Solutions to obesity: perspectives from the food industry

¹ From ConAgra Foods Inc, Omaha, NE

² Presented at the symposium "Science-Based Solutions to Obesity: What Are the Roles of Academia, Government, Industry, and Health Care?", held in Boston, MA, March 10–11, 2004 and Anaheim, CA, October 2, 2004.

³ Supported by ConAgra Foods Inc.

⁴ Address reprint requests and correspondence to P Verduin, ConAgra Foods Inc, 6 ConAgra Drive, Omaha, NE 68102. E-mail: pat.verduin{at}conagrafoods.com.

ABSTRACT

Obesity has become an epidemic and an important public health concern. Because the problem is multidimensional, the solution will require an interdisciplinary approach involving the cooperation of the food industry with other stakeholders, such as the government, academia, and health care providers. The consumer is an important player in the solution to obesity because the consumer can make healthy lifestyle choices at the individual level. The food industry is committed to providing the consumer with healthy food options and reliable nutrition information.

Key Words: Food industry • obesity • consumer choices • consumer attitude • dietary decisions • food labeling • healthy products

INTRODUCTION

Obesity has reached epidemic proportions in United States. Currently, more than 65% of Americans are overweight or obese (1). Obesity is correlated with several medical conditions, including type 2 diabetes, heart disease, high blood pressure, stroke, and certain types of cancer. Obesity and its related diseases are responsible for 400 000 deaths per year in the United States, paralleling the number of preventable deaths caused by smoking (2). Overweight in pediatric age groups has nearly tripled in the past 30 y (3). Today, an estimated 16.1% of adolescents (12–19 y of age) in the United States are overweight (body mass index 95th percentile for age) (4). Studies indicate that 50–77% of these adolescents will become obese adults; 80% of those with one obese parent will do so (5-8). Data show significantly lower quality of life scores for obese children compared with children of normal weight (9). They also show increased risk of obesity-related comorbidities, including degenerative joint disease (10, 11) and type 2 diabetes (5, 12-14).

Obesity is a multifaceted health issue that involves biological, behavioral, and environmental sources. Energy imbalance sits at the core of the obesity problem, because weight gain results from consuming more calories than one expends. In America, a changing environment has increased food choices and changed eating habits. Many Americans are sedentary: more than one-half of US adults do not meet recommended levels of moderate physical activity, and one-fourth engage in no leisure time physical activity (15). Technological inventions have created many time- and labor-saving products. As a result, we have reduced the overall energy expenditure in our daily lives. Critical approaches to weight reduction involve behavior change related to diet and exercise. Stakeholders, including the food industry, government, academia, and health care providers, can work together to influence the consumer to make healthy lifestyle choices. ConAgra recognizes the influence the food industry has on consumer choices.

ROLE OF THE CONSUMER

Consumers are the most important player in the solution to the obesity epidemic because they make individualized choices about food and lifestyle. As stated by Philipson in this symposium (16), if the consumer can be influenced with comprehensible nutrition information and a variety of healthy food choices, perhaps individuals can begin to address weight gain on a personal level. In addition to cultural and psychological influences, four motivators have been identified that affect consumer decisions: taste, quality, convenience, and price. Although consumers indicate that healthy eating and good nutrition are increasingly important to them, sales and surveys show they are more concerned with taste, convenience, and price (17, 18). There exists a gap between consumer attitude and behavior that the food industry must consider. Moreover, consumers are confused with the conflicting messages regarding fat, carbohydrates, protein, and calories. Consumers need clarity and reliable nutrition information to make responsible dietary decisions.

ROLE OF THE FOOD INDUSTRY

The food industry should help the consumer make healthy food choices. Food manufacturers are sensitive to consumer tastes and expectations. Industry should be committed to giving clear, consistent, and honest product claims, as well as working with retailers and restaurants to offer consumers relevant information about the products they purchase. Industry should promote nutrition education at all levels, from public schools to medical schools, and enhance nutrition awareness at the consumer level. Industry can create new products that meet individual nutritional needs, reformulate existing products to be healthier, and provide controlled portion sizes. In doing so, industry faces the challenge of satisfying consumer expectations for taste, quality, and price. The hope is that industry can develop healthier products by partnering with science-based communities and the government.

INDUSTRY COMMITMENT TO HEALTHY LIVING

The food industry recognizes the challenges a consumer faces when making food choices. ConAgra has developed new food products and improved old favorites to offer consumers a large range of healthy food options. The variety within this range of healthy products provides consumers with the flexibility to satisfy different dietary needs and different lifestyles.

The Healthy Choice product line began in 1988 and now has over 200 healthy products available. Healthy Choice provides consumers with low-calorie, nutritious meals, deli meats, breads, soups, and desserts. Healthy Choice "Flavor Adventures " are frozen meals with exciting seasonings and ingredients that enhance taste without compromising healthful benefits and nutrients.

Egg Beaters is another popular, tried-and-true item within the good-for-you product range. Egg Beaters is a real egg product that features no fat, no cholesterol, and half the calories of regular eggs, in addition to the ease of reusable packaging, which gives consumers another quick and healthy food option.

The PAM line of no-stick cooking sprays now includes fat-free original, fat-free olive oil, and fat-free "for grilling" varieties, which promote healthier and hassle-free options for cooking and grilling.

Fleischmann's margarine products, targeted at health conscious consumers, offers Light, Unsalted, and No Trans fat cholesterol-free alternatives to butter.

Hunt's Tomatoes and their foodservice counterpart Angela Mia have teamed with the American Dietetic Association to promote the health benefits of tomatoes, which are rich in lycopene. Hunt's also offers organic tomatoes.

The Lightlife brand caters to vegetarian needs with meatless, soy-based products.

ConAgra now features a new line called Life Choice for consumers who want meals low in carbohydrates.

Ultragrain, a creation of the ConAgra Ingredients group, combines the nutritional value of whole grains with the taste and texture of refined grains to enrich the diets of consumers who prefer refined grains.

ConAgra promotes healthy living in many other capacities, including a Healthy Choice website at www.healthychoice.com and a monthly email newsletter called "To Your Health" that features coupons, recipes, and nutritional tips.

CONAGRA'S COMMITMENT TO THE COMMUNITY

In addition to providing consumers with a multitude of healthy food options, ConAgra remains committed to helping the environment and communities in need. ConAgra's "Feeding Children Better" foundation has funded over 160 Kids Cafes, providing logistics assistance and food donations for millions of "food insecure" American children. ConAgra has joined with the American Dietetic Association to promote Home Food Safety and to decrease the prevalence of food-borne diseases.

COOPERATION WITH THE GOVERNMENT

ConAgra stresses the importance of a close harmony between the food industry and other important stakeholders within the obesity epidemic, such as the government, academia, and health care providers. The government can help educate consumers to make healthier choices through food labeling, physical activity endorsement, and the support of community-based programs. The food industry should cooperate with the government to guarantee the production and availability of low-calorie, nutritious foods. This can be achieved by providing incentives to industry and also stimulating media participation in the prevention of obesity. The government should develop and support new food technology and improve communication across responsible parties and consumers.

COOPERATION WITH ACADEMIA AND HEALTH CARE PROFESSIONALS

ConAgra relies on the expertise of scientists and health care professionals within the medical field. Scientists have a unique insight to provide scientific data influencing the decisions of industry and consumers. Research scientists can work together with the food industry to generate nutritious foods and to promote reliable, science-based nutrition information. Academic institutions also play a key role in educating health care professionals, who will educate their patients and our consumers. The medical community is uniquely positioned and trusted by consumers, because consumers look for nutritional advice from knowledgeable and trustworthy professionals. Health care providers can encourage consumers to make individual lifestyle changes that will improve their health. The health care professional, in assuming such a role, can transform their interaction on this topic from clinical resolution to thoughtful prevention, thus helping consumers develop and reinforce strategies for eating and physical activity that reduce overall individual health care risk

CONCLUSION

To help fight the battle against obesity, the food industry must team up with the government, academia, and the medical community to help inform consumers, strengthen nutrition education, and develop healthier product choices. ConAgra aims to work in concert with these groups to continue providing consumers with a range of healthy food options. Giving consumers the best nutrition information and the best nutritional food options may empower them to make individualized lifestyle changes that will help overcome energy imbalance and, in the long term, may help curb our struggle with obesity.

ACKNOWLEDGMENTS

We acknowledge and thank George L Blackburn (Harvard Medical School, Boston, MA), Pat Kearney (PMK Associates, Alexandria, VA), and Mike Fernandez (ConAgra Foods Inc, Omaha, NE) for their request to write this review, their critical review, and valuable suggestions.

REFERENCES

1. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002;288:1723–7.
2. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA 2004;291:1238–45.
3. Inge TH, Garcia V, Daniels S, et al. A multidisciplinary approach to the adolescent bariatric surgical patient. J Pediatr Surg 2004;39:442–7.
4. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 2004;291:2847–50.
5. Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics 2001;108:712–8.
6. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869–73.
7. Guo SS, Huang C, Maynard LM, et al. Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study. Int J Obes Relat Metab Disord 2000;24:1628–35.
8. Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med 1993;22:167–77.
9. Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA 2003;289:1813–9.
10. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101:518–25.
11. Karlson EW, Mandl LA, Aweh GN, Sangha O, Liang MH, Grodstein F. Total hip replacement due to osteoarthritis: the importance of age, obesity, and other modifiable risk factors. Am J Med 2003;114:93–8.
12. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992;327:1350–5.
13. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA 2003;289:187–93.
14. Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P. Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr 1996;128:608–15.
15. Manson JE, Skerrett PJ, Greenland P, VanItallie TB. The escalating pandemics of obesity and sedentary lifestyle. A call to action for clinicians. Arch Intern Med 2004;164:249–58.
16. Philipson T. Government perspective: food labeling. Am J Clin Nutr2005;82(suppl):1720S–2S.
17. Lando AM, Labiner JM, Williams RA. Consumer's use of food and restaurant labeling: focus group results. US FDA Center for Food Safety and Health Nutrition. Internet: http://vm.cfsan.fda.gov/frf/forum04/G-05.HTM (accessed 30 September 2004).
18. US Food and Drug Administration. Consumer research on food labels. Internet: http://vm.cfsan.fda.gov/lrd/ab-label.html (accessed 30 September 2004).