Tuesday, July 27, 2010

"Exercise is Medicine" (and a great smokescreen for Big Food)

Further to my post from yesterday regarding the innocence by association test for conflicts of interest comes "Exercise is Medicine".

Exercise is Medicine is a laudable organization whose aims are,

"To make physical activity and exercise a standard part of a disease prevention and treatment medical paradigm in the United States.


"For physical activity to be considered by all health care providers as a vital sign in every patient visit, and that patients are effectively counseled and referred as to their physical activity and health needs, thus leading to overall improvement in the public's health and long-term reduction in health care cost."
It has great buy-in too with a massive list of supporters that include the who's who in health promotion.

So why am I knocking it?

It's not so much that I'm knocking it, more I'm questioning its role, as Big Food conspiracist that I am, I see a dual role for Exercise is Medicine.

On the one hand its role is to encourage exercise for health - a true, valuable and important endeavour.

But on the other hand, its other role is to serve its founding sponsor Coca-Cola, in the promotion of the assertion that the best means to deal with our current obesity epidemic is to ensure that people exercise. Or to put it another way, that sugary soda's not a bad thing so long as you live an active lifestyle.

The "obesity can be treated effectively through exercise alone" message, crucial to the purveyors of high calorie foods everywhere, is indeed spread by Exercise is Medicine,
"This is just the beginning. Hopefully, the insurance and medical communities will soon realize that the most effective way to treat and prevent a wide variety of obesity-related conditions is through exercise."

- Press release from Exercise is Medicine founding partner Anytime Fitness, June 28th, 2010

"As a whole, people are significantly less active today, even compared to just 20 years ago. When we look at the data that shows how diseases like obesity and diabetes are rapidly increasing, there's an obvious correlation to the decline in physical activity.

Even though everyone has heard it before, something as simple as taking the steps instead of an elevator can make a big difference. It's too easy to consume a massive amount of calories and sit at a desk all day - both of which have negative consequences to our health. We need to remember to take breaks during the day to take a ten minute walk. Any bit of activity is better than being sedentary."

- Press release for Exercise is Medicine quoting Sandra Billinger, PT, PhD, FAHA, research assistant professor in the KU Physical Therapy and Rehabilitation Science department, June 9th, 2010

"Dr. Sallis poses this question to health-care providers: "What if there was one prescription that could prevent and treat dozens of diseases, such as diabetes, hypertension and obesity? Would you prescribe it to your patients? Certainly."

Well, there is one prescription available to you that will do just that. It's called exercise."

- Dr. Robert Sarlis, past President of the American College of Sports Medicine (a founding partner of Exercise is Medicine) to Charleston's Sunday Gazette-Mail, March 7th, 2010

"The International Health, Racquet & Sportsclub Association (IHRSA) announced today their partnership with the Institute of Lifestyle Medicine (ILM); a division of Harvard Medical School's Department of Physical Medicine and Rehabilitation and of Spaulding Rehabilitation Hospital. IHRSA and ILM join together to fight the global obesity epidemic by working to improve physician knowledge of the science and benefits of physical activity, and to increase the practice of physician-prescribed exercise."

- Press release from Active Doctors, an organization whose President is part of Exercise is Medicine's Task Force, May 19th, 2009

"In an effort to decrease the prevalence of childhood obesity and promote physical activity to children, the American College of Sports Medicine (ACSM) has announced a partnership with the Youth Fitness Coalition (YFC). This partnership will feature ACSM's Exercise is Medicine(TM) initiative, designed to encourage America's patients to incorporate physical activity and exercise into their daily routine, and YFC's signature program, Project ACES (All Children Exercise Simultaneously)."

- Press release from the American College of Sports Medicine, March 10th, 2009
The message that obesity can be prevented or treated with exercise is an important one to the food industry as it shifts the blame for obesity from the consumption of their calorific products to a decline in fitness, a link which at best is described as debatable and at worst, inconsequential. It also fuels Big Food's ability to preach about what Coca-Cola refers to as, "an active, balanced lifestyle", McDonald's a, "balanced, active lifestyle" and "it's what i eat and what i do ... i'm lovin' it" campaign, Pepsi a, "balanced lifestyle", Unilever a, "balanced diet and lifestyle", Mars a "well-balanced lifestyle", and Nestlé' a, "balanced lifestyle".

That the message is being spread by Exercise is Medicine and sometimes directly and other times by extension by the exceedingly reputable organizations included in Exercise is Medicine 397 signatory partners helps embolden the purveyors of calorific foods to make statements like Pepsi CEO's Indra Nooyi's,
"If all consumers exercised, did what they had to do, the problem of obesity wouldn't exist."
And Coca-Cola's President Sandy Douglas',
"And we're for active lifestyles, with more than 6 billion Diet Coke packages helping the National Heart, Lung and Blood Institute remind women about the importance of staying active and maintaining a healthy weight, and our support of physical activity initiatives like Exercise Is Medicine."
Ultimately, while exercise is indeed medicine, Exercise is Medicine again illustrates the risks and inherent conflicts of interest consequent to Big Food partnerships, and I would argue these risks and conflicts shouldn't come as a big surprise.


Because Big Food doesn't care about your health; they don't care about your well-being; and they don't care if you exercise. All Big Food cares about is whether or not you'll buy their products, and certainly every single dollar they spend on programs such as Exercise is Medicine are earmarked to further that goal. A goal Coca-Cola's certainly meeting as last week they reported North American sales volume growth for the first time in two years which led Coca-Cola CEO Muhtar Kent to proclaim,
"We firmly believe that North America will be a growth market of great opportunity for the next 10 years and beyond"
So while the notion of Big Food capitalizing on their investments in programs such as Exercise is Medicine to fuel sales isn't in and of itself surprising, what is surprising to me is the fact that well intentioned individuals, along with top-notch medical and public health organizations, don't seem to realize it, or simply don't care.

[For some further reading on what I think about "balanced, active lifestyles", please have a read of the article I co-authored this year, Running Away with the Facts on Food and Fitness, published in the journal Public Health Nutrition]

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  1. Anonymous8:41 am

    Great post, thank you for continuing to put out this important message. Big food has figured out how to promote "all you need is exercise" under cover of different seemingly fully credible organizations.

  2. Once people see what's behind (or in Coke - sugar sweetened soda), they tend to make a change - http://bit.ly/awEpYV

  3. Yoni, this message is at the heart of my passion. I have helped my patients to reverse diabetes, hyperlipidemia, hypertension, lower visceral adipocity, reduce risk of stroke and increase cardiac output. If I had used only exercise it would never have happened. My patients remove the soda, the packaged foods void of insoluble fiber like cereal, chips, baked goods,and simple sugars and in addition they reduce (slightly) total caloric intake.

    Without removing Big Food we've got nuttin' honey!

  4. Amy Laski, Coca-Cola Canada2:13 pm

    Coca-Cola agrees that obesity is a serious and complex global health problem and is committed to developing workable solutions to address obesity. Over the past number of years, Coca-Cola has taken steps to address the complex health and wellness issues facing Canadians by developing and implementing programs that provide nutrition information and education, and encourage physical activity. For example:
    • We are proud to be the first beverage company in the world to commit to putting caloric information on the front of almost all product packaging. In Canada, calories now appear prominently on the front of nearly all of our soft drink packages and we are well on our way to having them on all packages across our portfolio by 2011. The calorie count that appears on the front of the label is consistent with what appears on the Nutrition Facts Panel.
    • We have a continuously expanding portfolio of no and low-calorie beverages and have reduced the number of calories per serving in our beverages by nearly 20 per cent since 2000.
    • Our low- and no-calorie North American beverage portfolio includes more than 800 beverage products. This accounts for one-third of the company’s total volume.
    • We are making it easier for consumers to make balanced beverage decisions with the introduction of new packages, such as the 414mL bottle, and the 100-calorie mini-can, in addition to our classic 237 mL, 100-calorie glass bottle of Coca-Cola.
    • As part of our ongoing commitment to advance scientific knowledge, awareness and understanding of beverages, their ingredients, and how they interact with the body , the company has developed and continues to grow the Beverage Institute for Health and Wellness. (www.thebeverageinstitute.org).
    • We currently support more than 150 active living programs in more than 100 countries around the world and are committed to supporting active living programs in all 206 countries in which we operate by 2015.
    • In 2008, we joined in partnership with ParticipACTION, the national voice of physical activity and sport participation in Canada, to create Sogo Active. Sogo Active is unlike any other youth fitness initiative because it gives young Canadians the tools to design, change and control their own individual get active plan. The program currently has 13,000 youth and 1,300 Community Host members across the country and has awarded more than $500,000 in microgrants.

    I hope this helps you better understand of what Coca-Cola is doing not only to encourage active living, but importantly, to do our part to provide product and package choices, information, and education.

  5. You do succeed in making me think. Very useful, as I'm a fairly trusting person.