Science AMA Series: I'm Marie Bragg PhD, and I am the director of the SocioEconomic Evaluation of Dietary Decisions Program (SeedProgram) at New York University. Our research at SeedProgram looks at factors such as food marketing and policy in relation to obesity and health disparities. AMA!

Abstract

Hello Reddit! My name is Marie Bragg, and I am the director of the SeedProgram at NYU Langone Medical Center in the Department of Population Health. I received my PhD in Clinical Psychology from Yale University and I trained at the Rudd Center for Food Policy and Obesity From 2008 to 2014. I am an Assistant Professor in the Section on Health Choice, Policy and Evaluation in the Department of Population Health at the NYU Medical School, and also have a faculty appointment at the NYU College of Global Public Health. My research interests are centered around environmental and social factors associated with health disparities and obesity, and are focused in the topics of food policy, food marketing, and corporate behavior.

The SeedProgram is a research program set between NYU School of Medicine, and the College of Global Public Health. Our staff and interns work on research initiatives relating to the factors that play a role in exacerbating health disparities and obesity. Some of our current research initiatives include understanding the implications of racially targeted marketing by food and beverage companies on adolescents, corporate donations to academic institutions, and nutrition of sports advertisements. Last year, we published a study that showed the majority of food and beverage endorsements by popular music celebrities promoted unhealthy products, and it was well received by the reddit science community! .

I will begin answering questions at 2pm EST (11am PST). Ask Me Anything!

Check out the SeedProgram website for more information on our publications and our team! http://nyuseedprogram.org/

Edit: Hi Reddit! I am excited to get started with answering your questions and hear your responses. AMA!

Edit: Our Research Coordinator, Alysa Miller MPH, will also be joining us from 3-5PM to help answer some of your questions. Alysa and I have worked together since 2014, and she is a coauthor on the study on celebrity promoted products mentioned above.

Edit: Thanks so much for tuning in, Reddit! We had a lot of fun, and your questions were great. I hope you find ways to keep your enthusiasm about food policy and health moving forward, and that you'll have us back soon! -Marie and Alysa

What is the most tricksterish marketing you've seen that sends a "this is healthy" message to the consumer, but it could not be further from the truth? What was the product?

decoyduck12

Such an important topic!!! And I don't think there's enough time in the day to cover all the sneaky, sneaky things I've seen, but here are a few that stand out: Surprisingly, "organic" labels can really mess things up - Google, for example "organic oreos" and see how many cookies brands you find that are indeed organic. But they are still cookies with tons of fat and sugar. Most people might say 'oh, I know they are unhealthy because they are cookies, and I won't be tricked just because of that label.' But one study showed that people think it's more forgivable to skip exercise if you have had an organic dessert as opposed to NO DESSERT!

Even labels like 'low fat' (which appear on tons of products) can lead people to overeat.

Another thing that I really find to be tricky is the use of professional athletes like LeBron James and Peyton Manning to promote things like Sprite and Papa Johns etc. A few of our colleagues in Australia have done studies showing that kids are more likely to pick a product endorsed by an athlete and parents even think those types of food are healthier. Makes sense, right? The athletes are physically fit, and maybe they lead us to think 'if they eat it, I can too' or the influence might be more subtle and unconscious.

Pierre Chandon is a colleague of mine in France who does a lot of really interesting studies on portion size too, and shows you can really mess with people's bearings on how much they should eat when the bowl is really big, for example.

Even coloring can have an impact - anyone notice that a lot of frozen dinners that claim to be healthy have green packaging? They might still have tons of salt and fat, so checking labels is so critical! –M


What is your opinion on Keto diet?

Derfaust

I'm not well-versed in the Keto diet, but my sense is that it's a low/no carb approach. The sneaky things with diets is that they often work really well at first but can be hard for some people to sustain. I think we as a society get into dangerous territory when we vilify or idolize certain nutrients because not only are we missing out on really delicious foods, most nutrients can add something important to our health. My personal opinion (as a human person!) is more along the lines of the Michael Pollan approach to food: Eat Food. Not Too Much. Mostly Plants. He talks about eating food your grandmother would recognize (or maybe great grandmother for the really young ones out there!). Food Rules is a quick read and I think it really aims to get our society back to how we ate before obesity, diabetes, etc. really skyrocketed. And thanks for giving me a reason to learn more about the Keto diet! –M


How do you determine what's objectively healthy or unhealthy? What's your criteria for this?

Do you think marketing products as Non-GMO or Organic gives a false sense of 'healthiness'?

Thank you for your time!

Young_Zaphod

Great question! In our studies we use the Nutrient Profile Model (NPM), which is the standard for child-targeted food marketing in the UK, to categorize foods as healthy or unhealthy. This model grants points to foods that have nutrients that should be limited (calories, saturated fat, sodium, sugar), and subtracts points for nutrients that are encouraged (fruits, vegetables, nuts, fiber, protein) to generate a score that is then translated to a scale that is easy to understand (Nutrient Profile Index scores), where 1 is the worst nutrition score and 100 is the best score. A score greater than or equal to 64 is considered the threshold for products that can be advertised to children in the UK--so this number is used as our cut off point. Because a limitation of this model is that it codes some sugary beverages as healthy, we code beverages into 11 drink categories, 3 sugary drink subcategories, and 5 other drinks that were identified by the UConn Rudd Center’s Sugary Drink FACTS Report to make this distinction.

To address your second question, I do think marketing certain products with specific “health claims” does sometimes give a false sense of what is healthy vs unhealthy. Schuldt and Schwarz's "The "organic" path to obesity? Organic claims influence calorie judgments and exercise recommendations" study explores this and noticed that study participants are more inclined to eat a product that’s labeled “organic” compared to one without this label, and often fail to take into account the amount of calories and ingredients that are actually associated with the product. Thus, people tend to ignore (or simply not think about) the nutrition aspect of a product that has a “health claim,” which can make it difficult for people to make healthy choices. -AM


Hello Dr. Bragg,

Do you feel that childhood obesity is a problem that should be solved through government regulation or do you feel it can be corrected by social movements? For example the movements that are advocating buying local and being aware of food resources other than those supplied by big food companies. Thank you for taking the time to do this AmA it is much appreciated.

urnotmydaddude

A great question, and thanks for having me! Both government regulation and social movements are really critical because each can sneak into places that the other can't. For example, we know taxes are having a big impact on sales in Mexico and Berkeley, CA - a social movement might not create that much change in such a short period, perhaps because people are really sensitive to price in an immediate way. In contrast, companies' ads are really, really well protected under the 1st amendment of our Constitution, so we can't really regulate ads in this country like Chile, Argentina, and other areas. BUT, if people get really fired up about an issue (like targeting children with products that are going to set them up for health problems later on) - if people take to social media and demand companies change their practices, companies often listen. One example of recent backlash on an ad involved Pepsi's controversial commercial with Kendall Jenner. Anyone see it?

One big take home message I hope to leave you with is that your voice matters - companies care a lot about what you think. One of the reasons I was excited to do this AMA is because I think the Reddit community has a lot of potential to be a change agent for good in the case of obesity and using the internet to demand that companies promote healthier products to youth and communities of color. –M


my son is 2 and a half years old. I try to feed him nutrient dense organic food as best I can. we don't have any soda, candy, etc in the house. But it's hard to compete with the taste and fun factor of the processed foods he sees other kids eating at school. It's like crack cocaine when he gets a hit of that stuff.

I'm trying to get him to like and prefer well prepared healthy foods. Do you have any advice? I don't want him to grow up thinking all the processed junk is "normal".

Megajawn

I definitely understand how this could be difficult! Kate Adamick with Cook for America guest lectured in one of my Food Policy and Politics grad school course with Marion Nestle, and I especially remember her talking a lot about how preferences for foods are learned rather than an innate behavior. She mentioned how repetitive encounters with healthy foods are a good way to encourage and normalize these preferences, particularly when it comes to children. Obviously there will be some things your son prefers more than others, but I think setting the example at home (because research has shown how influential the home environment is for establishing eating behaviors) is an awesome way to start. As active members of society we can only do so much to control what we or our kids see being promoted in the environment, but you certainly have more control over this at home.

Another thing that I think is really important is to just continue to educate our kids on what should be normal eating behaviors compared to what shouldn’t be. So doing things like making fruits and vegetables more “fun” by cutting them into fun pieces, talking about how colorful and cool they are, showing them tools on the internet that describe how much sugar you’re supposed to have per day vs how much sugar is in one soda, or at an older age showing them how athletes like Steph Curry drink water which helps them perform better can be really effective. Sounds like you’re doing a great job by trying to combat the influence of the environment and with determined parents like yourself, I think our society is making a move in the right direction! -AM


Do you believe food stamps should be able to be used on nutritionally useless (or harmful) items like soda? Why or why not?

It seems like diverting that 5%+ of aid towards efforts like yours would be much more beneficial for society.

Hippie-Viking

This is a really controversial issue that we do believe is important to discuss. Howeve,r we don't do work specific to food stamps, but we have great colleagues who focus their work on this topic and help keep us involved in the discussion. The article above is a insightful read into whether to restrict or not in the SNAP program.


I constantly see anti-smoking commercials portraying smoking as something unsexy, unhealthy, and something one should never partake in. Do you think similar commercials about, sugary beverages, and/or other unhealthy foods could have a significant effect on reducing our consumption of said food?

kRobbn

Thanks for your question! It is possible that counter-marketing campaigns that show the negative impact of consuming unhealthy foods and beverages may influence eating behaviors. Studies show that there are many similarities between marketing practices of cigarette and food/beverage companies. Here’s one example

A recent study shows that counter-marketing campaigns similar to those aimed to reduce smoking may have similar effects on eating and drinking behaviors. The above article also highlights monetary resources as a competing factor between these campaigns and food/bev companies. Thus, as this article mentions, it is important to make these initiatives a group effort (i.e. involving government agencies, community organizations, and advocacy groups). -AM


What was something that you found to be surprising or shocking in your studies? Does your research mainly focus on adults or the population as a whole? Are there major behavioral differences if you were able to compare adults and children?

oldpplfreakmeout

One thing that I've found to be really shocking is how much money companies spend on endorsement deals, and just how MANY endorsement deals are out there. We did two studies, one on athletes and one on pop music celebs and the vast majority of products being endorsed are really unhealthy foods or sugary beverages like Coke, Pepsi, or Gatorade. Those two studies have some figures from media articles that estimate Beyonce, for example, made an estimated $50 million for her contract with Pepsi.

Our research is a mix of focus. One of our studies that had more of a youth angle showed that food products in supermarkets were really heavily kid targeted (meaning the products used cartoons or pictures of kids on the package) and most of those products were unhealthy too. (Picking up on a theme yet!?) And teens were more likely to see commercials for those products as compared to adults.

The main thing to be concerned about with kids is that often little ones under age 8 years don't yet have the capacity to distinguish ads from other tv programming (meaning they don't have a solid grasp that the point of the commercial is to sell them something). So there have been a couple of studies showing preschoolers actually think a food actually tastes better when a McDonald's logo is on the package, or in the other study, licensed characters like Shrek. Guess how much money in sales Spongebob is able to generate for products? The answer is in the intro of that paper... –M


what in your opinion is the biggest cause for childhood obesity?

kyleflippynips

I'm back after a break to head home! Obesity is really complex, with everything from the built environment (e.g. lack or presence of sidewalks, reliance on cars etc.) and lack of physical activity, to the cheap price of unhealthy food and everything in between. But we know you can't outrun a bad diet, and the high availability of really unhealthy food that's also cheap is a recipe (no pun intended!) for disaster. Imagine a world where the healthy food was dirt cheap and chips cost $10 a bag. It's hard to argue that the price and availability issues aren't huge factors in childhood obesity. One thing is for certain - no single policy or intervention will fix it all. We need to make changes in school foods, marketing, nutrition assistance programs, and access to food in low-income communities.


Would you ever consider studying the health impacts from taxes on soda or sugary foods?

Most_kinds_of_Dirt

Great question! We believe that this is a very important topic to study given findings that sugary beverages and nutrient-poor, energy dense foods contribute to obesity. Soda taxes have been implemented in Berkeley, CA and in Mexico, and research shows that soda sales have decreased. As soda taxes are passed in more cities (e.g. Philadelphia), we would definitely be interested in studying how this policy regulation will impact purchase behaviors, consumption, and overall health. -AM


I read an article a couple of years ago describing an experiment where cocaine addicted rats preferred sugar to a dose of cocaine. Is there anything to that? Do you think sugar could or should be classified as a drug?

Shitty_Orangutan

I don't study this area, but one of the women I went to graduate school with, studies food and addiction. Her name is Ashley Gearhardt, and she is at University of Michigan. There have been a number of studies that show peoples brains can respond to sugar similarly to addictive drugs like cocaine. It is unclear yet, how strong the linkage is, since our brain responds strongly to stimuli like sugar and sex, and defining what stimuli are addictive is the challenge. I don't believe the evidence is strong enough to label sugar as a drug, but more research on food and addiction is needed to illuminate the realities of a possible relation.


[removed]

[deleted]

Thank you for the question! In regard to what you should replace, one of the biggest factors is highly processed foods, especially those with lots of ingredients. One tip we often share when food shopping is to try to stick to the outer edges of the supermarket and only go into the aisles for packaged things that you know are healthier (e.g. go into the aisle for beans, but maybe not cookies!). Of course everything in moderation is a big mantra, but if I had one suggestion, it would be cutting out processed foods from the middle of the grocery store! –M


Has anyone looked at the health impact of the restrictions placed on which kinds of foods can be purchased with food stamps?

jaycatt7

We responded to a similar post about this, but I'll share more here too. I think it's a really seductive idea to restrict the kinds of foods that can be purchased using SNAP (previously food stamps). But a lot of experts have made the following points, and I think it's up to all of us to really, really challenge ourselves to be open to these points.

  1. It is unclear if SNAP item restriction will improve participant health outcomes.
  2. SNAP item restriction will decrease participants' agency and may increase stigma.
  3. Agency-preserving alternatives exist, some with population-wide health benefits.
  4. Trade-offs between lost agency, increased stigma, and health goals must be weighed.

Have you found evidence that an increase in advertising of healthy food products will shift people's purchasing choices away from their unhealthy substitutes?

JanJonDijonMustard

I was at a conference, and one of the speakers told a story about an advertising company who had done work with food an beverage companies, and they decided to do a pro bono campaign for broccoli. They came up with a campaign that included an ad painted on the side of a building in a town saying, "Broccoli, Now 35% less pretentious than kale", and the presenter said broccoli sales went up in the town where the ad was placed. The problem is that, healthy products often do not have enough money to compete with unhealthy products, and so funding would be needed or the public would have to urge companies to shift to healthier marketing practices. As well, it cant just be about advertising, but there must also be an increase in access to healthier foods. For example, in New York City the Green Carts initiative is working towards this, though they still face challenges with competition with unhealthy foods. Community Supported Agriculture (CSA) is another alternative to increase healthy food access, especially when you can sponsor a family in need of a CSA package. -M


If a celebrity came to you to ask you what food or beverage they should never endorse because it is the worst/unhealthiest out there, what would you tell them?

What do you think about the - in my view - overabundance of "healthier choice" and similar phrases on packaging of products that may not be all that healthy?

MartijnCvB

This is an interesting question! If a celebrity asked me this question, I would tell this person not to endorse any product that is incongruent with their own lifestyle choices. For example, I would tell an athlete not to endorse a soda product. It is unlikely that an athlete would choose soda over water after an intense workout mainly because it is sugary and will likely make the person feel weak and tired, the opposite of what is intended by exercising. Further, young people are impressionable and may wrongly perceive unhealthy products with being physically fit.

We believe that food and beverage companies should be transparent in communicating the healthfulness of their products. The FDA has restrictions on what can and cannot be defined as “healthy” which they are currently redefining. While this may be helpful, we as consumers should also pay close attention to nutrition labels on food and beverage products instead of relying solely on food and beverage companies’ definition of “healthy” . -AM


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redditWinnower

Neat! -M


There seems to be a lot wrong with our country's dietary habits. Where do you plan to begin? Can we get nutrition facts taken off water and put on alcohol?

Oliverheart84

That's a great idea! I have a hunch the alcohol industry might not be thrilled about putting calorie labels on bottles.

One place to begin is focusing on children, for a few of reasons: the dietary habits we set up in childhood often follow us into adulthood; people and policymakers AND even companies are usually much more receptive to working on prevention issues that affect kids as opposed to adults (because with adults it feels like it's being too restrictive); obese children are more likely to become obese adults (as compared to normal weight children), so prevention is going to be key. -M


Hello Dr. Bragg,

Can you elaborate on the effects of front of package labeling and how consumers may be better informed by making changes to labeling laws?

uditmodi

Great question Udit! :) We did a review paper on front of pack labels and found that the most effective labels are really clear, basic, simple labels with big font and an easy message. Specifically, some areas of the UK have had traffic light labels on products to signal which are unhealthy (red dots) vs medium healthy (yellow) vs healthy (green). But really detailed labels with small print and percentages are often really confusing for people.

Unfortunately, these kinds of labels don't do too much to impact consumers. I highly recommend Marion Nestle's blog called Food Politics if you're interested in following labeling laws!


As non-american, I love the titles of US programs compared to the lame ones we have in Europe.

Who was in charge and how long did it take to find the name for the program & the corresponding Seed acronym?

JJHeckman

Thanks!! It was actually my ten year old cousin who got me closest to the name. I told my family I'd give a prize to the person who came up with the best name. A few people made suggestions, but she emailed me different ideas for days. It was amazing. Some were cute and included words like 'tummy cravings' in the title, but when she said something about "socializing about dietary decisions", it was enough to get me the rest of the way with SeedProgram! She's a smart cookie, so I sort of hope she follows in a path of science too!


I've observed those with lower socioeconomic standing often unable to follow a vegan diet; do your data support this at all?

Zen_Balloon

We actually haven't done any research into effects of demographics on feasibility of the vegan diet. It does, however, make sense that you have observed those with lower SES to have increased difficulty in following such a diet compared to their higher SES counterparts due to factors such as low availability of these products and the higher cost of them. It would be interesting to have more information on this! -AM


How is academic or "real" science related to diet combating "fake" science news of the same variety?

btn1136

I hope doing things like this can help - we try to do radio shows so people can call in from anywhere in America, too, and a lot of questions will start 'I heard that....' and then cite fake science news. It's a good opportunity to share real science in a way that doesn't make people feel bad or like they were duped. I do think we need to do a better job teaching students (from elementary school through college) how to discern fake science from real science. My advisor in grad school used to say "Once a paper is published in a scientific journal, then the real work begins" - he emphasized the importance of disseminating research to policymakers, the communities we want to impact, and the media. I think part of my role can involve trying to encourage other scientists to think about the impact they can have in combating fake science by disseminating their work widely. -M


Hi! Thanks for having the guts to weigh in publicly on a topic so many people feel so passionate about. Do you see any generational differences? Are things improving with time or getting worse? I feel like people I know my age (late 20s) eat way healthier than our parents, but I also wonder whether that might just be my particular bubble.

dekker44

That's so nice of you! It was a little terrifying when I first thought about doing this, but we have two students in my group (shout out to Udit and Jessie!) who were really eager for us to give this a try, and I'm so glad we did. I don't know of exact generational differences in dietary trends, but a recent Nielsen survey suggests you're right.


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