By Gary Ruskin
Issue 121: November/December 2003
Early in the 20th century, urban squalor was emerging as an unsettling fact of American life, and there was great concern in the US over undernourished children. "At least one-third of all industrial families in the United States are underfed," concluded one 1911 study of Americans' standard of living.1 Nervous parents measured their kids against weight and height charts. Public health officials sounded a continuous alarm. Dr. Josephine Baker, head of New York City's Department of Health, worried that malnutrition was "the most serious and widespread physical defect found among school children."2 These concerns continued into the Great Depression, and gave rise to the National School Lunch program, among other measures. Combined with the general prosperity that followed World War II, these measures were a stunning success. In 1955, a government expert wrote that the evidence "supports the conclusion that the nation as a whole is fairly well fed."3
There are still malnourished kids today. But in recent decades the malnourishment problem has been eclipsed by an opposite one: fat kids. Kids who eat too much and don't exercise enough. Kids, in short, who are sadly obedient to the commercial messages that besiege them, literally, from morning till night.
The rise of childhood obesity in America is part of a larger story: how corporations have laid claim to children's imagination and play-to childhood itself. In the process of redefining children as "consumers," as the open maws at the end of a giant marketing machine, corporations have redefined as well the nature of childhood disease. Increasingly, our children suffer not from the results of infection or lack, but from the role the commercial culture has assigned them-from occupational illness, one might say.
Of these occupational illnesses of childhood, obesity is probably the greatest. Certainly it is the most apparent, as a visit to just about any elementary school or mall will confirm. Depending on how you measure it, between 15 and 24 percent of American children are overweight-a threefold increase since the early 1970s.4 "The No. 1 health problem in the United States is not SARS," said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC). "It is not emerging infectious diseases. It is the epidemic of obesity that we are watching unfold before our very eyes."5 Adds James Hill, director of the Center for Human Nutrition at the University of Colorado Health Sciences Center, "If these trends continue, within a few generations every American will be overweight."6
The Tragedy of Childhood Obesity
The epidemic of childhood obesity is a tragedy for many reasons, and portends poorly for the health of our entire nation in the coming decades. Obese children have a low quality of life; the quality of life of severely obese children is similar to that of kids with cancer.7 Obese children also have a strong predisposition to become obese adults, with a greater likelihood of developing a battery of serious chronic diseases, including diabetes, cardiovascular disease, and in the end, shorter life spans.
The obesity epidemic has spawned an epidemic of diabetes. The CDC recently warned that, if current trends continue, one in three Americans born in 2000 will develop diabetes. If the CDC's predictions are correct, 45 to 50 million Americans could have diabetes by 2050, according to Dr. Kevin McKinney, assistant professor of endocrinology at the University of Texas Medical Branch in Galveston. "There is no way that the medical community could keep up with that," he said.8
The obesity epidemic and its effects are striking younger and younger children. Amazingly, the warning signs of strokes and heart attacks can be detected even in children as young as two years.9 Type 2 diabetes, once known as "adult-onset" diabetes, now afflicts adolescents and even children. When these children grow up, they will face complications such as amputations, blindness, heart attacks, and kidney failure. Pediatricians think that the rise in type 2 diabetes can be attributed almost entirely to the obesity epidemic.
Why Childhood Obesity Came to the US
How did this happen? America is the richest nation in the world, and therefore should be the healthiest. How has it instead concocted a new epidemic to spread among its children? Though the forces had been gathering for decades, they came into full bloom in the 1970s, when the trend line of childhood obesity began to rise steeply.
Source: National Center for Health Statistics, Centers for Disease Control and Prevention, Prevalence of Overweight Among Children and Adolescents: United States, 1999-2000.
There are many causes. Most children today sit too much and play too little. They spend too much of the day riding in cars and staring at video screens. They eat food designed for the health of corporate balance sheets rather than the health of children's bodies. But under all of this runs the persistent theme of how corporations have insinuated themselves into virtually every corner of children's lives, and written the master script for children's interactions with their own families and with society at large.
There was a time, not that long ago, when parents decided what and when their kids ate. Today that seems a fond memory, even nostalgia. Parents find themselves increasingly on the defensive, fending off, deflecting, combating, and all too often making grudging compromises with the cravings that corporate marketers conjure in their kids. In the case of food, those cravings generally are for things that parents wish their children didn't want, and with good reason: almost without exception, they are foods that might as well have been specifically designed to make kids fat.
The assault began after World War II, but not until the 1970s did its physical effects on children began to become unmistakable. It was then that the marketing itself reached a point of critical mass.
The corporate redefining of childhood employed four main tools: television, the marketing of junk food, the commercial takeover of the schools, and the starvation of the public sector. These invasions of children's lives took place at a time when children were increasingly vulnerable because their parents were working more, and there were more single-parent families and less supervision at home.
Television and Obesity
Television literally is an obesity machine-both because of what it shows and the way it affects children's lives. It gives advertisers a way to walk through the front door of the home and speak directly to children. The average American child watches 19 hours and 40 minutes of TV per week-more than a thousand hours each year.10 That means an annual exposure to thousands of commercials for junk food and fast food. Then there's all the lost playtime-during those 20 hours each week, children aren't physically active. Medical research confirms just what you'd expect: the more TV children watch, the more likely they are to be overweight.11 "We are literally living ourselves sick, and television plays a large role in this downward spiral," wrote Mohammad N. Akhter, MD, when he was executive director of the American Public Health Association.12
Not surprisingly, childhood obesity is worse in some minority communities. Part of the reason is that African American children watch more TV on average than do other children. African American teens watch 40 percent more primetime TV and nearly twice as much daytime TV as other teens.13 They do so in part because they are more likely to live in places where it's unsafe to play in the park or the street. They also often receive less adult supervision, which means more opportunities for corporate marketers to intrude on their lives. And kids who have the least are the most impressionable, because they naturally hunger for what they lack. That means, among other things, burgers, fries, chocolate shakes, and soft drinks.
It is no dark mystery to parents that ads have an effect. Even the cautious federal science bureaucracy has acknowledged this to some degree. For example, back in 1977, the National Science Foundation concluded that advertising is "at least moderately successful" in creating "desire for the products advertised."14 When junk-food companies realized the power that TV marketing has over children, they invested heavily in it; the resultant rise in the marketing of junk foods was coextensive the rise in childhood obesity.
What is noteworthy-and utterly revealing-about advertising to children is that it almost always is for things most parents would not themselves choose for their kids, especially in regard to food. Turn on Saturday-morning TV: How many ads do you see for nutritious foods? In 1978, the Federal Trade Commission concluded that "The largest single part of the television advertising addressed specifically to children is for sugared foods."15
It has long been understood that young children are especially vulnerable to marketing messages. "Many young children-including an apparent majority of those under the age of eight-are so naïve," concluded the Federal Trade Commission in 1978, that "they cannot perceive the selling purpose of television advertising or otherwise comprehend or evaluate it and tend . . . to view commercials simply as a form of 'informational programming.' "16
But even PBS helps market junk food to our youngest children. In recent years, Teletubbies, a PBS television program targeted to toddlers, has made cross-marketing deals with McDonald's and Burger King, both of which sell high-calorie fast food. "Teletubbies was a great promo partner," gushed Cindy Syracuse, then Burger King's manager for youth and family marketing.17
Marketing Junk Food and Soft Drinks to Kids
McDonald's first national ad campaign, in 1967, was an unexpectedly huge success: 10 million kids wrote in to pick floats for Macy's Thanksgiving Day Parade. From then it was off to the races. McDonald's advertising director put this battle cry on his wall: "Early to bed / Early to rise / Advertise / Advertise / Advertise."18 Since then, McDonald's has been masterful in its use of beloved characters to sell its high-calorie fast food. Among others, McDonald's has employed Winnie-the-Pooh, 101 Dalmatians, Nemo, Furby, Tarzan, and Beanie Babies to sell its Happy Meals.
Fast-food marketers such as McDonald's and Burger King have reshaped the diets of American parents and kids, and the rise in fast-food consumption has paralleled the boom in the incidence of childhood obesity. Between 1977 and 1995, the percentage of meals and snacks eaten at fast-food restaurants doubled. This has been especially devastating to the health of children. Because fast food is typically so high in sugar, fat, and calories, these meals can quickly add pounds to a kid's waistline. In a study published in the International Journal of Obesity, researchers found that, compared to adolescents who did not eat at fast-food restaurants, boys and girls who ate fast food three times in the previous week had astoundingly higher calorie intakes: 40 and 37 percent, respectively.19
The increase in soft-drink consumption has been similarly damaging to children's health. Between 1977 and 1996, soda consumption among 12 to 19 year olds increased 75 percent for boys, 40 percent for girls.20 According to a study in The Lancet, for each can of soda drunk each day, a child is 1.6 times more likely to become obese, all other things held constant.21
Soft-drink companies use every trick in the book to hook kids on their high-sugar, caffeinated products. Coca-Cola and PepsiCo have been especially effective in marketing to children. Coca-Cola paid Warner Bros. an estimated $150 million for global marketing rights for the film Harry Potter and the Sorcerer's Stone.22 "The Coca-Cola Company recognized the wealth of possibilities inherent in [Harry Potter] for engaging the world's adults and children," explained Brad Ball, then President of Domestic Marketing for Warner Bros. Pictures, now Warner Bros. Entertainment. 23 Product placement, too, is great at implanting brands in the minds of children. When the movie E.T. The Extra-Terrestrial featured E.T. eating Reese's Pieces, sales of the candy shot up 65 percent; Hershey, maker of Reese's Pieces, had to put two factories on 24-hour production schedules to meet the demand.24
Product placements can now be found in nearly every medium children watch, and have taken over commercial television. Coca-Cola has been heavily featured in product placements on American Idol and the teen-targeted, short-lived Young Americans, which the New York Daily News called "a slick, thinly disguised commercial" for Coke.25 Pepsi is featured heavily in the WB network show Pepsi Smash, and Mountain Dew was showcased in the CBS reality shows Survivor and Survivor II.
Product placements have even spread throughout children's books. Junk foods now featured in children's books include Hershey's chocolates, M&M's, Froot Loops, Reese's Pieces, Oreo cookies, and Skittles. "It's not that these books resemble advertising-they are advertising," said Kate Klimo, vice president and publisher of Random House Books for Young Readers.26
The Commercial Takeover of the Schools
Years ago, public schools used to be places where good nutrition was taught. For example, in the 1920s, as a part of the home economics movement, millions of schoolchildren were taught about proper nutrition, and which foods contained the nutrients they needed to grow.27
To counteract this, junk-food marketers tried to invade the schools, but for decades their presence was relatively insignificant. Still, they had some successes. For example, a Texas Coke bottler bragged in 1931 about how "the kids play basketball at recess on Coca-Cola goals," he wrote, "use Coca-Cola blotters to blot out their troubles, consult a Coca-Cola thermometer, and write their notes on Coca-Cola tablets. Can you beat that?"28
The curriculum of junk nutrition began in earnest in 1989, with the launch of Channel One, an in-school TV marketing program. Chris Whittle, Channel One's founder, had the ingenious idea of harnessing the schools to show daily 12-minute TV broadcasts that included two minutes of ads. Since then, Channel One, now owned by Primedia, has been adopted by 12,000 schools. About 8 million children watch its ads for Pepsi, Mountain Dew, Hostess Twinkies, M&M's, Snickers, and the like.
"Channel One is the most effective way that junk-food marketers have gotten to children, because of the captive audience and the impact of watching it with your peer group," explains Jim Metrock, president of Obligation, Inc. According to a study by Obligation, during the past five school years, 27 percent of Channel One's ads were for junk food or soda pop.29
Schools have become a paradise for junk-food marketers. Vending machines stocked with candy and soft drinks are rife: Nearly 19 out of 20 high schools have vending machines that sell soda, while nearly 60 percent of elementary schools do. More than 70 percent of high schools sell chocolate candy in vending machines.30
Hundreds of school districts have signed marketing contracts in which a school district promises exclusive access to Coke or Pepsi in return for extra cash. Incredibly, these contracts often include financial incentives for school districts to sell more Coke or Pepsi. These schools have become soda pushers.
Nor is it only public schools that are putting themselves up for sale; leading organizations, too, are getting into the act. The venerable National PTA, which for more than a century has promoted the health of children, now lists Coca-Cola Enterprises as a "proud sponsor."'
"Corporate sponsors are not new to nonprofits, but they are fairly new to us," then-PTA President Shirley Igo told the Washington Post. "We really need them. Our budget is very thin and if we didn't have them, we wouldn't be able to develop new programs."31
Even worse, Coca-Cola Enterprises' senior vice president for public affairs, John Downs, Jr., was recently appointed to serve as an at-large member on the National PTA's Board of Directors. Downs is the point man for Coca-Cola Enterprises regarding the marketing of soft drinks to kids in schools.32 In effect, the National PTA is now run, in part, by Coca-Cola.
Such corruption isn't limited to the National PTA. Even some dentists have gotten their own Coke deals. The American Academy of Pediatric Dentistry (AAPD) recently received a $1 million contribution from the Coca-Cola Foundation.33 "I'm surprised that AAPD is willing to be co-opted in this way, and for relatively little money in the scheme of things. The Academy's leadership should resign," said Michael Jacobson, executive director of the Center for Science in the Public Interest.34
It's no surprise that companies will pay so much to advertise in schools. Advertisers know that their presence in the schools can pay off for years, if not decades, if they can hook kids for life on their products. Schoolchildren are "a captive audience and in a world where kids are torn between the Internet, [instant messaging], sports, TV and radio, school is the place where marketers can find them in an uncluttered environment," said Tom Harris, vice president of sales and marketing for the National Theatre for Children, which helps corporations market to children in elementary and middle schools.35
Fast-food companies, too, now have a big presence in the schools. It's a great way for them to bypass parents and promote their high-fat products to children. At least one out of every five schools now contains a fast-food outlet.36
The President is AWOL
Years ago, US presidents cared about the health of American children and strove to improve it. When he signed the National School Lunch Act into law in 1946, Harry S Truman said that "no nation is any healthier than its children." Later that year, Truman expanded on this theme: "The well nourished school child is a better student. He is healthier and more alert. He is developing good food habits which will benefit him for the rest of his life. In short, he is a better asset for his country in every way."
You'd think that would be a sentiment that President Bush could embrace. He is, after all, an avid athlete, a poster boy for physical fitness. He runs three miles a day, six days a week, at an impressive pace for his age. He lifts weights, and can bench-press five reps of 185 pounds. Again, impressive. But the Bush Administration has done little to counter the epidemic of childhood obesity. It is more devoted to its friends-and big campaign donors-in the junk-food industry than it is to our kids. For example, when the CDC launched "Verb Now," their $125 million "anti-obesity" campaign, they chose as their partners the same big-media companies that are pushing fatty foods and couch-potato habits on the nation's kids: AOL Time Warner, Viacom, Primedia, and others. For their lead ad agency, the CDC chose the Publicis Groupe's Frankel division, despite the fact that Publicis has an advertising contract with McDonald's. Given such conflicts of interest, it's not surprising that the campaign is ineffective. The ads are based on the ridiculous premise that one can motivate children to exercise by talking about grammar. Carrie McLaren, a schoolteacher who showed a CDC ad to her students, explained that "None of the kids had any idea what the ad was about. They guessed maybe grammar or reading or after-school programs."
Last year, Health and Human Services Secretary Tommy Thompson even urged the junk-food lobby to wage war on those who would protect children from obesity. He told members of the Grocery Manufacturers Association (GMA) to " 'go on the offensive' against critics blaming the food industry for obesity," according to a GMA news release.37 GMA members include such major junk-food companies as Coca-Cola, Mars, PepsiCo, and Philip Morris.
The Heavy Consequences of the Bush Tax Cuts
The Bush Administration has been eager to cut taxes, especially for the wealthy, who are its most generous campaign donors. Budget deficits are up and tax revenues are down. The net effect has been to drain federal, state, and local governments of funds. This will likely have a big effect on our children's waistlines.
Schools need money to keep kids thin. The national school-funding crisis makes schools more likely to sell out to the marketers of soft drinks, junk food, fast food, and Channel One. And when budget cuts hit a school, one of the first things to go is physical education. Daily phys-ed classes in grades 9 through 12 have already declined, from 42 percent in 1991 to 32 percent in 2001.38
Fiscal crises hurt local police, too, which in turn abets the junk-food marketers. When police are scarce, many kids no longer have safe nearby parks and streets to play in. Parents keep their kids indoors, gazing at the TV and its junk-food ads.
What You Can Do
There's plenty that parents and citizens can do to stop the epidemic of childhood obesity. Start with what you can do in your own household:
Minimize TV watching. Put the TV set in the closet, the attic, or somewhere else out of the way, far from an electrical outlet.
Don't buy soft drinks, junk food, or fast food.
If you do those two things, your kids will likely stay healthy and never become overweight. (The same will be true for you, too, of course.)
But to stop the childhood obesity epidemic, we must get rid of the powerful government policies that promote it. It's time for the government to side with parents, and not with the junk-food companies who want to hook their kids for life on their high-calorie products. "Our politicians need to find the courage to stand up to corporations that are selling our children shortened lives," explains Gerald Haas, MD, an assistant professor of pediatrics at Harvard Medical School.39 That means starting in the schools. Most kids eat about one-quarter to one-half of their meals in school. By improving what schools feed to children and stopping schools from marketing junk food, we'll go a long way toward halting the childhood obesity epidemic.
This is happening all over the country. We're winning. Parents are ridding the schools of junk-food marketers. (See sidebar, "Recent Victories.") The single best thing you can do is to tell your school-board members and state legislators to implement the Childhood Obesity Prevention Agenda, which has been endorsed by dozens of top obesity researchers and prominent public health groups. (See sidebar, "Childhood Obesity Prevention Agenda for States, Municipalities, and School Boards.")
You can also encourage your Congressional representative to support the Parents' Bill of Rights (see www.commercialalert.org/pbor.pdf and the January-February 2003 issue of Mothering, no. 116), which would ban marketing to kids under 12, mandate disclosure of product placements, require chain restaurants to put calorie and nutritional information on labels, and revoke the tax subsidy that corporations receive for marketing to children.
Finally, healthy kids require healthy state, school, and municipal budgets. Those budgets buy good food for schoolchildren, hire gym teachers, build gym facilities, and keep parks clean and safe so that kids can play outside without their parents worrying about them.
If we're going to stop the childhood obesity epidemic, we've got to stop the fiscal policies that are starving federal, state, and local government of funds. That means repealing the Bush tax cuts and sending some of that money back to the states, cities, police departments, and schools that need it.
1. Frank Streightoff, The Standard of Living Among the Industrial People of America (Boston: Houghton Mifflin, 1911), quoted in Harvey Levenstein, Revolution at the Table: The Transformation of the American Diet (Los Angeles: University of California Press, 2003), 113.
2. Harvey Levenstein, Revolution at the Table: The Transformation of the American Diet (Los Angeles: University of California Press, 2003), 114-115.
3. Margaret Reid, "Food, Liquor, and Tobacco," in J. Friedrich Dewhurst et al., eds., America's Needs and Resources (New York: Twentieth Century Fund, 1955), 165-166. Quoted in Harvey Levenstein, Paradox of Plenty: A Social History of Eating in America (Los Angeles: University of California Press, 2003), 135.
4. Cynthia Ogden et al., "Prevalence and Trends in Overweight Among US Children and Adolescents, 1999-2000," Journal of the American Medical Association 288 (9 October 2002): 1728-1732. Richard P. Troiano and Katherine M. Flegal, "Overweight Children and Adolescents: Description, Epidemiology, and Demographics," Pediatrics 101, no. 3 (March 1998): 497.
5. "Commencement Speeches a Part of Graduation Day," CBS Morning Show, 9 June 2003.
6. Carol Lynn Mithers, "From Baby Fat to Obesity: Why Kids Even as Young as 2 Are Developing Weight Problems," Parenting, October 2001.
7. Jeffrey B. Schwimmer et al., "Health-Related Quality of Life of Severely Obese Children and Adolescents," Journal of the American Medical Association 289 (9 April 2003): 1813-1819.
8. "CDC Issues Diabetes Warning for Children," Diabetes Week, 7 July 2003.
9. Ron Winslow, "Heart Disease Hits the Preschool Set: New Research Shows Warning Signs Begin in Early Childhood," Wall Street Journal, 18 March 2003.
10. Nielsen Media Research, "2000 Report on Television": 14.
11. Ross E. Andersen et al., "Relationship of Physical Activity and Television Watching with Body Weight and Level of Fatness Among Children," Journal of the American Medical Association 279, no. 12 (25 March 1998): 938.
12. Mohammad N. Akhter, "Another Reason to Turn the Television Off," Baltimore Sun, 6 May 1999.
13. Nielsen Media Research, "2000 Report on Television."
14. "Research on the Effects of Television Advertising on Children: A Review of the Literature and Recommendations for Future Research" (Washington: National Science Foundation, 1977), i.
15. "FTC Staff Report on Television Advertising to Children," Federal Trade Commission (February 1978): 2.
16. Ibid.: 1.
17. Louise Kramer, "McD's Steals Another Toy from BK; Teletubbies Set Move to Top Chain as 'Toy Story'-Pokemon War Looms," Advertising Age, 15 November 1999.
18. Max Boas and Steve Chain, Big Mac: The Unauthorized Story of McDonald's (New York: New American Library, 1976), 106-109.
19. S. A. French et al., "Fast Food Restaurant Use among Adolescents: Associations with Nutrient Intake, Food Choices and Behavioral and Psychosocial Variables," International Journal of Obesity 25 (2001): 1823-1833.
20. Michael F. Jacobson, Center for Science in the Public Interest, "Liquid Candy: How Soft Drinks Are Harming Americans' Health." Citing US Department of Agriculture Nationwide Food Consumption Survey, 1977-78; Continuing Survey of Food Intakes by Individual, 1987-88, 1994-96.
21. David Ludwig et al., "Relation between Consumption of Sugar-Sweetened Drinks and Childhood Obesity: A Prospective, Observational Analysis," The Lancet 357 (17 February 2001): 505-508.
22. Henry Unger, "Coca-Cola Looks for a Little Magic to Rub off from Harry Potter Film," Atlanta Journal Constitution, 20 February 2001.
23. "The Coca-Cola Company and Warner Bros. Pictures to Share the Magical Experience of Reading with 'Harry Potter and the Sorcerer's Stone,' " Coca-Cola-Warner Bros. news release, 20 February 2001.
24. Vernon Scott, " 'E.T.' Invades Five More Continents," United Press International, 6 November 1982.
25. Eric Mink, "WB Yet Again Leans on the 'Young' & Clichéd,' " New York Daily News, 12 July 2000.
26. David Kirkpatrick, "Snack Foods Become Stars of Books for Children," New York Times, 22 September 2000.
27. See Note 2: 156-157.
28. Mark Pendergrast, For God, Country and Coca-Cola (New York: Collier Books, 1993), 182.
30. "Fact Sheet: Foods and Beverages Sold Outside of the School Meal Programs," School Health Policies and Programs Study, Centers for Disease Control and Prevention (2000): www.cdc.gov/nccdphp/dash/shpps/factsheets/fs01_foods_sold_outside_school.htm.
31. Caroline E. Mayer, "PTA Turning to Corporate Sponsors for Funds; Donation From Coca-Cola to National Group Opposed by Some Parents," Washington Post, 21 June 2003.
32. Scott Leith, "Coca-Cola Enterprises Defends Presence in Schools," Atlanta Journal Constitution, 6 April 2003.
33. Marian Burros, "Dental Group is Under Fire for Coke Deal," New York Times, 4 March 2003.
34. "Pediatric Dentists Accused of Selling Out to Coke," Center for Science in the Public Interest news release, 4 March 2003, www.cspinet.org/new/200303041.html.
35. Caroline Mayer, "A Growing Marketing Strategy: Get 'Em While They're Young; Firms Sponsor School Activities and Books," Washington Post, 3 June 2003.
36. See Note 30.
37. "Top Administration Officials Brief GMA Board: Thompson, Hubbard, McClellan Give Views," Grocery Manufacturers Association news release, 12 November 2002, www.gmabrands.com/news/docs/NewsRelease.cfm?DocID=1028&.
38. Youth Risk Behavior Surveillance System, Centers for Disease Control and Prevention, www.cdc.gov/nccdphp/dash/yrbs/.
39. Gerald Haas, MD, "Fast Food, Fat Kids," Boston Globe, 23 December 2002.
For more information about children as consumers, see the following articles in past issues of Mothering: "Why They Whine: How Corporations Prey on Our Children," no. 97, and "Raising Children Free of Food and Weight Problems," no. 52.
Gary Ruskin, email@example.com, is executive director of Commercial Alert, a nonprofit organization that protects children and communities from commercialism. Commercial Alert has extensive materials on childhood obesity on its website, www.commercialalert.org