Professor Kelly Brownell, an expert on obesity and junk food from Yale University, presented a keynote address at this year’s APS Conference. This led to a flurry of media interest during his stay in Australia. APS senior researcher in the Public Interest team, Dr Susie Burke FAPS, did some background research to find out more about what’s got people so interested.
The buzz at the 46th APS conference in Canberra this year was around Professor Kelly Brownell’s keynote presentation – Causes and prevention of obesity: Is there the courage for change? In some ways it was a sort of sugar drink buzz, Professor Brownell being the psychologist kicking the hornets’ nest of the junk food industry with his proposed soft drink taxes, and worse.
Professor Brownell, who in 2006 was named by Time Magazine as one of the 100 most influential people in the world, is the Director of Yale University's Rudd Centre for Food Policy and Obesity in America. Brownell’s field is obesity. He has studied its driving factors for many years and has a set of disturbing data to prove just how in the thrall of foods that are high in fat, sugar and salt we are. This is a man who can set a conference buzzing, who gets governments twitching, and who can send the multi-million dollar fast food industry into an agitated state. What a treat it was to have him at the APS Conference – and how timely that the Conference took place in the national capital at the same time as the Federal Government’s Tax Summit! Brownell’s keynote presentation generated a huge amount of media interest, and he subsequently appeared for an interview on the ABC’s Lateline (www.abc.net.au/news/2011-10-19/professor-brownell-predicts-junk-food-regulation/3580266).
In his Australian presentations, Brownell made a compelling argument about how perverted the whole food system has become. Food companies work with scientists to figure out how to trigger the brain to want certain food, or respond to advertising for those foods. Brain imaging studies reveal powerful effects of substances like sugar on the brain. The effects resemble those of classic substances of abuse – not as strong, but evident nonetheless. Experiments show rats displaying withdrawal symptoms after eating junk food. Further, studies with rats that have become habituated to both cocaine and sugar show that 90 per cent of rats chose sugar over cocaine just about every time. Much food is now a concoction of chemicals. “We don’t know if these chemicals are safe, we don’t know how they work on the brain, but they are put in foods with abandon”, Brownell says. Foods are manipulated chemically to make us want more and more, and so we eat them – and want more and more. Food marketing is powerful, relentless and exploitative.
Taking on the fast food industry
A logical next step following from Brownell’s years of research has been to take on the fast food industry: fat taxes, sugar drink taxes, and ultimately, legal action for promoting foods with high levels of fat, sugar and salt. Could the food industry be held legally liable and financially culpable for intentional manipulation if these ingredients highjack the brain? Brownell is confident: “When this happens, this will change the world to be”, he says.
So how does a psychologist get from researching the drivers of obesity, to fat taxes and legal action? Brownell’s work is a wonderful example of psychologists moving from the laboratory into the field of public policy.
Traditionally, obesity prevention reveals a core philosophical tension between individual freedom and government actions designed to promote public welfare. On the one hand, a model emphasising personal responsibility identifies the causes of obesity as lying within the individual (e.g., biological factors and personal eating choices). To date, the efforts extending from this model have yielded insufficient success in stemming the childhood obesity epidemic. Brownell points out that nearly 30 years of work at this individual level (Australian examples are Life Be In It campaigns and education about healthy food pyramids) have hardly made a dint in the obesity epidemic. On the other hand, a public health model places more emphasis on environmental causes of obesity (e.g., sedentary lifestyles, obesegenic environments, socially irresponsible industries). These different models entail different ideas about how each problem should be addressed.Under the personal responsibility model, treatment focuses on education, self-control, and motivating ‘lifestyle’ and behavioural change, while in the public health model prevention and policy changes are key.
‘Optimal defaults’ model
Brownell uses an ‘optimal defaults’ model which he described in his APS keynote address. This model represents a compromise between the two models described above; public policies can determine what the optimal default positions are, yet the choice remains with the individual to opt out. The term optimal defaults describes conditions that promote beneficial or healthy choices as the default option. Rather than focusing on changing people’s behaviour one person at a time, good public policy makes positive changes in the environments that support particular behaviour patterns. For large scale effectiveness, this sort of intervention is much more successful. Practising more healthful behaviour becomes the optimal default – that is, choosing a more healthful behaviour becomes easier, if not automatic.
Brownell gave the example of organ donation. An optimal default could be created if people are automatically signed up for organ donation at the time of getting their driver’s licence. If people do not want to donate their organs, they need to request to opt out. In countries where optimal defaults have been used, this has changed the sign-up for organ donation from around 10 per cent to over 90 per cent. (In Australia, where the model is encouragement to opt in, the rate is less than 15 per cent.) Brownell pointed out that no public education campaign could ever hope to achieve such a massive swing in collective behaviour. At the APS Conference, you could practically hear the cogs turning – an auditorium full of psychologists from diverse areas all thinking about how they could improve uptake of their own interventions and increase success rates by using optimal defaults too!
Currently, our diet, and that of many other developed countries is driven by disastrous defaults: large portions, too much access to fast food, aggressive marketing of foods high in sugar, salt and fat directed at children, and economic policies that make healthy food cost more than high calorie highly processed foods. These defaults have a devastating effect on our health and wellbeing.
In eating terms, people respond to environmental defaults, which mean they will eat foods that are most easily available, least expensive and most heavily marketed. If the school canteen serves junk food, school children will eat junk food. If the school canteen serves healthy food, children will eat healthy food. If the only sized bottle of Coke in the dispenser is 1 litre, we will drink a litre. (Did you know that the standard or default size of a bottle
of Coke 50 years ago was 500ml? And check the size of your dinner plates with any remnants you still have in your cupboard from the 1970s.)
Optimal defaults to tackle obesity include things like reducing food portions, shrinking standard sizes of soft drinks and confectionery, reducing the amounts of sugar, salt and fat included in processed food, making low fat milk the default option for takeaway coffees and curtailing aggressive junk food advertising. Denmark just recently became the first country to impose a ‘fat tax’, increasing the cost of foods containing saturated fats.
Sugar taxes: a perfect target for change
Brownell’s current favourite food tax is a soft drink tax, and this is the main focus in the USA at the moment, with several States considering legislation. Soft drinks are the single greatest source of added sugar in the average person's diet. They have absolutely no nutritional value, are marketed aggressively and are linked with the risk for obesity and diabetes. Indeed, Brownell concludes that sugar sweetened drinks may be the single largest driver of obesity, which makes it a perfect target for change.
According to Brownell, the effect on taxing drinks can be estimated through research on price elasticity. When you know the price elasticity for soft drinks you can work out the effect of a tax on consumption. In his keynote address, Brownell explained that in the US a national ‘penny per ounce tax’ would lead to a decrease in consumption of 10 to 23 per cent. Further, he estimates that this would reduce health costs by $50 billion a year, and generate $150 billion revenue over 10 years. Comparable research into cigarette smoking shows that taxes have been the strongest influence on falling rates of consumption.
Conclusion
The media coverage received by Professor Brownell’s APS Conference keynote address was not surprising, coinciding as it did with the Federal Government’s Tax Summit. Brownell estimated that in Australia a penny per ounce tax would bring in $953,648,000 revenue over 10 years. Both the Prime Minister and the Opposition Leader subsequently found themselves vehemently denying that there were any plans afoot to introduce a soft drink tax in Australia. One can only wonder who was concerned enough to lobby the politicians so quickly, although Brownell did note in passing that junk food industries never oppose healthy eating or exercise campaigns – because they know they aren’t effective enough to threaten their markets.
Further reading
- Brownell, K.D., & Frieden, T.R. (2009). Ounces of Prevention:
The Public Policy Case for Taxes on Sugared Beverages. New
England Journal of Medicine, 360(18), 1805-1808.
- Brownell, K.D., Farley, T., Willett, W.C., Popkin, B.M., Chaloupka, F.J., Thompson,J.W., Ludwig, D.S. (2009). The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages. New England Journal of Medicine, 361(16), 1599-1605.