Friday, January 24, 2014

Can Subway be Healthy?

Today, Subway announced a new agreement with the Partnership for a Healthier America (PHA). PHA is a non-profit group that was started by First Lady Obama to reduce obesity in America.

When I saw Mrs. Obama speak last year at the PHA conference, she was really starting to emphasize that marketing is a big cause of overeating. You can provide all the "health choices" you want, but if you price the unhealthy ones lower, and have ads all over the television for them, they are going to sell more.

The new PHA agreement with Subway takes a step in the right direction. As part of the agreement, Subway will form a policy on advertising to children. (Hopefully PHA will have to approve this policy.) In addition, they will spend $41 million to advertise fruits and veggies to children. This type of advertising is badly needed to compete with the billions of dollars that advertise junk foods to kids.

So the real question is: will this get kids to eat healthier at Subway? In our study of what teenagers buy at Subway and McDonald's, we found they were eating a lot of processed food, few veggies, and a lot of calories.

My view is that the change in marketing is a positive step. But, there is still a problem with much of the food at Subway. We found that teens ate 2,149 mg of sodium in a Subway meal. That's more than 3 times what the National School Lunch Program recommends. Now, in truth, salt amounts are not very important for young kids. But the amount of salt tells us that the food at Subway is highly processed. For instance, the meat and bread have a lot of salt because they are highly processed. And we know that processed food leads to many of the problems of obesity. Notably, in the agreement they were only able to agree to 935mg of sodium in kids meals. That is more than our panel of experts and RAND recommended (700mg).

How else could we know if kids are eating healthier at Subway? I would want to know if they are eating more vegetables. I do not see any specifics in this agreement about Subway reporting how many servings of veggies they are selling to kids. PHA often does require these types of reports, but I do not see it in the press release. The best way to study this is doing what I did: collect receipts from kids and calculate what they are eating. But, it would be much easier if Subway would give vegetable sales out, so that researchers (like me) could analyze it.

What happens if they do get kids to eat more veggies, and somehow less meat and refined grains? What happens when the kids get to the cash register? For those of you who frequent Subway, you know there is a giant display of cookies. The sales clerk almost always asks, "Would you like a cookie and a drink with your sub?" Having cookies at the cash register is a risk factor for disease. So the easiest thing Subway could have done to improve health is to move the cookies to a place kids are less likely to ask for them, and parents are less likely to buy them.

I congratulate Subway and PHA for the agreement, but would like to see some objective and public research/analysis. Without this analysis, the public will not know if this is another Subway marketing scheme or an improvement in what kids are eating.
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