key: cord-0857915-idhbd102
authors: White, Mariel; Nieto, Claudia; Barquera, Simon
title: Good deeds and cheap marketing—The food industry in the times of COVID‐19
date: 2020-05-22
journal: Obesity (Silver Spring)
DOI: 10.1002/oby.22910
sha: 817ca89f69f3d07413cdeaa66f581579bb18ecc6
doc_id: 857915
cord_uid: idhbd102

The consumption of ultra‐processed foods is one of the main drivers of the global obesity and non‐communicable disease (NCDs) epidemic(1). It is well known that obesity is associated with a low intensity chronic inflammatory state that creates a suboptimal immune response,(2) which negatively affects the prognosis of COVID‐19(3). The epidemic of obesity and COVID‐19 can be viewed as a syndemic as they negatively interact with one another to exacerbate the course of disease, leading to greater complications and severe illness. Together, they create a simultaneous and significant burden on the health system(4). Thus, an in‐depth analysis on the food industry’s role in this pandemic and in our society is necessary.

The consumption of ultra-processed foods is one of the main drivers of the global obesity and non-communicable disease (NCDs) epidemic 1 . It is well known that obesity is associated with a low intensity chronic inflammatory state that creates a suboptimal immune response, 2 which negatively affects the prognosis of COVID-19 3 . The epidemic of obesity and COVID-19 can be viewed as a syndemic as they negatively interact with one another to exacerbate the course of disease, leading to greater complications and severe illness. Together, they create a simultaneous and significant burden on the health system 4 . Thus, an in-depth analysis on the food industry's role in this pandemic and in our society is necessary.

Since this pandemic began, the food industry has been proactive in supporting relief efforts. Many companies and fast food restaurants have donated money, in addition to providing medical supplies and free food. One of the most well-known initiatives is PepsiCo's global campaign-Give Meals, Give Hope-which has provided 45 million dollars in donations and 50 million meals to over 40 countries 5 . PepsiCo, Coca Cola, and other companies also gathered donations for the World Health Organization's COVID-19 Solidarity Response Fund 6 . According to their website, Coca-Cola has provided over 120 million dollars of aid. Likewise, Nestlé pledged around 10 million. Companies such as McDonald's, Hershey's, and Kellogg's also donated 2-7 million dollars. In Kingston, Jamaica, the Ministry of Education partnered with the franchise operators of Little Caesars pizza, Burger King, Popeye's, and KFC to provide school meals to children. 7 These companies have been applauded for their actions and have garnered massive public support. However, a number of studies point out that they aggressively market ultraprocessed foods and beverages, whose regular consumption is associated with weight gain and NCDs 8 .

Do these good deeds-or any social responsibility initiative-do away with the harmful actions that these companies engage in? Not only do many of their products promote

This article is protected by copyright. All rights reserved obesity, 7 but many companies also obstruct public health nutrition policies using a variety of documented strategies, such as lobbying, funding professional health organizations, discrediting scientific evidence, and interfering in governmental decision-making processes, among others. 9 A recent example involves attempts by the food industry to block the approval of a new front-of-pack (FOP) warning label system in Mexico to promote healthier food choices by organizing through the Mexican Chamber of Industry (CONCAMIN). The representative in the FOP discussion groups was an executive from Nestlé. Through this entity, industry filed a legal challenge, launched media campaigns, and petitioned the government to delay the implementation of the new law due to COVID-19 10 . Furthermore, the CEO of Nestlé sent a letter to its suppliers, asking them to "intervene in this process," 11 while Coca-Cola interfered by having lobbyists from the sugar-sweetened beverage industry visit congressmen to try and influence their vote. 12 Showing social responsibility publicly does not ensure a company's ethical behavior privately. In fact, one study of 49 Fortune 500 firms found that corporate social responsibility was associated with subsequent corporate social irresponsibility because it enabled company leaders to later behave less ethically towards stakeholders. 13 If food companies wish to be socially responsible, they should provide healthy food choices and restrain from deploying strategies that interfere with government attempts to build healthier food environments.

In addition, COVID-19 is being used as a new marketing strategy, considering recent shifts to at-home activities. Their publicity reference staying at home, social distancing, minimal contact, or boredom in quarantine. Some have recognized health workers and/or offered them free food. They also include messages, such as "we're in this together." In Mexico, Coca Cola released an image with spaces between the letters of its name to imply social distancing. Some companies offer ideas for coping with boredom, such as Jumex, a Mexican juice company, that created a "bowling alley" out of its used cans on Facebook. Others promote their products with activities for children. Hostess Snacks posted an ad on Twitter showing a woman running towards a bag of donuts with hashtags such as #AtHomeWorkout and #TreatYourself. In addition to the negative effects of consuming these products, this aggressive marketing promotes overeating and could worsen anxiety, especially since overconsumption of "comfort foods" has been tied to subsequent feelings of guilt 13 . Other common hashtags have been modified during the pandemic. For example, Mexican Burger King's #HaveItYourWay to #HaveItYourWayAtHome. Others make appeals to emotion, including #DriveThruHeroes in the U.S. or #WeAreWithYou in Mexico. Almost every food company or fast-food restaurant is promoting itself on delivery platforms, while offering special deals and "contactless" options to encourage consumption. Although these actions can be interpreted as the food industry taking advantage of a crisis to promote its products, others might say it is fair game to stay afloat or competitive. However, it is clear that many of these strategies are problematic for a number of reasons.

This article is protected by copyright. All rights reserved First, marketing of unhealthy foods contributes to obesogenic environments, which increase the burden of obesity and NCDs. Second, it exploits potentially harmful emotional relationships with these foods 14 . Third, research has shown that ultra-processed food and beverage marketing can influence food choices and overall eating behaviors, especially for children and adolescents 15 . And lastly, most people will be exposed to more marketing than usual during quarantine. Given what is already known about food marketing in general, it is not unreasonable to question if these negative effects will be exacerbated.

A lesson from this pandemic is that the food industry should not interfere in public health policies; in particular, through non-transparent actions, such as heavy lobbying and revolving-door tactics. Although industry has a right to participate in public consultations, they should not participate in private committees or governmental bodies whose sole purpose is to make decisions regarding health policy. In these contexts, an inevitable conflict of interest exists, which can have an undue influence on policy outcomes and population health. Their strong opposition to the health sector's attempts to provide better information to consumers and promote healthy eating, as well as their aggressive marketing strategies, are major barriers to creating healthier food environments. If large-scale preventive measures to reduce obesity and chronic diseases had been taken earlier, COVID-19 complications would not be as severe among people with these conditions and health disparities would not continue to be widened. Guidelines for ethical engagement with the food industry, such as those proposed by the World Health Organization to prevent and manage conflicts of interest 9 , should be reviewed and continuously updated. Industry interference is dynamic and occurs in real-time; systematic monitoring is needed to document new and evolving strategies, so that public health officials and researchers can quickly intervene.

Much like the examples identified in this paper from Mexico and the United States, the industry's actions have raised concerns around the world, especially regarding companies that sell unhealthy food products. As a result, the NCD Alliance and SPECTRUM research consortium launched a global survey to document the industry's responses to this pandemic, including corporate social responsibility and marketing campaigns, as well as their participation in policy discussions 16 .

If we wish to treat obesity seriously by promoting healthier environments and societies that can better respond to health challenges-such as the current COVID-19 pandemic-then there is no doubt that the food industry's strategies are working against this goal and should be effectively regulated.

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Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

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Associations between Consumption of Ultra-Processed Foods and Intake of Nutrients Related to Chronic Non-Communicable Diseases in Mexico

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Advertising as a cue to consume: A systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults

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This article is protected by copyright. All rights reserved