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4 Innovations and Future Work in Industry Practices T he second workshop panel focused on the actions of industry. Cathy Polley, vice president of health and wellness for the Food Market- ing Institute (FMI) and executive director of the FMI Foundation, provided an overview of the work of food retailers with children and their parents regarding healthy food choices. Elaine Kolish, vice president and director of the Children’s Food and Beverage Advertising Initiative (CFBAI), reported on progress to date and future directions for a major self-­regulation initiative undertaken by industry. Heather Rubin, senior manager of The Walt Disney Company’s corporate citizen and nutrition and well-being initiatives, described the company’s efforts to market and provide healthier foods to children and adolescents who watch Disney shows and visit Disney parks. Finally, Jennifer Harris, director of marketing initiatives at the Rudd Center for Food Policy and Obesity at Yale Univer- sity and research scientist in the Department of Psychology, detailed some of the center’s efforts to monitor and evaluate food marketing to children and adolescents. In emphasizing the progress that has been made, all four speakers also pointed to many steps that remain to be taken. HEALTHY FOOD MARKETING INITIATIVES IN RETAIL CHAINS Summary of presentation by Cathy Polley FMI conducts programs in public affairs, food safety, research, educa- tion, and industry relations on behalf of its 1,250 member companies— food retailers and wholesalers—in the United States and around the world. 23

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24 CHANGE IN FOOD MARKETING TO CHILDREN AND YOUTH FMI’s U.S. members operate approximately 25,000 retail food stores and 22,000 pharmacies, with a combined annual sales volume of $650 billion. Differentiation from the competition is the key to success in the food retail market, said Polley. Fully 80 percent of food retailers report using an emphasis on consumer health and wellness to this end (FMI, 2011). Their strategies include • exploration of in-store service offerings, including an expansion of fresh, pre-prepared foods and specialty meat, cheese, and seafood products; • nutrition labeling guidance programs to assist shoppers in making healthier choices; • an increased variety of private brand offerings, which may include innovative products with healthy attributes; and • increasing availability of specialty foods, such as low-sodium, heart-healthy, gluten-free, and lactose-free foods. Retailer Actions Related to Health and Wellness Polley cited several examples of retailer actions related to health and wellness, based on the results of an FMI survey of its members: • Seventy-nine percent of members are offering (physical) store tours, including those for children, school groups, shoppers with dietary restrictions, or shoppers interested in weight management. Such tours might describe, for example, how to pack a healthy lunch or how to incorporate vegetables into the dinner menu. • Fifty-nine percent of members reported providing nutrition coun- seling, whether at a store, regionally, or at the corporate level. • Fifty percent of members reported having front-of-pack labeling for their private brands, and more than half display healthy items in or at the ends of aisles. • Almost 90 percent are providing healthy recipes to shoppers, either through recipe cards at in-store kiosks, through a website, or on recipe cards throughout the store. Almost all—98 percent—have some type of health and wellness website. • Companies are starting to use coupons and other promotions to encourage healthier shopping and eating, which helps emphasize the point that it does not necessarily cost more to eat healthy foods. • More retailers are starting to share best practices as an industry rather than holding on to information as a competitive advantage, although more needs to be done in this regard.

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INNOVATIONS AND FUTURE WORK IN INDUSTRY PRACTICES 25 • Smartphone applications are growing rapidly, including help with diet and with choosing healthier items while shopping. Actions of Specific Retailers Polley also provided several specific examples of member retailers’ actions related to health and wellness: • H-E-B in Texas has a healthy eating program that specifically tar- gets young families with information about not only food but also exercise and health in general. • HyVee in West Des Moines, Iowa, employs a dietitian in all its stores. The in-store dietitians offer healthy kids cooking classes and work with education programs in schools. Programmers in stores help shoppers meet the U.S. Department of Agriculture’s MyPlate criteria. Children are involved in growing fresh fruits and vegetables in gardens at their homes, in the stores, or in schools, and stores offer a story and a snack class for toddlers. • Wegman’s in the northeast and mid-Atlantic regions offers stories on its website about healthy foods. Dietitians blog and reach out to schools and teachers. Wegman’s also offers cooking classes in stores and offers store tours to help children identify healthy choices. • Giant Eagle stores in Maryland, Ohio, Pennsylvania, and West V ­ irginia offer dietitian services, weight-loss and diabetes classes, and nutrition life coaching. Dietitians conduct field trips in stores, run wellness weekends to educate children on good nutrition and what is available in stores, and lead events in the community. Finally, the FMI Foundation supports a variety of programs. For exam- ple, almost 1,000 schools have applied for grants from the Fuel Up to Play 60 program, which features in-store classes and tours and other means of providing information about healthy eating. “[What] we hear in a lot of our reports is [don’t] tell me what to take out of my diet . . . tell me what I can put into my diet. . . . Give me some good ideas.” —Cathy Polley

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26 CHANGE IN FOOD MARKETING TO CHILDREN AND YOUTH PROGRESS TO DATE AND FUTURE DIRECTIONS FOR THE CHILDREN’S FOOD AND BEVERAGE ADVERTISING INITIATIVE Summary of presentation by Elaine Kolish In 2006 the Better Business Bureau and leading food companies, follow­ ing calls from the Federal Trade Commission (FTC) and the Institute of Medicine (IOM) for more self-regulation of food advertising to children, joined forces to create CFBAI. The goals of the initiative were to focus on what foods are advertised to children, with an eye to changing the mix toward healthier options, and to bring transparency and accountability to company commitments. CFBAI currently has 16 participants and tries to recruit new participants on an ongoing basis. CFBAI’s requirements have evolved since its 2006 launch. Since Janu- ary 2010, it has required that its participants include only healthier foods (ones that meet specified nutrition criteria) in child-directed advertising or not engage in advertising targeting children. In September 2010, CFBAI harmonized the definition of child-directed advertising so that it covers ads in programs with 35 percent or more child viewers (participants using a 50 percent definition moved to 35 percent). Starting in 2014, participants will implement CFBAI-developed uniform nutrition criteria to replace their company-specific criteria. The initiative also has expanded its covered venues from television, print, radio, and the Internet to include newer and emerging media, such as child-directed ads on mobile phones and ads on videogames for children. CFBAI considers “child-directed” ads those that are directed primarily to children under age 12. Children may also see ads on prime time dramas, ­ reality shows, or Internet sites that are directed primarily to families, adults, or teens. Kolish noted that an analysis of ads appearing in a sample of Nickelodeon programming for children showed that food ads were only a modest percentage of all the ads aired (23 percent); ads for sedentary entertainment, such as movies and video games, were far more common. While the percentage of children in a television audience works well as a means of identifying child-directed programming, it is insufficient for determining what is child-directed in the dynamic online world, Kolish said. CFBAI or individual companies may view websites as child-directed even if fewer than 35 percent or an unknown percentage of visitors are children. CFBAI conducts a multifaceted analysis of content, impression, intent, and other factors to determine whether a site is child-directed and provides lists of such sites in its reports.

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INNOVATIONS AND FUTURE WORK IN INDUSTRY PRACTICES 27 Monitoring and Reporting Provisions CFBAI monitors and reports on companies’ compliance with its com- mitments in several ways: • It requires companies to submit self-assessments, which provides an opportunity to detect and correct problems. • It performs independent monitoring of media, including children’s programming and many websites. • It conducts inquiries into complaints. • It publishes its findings in annual reports1 to provide transparency. Accomplishments Kolish cited a number of accomplishments of CFBAI participants that have resulted from the initiative’s efforts: • The use of nutrition standards to limit what foods are included in child-directed advertising has shifted attention to healthier foods. More than 100 foods have been changed or created to meet nutri- tion standards. • Other foods are no longer advertised or have been discontinued, and the reformulation of foods and development of new, healthier products are ongoing. • More advertised foods have fewer calories and less sodium, sugar, or fat and more calcium, vitamin D, potassium, and fiber. For example, 71 percent of ads are for foods with at least a half-serving of fruit or whole grains, which represents a 40 percent increase from 2010. • All meals, including small meals, now include fruit and/or a veg- etable as a side dish. • More products now contain whole grain or a larger amount of whole grain than they did in the past. For example, 71 percent of cereals covered by the program, up from 60 percent in 2011, contain at least 8 grams of whole grain per serving. • Both McDonald’s and Burger King recently dropped the caramel dipping sauces that were advertised and included with apples in children’s meals. • The sugar content of most cereal has steadily declined, from 15 grams of sugar per serving to less than or equal to 10 grams, 1 Annual reports are available at http://www.bbb.org/us/childrens-food-and-beverage- advertising-initiative/info/#key%20program (accessed February 5, 2013).

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28 CHANGE IN FOOD MARKETING TO CHILDREN AND YOUTH while the content of whole grains, fiber, and nutrients such as vita- min D has increased. • Sodium has been reduced in many products, and the fat content of foods advertised to children has dropped. For example, ConAgra Foods reduced the sodium in the Kid Cuisine meals advertised to children by an average of 15 percent from 2011 to 2012. • Point-of-sale practices of the two quick-serve restaurant chains participating in the program have changed. In 2011, Burger King instructed its servers to ask customers what side dish and beverage they wanted along with their entree and not to automatically pro- vide fries and soda. And in 2012, McDonald’s completed the imple- mentation of automatically including apples and a small serving of fries in every Happy Meal. Consumers also can opt to forego the fries and get two bags of apples instead. McDonald’s has estimated that this practice will put 100 million cups of apples in children’s hands annually. Next Steps Kolish briefly looked at CFBAI’s next steps. Its biggest action item is implementing the new uniform nutrition criteria that go into effect on December 31, 2013. These new criteria are far more comprehensive and stronger overall than the current company-specific criteria. The new criteria also will lead to more improvements. Many recipes will need to change if foods advertised in July 2011 (when the criteria were adopted) are to be advertised in 2014. Also, the criteria provide a strong but reasonable road- map for new product development. “In far less time than it generally takes the government to pro- pose and promulgate a rule, the Better Business Bureau not only created and implemented a comprehensive meaningful program but significantly expanded it several times. As a result, we have a robust voluntary program that has improved and continues to improve food advertising to children. This does not mean there isn’t room for improvement. There is always room for improve- ment. But I think it is important to have this perspective.” —Elaine Kolish

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INNOVATIONS AND FUTURE WORK IN INDUSTRY PRACTICES 29 CHANGING COMPANY-WIDE MARKETING PRACTICES AT THE WALT DISNEY COMPANY Summary of presentation by Heather Rubin A basic premise of The Walt Disney Company is that it wants to create stories and experiences that bring parents and children together, said Rubin. The opportunity is to create experiences that are both fun and good for chil- dren, rather than framing choices as a tug of war between things that are fun and those that are healthy. According to Rubin, children and families are at the heart of Disney’s brand identity. Disney therefore decided it was in a unique position to be part of the solution to an obesity epidemic that was threatening the health of children, disseminating a commitment from top leadership to business managers across the company. Disney was the first major media company to establish nutrition guide- lines that would associate its brands and characters with more nutritious portfolio products. The guidelines were developed with the help of health experts and aligned with federal dietary recommendations. Not only was this the right thing to do for families, Rubin said, but it was the right thing to do for the company. Disney next sought to implement these guidelines throughout the company: • Parks and resorts initiated healthier default beverages and side options in all prebundled children’s meals (e.g., milk and carrots rather than soda and fries). • Parks and resorts also featured healthier choices, such as fruit carts, low-fat foods, vegetarian options, and no-sugar beverages. • In the studio, some deals with fast-food companies were termi- nated, and new ways of promoting films were found. • Disney Studios developed new public service announcements about healthy habits with the U.S. Department of Agriculture and the Ad Council. • In the licensing of brands and characters, the food portfolio was rebalanced toward foods with less sugar. The company adopted an 85/15 balance rule, which specified that 85 percent of licensed foods would be everyday foods that meet nutrition guidelines, while 15 percent would be foods reserved for special-occasion treats (e.g., holidays, birthday celebrations). • In its media networks, Disney sought to model healthier lifestyles and behaviors. For example, it launched a new educational series called “Pass the Plate” focused on healthier foods and cooking for children.

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30 CHANGE IN FOOD MARKETING TO CHILDREN AND YOUTH These efforts have accelerated since 2009, when several key goals were achieved. In that year, the nutrition guidelines were rolled out internation- ally. In 2010, the company announced a consumer initiative, Magic of Healthy Living, focused on making healthy living simple and fun. As part of that initiative, the TRYit campaign featured content, contests, websites, and live events. One of these programs, the TRYathalon special, ranked among the top 10 telecasts for the Disney XD network since its launch. Disney’s research suggests that its efforts are making a difference, said Rubin: • According to a survey of 450 mothers and their children, 82 per- cent of children who had participated in the Magic of Healthy Living campaign said that it had made them more physically active, 78 percent ate more fruits and vegetables, and 71 percent drank more low-fat milk. • Working with KaBOOM!, Disney has built more than 30 play- grounds and learning gardens in communities across the United States. • Working with Feeding America, Disney has created a pilot program that has provided 25 million servings of produce to children and families nationwide. • Disney’s nutrition guidelines now encompass all child-oriented food business activities, including promotions, sponsorships, adver- tising, licensing, and specific initiatives in parks and resorts. The nutrition criteria focus even more on fruits and vegetables, low-fat dairy products, whole grains, and additional limits on sugar and sodium. • A program called Mickey Check provides a new tool for identifying more nutritious choices in stores, online, and while on vacation. • The Magic of Healthy Living campaign is being expanded, as is the company’s philanthropic commitment in this area, and results of all these efforts are included in the annually updated Corporate Citizenship Report. Reaching all employees with a commitment requires time, coordina- tion, and dedication. Disney has steering committees at multiple levels of the organization, has produced summaries of goals and strategies for employees, and provides its employees with training to support company objectives. It also is seeking to involve employees in its Magic of Healthy Living campaign in addition to its overall health and wellness efforts. Disney believes it has been successful because it has been able to do something that works for both its business and its consumers.

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INNOVATIONS AND FUTURE WORK IN INDUSTRY PRACTICES 31 “When you meet kids where they are, when they are responsive to new ideas, we really do have the ability to make behavior change fun.” —Heather Rubin MONITORING AND EVALUATING INDUSTRY INNOVATIONS Summary of presentation by Jennifer Harris As an independent academic organization, the Yale Rudd Center for Food Policy and Obesity can apply transparent and rigorous methods to examining industry innovations. The Rudd Center has a number of objectives, including identifying marketing practices, monitoring progress over time, and encouraging changes to improve the diets of children and adolescents. The center’s monitoring can be used to clarify industry claims, and has sometimes led to conclusions at odds with those of industry. For example, Coca-Cola stated in 2011 that two-thirds of its media spending was for light or low-calorie products. Using Nielsen data on spending, however, the Rudd Center found that the company spent about $150 mil- lion advertising its seven regular sodas and about $200 million on 27 other products—although when spending on the Coke brand, not broken down by specific products, was added to the latter number, the company’s spend- ing on all products other than the seven regular sodas was about 63 per- cent, close to the amount the company was claiming. Mixed Progress One of the Rudd Center’s major goals is to encourage changes designed to improve the diets of children and adolescents. Such changes would entail reduced exposure to marketing for calorie-dense, nutrient-poor foods in all media, in all forms of marketing, and for all youth. The Rudd Center is not against all food marketing, but believes marketing targeting children and adolescents should promote healthful foods. The Rudd Center monitors not just traditional media such as television and radio ads and television product placements but also digital media and other forms of marketing, such as in-store promotions and menu boards in restaurants. As an example, Harris cited the center’s monitoring of cereal marketing. In 2009 the center issued its Cereal F.A.C.T.s (for food advertising to children and teens), which it updated in 2012 (Harris et al., 2012). The biggest change over that period, according to Harris, was that

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32 CHANGE IN FOOD MARKETING TO CHILDREN AND YOUTH General Mills and Post foods, respectively, dismantled their Millsberry and Postopia advergame sites, which were among the most visited such sites on the Internet. Companies have devoted more effort to their single-brand sites since then, but the numbers for these sites are not comparable to those for Millsberry and Postopia, which were drawing hundreds of thousands of users and generating millions of banner ad impressions. Continuing Needs A commitment to the CFBAI policies does not mean that a company necessarily fosters healthy eating, said Harris. For example, Coca-Cola has a strong commitment to not placing any brand marketing in television, radio, or print that is directed primarily to children under age 12. But the company is quite open about its desire to target teens. As a senior vice presi- dent said in 2011, “We can’t afford not to talk to teens. You can’t think, ‘Teens already know us,’ and skip a couple of years. Every six years there’s a new population of teens in the world” (Zmuda, 2011). The Rudd Center has found that Coca-Cola, along with many other manufacturers of sugary drinks, markets in the full range of media, including television ads, product placements, radio, company websites, banner ads, social media, and mobile marketing. Children and teens see more product placements than television ads for Coca-Cola. My Coke Rewards, in which consumers collect bottle caps in return for various products, is the company’s biggest website and produces almost 500 million banner ad impressions per month. And as of June 15, 2011, Coca-Cola had more than 30 million Facebook fans (mak- ing it the number one brand on Facebook), 300,000 Twitter followers, and just under 23 million YouTube upload views (Harris et al., 2010). When all of these different kinds of ads are combined, children aged 2-11 see more ads for Coke than for Kool-Aid or Capri Sun, products that directly target them (Harris et al., 2010). Harris concluded with a 2010 quotation from the White House: “Key actors—from food and beverage companies, to restaurants, food retailers, ­ trade associations, the media, government and others—all have an impor- tant role to play in creating a food marketing environment that supports, rather than undermines, the efforts of parents and other caregivers to encourage healthy eating among children and prevent obesity” (White House Task Force on Childhood Obesity, 2010). “When you start naming names, companies pay attention and start changing their practices.” —Jennifer Harris