How Our Habits Would Need to Change for a Soda Ban to Matter

Brian Fung, The Atlantic, July 24, 2012

Will people actually consume less soda just because they can't buy it in one giant cup?

Chatter is picking up again around New York's plan to ban sodas larger than 16 ounces as the city gathers for its first public hearing on the proposed measure. Today's debate will be followed by a vote on Sept. 13, which -- hooray! -- leaves us a whole extra month to bicker over the bill.

With any luck, at least some of that talk will be informed by new research appearing in the New England Journal of Medicine explaining exactly what conditions Mayor Bloomberg would need for a soda ban to work.

Critics of Bloomberg's proposal point out that the soda ban does almost nothing to prevent those who want large quantities of soda from getting large quantities of soda. Remember that the stricture prohibits "food service establishments" from selling sugary drinks in quantities larger than 16 ounces. Diet sodas, dairy-based products like milkshakes, and alcoholic beverages are exempt from the ban. Determined soda addicts can simply buy two 16-ounce Cokes to get 32 ounces.

True enough, but left to their own devices, humans tend to think inside the box. You wouldn't ask Pepsi to design, test, and field a whole new 26-ounce bottle every time you're in the convenience store trying to decide between a 20-ounce bottle and a one-liter bottle. You'll probably choose one or the other and go about your business. In much the same way, Bloomberg hopes that consumers will simply accept buying 16-ounce sodas as the new norm.

For every person who opts for a 16-ounce soda over a larger size, New York restaurants will theoretically see a slight drop in the number of calories their customers are getting from sugary drinks. To find out just how much of an effect the ban might have on calorie intake, researchers at NYU gathered fast-food receipts from four regional cities, along with data from two existing studies on fast-food habits. Next, they cross-referenced that data with nutritional information supplied by the fast-food companies themselves. That gave the scientists a chance to calculate precisely, down to the item, how many calories were contained in a given meal.

Then, armed with that big stack of actual purchasing decisions, the researchers ran simulations in which a percentage of those (anonymous) consumers were "given" smaller sodas instead of bigger ones. They set up hypothetical scenarios where 10 percent of customers bought the smaller size (16 ounces) and 90 percent bought the larger size (32 ounces), running the simulation 1,000 times. They repeated that process for different distributions, from 20 percent on up to 100 percent of customers opting for the 16-ounce sodas.

What they found was that calorie consumption as a function of soda intake begins to come down when about a third of customers adhere to the soda ban instead of circumventing it by buying two sodas of a smaller size. Naturally, the more people that play by the rule, the bigger the general decrease in caloric intake from soda.

Here's the takeaway for New Yorkers (and Cambridge-ians, too): we no longer have to make assumptions about whether a soda ban would work based on ideological cues about freedom and the role of government in mandating nutrition. There's actual data now pinpointing the exact threshold between success and failure. As long as more than 30 percent of city residents accept the options they're given at the checkout counter, the share of calories they get from sodas is likely to drop. While that may or may not actually affect the overall health of New Yorkers, it would be a quantifiable win for Michael Bloomberg.

Food Orders Placed Online Are More Fattening, Complicated

Jie Jenny Zou, The Wall Street Journal, July 20, 2012
 
A new study suggests that consumers feel less inhibited while on the Internet, making for orders that are more complex and calorie-laden.

Ryan McDevitt, assistant professor of economics and management at the University of Rochester’s Simon Graduate School of Business, examined the North Carolina pizza chain of 160,000 orders over a four-year period with price and offerings remaining the same. When it came to web orders, customers exercised more choice, sometimes quadrupling their bacon or piling on toppings.

As a result, a pizza ordered online was about 15% more complicated and contained 6% more calories compared to orders placed on the phone or in person. The study also found that while the company’s move to the web didn’t result in more new customers, it increased how much existing customers spent by 4% — largely due to the cost of more toppings.

Economists have attributed the “long tail,” or varied sales distribution, of Internet companies like Amazon to larger inventories and search functions, which provide customers with more choices and allow them to find obscure items.

Mr. McDevitt expects similar customization to occur with online ordering regardless of product type and argued customers are better off on the Internet because they are more able to meet their product needs. Aside from the excessive calories, of course.

“They have the same choices as before, but they’re removing the social transaction costs,” said Mr. McDevitt. “From my own personal experience, I feel more comfortable ordering something online than at the counter.”

He mentioned how customers ordering at Starbucks might be less inclined to make elaborate drink orders as they peek over their shoulder at the line of people behind them, or how women have taken to reading racy content like “Fifty Shades of Grey” on e-readers, which provide anonymity.

The study also suggests other reasons for complex orders — namely that the Internet makes it easier for consumers to choose by giving them access to a full menu as opposed to someone who might call and order something more typical like a plain pepperoni pizza.

A Fresh Look at What School Menus Can Be

Dan Frosch, The New York Times, July 17, 2012

DENVER — With the authority of a celebrity chef, Adam Fisher gestured toward the bushels of fresh basil, oregano and parsley sitting on the counter in front of him, as the crowd leaned forward.

“We almost want to treat fresh herbs like we treat fresh flowers,” he commanded, speaking into a microphone clipped to his apron. “You want to snip off the ends, and ideally you want to store them in some water.” 

Mr. Fisher may not be some fast-talking TV personality, but he is a chef, a food supervisor for the Denver Public Schools, and he was giving a demonstration on how to whip up cafeteria food — in this case, cucumber and pasta salads — from scratch. 

With new federal standards for school meals going into effect this month, and a renewed focus on the issue brought by the first lady, Michelle Obama, thousands of school chefs, food service workers and nutrition experts from around the country gathered in Denver this week at an annual conference put on by the School Nutrition Association, a nonprofit organization of school food professionals. 

As vendors hawked samples of every imaginable school fare — whole-grain rolls, turkey sandwiches, pizza squares — cooks and school food administrators traded tips on how to improve their schools’ cuisine, part of a nationwide push to make school food tastier and more healthful. 

But it was the new federal Department of Agriculture nutrition standards for school meals that seemed the main topic of conversation. 

The rules establish calorie and sodium limits for meals, require schools to serve larger portions of fruits and vegetables and mandate that all milk be 1 percent or nonfat. Requirements for the use of whole grains are also being phased in. 

With more schools cooking meals from scratch — which invariably means more fresh local fruits and vegetables in the kitchens rather than processed foods — districts have largely been able to keep pace with the new regulations, nutrition experts said. 

“School districts for the last 15 years have been working on ways to improve their menus,” said Julia Bauscher, the School Nutrition Association’s new vice president and school nutrition director for the Jefferson County Public Schools in Louisville, Ky. “The majority of the members that are here probably are already meeting some of the new standards.” 

Gone, at least in many places, are the days when lunch ladies served fried just-about-anything with a side of unrecognizable slop. These days, many school meals start with raw ingredients and take longer to prepare. School staples like chicken nuggets are typically baked, not tossed in the fryer, and hot dogs are more likely to be made of turkey. And even those longtime favorites are served in the cafeteria less frequently. 

“Ten or 15 years ago, you wouldn’t have seen a salad bar, a fresh fruit and veggie bar, homemade pasta salads,” said Theresa Hafner, executive director of the food services department for Denver Public Schools. “You probably wouldn’t have seen homemade biscuits, or homemade hamburger buns, made with a white whole-wheat flour.” 

In Denver, for example, 95 percent of the public school lunch menu and about half of the breakfast menu is now prepared from scratch, since the school district introduced cooking from scratch in the fall of 2010. 

The switch has not come without a cost. Since 2010, Ms. Hafner has hired more than 100 additional food service workers, as scratch cooking is more labor intensive. And her food expenses have gone up 20 percent, since fresh produce must be bought for the schools’ fruit and salad bars. 

Adam Simmons, the child nutrition director for the public school system in Fayetteville, Ark., said that while the new rules were well intentioned, he worried that sodium limits and expanded servings of fruits and vegetables could result in more food being left on the tray.

“You’re increasing serving sizes on fruits and vegetables so much, I think you’re really going to just increase trash,” said Mr. Simmons, who spearheaded a switch to 70 percent scratch cooking in his school district. 

Ultimately, though, he and other nutrition experts viewed the new regulations as positive, as long as the school chefs still make the food taste good. 

“Putting things on a plate doesn’t make it a nutritious meal. The students have to consume it,” he said. “And if they do, it will open them to more fresh fruits and vegetables. In the long run, this can do great things.”

Vast F.D.A. Effort Tracked E-Mails of Its Scientists

Eric Lichtblau and Scott Shane, The New York Times, July 14, 2012

WASHINGTON — A wide-ranging surveillance operation by the Food and Drug Administration against a group of its own scientists used an enemies list of sorts as it secretly captured thousands of e-mails that the disgruntled scientists sent privately to members of Congress, lawyers, labor officials, journalists and even President Obama, previously undisclosed records show.

What began as a narrow investigation into the possible leaking of confidential agency information by five scientists quickly grew in mid-2010 into a much broader campaign to counter outside critics of the agency’s medical review process, according to the cache of more than 80,000 pages of computer documents generated by the surveillance effort. 

Moving to quell what one memorandum called the “collaboration” of the F.D.A.’s opponents, the surveillance operation identified 21 agency employees, Congressional officials, outside medical researchers and journalists thought to be working together to put out negative and “defamatory” information about the agency. 

F.D.A. officials defended the surveillance operation, saying that the computer monitoring was limited to the five scientists suspected of leaking confidential information about the safety and design of medical devices. 

While they acknowledged that the surveillance tracked the communications that the scientists had with Congressional officials, journalists and others, they said it was never intended to impede those communications, but only to determine whether information was being improperly shared.

The agency, using so-called spy software designed to help employers monitor workers, captured screen images from the government laptops of the five scientists as they were being used at work or at home. The software tracked their keystrokes, intercepted their personal e-mails, copied the documents on their personal thumb drives and even followed their messages line by line as they were being drafted, the documents show.

The extraordinary surveillance effort grew out of a bitter dispute lasting years between the scientists and their bosses at the F.D.A. over the scientists’ claims that faulty review procedures at the agency had led to the approval of medical imaging devices for mammograms and colonoscopies that exposed patients to dangerous levels of radiation.

A confidential government review in May by the Office of Special Counsel, which deals with the grievances of government workers, found that the scientists’ medical claims were valid enough to warrant a full investigation into what it termed “a substantial and specific danger to public safety.”

The documents captured in the surveillance effort — including confidential letters to at least a half-dozen Congressional offices and oversight committees, drafts of legal filings and grievances, and personal e-mails — were posted on a public Web site, apparently by mistake, by a private document-handling contractor that works for the F.D.A. The New York Times reviewed the records and their day-by-day, sometimes hour-by-hour accounting of the scientists’ communications.

With the documents from the surveillance cataloged in 66 huge directories, many Congressional staff members regarded as sympathetic to the scientists each got their own files containing all their e-mails to or from the whistle-blowers. Drafts and final copies of letters the scientists sent to Mr. Obama about their safety concerns were also included.

Last year, the scientists found that a few dozen of their e-mails had been intercepted by the agency. They filed a lawsuit over the issue in September, after four of the scientists had been let go, and The Washington Post first disclosed the monitoring in January. But the wide scope of the F.D.A. surveillance operation, its broad range of targets across Washington, and the huge volume of computer information that it generated were not previously known, even to some of the targets.

F.D.A. officials said that in monitoring the communication of the five scientists, their e-mails “were collected without regard to the identity of the individuals with whom the user may have been corresponding.” While the F.D.A. memo described the Congressional officials and other “actors” as collaborating in the scientists’ effort to attract negative publicity, the F.D.A. said that those outside the agency were never targets of the surveillance operation, but were suspected of receiving confidential information.

While federal agencies have broad discretion to monitor their employees’ computer use, the F.D.A. program may have crossed legal lines by grabbing and analyzing confidential information that is specifically protected under the law, including attorney-client communications, whistle-blower complaints to Congress and workplace grievances filed with the government.

Other administration officials were so concerned to learn of the F.D.A. operation that the White House Office of Management and Budget sent a governmentwide memo last month emphasizing that while the internal monitoring of employee communications was allowed, it could not be used under the law to intimidate whistle-blowers. Any monitoring must be done in ways that “do not interfere with or chill employees’ use of appropriate channels to disclose wrongdoing,” the memo said.

Although some senior F.D.A. officials appear to have been made aware of aspects of the surveillance, which went on for months, the documents do not make clear who at the agency authorized the program or whether it is still in operation.

But Stephen Kohn, a lawyer who represents six scientists who are suing the agency, said he planned to go to federal court this month seeking an injunction to stop any surveillance that may be continuing against the two medical researchers among the group who are still employed there.

The scientists who have been let go say in a lawsuit that their treatment was retaliation for reporting their claims of mismanagement and safety abuses in the F.D.A.’s medical reviews.

Members of Congress from both parties were irate to learn that correspondence between the scientists and their own staff had been gathered and analyzed.

Representative Chris Van Hollen, a Maryland Democrat who has examined the agency’s medical review procedures, was listed as No. 14 on the surveillance operation’s list of targets — an “ancillary actor” in the efforts to put out negative information on the agency. (An aide to Mr. Van Hollen was No. 13.)

Mr. Van Hollen said on Friday after learning of his status on the list that “it is absolutely unacceptable for the F.D.A. to be spying on employees who reach out to members of Congress to expose abuses or wrongdoing in government agencies.”

Senator Charles E. Grassley, an Iowa Republican whose former staff member’s e-mails were cataloged in the surveillance database, said that “the F.D.A. is discouraging whistle-blowers.” He added that agency officials “have absolutely no business reading the private e-mails of their employees. They think they can be the Gestapo and do anything they want.”

While national security agencies have become more aggressive in monitoring employee communications, such tactics are unusual at domestic agencies that do not handle classified information.

Much of the material the F.D.A. was eager to protect centered on trade secrets submitted by drug and medical device manufacturers seeking approval for products. Particular issues were raised by a March 2010 article in The New York Times that examined the safety concerns about imaging devices and quoted two agency scientists who would come under surveillance, Dr. Robert C. Smith and Dr. Julian Nicholas.

Agency officials saw Dr. Smith as the ringleader, or “point man” as one memo from the agency put it, for the complaining scientists, and the surveillance documents included hundreds of e-mails that he wrote on ways to make their concerns heard. (Dr. Smith and the other scientists would not comment for this article because of their pending litigation.)

Lawyers for GE Healthcare charged that the 2010 article in The Times — written by Gardiner Harris, who would be placed first on the surveillance program’s list of “media outlet actors” — included proprietary information about their imaging devices that may have been improperly leaked by F.D.A. employees.

F.D.A. officials went to the inspector general at the Department of Health and Human Services to seek a criminal investigation into the possible leak, but they were turned down. The inspector general found that there was no evidence of a crime, noting that “matters of public safety” can legally be released to the news media.

Undeterred, agency officials began the electronic monitoring operation on their own.

The software used to track the F.D.A. scientists, sold by SpectorSoft of Vero Beach, Fla., costs as little as $99.95 for individual use, or $2,875 to place the program on 25 computers. It is marketed mainly to employers to monitor their workers and to parents to keep tabs on their children’s computer activities.

“Monitor everything they do,” says SpectorSoft’s Web site. “Catch them red-handed by receiving instant alerts when keywords or phrases are typed or are contained in an e-mail, chat, instant message or Web site.”

The F.D.A. program did all of that and more, as its operators analyzed the results from their early e-mail interceptions and used them to search for new “actors,” develop new keywords to search and map out future areas of concern.

The intercepted e-mails revealed, for instance, that a few of the scientists under surveillance were drafting a complaint in 2010 that they planned to take to the Office of Special Counsel. A short time later, before the complaint was filed, Dr. Smith and another complaining scientist were let go and a third was suspended.

In another case, the intercepted e-mails indicated that Paul T. Hardy, another of the dissident employees, had reapplied for an F.D.A. job “and is being considered for a position.” (He did not get it.)

F.D.A. officials were eager to track future media stories too. When they learned from Mr. Hardy’s e-mails that he was considering talking to PBS’s “Frontline” for a documentary, they ordered a search for anything else on the same topic.

While the surveillance was intended to protect trade secrets for companies like G.E., it may have done just the opposite. The data posted publicly by the F.D.A. contractor — and taken down late Friday after inquiries by The Times — includes hundreds of confidential documents on the design of imaging devices and other detailed, proprietary information.

The posting of the documents was discovered inadvertently by one of the researchers whose e-mails were monitored. The researcher did Google searches for scientists involved in the case to check for negative publicity that might hinder chances of finding work. Within a few minutes, the researcher stumbled upon the database.

“I couldn’t believe what I was seeing,” said the researcher, who did not want to be identified because of pending job applications. “I thought: ‘Oh my God, everything is out there. It’s all about us.’ It was just outrageous.”

PLoS Medicine series on Big Food

Editorial: PLoS Medicine Series on Big Food: The Food Industry Is Ripe for Scrutiny, The PLoS Medicine Editors, PLoS Medicine: Published 19 Jun 2012 | info:doi/10.1371/journal.pmed.1001246
Essay: Big Food, Food Systems, and Global Health, David Stuckler, Marion Nestle, PLoS Medicine: Published 19 Jun 2012 | info:doi/10.1371/journal.pmed.1001242
Essay: Food Sovereignty: Power, Gender, and the Right to Food, Rajeev C. Patel, PLoS Medicine: Published 26 Jun 2012 | info:doi/10.1371/journal.pmed.1001223
Essay: The Impact of Transnational “Big Food” Companies on the South: A View from Brazil, Carlos A. Monteiro, Geoffrey Cannon, PLoS Medicine: Published 03 Jul 2012 | info:doi/10.1371/journal.pmed.1001252
Perspective: Thinking Forward: The Quicksand of Appeasing the Food Industry, Kelly D. Brownell, PLoS Medicine: Published 03 Jul 2012 | info:doi/10.1371/journal.pmed.1001254
Policy Forum: Soda and Tobacco Industry Corporate Social Responsibility Campaigns: How Do They Compare?, Lori Dorfman, Andrew Cheyne, Lissy C. Friedman, Asiya Wadud, Mark Gottlieb, PLoS Medicine: Published 19 Jun 2012 | info:doi/10.1371/journal.pmed.1001241
Policy Forum: Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco, David Stuckler, Martin McKee, Shah Ebrahim, Sanjay Basu, PLoS Medicine: Published 26 Jun 2012 | info:doi/10.1371/journal.pmed.1001235
Policy Forum: “Big Food,” the Consumer Food Environment, Health, and the Policy Response in South Africa, Ehimario U. Igumbor, David Sanders, Thandi R. Puoane, Lungiswa Tsolekile, Cassandra Schwarz, Christopher Purdy, Rina Swart, Solange Durão, Corinna Hawkes, PLoS Medicine: Published 03 Jul 2012 | info:doi/10.1371/journal.pmed.1001253