Commentary: The Heart Association Is Selling Its Soul

Few things proclaim good health as strongly as the simple red heart that serves as the logo of the American Heart Assn. For a nation obsessed with health foods, weight loss, and longevity, the "heart smart" logo is as American as low-fat apple pie. And now it's for sale.

For $2,400 the first year and $650 each year thereafter, food companies can slap the paramount symbol of heart health on their products. Since the program began in 1994, 636 foods have been certified as low in total fat, saturated fat, and cholesterol. They now carry the heart association seal--and more are coming.

But some of the certified foods seem to run afoul of the association's own dietary guidelines. V-8 juice, Promise Ultra Fat-Free Margarine, Yoplait Original Fat-Free Plain Yogurt, and Wheaties seem worthy of the association's seal of approval. But look at what products also proudly wear the logo: Cocoa Frosted Flakes, Fruity Marshmallow Crispies, and a brand of cappuccino called Belgian Creme. These products sneak through because, though certainly high in sugar, they are low in fats and cholesterol--the only things the heart certification process addresses.

GRAPHIC EVIDENCE. The heart association has also begun lending its logo to certain medicines to win corporate funding for broad public-education programs aimed at helping people reduce heart disease risks. AHA President Martha N. Hill insisted, though, that the heart association works hard to guard the sanctity of its logo: "It is very important to us, because it is the graphic representation of our credibility," she said at the AHA's annual scientific meeting in mid-November.

But seeking corporate support can be risky, as the American Medical Assn. found out recently when it announced a plan to allow its logo to be used on Sunbeam products such as heating pads and thermometers. A huge wave of criticism forced the ama to back out of the deal--and the heart association could run into the same kind of firestorm. Bristol-Myers Squibb Co., for example, paid $600,000 for use of the AHA logo for one year in ads for Pravachol, a cholesterol-lowering drug. To the casual eye, the ads seem to be a specific endorsement of Pravachol, one of many cholesterol-lowering drugs. "We're not saying that at all," insists Hill. "There's no value judgment there." Perhaps, but that qualifier does not appear in the ads.

A program in which the AHA teamed with Bayer Aspirin to raise funds was, likewise, not intended to be an endorsement. That program was questioned by the editors of The New England Journal of Medicine. "Why should the American Heart Assn. endorse only Bayer aspirin?" they asked in an editorial in September. Bayer is no better than other brands at reducing the risk of a heart attack.

The food-certification program, unlike the Bayer and Pravachol campaigns, is not intended to raise money for educational efforts. The $431,000 it has brought in since 1994 is intended only to cover administrative costs for the program, developed by the heart association's staff. Still, the scheme has provoked concern among members of the group's volunteer nutrition committee. Committee Chairman Dr. Ronald M. Krauss is concerned that the food-certification effort may be undermining the heart association's own dietary guidelines, which specifically do not identify good foods and bad foods. They instead say that the overall diet should be low in fat, cholesterol, and sodium. "The public may be attaching more significance to [the logo] than we think they should," Krauss laments. "This is not saying, `You should eat these foods so you don't get a heart attack."' The fine print beside the logo will soon change to say only that the foods meet fat and cholesterol standards--not that they belong in the diet.

That subtlety may be lost on companies paying for the logo. "The AHA logo...conveys instantly the health benefit of the product," says Pam Becker, spokeswoman for General Mills Inc.

As the heart association moves closer to industry, it might find its credibility suffering. It might also discover that its industry-supported programs are not improving public health. Some of those sugar-coated cereals could be doing the opposite.

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