Portion Sizes of Ultra-Processed Foods in the United States, 2002 to 2021.

Objectives. To assess the US food industry's response to calls from public health authorities to reduce portion sizes by comparing current with past sizes of selected examples of single-serve ultra-processed packaged and fast foods. Methods. We obtained manufacturers' information about current portion sizes and compared it with sizes when first introduced and in 2002. Results. Few companies in our sample reduced portion sizes since 2002; all still sold portions of ultra-processed foods in up to 5-times-larger sizes than when first introduced. Conclusions. Policies and practices focused on reducing portion size could help discourage the consumption of excessive amounts of ultra-processed foods. (Am J Public Health. 2021;111(12):2223-2226. https://doi.org/10.2105/AJPH.2021.306513).

The Supplemental Nutrition Assistance Program (SNAP): History, Politics, and Public Health Implications.

This commentary introduces a special section of AJPH on the Supplemental Nutrition Assistance Program (SNAP), the US government's largest antihunger program and third-largest antipoverty program. SNAP demonstrably lifts adults, children, and families out of poverty, thereby constituting a vital component of this nation's public health safety net.Despite its well-documented benefits, SNAP is under political and budgetary siege, mainly from congressional representatives and lobbying groups opposed to a federal role in welfare. In part, SNAP is protected from total annihilation by its unusual authorizing legislation-the Farm Bill.This commentary provides a brief overview of the political history of SNAP and its Farm Bill location as background to the deeper analyses provided in this series of articles.

Strategies to improve the dietary quality of Supplemental Nutrition Assistance Program (SNAP) beneficiaries: an assessment of stakeholder opinions.

OBJECTIVE: To examine the opinions of stakeholders on strategies to improve dietary quality of Supplemental Nutrition Assistance Program (SNAP) participants. DESIGN: Participants answered a thirty-eight-item web-based survey assessing opinions and perceptions of SNAP and programme policy changes. SETTING USA SUBJECTS: Survey of 522 individuals with stakeholder interest in SNAP, conducted in October through December 2011. RESULTS: The top three barriers to improving dietary quality identified were: (i) unhealthy foods marketed in low-income communities; (ii) the high cost of healthy foods; and (iii) lifestyle challenges faced by low-income individuals. Many respondents (70 %) also disagreed that current SNAP benefit levels were adequate to maintain a healthy diet. Stakeholders believed that vouchers, coupons or monetary incentives for purchasing healthful foods might have the greatest potential for improving the diets of SNAP participants. Many respondents (78 %) agreed that sodas should not be eligible for purchases with SNAP benefits. More than half (55 %) believed retailers could easily implement such restrictions. A majority of respondents (58 %) agreed that stores should stock a minimum quantity of healthful foods in order to be certified as a SNAP retailer, and most respondents (83 %) believed that the US Department of Agriculture should collect data on the foods purchased with SNAP benefits. CONCLUSIONS: Results suggest that there is broad stakeholder support for policies that align SNAP purchase eligibility with national public health goals of reducing food insecurity, improving nutrition and preventing obesity.

Utopian dream: a new farm bill.

In the fall of 2011, I taught a graduate food studies course at New York University devoted to the farm bill, a massive and massively opaque piece of legislation passed most recently in 2008 and up for renewal in 2012. The farm bill supports farmers, of course, but also specifies how the United States deals with such matters as conservation, forestry, energy policy, organic food production, international food aid, and domestic food assistance. My students came from programs in nutrition, food studies, public health, public policy, and law, all united in the belief that a smaller scale, more regionalized, and more sustainable food system would be healthier for people and the planet.

Food Industry Donations to Academic Programs: A Cross-Sectional Examination of the Extent of Publicly Available Data.

No studies have documented the prevalence of the food industry's funding of academic programs, which is problematic because such funding can create conflicts of interest in research and clinical practice. We aimed to quantify the publicly available information on the food industry's donations to academic programs by documenting the amount of donations given over time, categorizing the types of academic programs that receive food industry donations, cataloguing the source of the donation information, and identifying any stated reasons for donations. Researchers cataloged online data from publicly available sources (e.g., official press releases, news articles, tax documents) on the food industry's donations to academic programs from 2000 to 2016. Companies included 26 food and beverage corporations from the 2016 Fortune 500 list in the United States. Researchers recorded the: (1) monetary value of the donations; (2) years the donations were distributed; (3) the name and type of recipient; (4) source of donation information; and (5) reasons for donations. Adjusting for inflation, we identified $366 million in food industry donations (N = 3274) to academic programs. Universities received 45.2% (n = 1480) of donations but accounted for 67.9% of total dollars given in the sample. Community colleges, schools (i.e., preschool, elementary, middle, and high schools), and academic nonprofits, institutes, foundations, and research hospitals collectively received 54.8% of the donations, but made up less than one-third of the monetary value of donations. Half of the donations (49.0%) did not include a stated reason for the donation. In our sample, donations grew from $3 million in 2000 to $24 million in 2016. Food companies in our sample donated millions of dollars to universities and other academic programs but disclosed little information on the purpose of the donations. Achieving transparency in donation practices may only be possible if federal policies begin to require disclosures or if companies voluntarily disclose information.

Perspective: Challenges and Controversial Issues in the Dietary Guidelines for Americans, 1980-2015.

Since 1980, every edition of the Dietary Guidelines for Americans (DGAs) has recommended increased consumption of fruits, vegetables, and whole grains, but reduced consumption of saturated fat, sugars, and sodium and, therefore, their primary food sources. Every edition has generated controversy, mainly from producers of foods affected by "eat less" recommendations, particularly meat. Objections to the 2015 DGAs focused on environmental as well as scientific issues, but also on purported conflicts of interest among members of the Dietary Guidelines Advisory Committee. On this basis, critics induced Congress to authorize the National Academy of Medicine (NAM) to review the process of drawing up the guidelines. The NAM's 2017 reports should strengthen the process, but as long as science continues to support advice to reduce consumption of targeted foods, the guidelines will continue to elicit political controversy.

Portion sizes and obesity: responses of fast-food companies.

Because the sizes of food portions, especially of fast food, have increased in parallel with rising rates of overweight, health authorities have called on fast-food chains to decrease the sizes of menu items. From 2002 to 2006, we examined responses of fast-food chains to such calls by determining the current sizes of sodas, French fries, and hamburgers at three leading chains and comparing them to sizes observed in 1998 and 2002. Although McDonald's recently phased out its largest offerings, current items are similar to 1998 sizes and greatly exceed those offered when the company opened in 1955. Burger King and Wendy's have increased portion sizes, even while health authorities are calling for portion size reductions. Fast-food portions in the United States are larger than in Europe. These observations suggest that voluntary efforts by fast-food companies to reduce portion sizes are unlikely to be effective, and that policy approaches are needed to reduce energy intake from fast food.

The food industry and conflicts of interest in nutrition research: A Latin American perspective.

Conflicts of interest arise when corporations marketing harmful products establish financial relationships with research institutions, researchers, or public health organizations. As obesity becomes a worldwide epidemic, such relationships threaten to jeopardize the integrity of scientific research. Latin America, a region undergoing rapid development, is particularly vulnerable to such conflicts. Here, we provide examples of how food and beverage companies are funding nutrition-focused research and institutions in Latin America, putting their credibility at risk. Public health organizations and institutions should take measures to identify, manage, and limit (or eliminate) conflicts of interest caused by partnerships with food companies making and marketing unhealthful products.