Let's put all the cards on the table. I have worked for the food industry in science communications for about 25 years and I am beginning to wonder whether the main bete noirs of the industry, Popkin (UNC-Chapel Hill), Ludwig (Harvard) and Brownell (Yale), might be right about what the nation needs to do about obesity, diabetes and heart disease.
It is a sobering thought.
I was struck with this heretical thought when I was sitting in the lobby of the beautiful Durham Performing Arts Center waiting to see the national touring company's performance of Wicked. What grabbed my attention was the vast number of morbidly obese people who were there to see the show too. All I saw were people with diabetes and high risk factors for heart disease. According to the CDC, North Carolina has an adult obesity rate of about 29%, and I wondered how could they all be in Durham at the same place, at the same time, waiting to see the same show?
Then, about 10 days later, I was in the west North Carolina mountains where legendary golfer Bobby Jones built golf courses and mansions to escape Atlanta's blistering heat, and a family friend introduced me to a chef that had just opened a "good old southern home cooking" restaurant. The portions were enormous. USDA's MyPlate program was nowhere to be found. The only plate I saw was overflowing with fried food and canned green beans and corn.
How do you reconcile 30 years of dietetic advising, counseling, lecturing and cajoling consumers that there are no good foods or bad foods, just good diets and bad diets when the nation's obesity, diabetes and heart disease rates soar?
A bit of history - In 1990 when Congress passed the Nutrition Labeling and Education Act, those of us at the negotiating table, knew there would be a nutrition facts box and we also knew there would be no education. USDA and HHS tried a food pyramid but after 10 years it had become a prime example of federal program failure. Industry did not want it, and the Chairman of the Senate Committee, the late U.S. Sen. Ted Kennedy (D-MA) and the Ranking GOP Senator, Orrin Hatch (Utah) were not interested. Now USDA wants to market MyPlate, a plate that tells consumers it should be half filled with fruits and vegetables. There is no evidence or best practice that MyPlate will do any better than the disgraced Pyramid.
Think of the obesity challenge this way - every aisle of the supermarket has a lobby in D.C. The job of the lobby is to try to get the feds to promote their "good" foods or nutrients and leave all the others alone, although competing food groups do battle with each other through a maze of law firms and trade associations.
Several months ago, USDA's politically correct Food Nutrition Service and the "lefties" at the School Nutrition Association, proposed schools should be, in effect, be prevented to serve oven baked french fried potatoes, because they were starchy. No matter that according to the CDC, all white potatoes served in schools represent less than one percent of daily caloric intake for all school-aged children. No matter that white potatoes are cheap and packed with critically important potassium and dietary fiber, something that the Institute of Medicine has been saying for years to deaf policy-makers. The PCers also forgot that russet potatoes are grown in large abundance in more than 20 states, that's about 40 automatic "no" votes in the Senate. Eventually, after all the speeches were given, the ill-informed USDA language was deleted on the floor of the Senate and the issue died, for now.
Activists policy makers present a compelling argument, using current data, that the old mantra of "all foods fit" has failed. Therefore, new ideas to ban, tax and restrict foods served to school-aged children are needed, although there is no evidence these new measures will reduce total caloric intake. We do know all these taxes are regressive and adversely impact the poor, but the poor do not have as many votes as food growers or manufacturers.
We do need basic dietary guidelines but every five years the politics overwhelm the nutrition. The system to create the Dietary Guidelines is fatally flawed with self-interest from all sides.
Nutrition is a tower of Babel. The researchers speak in grams per kilograms of body weight. The Nutrition Facts Box is in grams when consumers barely understand ounces. No one really knows what a calorie is. Importantly, few consumers knows how much physical activity it takes to burn 100 calories, the new caloric yardstick from the food marketers at Cornell - it is a Hell of a lot of walking.
The Obama's personal chef goes on NPR to regale an audience with stories about how he picks vegetables from the White House garden every day for the First Family's dinner. FLOTUS, the First Lady, wows TV audiences with her ability to jump rope with national champions. Great for the Obamas, but what about the obese and morbidly obese?
RDs from across the nation who counsel obese patients, a far cry from the "ivory tower do gooders" tell me their patients know a banana is better than many of the foods they eat, but they do not want to change what they eat. That's the bottom line. People have to want to change. Government cannot force it. Maybe if you live in Norway or Denmark but not in the good old USA.
Is there a viable solution? I think not. Don't look to Congress, the House and Senate are dysfunctional. The Administration is engaged in house to house and street by street warfare in what may be one of the the most crucial elections about the future of the country. Meanwhile, the food industry will continue to carpet bomb state initiatives to tax or restrict the marketing of their products.
It may take a catastrophe combination of diabetes, amputations, and heart disease in school-aged children to make everyone care enough to reconsider what they want to eat. What a tragedy?