Big Food’s love for dietitians – it’s all about the money

Big Food
Photo credit: eltpics via / CC BY-NC

Big Food’s enduring love for dietitians is no big secret. As a Fortune magazine special report makes clear, it’s all about the money. Here’s the second of a two-part series looking at South Africa’s voluntary organisation of dietitians and their symbiotic relationship with food and soft drinks companies. Kellogg’s is a major focus but Coca-Cola and many others are just as bad, says the author. – Marika Sboros

By Sonia Mountford

The Association for Dietetics in South Africa (ADSA) has always maintained that it has no conflicts of interest. And that its association with Big Food is benign.

Yet it accepts sponsorship from companies that make products implicated in causing global epidemics of life-threatening non-communicable chronic diseases (NCDs). These include obesity, heart disease, cancer and diabetes. Dementia is another.  Specialists call it “type 3 diabetes”because of its links with diet.

Part 1: Can you trust dietitians who are in bed with Big Food?

ADSA also maintains that it can influence Big Food positively from within. It has even suggested (on Twitter) that the real question is: “Why should we not engage with Big Food?”

At best, that can seem naive. At worst, it’s a cynical rationalisation for an unhealthy relationship. Put another way, it’s a spin on the collaboration at the heart of dietetic associations, Big Food and Big Soft Drinks. This has spawned growing global concerns about negative effects on people’s health.

Uncomfortable truth

ADSA has also not been able to answer the really big question: Why is Big Food so interested in partnering with ADSA?

For Big Food, the rising obesity rates and NCDs present  an uncomfortable PR challenge. At the same time, Big Food has a duty to shareholders to make profits and to sell more products. That’s particularly the case in emerging markets.

Healthy profits!

Many unhealthy products are hugely profitable. Over the past decade sales of packaged foods globally have jumped by 92%, to $2.2 trillion in 2014, according to Euromonitor.

Big Food also knows that its products would not be quite so appealing without the sugar, salt and other additives and “flavourants” that they contain.

Salt, sugar, fat “The food companies themselves are hooked on salt, sugar and fat,” wrote Michael Moss, the Pulitzer Prize-winning New York Times journalist. Moss spent three years researching his book Salt, Sugar, Fat.

“Their relentless drive to achieve the greatest allure for the lowest possible cost has drawn them, inexorably, to these three ingredients time and time again. The industry has boxed itself in,” he wrote.

Thus, instead of making food healthier, Big Food has responded in other ways, for example, by emphasising active lifestyles. Coca Cola is one of the most active here. And Big Food finds ways to have their brand and products viewed favourably by “health washing”.

Industry tactic

It’s a tried-and-true industry tactic to make unhealthy foods seem nutritious.

One way is to use dietitians and dietetic associations to promote these products. To do that, they need to make sure that dietitians perceive their brand as promotion worthy. Thus, they don’t mind spending a lot of money to achieve that aim.

 ADSA actively promote their sponsors to member dietitians. Therefore, it should be no surprise that many dietitians endorse highly processed Kellogg’s products as “healthy”.

For example, take dietician X* who is registered with the Health Professions Council of South Africa (HPCSA) and ADSA. She regularly touts Trufruit bar, Noogy Bars, Kellogg’s Special K & All Bran Bar, Bokomo Breakfast bar, Woolworth’s Cereal bar, Granola bars, Weigh Less break-out bars as healthy.

Ingredients under spotlight

Let’s look at the ingredients of the Special K bar since Kellogg’s is a  “Gold Sponsor” of ADSA. Of course, that’s not to suggest that any of the other bars are any healthier.

KelloggsThe Special K Red Berries Bar: A Kellogg’s Special K cereal (45%) (Rice, Wholewheat (Gluten), Sugar, Barley (Gluten), Malted barley flour (Gluten), Barley malt flavouring (Gluten), Salt, Vitamin C, Niacin, Iron, Vitamin B6, Vitamin B2, Vitamin B1, Folic acid, Vitamin B12), Glucose syrup, Cranberry fruit pieces (12%) (Cranberries, Pineapple syrup, Pineapple juice concentrate), Fructose, Sugar, Dextrose, Humectant (Sorbitol, Glycerol), Skimmed milk powder (Cow’s milk), Milk whey powder (Cow’s milk), Flavourings, Citric acid, Calcium carbonate, Lactose (from milk) (Cow’s milk), Emulsifier (Soy lecithin) (Soybean), Antioxidant (E320).

‘Alarming’ sugar content

The sugar content alone is alarming but there’s not much about this product that is even close to “real food”. It is highly processed and includes artificial sweeteners. It also does not mention which “flavourings” producers have used. Consequently, dietitians put their credibility is at risk when they list such products under  “healthy bars”. 

ADSA regularly maintains that there is evidence to support processed cereal bars with added sugar to sporty children as a source of energy. UNICEF’s The Facts for Life public consultation document disagrees. It states that anyone making nutrition or health claims for products should not provide selective information. Products must contain all relevant information, including on what some may consider unhealthy ingredients. 

“For example, to suggest a food is a rich source of a nutrient but (to omit) that it also contains excessive amounts of fats, or salt, or added sugar is misleading.”

Health ‘halo’

Another trick is for companies to position themselves as healthy by association. That’s probably why Kellogg’s was  sponsors of the 2014 Nutritional Congress in Johannesburg that Nutrition Society of South Africa (NSSA) and ADSA hosted.

Kellogg’s has also trained nearly 600 health care professionals in South Africa via their Kellogg’s Corn Flakes® nutrition education campaign.

This is clearly a case of the fox watching the hen house.


ADSA, of course, doesn’t see it that way. On it internal Registered Dietitians portal, it said that “…Kellogg’s ran a very successful Nutrition Education campaign throughout clinics in Gauteng…”

Who is fooling whom?

Kellogg’s also claims “to provide access to the latest research, information and tools” via their website . It  launched that site in 2012 for health care professionals.

So do RDs and other health care professionals really have to look to Big Food for dietary guidance?

This is a perfect example of what the authors of an editorial in PLoS Medicine Series on Big Food: The Food Industry Is Ripe for Scrutiny say on the topic.  The growing number of private-public partnerships with public health organizations is further fuelling “the legitimization of food companies as global health experts”, they say. The ostensible aim is “to foster collaborative action to improve people’s health and wellbeing”.

Rebranding exercise

Food companies are rebranding themselves as ‘‘nutrition companies’’ . They are “offering business acumen and knowledge in food science and distribution”. They are also asserting authority over solutions to problems not just of food production but also malnutrition, obesity and even poverty”.

Kellogg’s has clearly done well with their health and wellness ruse to make their foods “favourable” to South African dietitians. They have also spent millions of dollars and lobbied US Congress in 2011 to weaken the standards of the proposed voluntary principles that industry uses as a guide for marketing food to children.

Does ADSA truly believe that it can influence Kellogg’s to improve the nutritional quality of their products to such a degree that it would make any real difference?

One thing that ADSA has been able to influence is ensuring that dietitians, and in turn, consumers view Kellogg’s products as “favourable”.

Perhaps it’s time for ADSA to realise that Kellogg’s and other Big Food companies producing unhealthy products, gave up on healthy food long ago. Instead, ADSA needs to see that it’s business as usual for the company.

Focus on the poor

Kellogg’s is clear about its focus. Its core categories include cereal, snack and frozen foods. Kellogg core strategy (2013) was and is to “remain a global cereal leader,” “become a global snacks player,” focus on frozen” and “increase focus on emerging markets”.

British investigative health journalist and author Jerome Burne puts it succinctly in a blog  on Cuddly dietitians in cosy embrace of industry fat cats: “Quite simply the industry is running rings round the dietitians.”  Years of attempting to get meaningful changes that would significantly improve the nation’s health “have achieved very little”.

A forensic analysis in the BMJ; Sugar: spinning a web of influence  in February looks at the true nature of the relationship between industry and nutritional experts.

The fact is that there are foods consumers should avoid as they are simply not healthy. And scientists have long ago pinpointed the link between processed foods filled with salt and fat and food addiction.

Addictive foods

A more recent Michigan University study  in PLOS ONE was titled Which Foods May Be Addictive? The Roles of Processing, Fat Content, and Glycemic Load . It is one of the first to examine which foods may be implicated in causing “food addiction”. The researchers found that highly processed foods were more likely to have the same effect on the brain as hard drugs. That was compared to non-processed foods, such as wheat, fish, and other “boring” and “healthy” foods.

It’s not only what ADSA dietitians RDs say but also what they don’t say that is a concern.  Are ADSA and its dietitian members at liberty to make overt cautionary statements about processed foods and sugar?  Are they hampered through the ties that bind them to Big Food?

Would they support nutrition policies that might upset corporate sponsors, such as sugar taxes and GMO labeling? Would they strongly discourage processed foods?

Incompatible goals

Dr Marion Nestle is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University and author of Food Politics. She believes that the goals of food companies and health professionals are rarely compatible.

She says that dietitians  ought to be advising clients and the public on optimum nutrition to stay healthy and prevent chronic disease. As a result, this necessarily means promoting consumption of some foods and discouraging others.

Nestle says that dietitians “cannot speak truth to clients and protect corporate sponsorship at the same time.

Between a rock and hard place

Burne sums up the predicament of ADSA perfectly in his article.

“They are firmly and apparently inescapably wedged between a rock and a hard place.” Admitting they had been wrong would effectively bit the hand that feeds them. In other words, it would mean “turning on the industry that not only provides them with vital funding but is now firmly embedded in the whole regulatory process.

“It must certainly be uncomfortable for them but it is deadly for many consumers.”

* Sonia Mountford has not used actual dietitians’ names. The Dietitian X example is “one of many”, she says. It would be unfair to single any out that are “not directly part of ADSA other than being a member”.


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