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PLOS Medicine’s Big Food Series: Shining a Spotlight on Industry’s Influence on Health

PLOS Medicine Deputy Editor, Paul Simpson, reflects on the PLOS Medicine Series on Big Food, which was published in 2012.

‘The Food Industry is Ripe for Scrutiny’ is the clarion call of the lead editorial that announced PLOS Medicine’s Big Food series. The series of eight commissioned articles was the brainchild of PLOS Medicine’s then Senior Magazine Editor, Jocalyn Clark (@jocalynclark), alongside guest editors for the series Marion Nestle (@marionnestle) and David Stuckler (@davidstuckler), and was published over three weeks in June and July 2012.

Image Credit: Todd Hryckowian, Flickr
Image Credit: Todd Hryckowian, Flickr

While the field of medicine has had a long interest in how global corporations influence human health, particularly the tobacco and pharmaceutical industries, the editors were inspired to commission the series because they noted a dearth of critical perspectives in the medical literature on the food industry’s role and competing interests in human health. This seemed especially pertinent as the global health community were and are increasingly focused on the health impact of two billion of the planets population being obese or overweight, while at the same time one billion people on the planet are hungry.

David Stuckler and Marion Nestle’s Essay, Big Food, Food Systems, and Global Health, clearly set the scene for the series by noting that, “food systems are not driven to deliver optimal human diets but to maximize profits.”  They highlighted three positions that public health advocates could adopt in relation to the food industry: The first is to do nothing and let the industry regulate itself; the second is to work in partnership with the industry; and the third is to take the view that there are inherent conflicts of interest between corporations that profit from unhealthy food and public health collaborations. Few in the field of public health would agree that self-regulation is likely to be optimal from a health perspective, others may see some merit in working alongside the food industry but in their essay the authors plant their flag firmly in the ground: “[W]e find no evidence for an alignment of public health interest in curbing obesity with that of the food and beverage industry.”

In an in-depth analysis for the series David Stuckler and colleagues provided a fascinating insight into the growth of unhealthy commodities, in particular processed food, across the globe. Their analysis suggests that low- and middle-income countries experiencing the highest exposure to unhealthy commodities are not just those in which growth is occurring most rapidly, which is a common explanation and often seen as inevitable, but those in which such development is occurring in the context of food systems that are highly penetrated by foreign multinationals. In another analysis Lori Dorfman and colleagues focused on corporate social responsibility (CSR) campaigns run by soda companies and draws a striking comparison with CSR campaigns run by the tobacco industry that aimed to focus responsibility on consumers rather than on the corporation, bolster the companies’ and their products’ popularity, and to prevent regulation.

Interestingly, the editors of the series found that many authors that they approached, especially the developing world, had established links with food companies, but two groups without industry connections provided viewpoints on the increasing influence of transnational food corporations in middle income countries with examples from Brazil and South Africa.

Rounding off the series are pieces by Rajeev Patel and Kelly Brownell. In his essay Rajeev Patel provides an examination of hunger and malnourishment noting that gender is key to understanding food insecurity, because women and girls are disproportionately disempowered through the current processes and politics of food’s production, consumption, and distribution. A forward looking perspective from Kelly Brownell closed the series, which warned against the quicksand of appeasing the food industry. His closing remarks are that, “to take the obesity problem seriously will require courage, leaders who will not back down in the face of harsh industry tactics, and regulation with purpose.”

After publication of the series the discussion continued on social media, including a Tweetchat, a Q&A with guest editor David Stuckler and additional blog posts on the food industry. The series itself deliberately did not provide a platform for the food industry to air its views, which it has done many times before. Unsurprisingly, in response to the series trade groups representing the food industry either deflected attention away from the central criticisms of food and beverage corporations or refused to accept the analysis.

The Big Food series represented a substantial undertaking for the series editors and proved to stimulate an important debate on an issue that is likely to be central to the future of global health. It represents a shining example in PLOS Medicine’s first 10 years and demonstrates the influence and vital need for an open access medical journal — free of industry interests – beyond being a vehicle for publishing high quality research.

You can read the whole series here:

The PLOS Medicine Series on Big Food


This is post 2 of 8 in PLOS Medicine’s 10th Anniversary blog series on the most interesting and influential articles of the last ten years. You can find links to all the posts in the series as they are published here.



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