French government caves in to pressure from food lobby over junk food

TheThe French food industry is opposed to the carrying out of a study into the potential health risks posed by eating too much so-called 'ultra-processed' food. That is a key finding of a joint investigation by Mediapart and consumer group and magazine Que Choisir into the influence of the food producers' lobby in France.

The food industry's opposition to this kind of research is revealed in a letter written by the sector's representative body the Association Nationale des Industries Alimentaires (ANIA) on April 19th 2019 as part of a wider reaction to the French government's plans for a new policy on food and nutrition. The document makes clear the organisation's unhappiness with the “launch of a study on the links between the consummation of 'ultra-processed foods' and health …. in as far as there exists today no scientific consensus nor regulatory basis for this category”.

Ultra-processed foods, a concept first described by a scientist in Brazil, have been defined as “formulations of food substances often modified by chemical processes and then assembled into ready-to-consume hyper-palatable food and drink products using flavours, colours, emulsifiers and . . . other cosmetic additives”. According to the British Medical Journal such foods include savoury snacks, reconstituted meat products, preprepared frozen dishes, and soft drinks.

The food industry's concern over a study into the potential health risks of such food was contained in a letter giving ANIA's response to the the government's new policies on food and nutrition and sent to the national food council the Conseil National de l’Alimentation (CNA). This is a consultative body whose president is former junior food industries minister and current socialist Member of Parliament Guillaume Garot. The CNA met behind closed doors on Wednesday June 5th to prepare a report on the responses to the government's food and nutrition plan.

In general the food lobby will be happy with that new government plan. It contains few of the ideas that originally came from the Ministry of Health and which were aimed at combating the health impact of junk food. But the food industry is still concerned about some areas.

ANIA says it is “particularly critical” of the way the health authorities have taken into account the classification of ultra-processed foods. Back in February 2018, in fact, the independent health body which evaluates national public health strategies, the Haut Conseil de la Santé Publique (HCSP), recommended a 20% reduction in the intake of such foods.

Then in January 2019 Santé Publique France, an agency that directly reports to the Ministry of Health, passed on this recommendation stating that as well as containing lots of fat, sugar and salt, the produce whose consumption should be limited is often “ultra-processed”. It continued: “...in other words, they contain numerous additives (colourants, emulsifiers, preservatives, flavour and aroma enhancers...)”.

The agency said: “These additives often feature on the list of ingredients with the letter E. We still don't precisely know their impact on human health. As a precaution, choose foods without additives or with the shortest list of additives.” The health body also recommended that people opt for “home-made” food by using fresh or conserved products or frozen food that is not preprepared.

Epidemiological studies that have appeared in major scientific publications, such as the British Medical Journal, have shown correlations between consuming ultra-processed products and the emergence of health problems. There is an increased risk of cancer according to a study published in February 2018, and of cardiovascular disease according to a study published on May 29th 2019, with analysis from the French public scientific and technological institute INSERM here and here. Yet the food industry body ANIA insists that the classification of 'ultra-processed' foods is “considered by many scientists to be lacking in robustness, rigour, precision and consistency”. It cites in support of its view the position adopted by members of the French Academy of Agriculture - the Académie d’Agriculture de France – many of whose members are retired or business consultants, as Mediapart has reported.

In its April letter to the CNA, ANIA says that it wants France to agree “in advance” with the European health authorities on a reliable basis for conducting such a study before committing to one.
However, the idea of a study on the impact of eating ultra-processed foods on health in order to arrive at an “operational definition of the different categories of processed foods” was indeed written into the national plan on food and nutrition that was presented by the inter-ministerial committee on health – presided over by prime minister Édouard Philippe - on March 25th 2019. The current available systems for categorising foods in this way are the NOVA system from Brazil – which puts foods into four categories of unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods – and the Siga classification, a French version that was based on the work of NOVA and which is used by some smartphone apps. Both are unpopular with the food industry.

The food industry group says that if – despite their demands – the study is carried out then people from the sector “should be involved in the work in order to bring their expertise in terms of explaining the process of processing foodstuffs”.

ANIA – which is classified as an interest or lobby group by the independent ethical body the Haute Autorité pour la Transparence de la Vie Publique (HATVP) – is thus seeking to impose its own conditions and become involved in public research. In fact, it already uses public-private partnerships inside those bodies it controls - such as the food and health organisation Fonds Français pour l’Alimentation et la Santé – to attract public money, public laboratories, scientists employed by the state and even senior civil servants on attachment.

Throughout the government's lengthy consultation on food and health, ANIA's concerns have largely been listened to by the authorities. In its April letter it therefore welcomed the “implementation of a global and ambitious policy”. This was for two reasons. One was that the government is aiming to “target sensitive populations” - meaning poorer groups more often affected by obesity – and not the population as a whole. The other was that the government has opted for the “incentive approach” rather than the use of regulations and constraints that had been envisaged by health bodies such as the HCSP.

Indeed, the inter-ministerial group on health has ignored most of the recommendations put forward by the HCSP for the national nutrition and health plan, which is formally known as the Plan National Nutrition Santé or PNNS. The health body's proposals had been based largely on the Nutri-Score system in France which tells consumers the quality of a product's nutrition on a scale of A to E and which is also colour-coded green to red. In particular the HCSP recommended:

• The creation of a tax proportional to the nutritional value of food, in other words building on the Nutri-Score principle and allowing taxes on low-scoring products – D and E – and then reducing the tax if an effort is made to improve them.
• Banning products with a Nutri-Score of D or E from shop promotions, display at the end of shelves and from the checkout area.
• Banning the use of all marketing for products with a score of D and E on Nutri-Score that are aimed at under 16s.
• The regulation of marketing and a ban on marketing communications for foods that score less well in terms of nutrition, as well as a ban on promotional sales (rewards promotions, selling in batches, promotional games). This recommendation covers television, cinema, radio and internet advertising from 7am to 10pm.
• Regulation of the food that can be sold in automatic dispensers, limiting sugary or sweetened drinks (including fruit juices) to 50% of available drinks. For food it would ensure that at least 50% of products scored A or B on Nutri-Score.

However, rather than these recommendations the inter-ministerial health committee presided over by prime minister Édouard Philippe announced on March 25th that it would implement the following:

• A study to “evaluate the impact of tax on the sale of sugary drinks” and the likelihood of their ingredients being changed.
• The use of “co-regulation” - one step further than self-regulation – to reduce the exposure of young children and teenagers to advertising for drinks and foods that are not recommended.
• An “incentive” for managers of vending machines to sell healthier products.
• The drawing up of official “recommendations” on public catering and an “incentive” to use Nutri-Score in it.
• An “incentive” for the voluntary use of Nutri-Score on online packaging and sales.

However, as Mediapart and Que Choisir revealed last month, back in December 2018 the health authorities had rejected the third draft of the good conduct charter with ANIA in the TV and radio sector because it did not include a “commitment to a reduction in food advertising in children's programmes”. Yet in March the inter-ministerial committee chaired by the prime minister once again backed the principle of a non-binding charter of commitment.

'Companies are getting confused with all these plans'

ANIA also asked the public authorities to remove the term “nutrition” from the plan's title, so that it would instead simply be a “national food policy”. That would be “more global and meaningful than the term nutrition”, the lobby group said in its letter. The government has in fact decided to merge two national plans that were usually kept separate: the national nutrition and health plan PNNS which comes under the Ministry of Health and which contains proactive health measures, and the national food plan or PNA which comes under the Ministry of Agriculture. This latter plan is directed more at issues in the sector such as traceability, use-by dates, wastage and so on. However, though the two plans have been brought together, the two ministries each retain control over their part.

In this attempt at simplification the food industry sees an opportunity for “clear political control” which “brings together the economic players” and which as a result would marginalise the health professionals. “The companies are getting confused with all these plans which are not always comprehensible,” Catherne Chapalain, secretary general of ANIA, told Mediapart. She supports the idea of one “global plan”.

Meanwhile the climate action network Réseau Action Climat, which brings together 22 non-governmental organisations, has said that it does not want to see the nutrition and food plans merged. Even if the nutrition section is put “under the umbrella” of the new combined plan, it “must remain solely under the control of the Ministry of Solidarity and Health”, said a spokesperson for the network, fully aware of the risks involved.

For influencing the nutrition plan or even “actively taking part in its drawing up” has long been one of ANIA's strategic objectives, as shown by one of its internal notes dating from 2015. In particular it has wanted to “obtain” nutritional benchmarks that are “in line” with its own position and with health messages which do not “stigmatise”.

As the document we publish below shows, the food lobby association also hoped that the national plan would not include the objective of seeking to change products' nutritional contents. Yet that is precisely one of the aims of the health authorities - to be able to get  food producers to change what they put in their products.

In fact, some producers have willingly gone along with this approach since the introduction of the Nutri-Score system. Indeed, the major French food producer Fleury Micho supported the Nutri-Score system from the start and left the charcuterie inter-professional body - FICT - because the latter refused to adopt it.

In its letter outlining its reaction to the national food and nutrition plan, ANIA said that in relation to the “objective to reduce sugar/salt/fat and increase fibre” the “setting of the thresholds should be carried out in consultation with the professionals”. Yet virtually all these “professionals” - food industry experts – are firmly behind ANIA's stance. The association's headquarters on Boulevard Malesherbes near Place de la Madeleine in Paris, is home to Alliance 7 – which represents confectioners and biscuit makers - the Association des Entreprises des Glaces for ice cream makers, the Fedération de la Charcuterie (FICT), the Alliance pour la Préservation des Forêts – which includes Ferrero, Nestlé and Unilever who want to continue producing palm oil, cacao and coffee - the yeast producers' Confédération des Producteurs de Levure, and the brewery industry's Brasseurs de France. In all, ANIA has 25 member federations.

Several of those members are fighting against a reduction in salt in foodstuffs: the salt producers' Comités des Salines de France, the bakers' Fédération des Entreprises de Boulangerie et Pâtisserie Françaises and the bakery suppliers the Syndicat National des Fabricants de Produits Intermédiaires pour Boulangerie, Pâtisserie et Biscuiterie (SYFAB). On the subject of how much salt should go into bread, ANIA itself says it is against reducing the level to 16g of salt per kilo of flour. “At that level the taste of French bread is spoilt,” says the association.

“All European countries adopt a method that calculates the grammes of salt in the final product,” the food producers' lobby group says. “In the interests of consistency and harmonisation with all the member states, we're opposed to calculating the content of salt by g/kg in bread-making flour and thus prefer an approach [based on] grammes of salt in the finished product.” Serge Hercberg, professor of nutrition at Paris XIII university and a former president of the PNNS nutrition plan, told Mediapart this was a lazy argument. “You have to work on the flour so that it impacts on the final product,” he said. “Besides, you can progressively reduce the level of salt from 18g to 16g/kg without the consumers realising it, and even go down to 14g/kg.”

ANIA's federation members have also mobilised in unprecedented fashion against new consumption levels proposed by the public health body the HCSP and approved in January this year. According to the letters seen by Mediapart and Que Choisir, the Fedération de la Charcuterie (FICT) wrote to the HCSP in astonishment that they were recommending that consumers should “limit the consumption of charcuterie” to 150 grammes a week or 21 grammes a day.

“The average consumption of charcuterie is between 31g and 35g [editor's note, per day],” said the federation. “So this type of recommendation aims at reducing the consumption of three-quarters of the population. Yet it's just heavy consumers, in others words the quarter [of the population] eating more than 50g [a day], who should be targeted by such messages.” The federation continued: “The HCSP's opinion makes references to 'lovers' of meat and charcuterie. Isn't this reference, which does not feature in the other families of products, a form of shaming consumers as a whole?”

The dairy industry is also unhappy. Its representative bodies the Centre National Interprofessionnel de l’Économie Laitière (CNIEL), Syndilait and Syndifrais complained to the top civil servant at the Ministry of Health, the Directeur Général de la Santé, and to the Agency for Food, Environmental and Occupational Health & Safety (ANSES) about calls to reduce the recommended intake of dairy products from three to two items a day. The dairy lobby demanded scientific explanations for these recommendations. However, the food lobby failed in its attempts to get the health authorities to give way on these strategic points.

Meanwhile, new technology is starting to change the way that health messages are delivered. In the past, food health plans have struggled to get their recommendations implemented. But the adoption of Nutri-Score and its spread via various apps such as Open Food Facts and Yuka now offers consumers a very simple way to recognise products that might be less beneficial for their health. The calculation of the nutritional score per 100g takes into account the content of nutrients and foodstuffs to favour – fibre, protein, fruit and vegetables – and those factors and ingredients to reduce, such as calories, saturated fats, sugar and salt.

The resulting score therefore enables consumers to choose the more favourable item from products in the same range. As a result Nutri-Score has led food producers to change what they put in their products and to use less fat, sugar and salt, and it has become a useful tool in terms of prevention and public health policy. That is one of the reasons why ANIA has been opposed to it and is still battling for it to be “optional”, and is fighting the apps that use it head-on.

In its letter to the CNA outlining its concerns, ANIA said it was “urgent” that the public authorities take a look at the issue of the “reliability of the information transmitted via the product-grading apps”. It said: “Some apps used by millions of consumers supply distorted and scientifically invalid information. This type of information contributes to the cacophony over diet.”

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• The French version of this article can be found here.

English version by Michael Streeter