative food systems approaches. We suggest that the power dynamics that drive the food produced, sold, and consumed should be recognised in all (inter)national governance decision-making. The 2021 United Nations Food System Summit - when interest groups were perceived to overly influence the summit proceedings - is an example of how neglecting the role of power dynamics can undermine and slow food system transformation.
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Affiliation(s)
- Angela Carriedo
- Department of Health, University of Bath, Bath, UK
- World Public Health Nutrition Association, Peacehaven, UK
| | - Helen Walls
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Kerry Ann Brown
- College of Life & Environmental Sciences, University of Exeter, Exeter, UK
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Silva KC, de Castro IRR, de Carvalho CMP, de Camargo KR. Baby food industry interference with infant feeding international regulation-A case study on the standard for follow-up formula. Front Public Health 2022; 10:984385. [PMID: 36483244 PMCID: PMC9723377 DOI: 10.3389/fpubh.2022.984385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/27/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Globally, first-food systems have changed and breastfeeding has decreased due to the increased growth in commercial breast milk substitute (BMS) consumption, which includes both follow-up and toddler formulas. These products are manufactured by a small number of corporate leaders in international BMS sales. Discussions for global regulation of these products take place in the Codex Alimentarius and are permeated by the strong participation of these corporations in the Codex committees. Objective In the present study, the participation of the baby food industry in the review of the follow-up formula standard in the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) was analyzed. Methods The analysis of the CCNFSDU documents was based on the period from 2009 to 2019 and used quantitative and qualitative approaches. Compositional and participation data from country delegations and observer organizations on the representative profiles of the involved institutions and the baby food industry's involvement in this process were established systematically. Results In total, 134 out of the 189 Codex Alimentarius member countries engaged in the standard review process, of which 28% were involved in the entire process. The private sector was present in 81% of the most assiduous member state delegations to the meetings. Furthermore, ~60% of the observer organizations involved in the review process were business associations representing industry interests. Moreover, the International Special Dietary Foods Industries was the only business association with observer status in the CCNFSDU that was specifically dedicated to representing the baby food industryduring the review process. Conclusion These research results expand the body of evidence confirming the expressive and disproportionate participation of baby food industries and their representatives in the discussion processes within the scope of the CCNFSDU. However, studies investigating the Codex and the public documents of its respective committees are limited. Thus, this was the first study to analyze the influence of the baby food industry on BMS global regulatory compliance.
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Affiliation(s)
- Kimielle Cristina Silva
- Institute of Social Medicine, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil,*Correspondence: Kimielle Cristina Silva
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Rinaldi C, van Schalkwyk MCI, Egan M, Petticrew M. A Framing Analysis of Consultation Submissions on the WHO Global Strategy to Reduce the Harmful Use of Alcohol: Values and Interests. Int J Health Policy Manag 2022; 11:1550-1561. [PMID: 34273930 PMCID: PMC9808336 DOI: 10.34172/ijhpm.2021.68] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In response to the magnitude of harms caused by alcohol, the World Health Organization (WHO) Global Strategy to Reduce the Harmful Use of Alcohol (GAS) was endorsed in 2010. We analysed submissions to the 2019 WHO consultation on the implementation of the GAS to identify how different stakeholders frame alcohol use and control; and to assess how stakeholders engage with the consultation process, with possibly harmful consequences for public health policy. METHODS All submissions from WHO Member States, international organisations, non-governmental organisations (NGOs), academic institutions and private sector entities were identified and used as data for an inductive framing analysis. This involved close reading and data familiarisation, thematic coding and identifying emergent framings. Through the analysis of texts, framing analysis can give insights into the values and interests of stakeholders. Because framing influences how issues are conceptualised and addressed, framing analysis is a useful tool to study policy-making processes. RESULTS We identified 161 unique submissions and seven attachments. Emerging frames were grouped according to their function: defining the problem, assigning causation, proposing solutions, or justifying and persuading. Submissions varied in terms of the framing they deployed and how this was presented, eg, how the problem was defined. Proposed policy solutions also varied. Targeted solutions emphasising individual responsibility tended to be supported by industry and some Member States. Calls for universal regulation and global mobilisation often came from NGOs and academia. Stakeholders drew on evidence and specific value systems to support the adoption of certain problem and solution ideas and to oppose competing framing. CONCLUSION Alcohol control is a contested policy field in which different stakeholders use framing to set the agenda and influence what policy solutions are considered legitimate. WHO should consider which interests are served by these different framings and how to weigh different stakeholders in the consultation process.
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Affiliation(s)
- Chiara Rinaldi
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - May CI van Schalkwyk
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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Erzse A, Karim SA, Foley L, Hofman KJ. A realist review of voluntary actions by the food and beverage industry and implications for public health and policy in low- and middle-income countries. NATURE FOOD 2022; 3:650-663. [PMID: 37118592 DOI: 10.1038/s43016-022-00552-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/14/2022] [Indexed: 04/30/2023]
Abstract
The increasing availability of unhealthy processed food products is linked to rising rates of non-communicable diseases and obesity in low- and middle-income countries. Voluntary actions (VAs) are often adopted in lieu of regulating the composition, production, marketing and sale of unhealthy commodities, but their effectiveness is unclear. This realist review examines VAs adopted by the food and beverage industry in low- and middle-income countries. We developed a conceptual framework and followed a three-stage search to identify literature and VAs and, adhering to the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines, we produced a synthesized analysis of VAs. VAs, often initiated in response to governments' efforts to introduce regulations, were difficult to evaluate due to vague language and a lack of enforcement mechanisms. The review found no evidence indicating that VAs are effective in safeguarding public health. Yet their implementation has resulted in weaker responses and policy substitution, and so we suggest that VAs have the potential to negatively influence public health and policy. The United Nations should rescind their endorsement of industry involvement and mandatory measures should be favoured over VAs.
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Affiliation(s)
- Agnes Erzse
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa.
| | - Safura Abdool Karim
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Karen Joanne Hofman
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
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Carriedo A, Lauber K, Miller MM, Ralston R. Lacking Clarity or Strategic Ambiguity? Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases". Int J Health Policy Manag 2022; 11:1215-1218. [PMID: 34523859 PMCID: PMC9808189 DOI: 10.34172/ijhpm.2021.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/21/2021] [Indexed: 01/12/2023] Open
Abstract
This commentary engages with Suzuki and colleagues' analysis about the ambiguity of multi-stakeholder discourses in the United Nations (UN) Political Declaration of the 3rd High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (HLM-NCDs), suggesting that blurring between public and private sector in this declaration reflects broader debates about multi-stakeholder partnerships (MSPs) and public-private partnerships (PPPs) in health governance. We argue that the ambiguity between the roles and responsibilities of public and private actors involved may downplay the role (and regulation) of conflicts of interest (COI) between unhealthy commodity industries and public health. We argue that this ambiguity is not simply an artefact of the Political Declaration process, but a feature of multi-stakeholderism, which assumes that commercial actors´ interests can be aligned with the public interest. To safeguard global health governance, we recommend further empirical and conceptual research on COI and how it can be managed.
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Affiliation(s)
| | - Kathrin Lauber
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Margaret M. Miller
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Rob Ralston
- Global Health Policy Unit, Social Policy, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
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Cuevas S, Patel N, Thompson C, Petticrew M, Cummins S, Smith R, Cornelsen L. Escaping the Red Queen: Health as a corporate food marketing strategy. SSM Popul Health 2021; 16:100953. [PMID: 34815996 PMCID: PMC8592866 DOI: 10.1016/j.ssmph.2021.100953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/25/2021] [Accepted: 10/25/2021] [Indexed: 11/27/2022] Open
Abstract
Public health advocates highlight the role of corporate actors and food marketing in shaping diets and health. This study analyses insider-oriented communications in food industry magazines in the UK to analyse actions and narratives related to health and nutrition, providing insights into relatively overlooked areas of marketing strategy including inter-firm dynamics. From a sample of four specialized food industry magazines covering the main industry segments we identified 319 articles (published 2007-2018) mentioning health or nutrition together with industry actions affecting the food environment. We identified health-related actions and analysed underlying strategies through content and thematic analyses. Health and nutrition have a rapidly growing role in food marketing strategy. Content analysis revealed a focus on ultra-processed foods, as well as product and nutrient-specific trends including increased health-based marketing of snacks and "protein rich" products. Health-related actions predominantly relied on consumer agency rather than invoking structural food environment changes. Thematic analysis identified proactive and defensive marketing strategies. Proactive approaches included large investments in health-related promotion of ultra-processed foods which are made highly visible to competitors, and the reliance on a "credence goods" differentiation strategies. Defensive strategies included a 'Red Queen' effect, whereby firms take health-related actions to keep up with competitors. These competitive strategies can create challenges, as well as some opportunities, for public health promotion. Challenges can include undermining efforts to support product comparison and healthier choice, and limiting firms' engagement in specific health improving actions. Systematic analysis of health-oriented marketing strategies could support more effective public health intervention.
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Affiliation(s)
- Soledad Cuevas
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Nishali Patel
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
- University of Washington, Department of Health Metric Sciences, USA
| | | | - Mark Petticrew
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Steven Cummins
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Richard Smith
- University of Exeter, Medical School Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
| | - Laura Cornelsen
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
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11
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Lacy-Nichols J, Williams O. "Part of the Solution": Food Corporation Strategies for Regulatory Capture and Legitimacy. Int J Health Policy Manag 2021; 10:845-856. [PMID: 34634883 PMCID: PMC9309978 DOI: 10.34172/ijhpm.2021.111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/21/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND For decades, the food industry has sought to deflect criticisms of its products and block public health legislation through a range of offensive and defensive strategies. More recently, food corporations have moved on to present themselves as "part of the solution" to the health problems their products cause. This strategic approach is characterised by appeasement, co-option and partnership, and involves incremental concessions and attempts to partner with health actors. This paper details how corporate practices have evolved and changed over the past two decades and gives some definition to what this new political economy signifies for the wider behaviours of corporations producing and selling harmful commodities. METHODS This paper draws on public health and political science literature to classify the food industry's "part of the solution" strategy into three broad components: regulatory responses and capture; relationship building; and market strategies. We detail the key characteristics and consequences of each component. RESULTS The three components of the food industry's "part of the solution" strategy all involve elements of appeasement and co-option. They also improve the political environment and resources of the food industry. Regulatory responses offer incremental concessions that seek to maintain corporate influence over governance processes and minimise the threat of regulations; relationship building fosters access to health and government stakeholders, and opportunities to acquire and maintain channels of direct influence; and market strategies to make products and portfolios healthier bolster the market share and revenue of food corporations while improving their public image. CONCLUSION Rather being a signal of lost position and power, the food industry's repositioning as "part of the solution" has created a highly profitable political economy of 'healthy' food production, alongside continued production of unhealthy commodities, a strategy in which it is also less burdensome and conflictual for corporations to exercise political power and influence.
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Affiliation(s)
- Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Owain Williams
- School of Politics and International Studies, University of Leeds, Leeds, UK
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Carters-White L, Chambers S, Skivington K, Hilton S. Whose rights deserve protection? Framing analysis of responses to the 2016 Committee of Advertising Practice consultation on the non-broadcast advertising of foods and soft drinks to children. FOOD POLICY 2021; 104:102139. [PMID: 34720343 PMCID: PMC8547229 DOI: 10.1016/j.foodpol.2021.102139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 06/30/2021] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
Exposure to advertising of food and beverages high in fat sugar and salt (HFSS) is considered a factor in the development of childhood obesity. This paper uses framing analysis to examine the strategic discursive practices employed by non-industry and industry responders to the Committee of Advertising Practice's consultation responses (n = 86) on UK regulation of non-broadcast advertising of foods and soft drinks to children. Our analysis demonstrates non-industry and industry responders engaged in a moral framing battle centred on whose rights were deemed as being of greatest importance to protect: children or industry. Both industry and non-industry responders acknowledged that childhood obesity and non-broadcast advertising were complex issues but diverged on how they morally framed their arguments. Non-industry responders employed a moral framework that aligned with the values represented in social justice approaches to public health policy, where children were identified as vulnerable, in need of protection from harmful HFSS product advertising and childhood obesity was a societal problem to solve. In contrast, industry responders emphasised industry rights, portraying themselves as a responsible industry that is victim to perceived disproportionate policymaking, and values more closely aligned with a market justice approach to public health policy. Our analysis provides detailed insights into the framing strategies used in the policy debate surrounding the non-broadcast advertising of HFSS foods to children. This has relevance as to how advocacy organisations can develop counter-framing to industry frames which seek to limit effective regulation.
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Affiliation(s)
- Lauren Carters-White
- MRC/CSO Social and Public Health Science Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, United Kingdom
- SPECTRUM Consortium, Usher Institute of Population Health Sciences and Informatics, Doorway 1, Old Medical School, Teviot Place, University of Edinburgh, Edinburgh EH8 9AG, United Kingdom
| | - Stephanie Chambers
- MRC/CSO Social and Public Health Science Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, United Kingdom
- School of Social and Political Sciences, University of Glasgow, United Kingdom
| | - Kathryn Skivington
- MRC/CSO Social and Public Health Science Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, United Kingdom
| | - Shona Hilton
- MRC/CSO Social and Public Health Science Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, United Kingdom
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Lauber K, Hunt D, Gilmore AB, Rutter H. Corporate political activity in the context of unhealthy food advertising restrictions across Transport for London: A qualitative case study. PLoS Med 2021; 18:e1003695. [PMID: 34473694 PMCID: PMC8412307 DOI: 10.1371/journal.pmed.1003695] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/14/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diets with high proportions of foods high in fat, sugar, and/or salt (HFSS) contribute to malnutrition and rising rates of childhood obesity, with effects throughout the life course. Given compelling evidence on the detrimental impact HFSS advertising has on children's diets, the World Health Organization unequivocally supports the adoption of restrictions on HFSS marketing and advertising. In February 2019, the Greater London Authority introduced novel restrictions on HFSS advertising across Transport for London (TfL), one of the most valuable out-of-home advertising estates. In this study, we examined whether and how commercial actors attempted to influence the development of these advertising restrictions. METHODS AND FINDINGS Using requests under the Freedom of Information Act, we obtained industry responses to the London Food Strategy consultation, correspondence between officials and key industry actors, and information on meetings. We used an existing model of corporate political activity, the Policy Dystopia Model, to systematically analyse arguments and activities used to counter the policy. The majority of food and advertising industry consultation respondents opposed the proposed advertising restrictions, many promoting voluntary approaches instead. Industry actors who supported the policy were predominantly smaller businesses. To oppose the policy, industry respondents deployed a range of strategies. They exaggerated potential costs and underplayed potential benefits of the policy, for instance, warning of negative economic consequences and questioning the evidence underlying the proposal. Despite challenging the evidence for the policy, they offered little evidence in support of their own claims. Commercial actors had significant access to the policy process and officials through the consultation and numerous meetings, yet attempted to increase access, for example, in applying to join the London Child Obesity Taskforce and inviting its members to events. They also employed coalition management, engaging directly and through business associations to amplify their arguments. Some advertising industry actors also raised the potential of legal challenges. The key limitation of this study is that our data focused on industry-policymaker interactions; thus, our findings are unable to present a comprehensive picture of political activity. CONCLUSIONS In this study, we identified substantial opposition from food and advertising industry actors to the TfL advertising restrictions. We mapped arguments and activities used to oppose the policy, which might help other public authorities anticipate industry efforts to prevent similar restrictions in HFSS advertising. Given the potential consequences of commercial influence in these kinds of policy spaces, public bodies should consider how they engage with industry actors.
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Affiliation(s)
- Kathrin Lauber
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
- * E-mail:
| | - Daniel Hunt
- Independent Researcher and Freelance Health Policy Consultant, Bath, United Kingdom
| | - Anna B. Gilmore
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
| | - Harry Rutter
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, United Kingdom
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
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Lauber K, McGee D, Gilmore AB. Commercial use of evidence in public health policy: a critical assessment of food industry submissions to global-level consultations on non-communicable disease prevention. BMJ Glob Health 2021; 6:bmjgh-2021-006176. [PMID: 34426403 PMCID: PMC8383892 DOI: 10.1136/bmjgh-2021-006176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/04/2021] [Indexed: 12/22/2022] Open
Abstract
Background Ultra-processed food industry (UPFI) actors have consistently opposed statutory regulation in health policy debates, including at the WHO. They do so most commonly with claims that regulatory policies do not work, will have negative consequences or that alternatives such as self-regulation work well or better. Underlying this are often assertions that industry is aligned with principles of evidence-based policymaking. In this study, we interrogate if this holds true by exploring the extent and quality of the evidence UPFI respondents employed to support claims around regulatory policy, and how they did this. Methods First, we identified all submissions from organisations who overtly represent UPFI companies to consultations held by the WHO on non-communicable disease policy between 2016 and 2018. Second, we extracted all relevant factual claims made in these submissions and noted if any evidence was referenced in support. Third, we assessed the quality of evidence using independence from UPFI, nature, and publication route as indicators. Lastly, where peer-reviewed research was cited, we examined if the claims made could be justified by the source cited. Results Across 26 included consultation responses, factual claims around regulation were made in 18, although only 10 referenced any evidence at all. Of all 114 claims made, 39 pieces of identifiable evidence were cited in support of 56 claims. Of the 39 distinct pieces of evidence, two-thirds were industry-funded or industry-linked, with only 16 externally peer-reviewed. Over half of industry-funded or industry-linked academic articles failed to declare a conflict of interest (COI). Overall, of only six claims which drew on peer-reviewed and independent research, none appropriately represented the source. Discussion UPFI respondents made far-reaching claims which were rarely supported by high-quality, independent evidence. This indicates that there may be few, if any, benefits from consulting actors with such a clear COI.
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Affiliation(s)
- Kathrin Lauber
- Department for Health, University of Bath, Bath, Somerset, UK
| | - Darragh McGee
- Department for Health, University of Bath, Bath, Somerset, UK
| | - Anna B Gilmore
- Department for Health, University of Bath, Bath, Somerset, UK
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Fong M, Scott S, Albani V, Adamson A, Kaner E. 'Joining the Dots': Individual, Sociocultural and Environmental Links between Alcohol Consumption, Dietary Intake and Body Weight-A Narrative Review. Nutrients 2021; 13:2927. [PMID: 34578805 PMCID: PMC8472815 DOI: 10.3390/nu13092927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Alcohol is energy-dense, elicits weak satiety responses relative to solid food, inhibits dietary fat oxidation, and may stimulate food intake. It has, therefore, been proposed as a contributor to weight gain and obesity. The aim of this narrative review was to consolidate and critically appraise the evidence on the relationship of alcohol consumption with dietary intake and body weight, within mainstream (non-treatment) populations. Publications were identified from a PubMed keyword search using the terms 'alcohol', 'food', 'eating', 'weight', 'body mass index', 'obesity', 'food reward', 'inhibition', 'attentional bias', 'appetite', 'culture', 'social'. A snowball method and citation searches were used to identify additional relevant publications. Reference lists of relevant publications were also consulted. While limited by statistical heterogeneity, pooled results of experimental studies showed a relatively robust association between acute alcohol intake and greater food and total energy intake. This appears to occur via metabolic and psychological mechanisms that have not yet been fully elucidated. Evidence on the relationship between alcohol intake and weight is equivocal. Most evidence was derived from cross-sectional survey data which does not allow for a cause-effect relationship to be established. Observational research evidence was limited by heterogeneity and methodological issues, reducing the certainty of the evidence. We found very little qualitative work regarding the social, cultural, and environmental links between concurrent alcohol intake and eating behaviours. That the evidence of alcohol intake and body weight remains uncertain despite no shortage of research over the years, indicates that more innovative research methodologies and nuanced analyses are needed to capture what is clearly a complex and dynamic relationship. Also, given synergies between 'Big Food' and 'Big Alcohol' industries, effective policy solutions are likely to overlap and a unified approach to policy change may be more effective than isolated efforts. However, joint action may not occur until stronger evidence on the relationship between alcohol intake, food intake and weight is established.
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Affiliation(s)
- Mackenzie Fong
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE1 4LP1, UK; (S.S.); (V.A.); (A.A.); (E.K.)
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Chavez‐Ugalde Y, Jago R, Toumpakari Z, Egan M, Cummins S, White M, Hulls P, De Vocht F. Conceptualizing the commercial determinants of dietary behaviors associated with obesity: A systematic review using principles from critical interpretative synthesis. Obes Sci Pract 2021; 7:473-486. [PMID: 34401205 PMCID: PMC8346378 DOI: 10.1002/osp4.507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/04/2021] [Accepted: 03/12/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Unhealthy diet is an important preventable risk factor for overweight and obesity. Identifying the key drivers of an unhealthy diet is an important public health aim. "Big Food" has been identified as an influential factor shaping dietary behavior and obesity, and their practices have broadly been labeled as the "commercial determinants of obesity," but there is a lack of definitions and conceptualizations for these terms. This review aimed to synthesize literature on the commercial determinants of dietary behavior associated with obesity. It presents the development of an integrative definition and a conceptual framework involving potential influences on dietary behavior, and it examines the prevalence of certain narratives within papers that focus on children and adolescents. METHODS Four electronic databases (Ovid MEDLINE, PubMed, Web of Science, and Scopus) were searched up to December 2020. Eighty-one articles met the inclusion criteria: they were published in a peer-reviewed academic journal, described a practice from the food/beverage industry in relation to dietary behavior or obesity. Data were integrated using critical interpretative synthesis. RESULTS The commercial determinants of dietary behavior are conceptualized in terms of three corporate spheres of action-political and legal; production, processing and design; and marketing and preference shaping-which enable powerful food industry to successfully pursue their business, market, and political objectives. The most frequently reported sphere of action targeting children and adolescents was marketing and preference shaping. CONCLUSIONS In the included literature, the commercial determinants of dietary behavior associated with obesity have been conceptualized as being part of a complex system where corporate practices are enabled by power structures. The proposed framework can facilitate a structured identification and systematic study of the impact of specific aspects of food industry's strategies and increase opportunities for primary prevention by anticipating industry responses and by discouraging corporate practices that harm health.
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Affiliation(s)
- Yanaina Chavez‐Ugalde
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Russell Jago
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
| | - Matt Egan
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Steven Cummins
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Martin White
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Diet and Activity Research (CEDAR) MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Paige Hulls
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Frank De Vocht
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
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Maani N, Van Schalkwyk MC, Petticrew M, Ralston R, Collin J. The new WHO Foundation - global health deserves better. BMJ Glob Health 2021; 6:bmjgh-2021-004950. [PMID: 33547178 PMCID: PMC7871260 DOI: 10.1136/bmjgh-2021-004950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/09/2021] [Accepted: 01/14/2021] [Indexed: 12/19/2022] Open
Affiliation(s)
- Nason Maani
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, Greater London, UK .,SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, UK
| | - May Ci Van Schalkwyk
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, Greater London, UK.,SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, UK
| | - Rob Ralston
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, UK.,Global Health Policy Unit, School of Social and Political Science, The University of Edinburgh, Edinburgh, UK
| | - Jeff Collin
- SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University, Edinburgh, UK.,Global Health Policy Unit, School of Social and Political Science, The University of Edinburgh, Edinburgh, UK
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Lauber K, Rutter H, Gilmore AB. Big food and the World Health Organization: a qualitative study of industry attempts to influence global-level non-communicable disease policy. BMJ Glob Health 2021; 6:e005216. [PMID: 34117011 PMCID: PMC8202098 DOI: 10.1136/bmjgh-2021-005216] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/08/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION There is an urgent need for effective action to address the over 10 million annual deaths attributable to unhealthy diets. Food industry interference with policies aimed at reducing non-communicable diseases (NCDs) is widely documented at the national level but remains under-researched at the global level. Thus, this study explores how ultra-processed food industry actors have attempted to influence NCD policy at WHO. METHODS A combination of inductive and deductive thematic coding of internal industry documents, academic literature and interviews with key informants from international organisations and global civil society was used to identify action-based strategies ultra-processed food industry actors employ to influence global-level policy. RESULTS Ultra-processed food industry actors have attempted to influence WHO and its policies through three main action-based strategies: coalition management, involvement in policy formulation, and information management. Coalition management includes the creation and use of overt alliances between corporations-business associations-and more covert science-focused and policy-focused intermediaries, the hiring of former WHO staff and attempted co-option of civil society organisations. Industry involvement in policy formulation is operationalised largely through the lobbying of Member States to support industry positions, and business associations gaining access to WHO through formal consultations and hearings. Information management involves funding and disseminating research favourable to commercial interests, and challenging unfavourable evidence. CONCLUSION We provide novel insights into how ultra-processed food industry actors shape global-level NCD policy and identify a clear need to guard against commercial interference to advance NCD policy. In their approach, the political behaviour of multinational food corporations bears similarities to that of the tobacco industry. Increased awareness of, and safeguarding against, commercial interference at the national as well as the global level have the potential to strengthen the crucial work of WHO.
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Affiliation(s)
- Kathrin Lauber
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Anna B Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
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