People assume they can eat larger portion sizes of foods labeled “healthy,” even when those foods actually have the same amount of calories as the “non-healthy” versions, according to the results from a new study. The research project was an attempt to assess whether food companies’ marketing efforts to brand their products as healthier have an impact on consumer choices.

Researchers asked 186 adults to determine the appropriate portion sizes of both “healthy” and regular brands of different foods. The participants tended to serve themselves larger portions of the “healthy” food, and they also tended to underestimate the amount of calories that were actually in it. The study’s researchers attribute these behaviors to the effective marketing strategies that the food industry uses to convince people that even processed foods aren’t so bad if they’re being touted as healthier options:

“People think (healthier food) is lower in calories,” said Pierre Chandon, a marketing professor at the INSEAD Social Science Research Center in France, and they “tend to consume more of it.”

That misconception can lead to people eating larger portion sizes of so-called healthy foods, and therefore more calories.

“Foods are marketed as being healthier for a reason, because food producers believe, and they correctly believe, that those labels will influence us to eat their products and perhaps eat more of their products,” said Dr. Cliodhna Foley Nolan, the director of Human Health and Nutrition at Safefood, a government agency in Ireland.

The new study builds upon previous research that found that green labeling is “coded” as healthier — so when a product is marketed in green packaging, Americans tend to assume it has fewer calories, even if it’s a product like a candy bar.

As Americans continue to grapple with an ongoing obesity epidemic, fast food companies in the United States have attempted to use these type of marketing tactics in order to rebrand themselves as healthier choices Popular chains like McDonald’s, Panda Express, Taco Bell, and Coca-Cola have all attempted to improve their national image by offering up “healthy” options — even though they haven’t actually changed much about the actual nutritional content of their products.

Coca-Cola unveiled a new anti-obesity campaign Wednesday, pledging to better regulate its advertising to children and ensure clear nutritional labeling is available on its drinks around the world.

In the U.S., calorie counts for Coca-Cola products are displayed on the front of drink labels and no-calorie diet versions of drinks are readily available, but in other countries, there’s not as much consistency in product labeling and the availability of diet drinks. Coke’s new push aims to remedy that, and will also halt all advertising targeted at audiences younger than 12.

Coke, which is based in Atlanta, also announced Wednesday that it would contribute $3.8 million to support nutrition education and physical activity programs in Georgia. Most of the money will go toward the Georgia SHAPE program, an initiative that works with k-12 school districts to increase students’ physical activity, and the Centers of Hope program, which connects at-risk students to physical activity and leadership development programs.

While the pledges and donations help improve Coke’s public image, they don’t address the core of the the company’s public health problem: the increasing body of literature that has linked soda and other sugary drink consumption to diabetes, obesity and even death. Even diet drinks — which Coke lauds as some of its healthier options — have been tied to negative health effects, like an increased risk of heart attack, stroke, heart disease, high blood pressure, obesity and Type 2 diabetes.

And despite Coke’s public relations campaign, the company, through the American Beverage Association (ABA), has historically fought against public health efforts to increase government regulation of the soda industry. The ABA has lobbed against soda taxes and New York Mayor Michael Bloomberg’s proposed ban on large soft drinks.

Coke’s most recent efforts come on the heels of an anti-obesity advertising campaign launched by the company in January, which featured TV ads that acknowledged America’s obesity problem and pointed out steps the Coke had taken — including creating smaller portion sizes for its drinks and sponsoring children’s programs such as the Boys and Girls Club — to address the issue. The ad ends by explaining that “all calories count, no matter where they come from,” a claim that sparked an outcry among critics, who point out that calories from soda are entirely empty calories from added sugar and contain no nutritional value.

Despite lauding new, “healthier” choices such as egg whites and wraps, major fast food chains’ menus haven’t improved much over the past decade in terms of nutritional value, according to a new study.

The study, recently published in the American Journal of Preventive Medicine, looked at the menus of eight fast food chains between 1997 and 2010. Researchers judged menus by using the U.S. Department of Agriculture’s Healthy Eating Index, a 100-point scale that determines the nutritional value of American diets based on the variety of foods eaten; the intake of each major food group; and the intake of fat, cholesterol and sodium. The study found fast food menus only increased their nutritional value by three points in the last 14 years — from 45 to 48 points. The score is lower than the general American food supply’s score of 60 points and far below the 80-plus points that the USDA recommends for a “good” diet.

And the scores of the menus from the eight restaurants studied — McDonald’s, Burger King, Wendy’s, Taco Bell, Kentucky Fried Chicken, Arby’s, Jack in the Box and Dairy Queen — actually worsened over time in the sodium category. That result is especially alarming, given that overuse of salt in the food and restaurant industry now contributes to an estimated 100,000 American deaths per year.

The study provides empirical evidence for a growing trend among fast food restaurants: marketing “healthy” options with little added nutrition in order to make the restaurants as a whole seem healthier. In April, McDonald’s introduced the Egg White Delight McMuffin, an item which contains 34 percent of an adult’s daily sodium intake and only 50 fewer calories than the original McMuffin. The restaurant chain also made its green-wrapped (and therefore healthier-looking) chicken McWraps, which contain up to 590 calories and 44 percent of a person’s recommended daily fat intake, a permanent menu item. And in March, Buger King rolled out a turkey burger that weighs in at 530 calories and contains more sodium than a Whopper.

The study’s findings have serious implications for Americans’ diets. As the report notes, one in four American adults eat fast food at least twice a week — which contributes to the fact that the quick, convenient food choice currently accounts for 15 percent of Americans’ total energy intake. The findings also echo results from a recent study that found the kids’ menus in popular chain restaurants fall short of USDA nutrition recommendations a staggering 97 percent of the time.

In an editorial accompanying the study, Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, called on fast food chains to reduce portion sizes for food and drinks, offer more fruit, vegetables and whole grains, and reduce their menu items’ sodium content. She also suggested requiring all restaurants — not just the large chain restaurants required under Obamacare — to post calorie counts on their menus so that consumers could distinguish for themselves which options were healthier.

The obesity epidemic has a particularly high toll on children of color: 39.3 percent of Mexican-American children are overweight, 10 percent higher than non-Latino white children, and diabetes rates are rising fastest among Hispanic children. Aggressive marketing plays its part. Between their favorite shows, children are much more likely to see a Spanish-speaking SpongeBob Squarepants or Shrek invite them to try Burger King and McDonald’s kids meals than if they were watching English-language shows.

According to a new study published in Journal of Health Communication, fast food companies are packing children’s TV programs with Spanish-language marketing. More than three-quarters of Spanish-language food ads used children’s favorite cartoon characters to market the unhealthiest foods. On English-language shows that number drops to just under half of the ads.

Forbes’ Rob Waters discusses the study, which found that fast food commercials dominated 158 hours of children’s programming:

The research, led by Dale Kunkel, a professor of communications at the University of Arizona, found that 84 percent of the food commercials aimed at Spanish-speaking kids promoted foods ranked in the worst of three food categories devised by federal health officials. Such foods are so high in fat and sugar, and so low in nutrients, that health experts say they should rarely be eaten. Less than 1 percent of the ads promoted fruits, vegetables, whole grains or other healthy foods, while 15 percent advertised moderately nutritious foods that should be eaten just a few times a week.

There is a strong case for why aggressive targeting matters to public health: Children spend the most amount of time in front of a TV (except for sleeping), and the food and beverage industries are powerful players in cultivating children’s tastes and brand preferences. While companies have promised to reform early-childhood marketing, they are only accountable to their self-regulated pledges. “Industry self-regulation is less effective on Spanish-language television channels,” notes the study’s authors.

Perhaps the most disturbing aspect of fast food marketing is the amount that preschoolers are targeted. Research from Yale’s Rudd Center for Food Policy and Obesity found that preschoolers generally saw more ads for McDonald’s, Burger King, and Subway than their older counterparts. Spanish-speaking preschoolers see 290 fast food ads per year, with McDonald’s responsible for a quarter of those commercials. At that age, and up to 6 years old, kids are generally unable to distinguish between programming and advertising.

Soda company marketing is another culprit. A University of Illinois at Chicago Helath Policy Center study found that low-income black and Latino youth were exposed to 80 percent and 49 percent more ads than white children, respectively. But in keeping with the industry’s attempts to head off reform by self-regulating, Coca-Cola announced Wednesday it would stop marketing to children under age 12. However, companies rarely keep to those promises.

New Jersey Gov. Chris Christie (R) has gone public about the fact that he secretly underwent lap band surgery in February, not long after his 50th birthday, at the encouragement of his family and friends. The governor’s weight has come under constant media scrutiny throughout his time in politics. “I’ve struggled with this issue for 20 years,” Christie told the New York Post. “For me, this is about turning 50 and looking at my children and wanting to be there for them.”

So what’s a lap band procedure, and how common is Christie’s decision to address his weight with surgical intervention? In fact, the governor — who says he has already lost 40 pounds — opted for an increasingly popular weight loss surgery among Americans struggling to combat epidemic rates of obesity.

Lap bands, which were first approved by the Food and Drug Administration in 2001, are considered to be the least traumatic type of weight loss surgery. Unlike gastric bypass procedures, which permanently reduce the capacity of the stomach, lap band surgeries are reversible. The procedure involves fitting a plastic belts around a patient’s stomach, creating a small pouch that can only hold a certain amount of food. That allows the patients to feel fuller sooner and prevents them from overeating. Since the diameter of the lap band is adjustable, patients’ stomach capacities can be adjusted to suit their needs, and some people gradually move back toward a normal stomach capacity as they lose weight. If the lap band needs to be removed for any reason, the stomach will return to its normal size without any lasting side effects.

Gastric bypass has long been the most popular weight loss surgery. But lap band surgery, touted as a safer and less invasive option, has steadily grown in popularity since it was first introduced. Between 2004 and 2007, its use rose from 7 percent to 23 percent. And in 2011, the FDA approved the lap band procedure for an expanded population of Americans, lowering the recommended body mass index (BMI) needed to qualify for getting a lap band and allowing even more people to pursue the surgery.

Patients who opt for the lap band typically take a longer time to lose all of the weight, but some studies have suggested they’re more likely to keep it off than the patients who undergo gastric bypass. A recent study found that one year after undergoing the procedure, nearly 85 percent of the lap band patients had lost at least 30 percent of their excess body weight, and about 66 percent of the patients were no longer considered obese. Most importantly, the obesity-related health conditions improved for many of the subjects of the study — 64 percent of those with high cholesterol, 59 percent of those with high blood pressure, and 85 percent of those with diabetes all saw better health outcomes after using the lap band for a year.

Read more

A New York City elementary school became the first public school in the nation to go completely vegetarian when it stopped serving meat in its cafeteria this year.

Flushing’s P.S. 244 consists of about 400 students between kindergarten and third grade. And the staff say that the school lunches — which include options like black bean quesadillas, brown rice, falafel, roasted red potatoes, and tofu — are a hit among those young kids, some of whom have started requesting similar foods at home:

“It’s been a really great response from the kids, but they also understand it’s about what is the healthiest option for them,” principal Bob Groff told ABCNews.com. “Because we teach them throughout our curriculum to make healthy choices, they understand what is happening and believe in what we’re doing too.”

When the school opened in 2008, they started serving vegetarian meals three days a week. The campus became a vegetarian test kitchen for the city, Groff said. [...]

The recipes were a hit, Groff said, prompting the school to expand its meat-free meals to four days a week and then adopting a 100 percent vegetarian kitchen in January.

“The big thing I would like people to know is, this isn’t just about a vegetarian menu,” Groff said. “It’s about living a healthy lifestyle and educating students on what options are out there.”

When P.S. 224 first opened, school officials noticed many students bringing their own vegetarian lunches from home, inspiring administrators to experiment with some meat-free menus. Now that the cafeteria is totally vegetarian, students are of course still welcome to pack lunches that include meat. The cafeteria food adheres to the USDA’s standards for school lunches, so students receive the recommended levels of nutrients and protein.

School cafeterias have become critical battlegrounds in the fight to address childhood obesity, which has reached epidemic levels in the United States. Encouraging healthy eating habits among younger children has been a particular area of interest for First Lady Michelle Obama and her ongoing “Let’s Move” campaign. But public health policies in this space have been met with significant resistance, both from powerful food corporations and from conservative critics of government overreach. Significantly, however, the cities with the most aggressive nutrition policies are the same ones that have seen the biggest drops in their childhood obesity rates.

Vegetarian options tend to be healthier in part because of the health risks posed by the U.S. meat industry. Over half of the meat sold in this country contains bacteria that can’t be treated with antibiotics. Chicken and ground beef are the two most dangerous types of meat, since they’re most likely to send Americans to the hospital with a foodborne illness.

As a growing number of Americans cite obesity as the most urgent health problem facing the country, the food industry is looking for a way to profit.

Despite playing a critical role in enabling America’s obesity epidemic, fast food chains have recently announced attempts to make their product seem healthier — a number of new menu items that may substitute whole grain for white or turkey for red meat. But for many of these companies, the rebranding is superficial:

Panda Express: Customers at Panda Express will have two rice choices: Steamed white rice or fried brown rice (brown rice has more nutritional value) Chief Marketing Officer Glenn Lunde described how Panda Express hopes to avoid shocking customers. “If you just sell steamed brown rice, you’re not going to sell that much.” He added, “Aren’t we fabulous?”

Taco Bell: The chain that popularized Doritos Locos Tacos announced it would make 20 percent of its meals meet nutritional guidelines, but not before 2020.

Burger King: Burger King’s limited time turkey burger is its attempt at a “game-changer” healthier option. It still weighs in at 530 calories.

McDonalds: McDonalds’ new McWrap uses a green label to trick customers into thinking it’s healthier. Its “healthy” Egg White Delight is 40 calories less than the original and complete with bacon and cheese.

Many executives say they are hesitant to make any major changes, because they expect healthy foods to taste bad and perform poorly. Huffington Post’s Joe Satran described the motivation for the incremental change: Chains add new items “to make consumers think of their restaurants as healthy — or at least not gratuitously unhealthy — and, by extension, OK to visit. In other words, healthy menu items are marketing tools. Like any other new product introduction, they bring attention to the chain; unlike, say, Cool Ranch Doritos Tacos, they shift perception of the brand toward virtue.”

Of course, the problem is not limited to fast food, with sugary drink brands suddenly advertising their nutrition. At least now consumers will have more information to make healthier choices. Obamacare requires chains with more than 20 locations to post calorie counts on their menus.

For the bulk of the 20th century, Big Tobacco reigned supreme in the advertising world. Through aggressive marketing on billboards, magazine covers, television, radio, and corporate and celebrity sponsorship, cigarette manufacturers successfully hooked half of all American males and a quarter of American females in the 1950s and ’60s on cigarettes — a corporate coup whose adverse health effects are being felt to this day.

But just because the tobacco lobby’s stranglehold on Washington has somewhat subsided over the last several decades doesn’t mean that its marketing strategies have been left to the dustbin of history. To the contrary, manufacturers of some of America’s most medically harmful commodities — including processed foods and indoor tanning beds — take their advertising campaigns straight from Big Tobacco’s playbook. Unfortunately for Americans, the combination of these successful marketing strategies and the products’ addictive qualities make it extraordinarily difficult for consumers to change their lifestyles — even when the commodity in question makes them sick. For instance, somewhere between 14 and 20 percent of smokers who develop lung cancer continue to smoke even after being diagnosed with the disease.

Here are three Big Tobacco marketing strategies that food makers and tanning salons mimic in an effort to achieve that level of brand loyalty:

1. Gaining users’ trust through the use of authority figures.

This is perhaps the tobacco industry’s most infamous marketing tactic from the mid-20th century. In numerous television advertisements from the era, cigarette ads prominently featured doctors and nurses winding down from a long day of work with a smoke. Camel even had an ad claiming that “more doctors smoke Camels than any other brand.” The appeal to authority inherent in this tactic is extremely successful, as consumers react by assuming that the product use is medically safe.

Doctors have long ditched the likes of Philip Morris — but food makers and tanning salons use this same appeal to authority in this day and age. According to a landmark 2010 study in the Journal of the American Academy of Dermatology, researchers compared tanning marketing techniques to those used by tobacco distributors in the 1950s and found striking similarities — specifically, the use of physicians and faulty medical research downplaying health risks in their ads. “The thinking behind these ads is that if physicians do something, then somehow it must be okay,” said study author Dr. David Jones. “However, these ads omit the results of a recent survey indicating that 100 percent of dermatologists and 84 percent of non-dermatologist physicians would discourage UV tanning for non-medical purposes, even in healthy patients.”

While the food industry is a bit more hard-pressed to find doctors willing to peddle products high in salt, sugar, and fat, they compensate through corporate sponsorship with athletes and sports organizations. For instance, McDonald’s alone is affiliated with the National Hockey League, the Olympics, the FIFA World Cup, and has had a line of athletes ranging from Kobe Bryant to Venus Williams as its spokespeople.

Read more

In an attempt to lower health care costs, employers are getting creative with new initiatives to encourage their workers to make healthy choices. CVS made headlines last month when the national chain announced a new policy to require its employees to report their weight or pay a fine. Other companies, like Whole Foods, attempt to incentivize their workers to lead healthier lifestyles by offering discounts to employees who weigh less.

Now, a new online tool hopes to provide yet another service for employers who are experimenting with these types of worker wellness initiatives. NutriSavings will allow employers to give their workers coupons based on their grocery purchases — in the same way that a grocery store loyalty card can track purchases and offer rewards. The NutriSavings system can track what types of food that people are buying and score those purchases along a nutritional quality scale, offering discounts for healthier alternatives to those who are scoring low and coupons for the same kind of healthy foods to those who are already achieving high scores:

“Your boss will never know what you’re eating,” says NutriSavings CEO Gerard Bridi, who says NutriSavings is an opt-in program.

But employers do get to see aggregate data on how healthily their workers are shopping. At NutriSavings, for example, Bridi says employees can get up to $30 cash back per month through the program on the purchase of fresh fruits and vegetables. If despite that perk, the collective nutrition score of employee grocery choices still comes in low on a scale of 1 to 100, the company can tweak the benefit to encourage them to put more produce in their carts.

According to Bridi, the economic incentive for companies and insurers to get more involved in their workers’ eating habits is plain. Most health care spending goes to treat chronic diseases, many of which are preventable through better lifestyle and diet choices.

According to Bridi, NutriSystem isn’t just about offering economic rewards; it’s actually designed to re-educate people’s approach to healthy eating. Workers will have to regularly return to the NutriSystem site in order to access their coupons, and that site will present them with other resources to help encourage better nutrition — including articles on healthy eating, and links to healthier alternatives for their recent grocery purchases.

Regardless of big companies’ concern with their bottom lines, that type of preventative strategy could go a long way to curb health costs in the United States. The sharp rise in diabetes rates, largely fueled by the nation’s ongoing obesity epidemic, is currently the bigger driver of U.S. medical costs.

And as long as American workers don’t resent a perceived intrusion into their grocery carts, focusing on changing individuals’ own decisions may be a more politically viable public health initiative than regulating the food industry itself. Some lawmakers — most notably, New York Mayor Michael Bloomberg (I) — have attempted to take steps to address obesity rates by regulating the food and beverage industries, but those legislative efforts have so far been met with significant resistance.

According to researchers from the American Heart Association (AHA), a staggering 80 percent of U.S. teens have diets high in salt, sugar, and fat, but low on fruits and vegetables — placing them squarely on the road to developing heart disease.

Study author Christina Shay of the University of Oklahoma Health Sciences Center told NBC News that those unhealthy eating habits are exacerbated by a lack of exercise. “The far less-than-optimal physical activity levels and dietary intake of current U.S. teenagers, is translating into obesity and overweight that, in turn, is likely influencing worsening rates of high blood pressure, high cholesterol and blood glucose at these young ages,” she said. According to the report:

Fewer than 80 percent scored well on diet. Just 1 percent met the ideal guidelines of 4.5 or more cups a day of fruits and vegetables, two servings of fish a week, 3 ounces a day of whole grains, less than 1,500 mg of salt a day and no more than 450 calories worth of sugar-sweetened drinks a week.

Only 45 percent scored acceptably on five or more of the factors. Only 44 percent of girls and 67 percent of boys reported ideal physical activity levels. Just two-thirds had ideal weights.

A third already had unhealthy cholesterol levels or were on the way there, the report found. The good news came on blood pressure – 90 percent of the girls and 78 percent of the boys had healthy blood pressure. And 66 to 70 percent had never tried smoking.

While plummeting smoking rates among U.S. teens have been a signature public health success story, childhood obesity remains a stubborn hurdle to improving Americans’ wellness and reducing national health expenditures. A February study by the Centers for Disease Control found that, while American children reduced their overall caloric intake between 2009 and 2010, the proportion of fat making up their diet was still above recommended levels. Even worse, children who were already obese were among the groups that ate the most unhealthy foods, highlighting the reality that ingrained dietary behavior is extremely difficult to change.

These childhood behaviors have long-lasting consequences, as lifelong chronic illnesses such as obesity, diabetes, and heart disease take root at a young age. In March, a team of Harvard researchers found that sugary drinks commonly peddled to youth were linked to 180,000 worldwide deaths every year, and excess salt consumption was responsible for one in 10 American deaths in 2010. But perhaps the latest AHA numbers shouldn’t be surprising, given that almost all “kids’ meals” at affordable chain restaurants flunk healthy nutritional standards and fast food establishments like McDonald’s use misleading ad campaigns to make their products appear to be healthy.