by Marion Nestle

Search results: public health strategies

Jun 27 2013

World Health Organization takes on the food industry

I’ve just been sent a copy of  the opening address given by the Director-General of the World Health Organization, Dr Margaret Chan, to a Global Conference on Health Promotion in Helsinki on June 10.

Here is an excerpt from her extraordinary remarks:

Today, getting people to lead healthy lifestyles and adopt healthy behaviours faces opposition from forces that are not so friendly.  Not at all.

Efforts to prevent noncommunicable [chronic] diseases go against the business interests of powerful economic operators.

In my view, this is one of the biggest challenges facing health promotion…it is not just Big Tobacco anymore.  Public health must also contend with Big Food, Big Soda,and Big Alcohol.

All of these industries fear regulation, and protect themselves by using the same tactics.

Research has documented these tactics well. They include front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that confuses the evidence and keeps the public in doubt.

Tactics also include gifts, grants, and contributions to worthy causes that cast these industries as respectable corporate citizens in the eyes of politicians and the public.

They include arguments that place the responsibility for harm to health on individuals, and portray government actions as interference in personal liberties and free choice.

This is formidable opposition. Market power readily translates into political power…

Not one single country has managed to turn around its obesity epidemic in all age groups.  This is not a failure of individual will-power. This is a failure of political will to take on big business…

I am deeply concerned by two recent trends.

The first relates to trade agreements. Governments introducing measures to protect the health of their citizens are being taken to court, and challenged in litigation. This is dangerous.

The second is efforts by industry to shape the public health policies and strategies that affect their products. When industry is involved in policy-making, rest assured that the most effective control measures will be downplayed or left out entirely. This, too, is well documented, and dangerous.

In the view of WHO, the formulation of health policies must be protected from distortion by commercial or vested interests.

Dr. Chan was courageous to say this so clearly.  Would that our health officials would be as brave.

Dec 6 2012

New books take a fresh look at public health

If I were teaching public health nutrition right now, here’s what I’d want students to read:

Geof Rayner and Tim Lang, Ecological Public Health: Reshaping the Conditions for Good Health, Routledge Earthscan, 2012.

Our case is that public health is an interdisciplinary project, and not merely the preserve of particular professionals or titles.  Indeed, one of the themes of the book is that public health is often improved by movements and by people prepared to challenge conventional assumptions and the status quo…In these cynical academic times, when thinking is too often set within narrow economistic terms—What can we afford? What is the cost-benefit of health action?—and when the notion of the ‘public’ is often replaced by the ‘individual’ or the ‘private,’ this book offers an analysis of public health which is unashamedly pro bono publico, for the public good.

David Stuckler and Karen Siegel, eds.  Sick Societies: Responding to the Global Challenge of Chronic Disease, Oxford University Press, 2011.

Sick Societies argues that we are building environments that are poorly designed for our boides: we create societies where tobacco, alcohol, and foods containing high levels of salt, sugar, and fats are the easiest, cheapest, and most desirable choices, while fruits, vegetables, and exercise are the most expensive, inaccessible, and inconvenient options.  The rise in chronic diseases is the result of a model of societal development that is out of control: a model that puts wealth before health.

Wilma Waterlander, Put the Money Where the Mouth Is: The Feasibility and Effectiveness of Food Pricing Strategies to Stimulate Healthy Eating, Vrije Universiteit, Amsterdam, 2012.

This one is for policy wonks and change agents.  This is Waterlander’s doctoral dissertation done as a published book but it is written clearly and forcefully.  Her conclusions:

The studies presented in this thesis show that the healthy choice is the relatively expensive choice; that price fundamentally affects food choice and may even form a barrier for low SES consumers in selecting healthier foods.  These findings make pricing strategies a justifiable tool to stimulate healthier choices…making healthier foods cheaper was found to be the most feasible pricing strategy to implement.

Mar 7 2012

U.N. Special Rapporteur: Five Ways to Fix Unhealthy Diets

Olivier de Schutter, the United Nations Special Rapporteur on the Right to Food, has issued five recommendations for fixing diets and food systems:

  • Tax unhealthy products.
  • Regulate foods high in saturated fats, salt and sugar.
  • Crack down on junk food advertising.
  • Overhaul misguided agricultural subsidies that make certain ingredients cheaper than others.
  • Support local food production so that consumers have access to healthy, fresh and nutritious foods.

De Schutter explains:

One in seven people globally are undernourished, and many more suffer from the ‘hidden hunger’ of micronutrient deficiency, while 1.3 billion are overweight or obese.

Faced with this public health crisis, we continue to prescribe medical remedies: nutrition pills and early-life nutrition strategies for those lacking in calories; slimming pills, lifestyle advice and calorie counting for the overweight.

But we must tackle the systemic problems that generate poor nutrition in all its forms.

Governments, he said:

have often been indifferent to what kind of calories are on offer, at what price, to whom they are accessible, and how they are marketed…We have deferred to food companies the responsibility for ensuring that a good nutritional balance emerges.

…Heavy processing thrives in our global food system, and is a win-win for multinational agri-food companies…But for the people, it is a lose-lose…In better-off countries, the poorest population groups are most affected because foods high in fats, sugar and salt are often cheaper than healthy diets as a result of misguided subsidies whose health impacts have been wholly ignored.

Much to ponder here.  Let’s hope government health agencies listen hard and get to work.

For further information, the press release adds these links:

Feb 1 2012

Survey result: low-income families want to eat healthfully too

I was invited yesterday to a press event to announce the results of a survey conducted by Share Our Strength’s Cooking Matters program.  The program and the survey, It’s Dinnertime: A Report on Low-Income Families’ Efforts to Plan, Shop for and Cook Healthy Meals, are sponsored by the ConAgra Foods Foundation.

I went because I was interested in the survey and also because I admire the work of chef Sara Moulton who, among many other things, works with Share Our Strength on this program.

Cooking Matters is part of Share Our Strength’s No Kid Hungry Campaign.  Its goal is to help low-income families increase access to public food resources (food assistance benefits, farmers’ market coupons) and produce healthy meals at low cost.  It does this through a 6-week course that teaches shopping strategies, meal planning, and cooking.

The research produced some important findings, perhaps obvious:

  • 8 out of 10 low-income families cook at home at least 5 times per week, more if they are poorer.
  • 85% of low-income families consider eating healthy meals to be important and realistic.
  • Low-income families struggle to put healthy meals on the table: food costs and preparation time are big barriers.
  • Low-income families are eager for cooking and budgeting tips and tools.

Where does ConAgra fit in?

ConAgra owns countless food product brands that pack the center aisles of supermarkets.

Working under the premise that it takes more than food to fight hunger, the ConAgra Foods Foundation, a national sponsor of Cooking Matters, funded It’s Dinnertime as part of its ongoing strategy to find sustainable solutions to help surround kids with the nourishment they need to flourish.

The ConAgra Foods Foundation is funded solely by ConAgra Foods.  One of the study’s conclusions is very much in ConAgra’s interest.

A better understanding of the health benefits of frozen and canned fruits and vegetables could also put more healthy options in reach for low-income families: While 81 percent of low-income parents rated fresh produce as extremely healthy, that rating drops down to 32 percent when it comes to frozen fruits and vegetables and 12 percent with canned fruits and vegetables.

The program works to improve the image of frozen and canned fruits and vegetables among low-income families.

Ordinarily, food industry-sponsored programs make me squirm.  This one makes me squirm less than most even though Sara Moulton was cooking with at least one ConAgra product: Wesson Oil.

But the program worked with 18,000 families last year and its goals make sense.

Canned and frozen fruits and vegetables really do retain much of the nutritional value of fresh produce unless they are loaded with salt and sugars.  Sara was cooking with low-salt products and the dishes she made were easy, inexpensive, nutritious, and quite delicious.

I’m impressed with how this program teaches families to fend for themselves in today’s tough environment.

Now, if ConAgra would just get busy promoting policies to improve access to healthy foods for everyone….

 

Jul 13 2011

Google’s impressive healthy food program

I’m just back from judging Google’s first Science Fair for kids 13 to 18 at its corporate headquarters in California (yes, those are tomatoes growing in the foreground).

Google’s famous food program: Why famous?  It is:

  • Available 24/7
  • Totally free
  • Varied and delicious
  • Designed to promote health as well as environmental values (local, organic, sustainable)

On this last point, the recycling program is comprehensive and the campus is planted with organic vegetables, free for the picking:

But what about the “freshman 15”?

If free food is available 24/7, isn’t Google creating a classic “obesogenic” environment?  Do new Google employees gain weight?

Indeed, they do, and this creates a dilemma for the food team.  I met with Joe Marcus, Google’s food program manager, and executive chef Scott Giambastiani.  Free and very good food, they explain, is an important recruiting perk for Google.   Employees learn to manage it.  And those who are eating healthy food for the first time in their lives find that they actually lose weight.

Google’s food labeling program

Google labels its snacks, drinks, and the foods prepared in its 25 or so cafeterias with traffic lights: green (eat anytime), yellow (once in a while), or red (not often, please).  It bases the decisions about which food goes where on the Harvard School of Public Health’s healthy eating pyramid.   It labels foods at the top of the Harvard pyramid red, the ones in the middle yellow, and those at the bottom green.

In theory this makes sense as a starting point.  In practice, it tends to seem a bit like nutritionism—reducing the value of the foods to a few key nutrients.

The difficulties are most evident in the snack foods, freely available from kiosks all over the campus.   Products are displayed on shelves labeled red, yellow, or green.  For example:

GREEN: Sun chips, 1.5 oz, 210 kcal, 10 g fat, 180 mg sodium, 3 g sugar, 4 g fiber

YELLOW: Lentil chips, 1 oz, 110 kcal, 3 g fat, 170 mg sodium, 1 g sugar, 3 g fiber

YELLOW: Walnuts, 0.8 oz, 150 kcal, 15 g fat, 0 g sodium, 1 g sugar, 2 g fiber

RED:  Luau BBQ chips, 1.5 oz, 210 kcal,  14 g fat, 158 mg sodium, 2 g sugar, 1 g fiber

Note: the weights of the packages are not the same, so the amounts are not really comparable, but the ranking scheme seems to give most credit for fiber.

As for these and the foods cooked in cafeterias, Google uses other strategies to promote healthier choices.  It:

  • Puts the healthiest products at eye level
  • Uses small plates
  • Tries to include vegetables in everything
  • Makes healthier options available at all times
  • Uses the smallest sizes of snack foods (packages of 2 Oreos, rather than 6)
  • Makes it easy to be physically active (Google bicycles!)

The only place on the campus where employees pay for food is from a vending machine.  The pricing strategy is based on nutrient content, again according to the Harvard pyramid plan.  For the vended products, you pay:

  • one cent per gram of sugar
  • two cents per gram of fat
  • four cents per gram of saturated fat
  • one dollar per gram of trans fat

On this basis, Quaker Chewy Bars are 15 cents each, Famous Amos cookies re 55 cents, and an enormous Ghirardelli chocolate bar is $4.25.  Weights don’t count and neither do calories.  The machine is not run by Google.  Whoever does it has a sense of humor.

Impressive, all this.  Not every company can feed its nearly 30,000 employees like this but every company can adopt some of these strategies.  It might save them some health care costs, if nothing else.

Nov 25 2008

Publications

This page lists books and articles. Books start under the first photo, and articles under the second.

Witt Program on Activism, DeWitt Clinton High School, Bronx NY, 12-8-09

BOOKS: For more information on books, click here

  • 2015: Nestle M.  SODA POLITICS: TAKING ON BIG SODA (AND WINNING), Oxford University Press..
  • 2013: Nestle M.  EAT, DRINK, VOTE: AN ILLUSTRATED GUIDE TO FOOD POLITICSRodale Books.
  • 2012: Nestle M, Nesheim M. WHY CALORIES COUNT: FROM SCIENCE TO POLITICS, University of California Press.  Paperback, 2013.
  • 2010: Nestle M, Nesheim MC. FEED YOUR PET RIGHT, Free Press/Simon & Schuster.
  • 2008: Nestle M. PET FOOD POLITICS: THE CHIHUAHUA IN THE COAL MINE, University of California Press. Paperback, 2010.
  • 2006: Nestle M. WHAT TO EAT, North Point Press/Farrar, Straus and Giroux. Paperback, 2007. Hebrew edition, 2007.
  • 2003: Nestle M. SAFE FOOD: BACTERIA, BIOTECHNOLOGY, AND BIOTERRORISM, University of California Press.  Paperback 2004; Chinese edition 2004, Japanese edition 2009. Revised and expanded edition retitled SAFE FOOD: THE POLITICS OF FOOD SAFETY, 2010.   
  • 2002: Nestle M. FOOD POLITICS: HOW THE FOOD INDUSTRY INFLUENCES NUTRITION AND HEALTH, University of California Press. Paperback 2003; Revised and expanded edition 2007; Chinese edition, 2004; Japanese edition, 2005; 10th Anniversary Edition with a Foreword by Michael Pollan2013).
  • 1985: Nestle M. NUTRITION IN CLINICAL PRACTICE. Greenbrae CA: Jones Medical Publications. Asian edition, 1986. Greek edition, 1987.

Edited Books

Dr. Nestle at FAO 082

ARTICLES (SELECTED): For the most part, these are columns, professional articles, book chapters, letters, and book reviews for which links or pdf’s are available (or will be when I get time to find or create them). Additional publications are listed in the c.v. link in the About page.

2017

2016

2015

2014

2013

2012

2011

2010

2009

2008

2007

2006

2002 – 2005

  • Nestle M. Preventing childhood diabetes: The need for public health intervention (editorial). American Journal of Public Health 2005;95:1497-1499.
  • Nestle M. Increasing portion sizes in American diets: more calories, more obesity (commentary). Journal of the American Dietetic Association 2003;103:39-40.
  • Berg J, Nestle M, Bentley A. Food studies. In: Katz SH, Weaver WW, eds. The Scribner Encyclopedia of Food and Culture, Vol 2. New York: Charles Scribner’s Sons, 2003:16-18.

  • Nestle M. The ironic politics of obesity (editorial). Science 2003:299:781.

  • Nestle M. Not good enough to eat (commentary). New Scientist 2003;177 (February 22):25.

  • Nestle M. Hearty Fare? Review of Faergeman, O. Coronary Heart Disease: Genes, Drugs, and the Agricultural Connection. Amsterdam: Elsevier, 2003. Nature 2003;425:902.
  • Nestle M. Thinking about food (letter). Wilson Quarterly Autumn 2003 [27(4)]:4.

  • Young LR, Nestle M. The contribution of expanding Portion Sizes to the U.S. obesity epidemic. American Journal of Public Health 2002;92:246-249.
  • Mahabir S, Coit D, Liebes L, Brady MS, Lewis JJ, Roush G, Nestle M, Fay D, Berwick M. Randomized, placebo-controlled trial of dietary supplementation of a-tocopherol on mutagen sensitivity levels in melanoma patients: a pilot trial. Melanoma Research 2002;12:83-90.
  • Byers T, Nestle M, McTeirnan A, Doyle C, Currie-Williams A, Gansler T, Thun M, and the American Cancer Society 2001 Nutrition and Physical Activity Guidelines Advisory Committee. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity. CA Cancer Journal for Clinicians 2002;52:92-119.
  • Fried EJ, Nestle M. The growing political movement against soft drinks in schools (commentary). Journal of the American Medical Association 2002;288:2181.

2001

  • Nestle M. Genetically engineered “golden” rice unlike to overcome vitamin A deficiency (letter). Journal of the American Dietetic Association 2001;101:289-290.
  • Nestle M. Nutrition and women’s health: the politics of dietary advice [editorial]. Journal of the American Medical Women’s Association 2001;56:42-43.

  • Kumanyika SK, Morssink CB, Nestle M. Minority women and advocacy for women’s health. American Journal of Public Health 2001;91:1383-1388.

  • Nestle M. Food company sponsorship of nutrition research and professional activities: A conflict of interest? Public Health Nutrition 2001;4:1015-1022.
  • Nestle M. Review of: Bendich A, Deckelbaum RJ, eds. Primary and Secondary Preventive Nutrition (Totowa, NJ: Humana Press, 2001). American Journal of Clinical Nutrition 2001;74:704.

2000

1999

  • Nestle M. Hunger in America: A Matter of Policy. Social Research 1999;66(1): 257-282.
  • Nestle M. Commentary [dietary guidelines]. Food Policy 1999;24(2-3):307-310.
  • Nestle M. Meat or wheat for the next millennium? Plenary lecture: animal v. plant foods in human diets and health: is the historical record unequivocal? Proceedings of the Nutrition Society 1999;58:211-218 (online here).
  • Nestle M. Heart disease’s decline (letter). New York Times, August 12, 1999:A18.
  • Nestle M. Dietary supplement advertising: a matter of politics, not science. Journal of Nutrition Education 1999;31:278-282.

1998

1987-1997

  • Nestle M.Broccoli sprouts as inducers of carcinogen-detoxifying enzyme systems: clinical, dietary, and policy implications [Commentary].Proceedings of the National Academy of Sciences, USA 1997;94:11149-11151.

  • Nestle M.The role of chocolate in the American diet: nutritional perspectives.In: Szogyi A, ed.Chocolate, Food of the Gods.Westport, CN: Greenwood Press, 1997:111-124.
  • Nestle M.Epidemiologists’ Paradise.Junshi C, Campbell TC, Junyao L, Peto R.Diet, Life-style, and Mortality in China: A Study of the Characteristics of 65 Chinese Counties.NY: Oxford University Press, 1990 [book review].BioScience 1991;41:725-726.

  • Nestle M. National nutrition monitoring policy: the continuing need for legislative intervention. J Nutrition Education 1990;22:141-144.
  • Nestle M, Porter DV. Evolution of federal dietary guidance policy: from food adequacy to chronic disease prevention.Caduceus: A Museum Journal for the Health Sciences 1990;6(2):43-67.

  • McGinnis JM, Nestle M. The Surgeon General’s report on nutrition and health: policy implications and implementation strategies. American Journal of Clinical Nutrition1989;49:23-28.
  • Department of Health and Human Services, Public Health Service. The Surgeon General’s Report on Nutrition and Health. Publ. No. (PHS) 88-50210. Washington DC: U.S. Government Printing Office, 1988, 712 pages [Managing Editor]. Reprint: Prima Publishing, 1989. Reprint: Warner Books, 1989.

  • Nestle M. Promoting health and preventing disease: national nutrition objectives for 1990 and 2000. Food Technology 1988;42(2):103-107.
  • Nestle M, Lee PR, Baron, RB. Nutrition policy update.  In: Weininger J, Briggs GM, eds.  Nutrition Update, Vol 1.  New York: John Wiley and Sons, 1983:285-313.

1968-1969 Dissertation Papers

Nestle M, Roberts WK.  An extracellular nuclease from Serratia marcescens. II. Specificity of the enzyme.  Journal of Biological Chemistry 1969;244:5219-5225.

Nestle M, Roberts WK.  An extracellular nuclease from Serratia marcescens. I.  Purification and some properties of the enzyme.  Journal of Biological Chemistry 1969;244:5213-5218.

Nestle M, Roberts WK.  Separation of ribonucleosides and ribonucleotides by a one-dimensional paper chromatographic system. Analytical Biochemistry 1968;22:349-351.

 

 

Jun 12 2017

Food Navigator’s special edition on “clean” labels

This is one of Food Navigator’s collection of articles, videos, and podcasts on single topics, in this case “clean” labels, clearly a hot trend.

Special Edition: Where next for clean label?

How is the ‘clean-label’ trend evolving? Is it still about avoiding certain ‘artificial’ or ‘artificial-sounding’ ingredients, or is it now part of a broader conversation about GMOs, animal welfare, sustainability, and business ethics? What do consumers understand by ‘clean’ food? And how will they view innovations from monk fruit produced from microbes, to ‘meat’ and ‘milk’ made without raising animals?

To the casual observer, ‘cleaning up’ our food sounds like an eminently sensible thing to do. But where is the clean label trend going, and is ditching every ingredient you can’t pronounce really the key to fixing the ‘broken’ food system (as Panera implies in a recent ad) or improving the health of people and the planet? .. Read

May 2 2017

Breastfeeding policies are a barrier to trade? The U.S. trade office thinks so

Trade rules are not easy to understand because they are so remote from most people’s lives.  But Public Citizen is keeping an eye out on what’s happening in the trade world, and making its meaning clear.

It reports that the Office of the United States Trade Representative (USTR) has just released its latest National Trade Estimate.  This reviews our trading partners’ actions that we think constitute “significant trade barriers” and want to eliminate.

What might these be?

This may be hard to believe but high on the list are other countries’ policies to promote breastfeeding, of all things.

The Trump administration wants to get rid of these “technical trade barriers:”

  • Hong Kong draft code designed to “protect breastfeeding and contribute to the provision of safe and adequate nutrition for infants and young children.” This, according to USTR, could reduce sales of food products for infants and young children.
  • Indonesia: USTR wants to get rid of a draft regulation to ban advertising or promotion of milk products for children up to two years of age.
  • Malaysia: USTR doesn’t like its code restricting corporate marketing practices aimed at toddlers and young children.
  • Thailand: USTR wants to eliminate penalties for corporations that violate laws restricting the promotional, and marketing activities for modified milk for infants, follow-up formula for infants and young children, and supplemental foods for infants.

This is about protecting sales of infant formulas and weaning foods heavily marketing to mothers in developing countries as superior to breastfeeding, this despite vast amounts of evidence for the superiority of breastfeeding over any other method for promoting infant health.

Public Citizen’s Eyes on Trade reminds us:

For decades, infant formula manufacturers have been accused of aggressive marketing campaigns in developing countries to discourage breastfeeding and instead, to push new mothers into purchasing formula.  The famous boycott of Nestlé in the 1970s led to the development and adoption by nations worldwide of the UNICEF/World Health Organization (WHO) International Code of Marketing of Breastmilk Substitutes (The Code) in 1981. The Code sets guidelines and restrictions on the marketing of breastmilk substitutes, and reaffirms governments’ sovereign rights to take the actions necessary to implement and monitor these guidelines.

To promote and protect the practice of breastfeeding, many countries have implemented policies that restrict corporate marketing strategies targeting mothers. These policies have led to increased breastfeeding in many countries even though greater progress is still needed.

These are the policies the USTR wants eliminated.

For shame.

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