Latest / REAP/SOW / To me, it’s junk food – a Q and A with Marion Nestle
Transcript
- Teresa Cotsirilos: You’re listening to REAP/SOW, dispatches from the frontlines of food, farming, and the environment. I’m your host, Teresa Cotsirilos. So here’s a stat that might turn your stomach a little: The average American gets nearly two-thirds of their calories from foods that are considered “ultraprocessed.” Two-thirds! We’re talking potato chips and chicken nuggets. Foods that are loaded up with sugar, tons of salt and saturated fats…you know, the good stuff! Scientists and medical professionals have been warning us to avoid these foods for years now…and the health impacts are becoming more and more apparent. FERN recently partnered up with Inverse to publish a five-part in-depth series on all this. And as a part of this series, FERN contributor Claire Maldarelli interviewed the one and only Marion Nestle. Nestle is a renowned public health advocate and a professor emeritus of nutrition, foods studies and public health and NYU. And when it comes to the ultraprocessed food craze, she’s probably the best person in the country to talk to. I’ll let Claire take it from here. Claire Maldarelli: Hi, this is Claire Maldarelli, and I have with me Marion Nestle, who has been, I would say, in the food politics scene for the better part of, I don’t know, you tell me later, but for at least the past couple of decades. And this will be an interview focused on ultraprocessed foods, and it will be part of a larger package on ultraprocessed foods and their influence on our health. So I am going to start my question with how you originally got interested in this field, particularly food and food politics. You’re such a constant figure in this scene now for so long. But what originally got you interested in it? Marion Nestle: I got interested in food because I liked to eat. I was teaching cell and molecular biology at Brandeis University, and I got handed a nutrition class to teach. And, you know, I did a memoir a couple of years ago and I tell this story in the memoir, but it was like falling in love, and I’ve never looked back. I just thought it was, first of all, one thing, it was so much easier to teach than cell and molecular biology, because students were just passionately interested in the topic and they really cared about what they were eating. And in those days, students could do tremendous research and write terrific papers, and they all wrote terrific papers. So we had a really good time. Claire: Why do you think that is? Because cell and molecular biology is so abstract, I suppose, and food, we eat it every day, like multiple times a day, so, yeah ... Marion: Well, and then also cell and molecular biology until very recently was not affected by politics. Whereas politics affects everything in, about what we eat. And so in, even in my first class, I was talking about agriculture, food, nutrition, and health. The political and social and economic and environmental forces that were contributing to that. And also the science. Cause I was trained in the science, so I was having students, and this was in the biology department, they were supposed to be able to read scientific papers, and they could. It turns out ones in nutrition are much easier to read than ones in molecular biology. So it was just a phenomenal way to teach basic critical thinking about research. Claire: Do you think that the focus on food and nutrition was as strong then as it is now? I mean, our, the number of food companies and their control over the food system has only grown. With that has the interest in food and nutrition studies grown as well, do you think? Marion: Well, I was asked that same question in 1975, when I started out. Everybody thought that there had been this sudden interest in nutrition. Linus Pauling had just published diet for, had just published Vitamin C and the Common Cold. Francis Moore Lappé had just finished publishing Diet for a Small Planet, which was enormously influential. Michael Jacobson had just started the Center for Science in the Public Interest, which published a book called Food for People, Not for Profit that I used as a textbook in that first class in 1975. That laid out all the political issues. It was right there, from the beginning. So, yes, the interest has grown, and there’s much more about it in the popular press, but there was a lot then, too. Claire: I think that leads into, into my first, like, bigger question, more specifically on ultraprocessed food. And they have headlines, much of the nutrition and health news over the past couple of years, yet the term itself is still somewhat ambiguous and confusing to many Americans at least. So briefly, if you’re able to, what exactly is an ultraprocessed food? Marion: Yeah, I mean, first of all, I don’t find the term ambiguous or confusing at all. I don’t. I mean, to me, it’s junk food, you know, it’s a category of junk food that’s industrially produced, designed to be profitable and addictive, usually contains a lot of junk: additives, color, flavor, texture, additives. Sometimes a lot of sugar and salt and saturated fat, but not always. And you can’t make it in home kitchens. So it’s a, it’s a defined category of junk foods. They always used to be called junk foods. Everybody knows what junk food is. Really. Where the arguments are is at the margins. Okay. There are some ultraprocessed foods that aren’t as junky as others — whole wheat bread, for example. Or the other standard example is commercially produced yogurt that has a lot of sugar in it. But beyond those examples, and they’re very, very few of them, so there’s no point in focusing on them. The evidence is really very clear that the products that meet that definition — Doritos instead of corn on the cob or canned or frozen corn — are associated with poor health outcomes. And the number of studies is in the thousand by now. I mean, there’ve been literally hundreds of studies linking ultraprocessed foods with obesity, type 2 diabetes, heart disease, cancer, poor cognition, overall mortality — practically anything that you can think of. Okay. Those are observational studies, and they show correlation, not causation. But there are now at least three extremely well-controlled clinical trials that show that ultraprocessed foods induce people to eat more calories than they otherwise would. A lot more calories, enough more calories to account for weight gain in the population and to account for obesity in the population. And these studies are short term, but they’re now three of them. And they were done under extraordinarily well-controlled scientific conditions. I think they need to be taken very seriously. When I’m at my most hyperbolic, I say they’re the most important studies done in nutrition since vitamins. I think they’re really studies. So the subjects in those studies who were in locked metabolic wards where they couldn’t lie or cheat about what they were eating, couldn’t tell the difference between the two different kinds of diets they were put on. The diets were matched in protein, fat, carbohydrate, vitamins, minerals, and fiber, and palatability. And so now the investigators are trying to figure out what it is about these foods that encourages people to eat so much of them, because the difference in calories is 500 to 1,000. The three studies show the minimum was 500, an average of 500 calories more a day. And in the more recent study, it’s 1,000, and the one that was done in Japan was 800. I mean, that’s a phenomenal result. Claire: It is. Marion: Usually dietary studies, if they can find a difference of 50 calories, they think they’ve performed a miracle. Five hundred? I mean, an astonishing result. Absolutely unambiguous result. And yes, they were short-term studies, and I wish that the investigators had the money to run longer studies, and maybe they will. Claire: Do you think calorie intake is the most important concern when we’re talking about ultraprocessed foods? I know there’s so many food additives in them and other things that people kind of try to focus on, but to you it seems like calories are maybe the most important thing? Marion: I’m a calorie person. I think you can explain a great deal of the rise in chronic disease. You certainly can explain obesity from calories. You know, what the causes of that are is much more complicated. But, you know, the idea that obesity is the result of too many calories for the calories expended, that’s thermodynamics. You can’t argue with that. Why that happens is what’s being studied, and a lot of people have a lot of things to say about it. But I think we live in a food environment that encourages us to eat foods that are ultraprocessed because they’re the most profitable in the food supply, and they were deliberately designed to be irresistibly delicious so you can’t stop eating them and you want more. That was their purpose. Whether this is addiction in the formal sense of the word, whether or not, we can argue about. But as one of my friends explained it, Marion, when you eat a salad, you know when you’ve had enough salad. Put Oreo cookies or barbecue potato chips in front of me and I can’t stop. You know, I mean, everybody has this experience. And so that’s what ultraprocessed foods are designed to do, is to get you to keep eating them, because their purpose is to sell food products. Claire: Going back to what you said earlier where you said that, you know, junk food is just another name for ultraprocessed foods … Marion: Not quite, not quite. Ultraprocessed foods are a subcategory of junk foods. There are junk foods that are not ultraprocessed. Homemade ice cream, not ultraprocessed. Claire: But definitely, definitely an indulgent junk food. Marion: But definitely an indulgent. Claire: Why, why is it important or when did, first when did this term ultraprocessed food come to research and, like, the public interest? And then second, why is it important to make that distinction between junk food and … Marion: Well, it was invented in 2009 by Carlos Monteiro, who’s a professor of public health at the University of São Paulo in Brazil. He’s now retired. But he and his colleagues developed the term to try to understand what was happening in Brazil with the introduction of these new products that were changing the way Brazilians ate. Going from a traditional Brazilian diet that was really pretty healthy and based on real foods to one that was based on processed foods, and they could see that the nutrition, what’s called the nutrition transition, was occurring and people in Brazil were gaining weight and they were, and the kids were eating junk food and, you know, all this stuff was happening. And so they developed the term, and the thing that’s so important about the term is that once you have a definition of a category of food, you can go back and look at loads and loads and loads of studies, epidemiological studies, and see which category of, you know, they divided food into four categories. Three of them are food, and one of them is ultraprocessed. So you could take the ultraprocessed foods and look and see what people were eating and how much of the foods they were eating was ultraprocessed and do these correlation studies. And the correlation studies have a level of consistency that’s kind of breathtaking. So, I mean, they just basically all show the same thing: that the more ultraprocessed foods people eat, the worse health outcomes they have. You know, it’s, it’s linear, you know, and it’s phenomenally consistent. So that in meta-analyses that have been done — and there have now been a bunch of those — they all show that ultraprocessed food intake is correlated with obesity, type 2 diabetes, heart disease, cancers, et cetera, et cetera, et cetera, and overall mortality. So you could do research. And then you could do controlled clinical research. And the point about the metabolic ward studies, particularly the ones that were done by Kevin Hall and his colleagues at NIH, is that Kevin Hall didn’t believe a word of it. He just absolutely didn’t believe a word of it. He thought that the idea that processing would have any difference at all, would make any difference at all in what people ate was just ridiculous because all foods are processed to some extent. This is a particular category of processed foods. He was floored by the result. It was totally unexpected. He couldn’t believe it. Claire: So he originally thought that there would be … Marion: His hypothesis was the null hypothesis that there would be no difference. That processing would make no difference whatsoever. So he ran a short-term study to prove that processing would make no difference whatsoever. And to his astonishment — and I’ve heard him talk about this many times — he was astonished. Claire: Even in light of all of the correlation studies that had already come out. He still went … Marion: But they were correlation studies. Everybody lies about what they eat. Claire: Right, right. Marion: That’s why correlation studies are criticized, because they’re based on self-reported dietary intake. And you have no idea whether to believe it or not, you have no way of evaluating the quality of that data because people tend to, I mean, there are many studies that show that people tend to overreport intake of foods that they think the investigators will think are good for them, and they tend to underreport consumption of things that are supposed to be bad for them. So you really have, you know, no way of knowing, and so in a sense he wasn't paying, you know, those results, all of which showed major improvements in health among people who were not eating ultraprocessed foods, made him think that there was just something funny about that. And because he’s a superb scientist, he designed a really, really well-controlled study in which these diets were astonishingly well matched, so well matched that the participants couldn't tell which diet they were eating. They liked them all. They thought they all were equally good and they had no idea what was being studied. You know, they just didn't know. They were fed a diet for two weeks and another diet for two weeks. They didn’t realize they were gaining weight. They didn’t realize they were losing weight. So I think, you know, this is just a hugely important study. Claire: Yeah, I think that was gonna lead into my next question. What is sort of the weight of these studies, like these mechanism studies or noncorrelation studies? Not just that it proves what the correlation studies have already concluded, but what else can these studies do that the correlation studies can’t? Marion: Well, they came out with a result that was so unambiguous that if you were going to issue dietary guidelines, the first thing you would do would be to advise people to cut down on ultraprocessed foods. But it depends on who you are. So the dietary guidelines advisory committee, for example, chose not to consider those studies in its discussion of dietary in its recommendations to the departments of Health and Human Services and USDA. Claire: Why is that? Marion: Because the studies were too short, and they said if the studies had lasted longer, they would’ve shown a much smaller difference in calorie intake. Well, we don’t know that, do we? I mean, it’s a good guess, but we don’t know that. But the idea that they would ignore these studies to me was like ignoring the elephant in the room. There’s an elephant in the room, but let’s not pay any attention to it. I was kind of flabbergasted. Claire: Why have there been so few of these studies? Are they expensive or … Marion: They cost a bloody fortune. You have to, first of all, you have to get volunteers who are willing to be locked up for a month, not leave. And while they’re there to be fed and to be measured endlessly — everything they eat, drink, and excrete is measured. And also their physical activity. I mean, everything about them is measured. And they cannot leave. They cannot lie or cheat. And they’re paid in order to get people to do this. They’re paid. So you’re giving people a month’s salary, you know, and you’ve got all these people doing all these expensive tests. So costs a fortune, and people don’t wanna be locked up for that long, you know? So they are very few, very rare. And Kevin Hall is a national treasure and ought to be treated as such. Claire: So aside from these studies, like Kevin Hall’s study, influencing dietary guidelines, what role do they play for food companies? Because many people know that ultraprocessed foods like packaged cookies aren’t good for our health, but yet billions are still sold every year in the United States. So if a food company’s ultimate goal is to sell a product and to make a profit, what could make them sell a product that is, say, ultraprocessed and healthy? And would these studies influence that? Marion: I’m not, I’m not sure. You mean ultraprocessed and healthy? We don’t have the evidence that ultraprocessed foods are healthy. Claire: Is there a, would there be a way to make an ultraprocessed food healthy? Marion: Why would you want to, who would buy it? Claire: Well, if an, if a … Marion: I mean, you’re asking a very complicated question. Claire: Yes. Marion: Look, the food industry is in trouble right now. It has, there are four threats to the food industry right now. One is public interest in ultraprocessed foods. Another is the GLP-1 drugs, which one of their side effects is they make people not want to eat ultraprocessed foods. People are turned off of junk food. They don’t want to eat it. The third is inflation. The price of foods has gone up enormously, so people are buying less of it. And the fourth is RFK Jr., who wants to get ultraprocessed foods out of the food supply. So the food industry sees this as the writing on the wall and these four things coming together have pushed the food industry to try to figure out what to do next. Well, Nestlé has started a new line of products aimed at people taking GLP-1 drugs, and this line of products is higher in protein and higher in vitamins and minerals and fiber or whatever. Will anybody wanna buy it? I have no idea. You know, other companies are looking at ways. ConAgra has developed a set of products where they’re advertising them for GLP-1 takers. You know, I mean, are these products good, bad, or indifferent? Will they sell as much as junk food? I have no idea. I doubt it. Claire: But what you’re saying is their ultimate, if their ultimate goal is to sell, their ultimate goal is never going to be whether or not this is healthy or not. Marion: Oh, that’s not an issue. Claire: Yeah. Marion: It’s a nonissue. The purpose of a food company is to sell food, especially if it’s publicly traded. If it’s publicly traded, then it goes by the shareholder value movement, in which the single purpose of a corporation is to make profits for stockholders. I mean, it’s, that’s the investment environment we live in. You know, and unless we change that and change the rules by which companies evaluate, which Wall Street evaluates corporations, that’s not gonna shift, though, so the healthfulness of the product is a nonissue. Claire: Jumping back to RFK, like you said, RFK Jr., like you said, the Senate Finance Committee in late, he told the Senate Finance Committee in late January that, quote, highly chemical, intensive, processed foods were the, quote, culprit behind many of the chronic diseases affecting Americans. And that if confirmed, he would attempt to fix the food supply by targeting ultraprocessed foods. So if RFK is confirmed, what would you want him to, or whoever is put in charge of this department, what would you want this person to do regarding ultraprocessed foods? Marion: Well, he says he wants them out of schools, but that’s Department of Agriculture. I don’t know whether he has any control over that. And the kinds of things that you would need — I mean, he could put warning labels, he could call for warning labels on ultraprocessed foods like they have in lots of Latin American countries. That would be one thing to do. Raise the price, put restrictions on marketing, particularly to children. I mean, there are a number of things that you could do to make it more inconvenient and more expensive to buy those foods. That’s never been a Trump agenda, so I’m not sure where that’s going to go, and I haven’t seen strong food industry opposition to his candidacy. It may be behind the scenes, but I haven’t seen any public statements opposing his candidacy from the food industry, which makes me think that the food industry must not think that he’s for real. But I don’t know that. We’ll find out in due course. Claire: Has anyone been able to stand up to the food industry in the way that you’re, that he’s trying? Is there any precedent for that? Marion: Well, there’s certainly precedent in Latin American countries, where they’ve been able to get warning labels on food products in several countries in Latin America. They’re very, very worried about obesity there because they don’t have enough money to pay for treatment of type 2 diabetes, which is an expensive disease to treat. But there have been examples here. I mean, Center for Science in the Public Interest for 50 years has been fighting the food industry in ways that it can, on particularly labeling issues and content issues, and they’ve won some battles and lost others. But certainly there’s precedent for some wins. And there’s a big, I mean, Kennedy has a lot of bipartisan support for doing something about the food industry. I mean, that came as a big surprise to me. But there it is. And yeah, let’s get color additives out of cereals. I’m for that. I don’t think it’s the most important issue in the world, but I think ultraprocessed foods is much more important. But, you know, there’s never been a public health campaign at the national level, a real one to try to get people to reduce their calorie intake. And part of that is because eating less is really bad for business. It’s bad. The food industry doesn’t like it. The food industry’s job is to sell more food, not less. Claire: Right. Marion: So, you know, there are these sort of built-in contradictions here. Very hard to know how this is gonna play out. Claire: Do you think ultraprocessed food, this debate is more politicized than other food issues in the past? And if yes, why? Marion: Well, I do, because there are two sets of opponents. Two quite discrete sets of opponents to the concept of ultraprocessed food. One is the food industry. Ultraprocessed food is an existential threat to the food industry because it’s their most profitable products. But it also turns out, interestingly enough, to be an existential threat to a lot of nutrition researchers, who have spent their careers worrying about nutrients. Ultraprocessed food is not about nutrients, it’s about processing. And so some very surprising mainstream nutrition research leaders have come out against the concept of ultraprocessed food, complaining that it’s not well defined, it excludes healthy foods, it has all these problems with it, and I think that’s unfortunate. Claire: Unfortunate why? Marion: Because it’s a really important concept with a lot of research behind it. And if nothing else, if nothing else, these foods encourage people to eat more of them. I don’t think you need to know anything else. You know, I mean, if you are somebody who’s struggling with weight, and 75 percent of American adults are overweight or obese, well, here’s something you can do. Cut down on sugar-sweetened beverages and cut down on ultraprocessed foods. That doesn’t mean eating none of them. But it means eating less and, you know, if you can’t have these things in the house without eating all of them, don’t have them in the house, or buy them in small packages that have to be, you know, opened individually. I mean, it seems to me it makes nutrition advising really easy. Not gaining weight would be a really good thing to do for people’s health, and it’s very, very hard not to in the current food environment. Claire: Yeah, I think that was my next question of how easy is it to do. I think a lot of the blame gets placed on individuals, but how easy is it to just say, okay, I'm just going to avoid ultraprocessed foods? Marion: Oh, good luck with that. Claire: Right, right. Marion: You know, they’re in front of you all the time, and they’re cheaper than healthier foods. So there’s a built-in disincentive. You know, the way that I think about it is, if you are trying to eat healthfully in the current food environment, you, on your own, are fighting a $2 trillion industry. Claire: Yes. Marion: On your own. You know, I mean, these are powerful forces who are, that are in every possible way trying to get you to eat more of their products in every possible way. By having them displayed, by having them cheap, by advertising them, by having them talked about on social media, by having them seem so normal that to go to a supermarket and not buy sugar-sweetened beverages seems like a weird thing to do. Claire: What do you mean by seems so normal? In that, like, the advertising for them makes us not able to see what they’re trying to sell us, or, yeah … Marion: Well, yeah. It’s part of the landscape. You’re not supposed to notice it, and you don’t. You have to consciously, you know, the way an advertising executive explained it to me was that if the advertising is successful, it slips below the radar of conscious thought. So it approaches you on an unconscious level. And you don’t even realize it’s happening, and it’s so much this kind of advertising, product placement in supermarkets, you don’t even notice it. Claire: So that makes us almost up against an impossible, an individual up against an impossible battle. Marion: Oh, it’s impossible. Also, a lot of the marketing is aimed at kids, so you’re dealing with kids who are demanding that you buy this stuff, and, you know, sometimes if you haven’t got a lot of money, the one thing you can do for your kids that’s a treat is you could buy them junk food. You know? I mean, and there’s very good research showing exactly that attitude, that low-income parents are looking for ways and, you know, they can’t buy their kids bicycles.They can’t buy their kids cars. They can’t buy their kids expensive clothes, but they can buy their kids soda. Or junk food. And this is a way of expressing their love for their children. Well, the food industry did a really great job of setting that up. Claire: Given all of these players and the situation that we’re in, what would be your dream scenario? Not one that you think will come to reality, but what would be your dream scenario? Marion: First of all, we would get money out of politics, so we would have publicly funded election campaigns and candidates for office would not be able to spend one penny more than what the public allowed. We would overturn the Citizens United, the Supreme Court decision that allowed unlimited corporate money in politics. That’s my starting place. Then I want an agricultural system that is focused on food for people rather than feed for animals and fuel for automobiles. I want farmers growing fruit and vegetables for people under regenerative, sustainable conditions, organic, sustainable conditions. I want universal school meals, so kids get fed in school. I want enough money in school so the foods that the kids are eating in school can be healthy. And I totally agree with RFK Jr.’s. ask that ultraprocessed foods be removed from schools. I’m for that totally. I want to see a universal basic income so that poor people can have enough money to buy healthy foods. Dietary guidelines that are straightforward and honest. And talk about the need to avoid eating junk food and ultraprocessed foods. Claire: What about the role of food companies in advertising? Marion: Oh, I’d like restrictions on advertising, especially restrictions on advertising to children. I think advertising junk food to children is unconscionable. You know, I once went to a meeting at the White House when the Obamas were in it, and it was a meeting run by Michelle Obama about marketing food to kids. And after the speeches, everybody broke up into smaller groups to discuss what could be done. And in my smaller group, there was an executive from a very large food company who said, you know, I wish we didn’t have to market to kids. I really don’t think it’s right. I wish we could stop, but our stockholders won’t let us. So there you have it. There it is, phrased as overtly and, you know, as straightforwardly as you could ever hear it expressed. And so that’s what we’re up against. And if you as an individual are trying to keep your kid from demanding sugar-sweetened cereals or other kinds of snack foods that are designed for kids — the drinks, the sweetened drinks that are designed for kids, you know, with millions and millions of dollars in advertising and promotion budgets behind them — you are fighting that on your own. That’s pretty hard for individuals to do. Claire: Do you think that means individuals should just give up? I think that’s a really hard stance to be in … Marion: No! Organize, advocate, join organizations. You know, I mean, pull it all together. Yes, there are things that individuals can do on their own. I write a blog for politics.com. Tomorrow I’m going to be posting what you can do if you want to express your opinion about what’s going on these days. But there are ways of doing it, and everybody says they’re really powerful. If a senator or representative’s office is flooded by phone calls and letters asking them to do something or to stop doing something, they’re gonna have to pay attention. So yes, it’s a slow process. Yes, it’s a cumbersome process. Yes, food companies have a lot more money than you do, but there are ways of fighting back, and sometimes you succeed. And if you don’t fight back, you certainly won’t get what you want. Teresa: REAP/SOW is a production of the Food and Environment Reporting Network. Our Executive Producers are Theordores Rosss, Tom Laskawy, and Brent Cunningham. Our Sound Engineer is LAuryn Newson. Katie Gardner is the Producer and Video Producer for REAP/SOW. I’m your host, Teresa Cotsirilos. Special thanks to Claire Maldarelli for her work on this episode. Find out more about FERN and donate to support our independent non-profit reporting at www.thefern.org.