Monday, February 23, 2015

Marion Nestle on what really influences eating in America

Spencer Platt/Getty Images
The way we think about food in America is about to change again. On Thursday, a government-appointed scientific panel released a 600-page document that will start a year-long process to update the 2015 US dietary guidelines for Americans. These guidelines only come out every five years, and they matter for one simple reason: they truly set the tone for how Americans think about the commonest medicine of all — food — and so they impact health outcomes in this country.
food politics nestle
(image via Amazon.com)
This document was of particular interest to Marion Nestle, a New York University professor who wrote the seminal tome on the politics of nutrition (it is appropriately named Food Politics). In the book, she documented how American eating practices are shaped much more by the invisible forces of industry and powerful lobbying groups than science.

Since the 1970s, for example, the group that sets the national guidelines caved under pressure from the meat industry, shying away from warning against the potential health harms and environmental damage of eating too much meat. They also vilified dietary fat based on very weak scientific data, driving the food industry to respond by packing sugar into newly marketed "low-fat" products. This amounted to what some have called a "global, uncontrolled experiment" that can be likened to "mass murder."

I emailed with Nestle about this new round of recommendations — what they mean, whether they show industry influence, and how they could shape the future of food in America. Here's what she had to say.
Julia Belluz: You've been writing for years about how these food guides aren't exactly been free of politics and industry influence. Where did you see the fingerprints of those forces on this new document?
Marion Nestle: This document is remarkably free of such influence. But these are not the actual guidelines. This is a research report. The agencies — USDA and HHS — will use this as the basis of writing the actual guidelines.  But the agencies will also draw on public comments. That's where the politics will come in. Stay tuned.
JB: Are you optimistic? Do you think America is moving closer to science when it comes to food policy? 

MN: The guidelines have always been based on science and the overall science hasn't changed that much. What has changed is the politics.  Guidelines have never been allowed to say, "eat less of anything." Instead, they couched the advice in euphemisms like "choose lean [meat]."  But the food movement has made it obvious that it's much healthier for people and the planet to eat some kinds of foods more than others. This committee is saying that loud and clear. For those messages to stick, people will need to file supportive comments over the next few weeks. The lobbyists will be weighing in so it's important that this committee report gets a lot of support.

brazil

A page from the Brazilian food guide.
JB: I recently looked at Brazil's food guide, which I know you're familiar with, and I was taken aback by how common sense and easy to follow it was, how it actually reflected the way people live with food. What's standing between America and a more reasonable approach to food like the one set out in Brazil?

MN: Food industry opposition and a Congress that is friendlier to corporations than it is to public health. Congress has already weighed in. Food trade associations will weigh in during the public comment period.
JB: A lot of the talk around the new recommendations has focused on potential changes that might come down in the forthcoming guidelines: adding a cap on added sugar intake and saturated fat, noting that coffee can be part of a healthy diet — and dropping the long-standing warnings about cholesterol as a "nutrient of concern." Any thoughts on how these suggestions could shape the future of food and eating in America? What's standing between Americans and a better diet?
MN: In two words, lobbying and marketing. Food lobbies are fierce in defending against anything that might affect product sales. And the food industry spends close to $20-billion a year to convince the public that its products are delicious, nutritious, and fun to eat.

It's hard to evaluate the impact of dietary guidelines on consumer behavior. These are guidelines for policymakers and professionals, not the general public. And right now, these are not yet guidelines.  They are recommendations based on research and the agencies write the guidelines.  But if the guidelines say "drink less soda" and "eat less meat," the message will be clear and could have a big effect on behavior.

JB: If you were food czar, what kind of guidelines would you make?


MN: I think dietary advice should be simple: eat more plant foods (fruits, vegetables, nuts, grains), don't eat too much junk food, and balance the amount you eat with physical activity.  Beyond that, there's plenty of room to eat what you like and stay healthy.
CARD 1 OF 15LAUNCH CARDS

What is obesity and why are we so obsessed about it?

The word obesity comes from the Latin "obesitas," meaning fat or plump. "Body mass index" or BMI — a calculation of a person’s height and weight — is the most widely used method for measuring obesity, though it is by no means perfect. BMI will put really muscular folks — and actors like Tom Cruise — in the overweight and obese categories because it cannot distinguish between lean muscle mass and fat mass. 

Most people aren't athletes or Tom Cruise, however, so BMI remains a pretty good indicator. You can find your BMI using this online calculator or on the chart here. A BMI of 25 or more puts a person in the overweight category; 30 is the threshold for obesity.

As for the attention on obesity, the reason is simple: it's become one of the greatest health scourges of our time in developed and developing countries alike. 
"Obesity costs the world nearly as much as war, armed violence and terrorism," one Financial Times writer put it. He also wrote: "Yet in dealing with obesity, we are like 16th century navigators using maps with missing islands and misshapen continents." 

Obesity is linked with a range of diseases, from diabetes to cancer, and around the world, it's thought to contribute to three million deaths each year — yet we don't know precisely what has caused rates of obesity to rise or how to stop the spread. There are also more than a billion adults who now classify as overweight or obese, and the epidemic has hit low- and middle-income countries, where starvation and malnutrition are still widespread.

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