But in what sense is this a ‘right’ to which anyone would freely wish to be entitled? Each year in the United States, 400,000 deaths are attributable to cigarette smoking alone, and another 50,000 citizens die prematurely from exposure to second-hand smoke. This number amounts to one fifth of deaths in the US and accounts for more deaths than HIV/AIDS, drug abuse and alcohol related deaths, automobile accidents, murders and suicides combined, according to the state of Virginia Department of Health.

The US Centre for Disease Control reported last year that men who smoke will become ten times more likely to die from bronchitis or emphysema and over 22 times more likely to die from lung cancer. In addition, smoking triples the risk of premature death from cardiovascular disease among middle age men.

As Peter Galuszka writes in the Washington Post, tobacco has been a powerful US industry since the first English colonies were established on her shores in Jamestown Virginia; this new effort on behalf of big tobacco extends and expands the industry battlefield in a new and insidious way.

Sources: Washington Post, 3 January 2011; CDC Factsheet, 21 March 2001 Tobacco Related Mortality (here >>); Virginia Tobacco Use Control Project Smoking Attributable Deaths in Virginia, 2008.

In a similar vein, the European Journal of Public Health recently published a study showing the way package labelling can assist individuals in making healthy food purchases and consumption choices.  Although there has been prior research detailing strategies to assist consumers wade through nutritional labels in the food marketplace in attempt  to  making healthier food product selection, use of front-of-package nutrition labelling is a relatively new approach to providing information about food, and is now widely used throughout Europe.

This study assumes, based on earlier evidence, that nutritional labelling can be a helpful consumer tool, and looks into whether having multiple labelling formats creates an impediment to understanding nutritional composition.  It further looks to identify which labelling formats are the most easily understood.

Qualitative interviews were conducted and interviewers found a great deal of confusion among interviewees, who found it ‘challenging’ to compare among labels which lacked common elements, such as  label formats or text type. The comparisons also took time and effort that would be a deterrent in real-world situations.

The study results demonstrate that in shopping situations, consumers may not be inclined to use data which is difficult to compare, and that a consistent label format would make it easier for consumers to compare food products without misinterpretation.

Sources: Draper, ‘ Front of package product labelling: are multiple formats a problem for consumers?’, European Journal of Public Health, 14 September 2011; Oxford Journals release, 2 December 2011.

• In France, the Foundation is providing funding for 220 refrigeration units to French Red Cross locations across the country. This will allow for better distribution of fresh foods, including fruits, vegetables, dairy and meat, which are  Over the next three years, the units are expected to help distribute up to 50 million more meals to those in need over the next three years. A pilot programme will also be funded to implement a nutrition education workshop in 30 French Red Cross locations, to teach those attending how to cook cheap, healthy meals.
• In Germany, the Foundation is holding 800 healthy lifestyle classes 20,000 primary-school children over five years, covering nutrition, exercise, relaxation, life skills and saying no to tobacco and alcohol. Parents are also involved, and support their children with activities to do at home.
• In Italy, where nearly a quarter of children struggle with their weight, with its partners the Foundation is launching healthy living classes (including sport activities and games, as well as healthy eating workshops) are launching in 10 Italian cities to benefit at-risk communities – and the funding will also help to improve sports facilities and playgrounds. It will reach 32,000 children in three years.
• Finally, in Spain, the Alicia Foundation and Kraft Foundation will fund health education programmes and cooking workshops in schools. Children will track their food intake and physical activity, and they will analyse the data and come up with solutions to improve lifestyles. The 10 best proposals will be published online for educators across Spain to use.

Source: CSR Wire, 29 November 2011.

Initiatives highlighted at the meeting included efforts by health authorities in Argentina and Chile to work with large and small bakeries to reduce the salt content of bread, and in Brazil, major food manufacturing associations have agreed to reduce salt in industrially produced bread and buns by 10 per cent per year to 2014.

Salt consumption in the region is much higher than the WHO-recommended 5g maximum per day. In Argentina, for example, 12g a day is consumed on average, with Brazil not far behind on 11g a day. The figure for the US is 8.7g and 7.7g in Canada.

It has been estimated that reducing salt intake by just 10 per cent each year in 18 Latin American countries could prevent 593,000 cardiovascular events and save around 54,000 lives – and studies into the cost-effectiveness of such efforts show that these benefits could be delivered at a cost of between just 4 and 32 US cents per person per year.

The Food and Drug Administration is undertaking a consultation to gather opinions on salt reduction in the United States – the American Heart Association has put together a form letter (which you can adapt) to use as the basis of any comments that you might wish to send to the FDA – click here>> to take part.

Sources: PAHO, 2 November 2011; American Heart Association website, accessed 14 November 2011.

In the Lancet randomised control trial funded by weight-loss company Weight Watchers, saw a total of 772  obese or overweight men and women from Germany, Austria and the UK assigned to receive either monthly physician-led sessions in a clinical setting or were provided a no-cost 12-month membership with a local Weight Watcher’s branch. 40 per cent of the group overall dropped out of the study.   The mean age of the group was 47 and 87 per cent of the participants were women.  The 11.1lb lost by the Weight Watchers participant group was more than double the 5lb lost by the GP-led group; the Weight Watchers group also showed lowered fasting blood glucose levels and cholesterol levels.

The Weight Watchers model relies on the four pillars of food, group support, small changes in behaviour, and exercise, to encourage participants to develop better food and activity choices.  The multifaceted approach which includes weighing, advice and online or in-person group and individual support appears to provide a ‘…clinically useful intervention for weight management in overweight and obese people that can be delivered at large scale’.

Sources: BMJ, 3 November 2011 (Truby et al.); The Telegraph, 4 November 2011; The Lancet, 8 September 2011 (Jebb et al.); Weight Watchers UK website.

Low levels of vitamin D can cause chronic bone disease, including rickets and osteoporosis; recent research suggests that vitamin D deficiency may lead to a variety of chronic diseases and conditions, including MS, heart disease, high blood pressure , type 1 diabetes and some cancers.

Kellogg’s has fortified cereals since the 1980s, when it introduced folic acid to breakfast cereals, which dramatically reduced the incidence of neural tube defects.

Although the UK government has not at this time recommended fortification of food products with vitamin D,  the Kellogg’s nutrition team  decided to introduce fortification in cereal products particularly popular with children when a recent Southampton University study estimated that 20 per cent of young children  suffer from rickets, a disease which causes weak and deformed bones, previously thought to have been eliminated in the 1930s when government introduced a rationing programme that included milk and cod-liver oil. Two-thirds of UK infants had rickets prior to this time.  Health practitioners have seen a steady increase in the condition during recent years. The rest of the Kellogg’s cereal range will be fortified with vitamin D by next year.

The company’s move has received wide-ranging praise from health experts, including the British Dietetic Association.

Sources: Daily Telegraph, 2 November 2011; The Mirror, 28 October 2011; Your Wellness.net, 28 October 2011; Early Nutrition and Lifelong Health (February 2009, BMA Board of Science).

Last April, the Australian government presented a proposal that involves requiring that all cigarettes sold be displayed without branded labels and in non-descript olive-green packaging, which smokers are reported to favour least, with graphic depictions of smoking-related illnesses.  Brand names will be displayed in a single, standard font and size. In October, Philip Morris, the cigarette manufacturer that holds eight of the top 15 selling brands, including the best-selling brand, Marlboro, lashed out at the proposal, and said they were preparing for legal battle if the plain-packaging bill becomes law.

The Financial Times reports that Hermann Waldeme, Phillip Morris’ CFO claims that there is ‘no evidence’ that removing logos from packaging reduces smoking either in general or among youth – a claim made in spite of evidence from studies demonstrating that plain packaging both decreases brand appeal and general pleasure derived from smoking.  Tobacco companies have raised challenges around the ‘forced removal of trademarks’ in terms of both commercial and intellectual property law, and international law.  But Prime Minister Julia Gillard says that she will not be intimidated by big tobacco.

Sources: Financial Times, 20 October 2011, BBC News online, 8 April 2011;  Sydney Morning Herald, 27 June 2011; Tobacco Control (BMJ,’Welcome to cardboard country: how plain packaging could change the subjective experience of smoking‘ (Melanie Wakefield, Centre for Behaviour Research in Cancer, Cancer Council Victoria, Melbourne, Australia)

The Clinton Global Initiative was established in 2005 to convene global leaders across sectors to develop and implement solutions to the most urgent problems facing the world. Since over half of premature deaths from NCDs are linked with lifestyle decisions that begin during childhood and adolescence, interventions that tackle the challenge of influencing choice can have a crucial impact on long term health and NCD prevention. The relationship between young people and NCDs is often overlooked. This partnership is part of a broader Young Health Programme that intends to reach 500,000 young people between ages 10-24, and was launched in Zambia last week and is already active in Brazil, India, Sweden, the United Kingdom and Canada.

The Young Health Programme also has a 2 part research component called WAVE: Well Being of Adolescents in Urban Environments which will set the stage for health interventions using cell phones and other social media to communicate with young people at risk of NCDs. AstraZeneca partners with the Urban Health Institute and the Centre for Adolescent Health for this research programme in six study sites: Baltimore, USA; Johannesburg, South Africa; Shanghai, China; Delhi, India; Rio de Janeiro in Brazil, and Ibadan in Nigeria.  WAVE, which will partner with community youth workers and young people themselves to ensure accurate survey methods, intends to collect robust data around adolescent health care access, resources and services in each survey site.

Sources: Johns Hopkins School of Public Health, Centre for Adolescent Health. AstraZeneca, news release, 21 September 2011. Young health Programme, accessed 29 September 2011

At present, the International Monetary Fund lists Ethiopia as the 6^th-largest producer of chickpeas in the world, with much of this staple crop developed using traditional labour methods. The current yield, which PepsiCo estimates at 287,000 tonnes/year, is, according to Pepsico Director of Global Health Derek Yach, hampered by farming practices  that result in reduced harvests. Since 2009 the Ethiopian government has shifted toward supporting the development of commercial farms and food processing operations.

The Pepsi plan involves assisting the local businesses that use the chickpeas, which will aid in developing the beleaguered Ethiopian private sector, while developing a quality supply of chickpeas, including expanding the varieties of chickpeas produced. Pepsi uses chickpeas in its Sabra-branded hummus, a nutritious chickpea-based snack food.  The Sabra brand is co-owned with the Strauss group of Israel.

In conjunction with the World Food Programme, Pepsi is also looking to cultivate and develop a food supplement based on chickpeas, which will target malnourished children in Ethiopia.  If the initial pilot project targeting a few thousand children is successful, it will be scaled up and the company will invest $1,000,000 to extend access to the supplement to reach 40,000 children affected by famine in the region.

Sources: Reuters: PepsiCo partnership to boost Ethiopian chickpeas 20 September 2011; US Department of State, 2011 Investment Climate, Ethiopia.

As NCDs like diabetes, respiratory illness, heart disease and cancers disproportionately impact economically disadvantaged citizens of low- and middle-income nations, this will be the partnership focus.  The company notes that chronic disease is an enormous barrier to development and a major source of poverty. Currently 80 % of all NCD deaths occur in low- and middle-income countries.

The announcement sets forth the initial phase of the partnership in communities in 4 countries; India, South Africa, Brazil and Mexico. In the first instance the project focus will be diabetes care, and will eventually include cancer as well. Both are areas in which Eli Lilly has substantial expertise.

The initiative sets national target objectives and the company intends to invest greater sums in the partnership if these goals are met. Using the Harvard Business School model of what Michael Porter calls ‘shared value’, the company seeks to employ holistic and community-driven strategies to develop sustainable methods of patient care in low resource settings.

Chairman and CEO John Lechleiter said in making the announcement: “we believe we have a responsibility -and are uniquely positioned – to assist the global fight against these diseases”.

Source: Eli Lilly and Company press release, 13 September 2011