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.

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.
Apr 29 2016

Organic Life: Eight books about organic food systems

I did an interview last year with Rebecca Straus of Organic Life about books of interest to the magazine’s readers.  I never heard what happened to it but learned from a recent tweet that it is now available online.  So consider this a late catch up.

Marion Nestle’s Favorite Organic Books: Eight reads to get you thinking about where your food is coming from.  Organic Life, September 11, 2015.

Food advocate Marion Nestle, a professor of nutrition and food studies at New York University, has long been outspoken in her support of organic farming and opposition to GMO crops. Her books and articles on how science, marketing, and society impact food choices and obesity have influenced everyone from Michelle Obama to Michael Pollen, who named her the second most powerful foodie in America.  Her new book Soda Politics: Taking on Big Soda (and Winning), comes out in October. But even when she’s busy writing, Nestle takes time to review other recent titles on her popular blog, Food Politics. “I’m overwhelmed by the avalanche of outstanding books that I run across or that get sent to me,” she says. But when forced to choose, she settled on these eight as some of the best writing and original research in the bunch, adding, “They deserve much more attention than they’ve received.”

Food, Farms, and Community: Exploring Food Systems by Lisa Chase and Vern Grubinger

“Many people don’t understand what food systems  are, and it’s very hard to explain, so this book is a terrific introduction. The authors take a big-picture approach to explain how our food gets from production to consumption,.They also focus on how we can create food and farming systems that promote the health of people and planet. It’s very readable.”

The End of Plenty: The Race to Feed a Crowded World by Joel K. Bourne, Jr.

“This book takes a look at industrial farming and discusses how food production must change to meet the world’s demands. But if you think the title sounds depressing, you shouldn’t.  The food situation is so much better than it was 20 years ago. There’s so much more organic, local, and seasonal growing. Students are interested in these issues, and that’s inspiring to me. You can make progress without overturning the whole system. My personal measure is that when we started food studies at NYU in 1996, we were the only program like that in the country. Now every university offers food studies and has an organic garden.”

From Field to Fork: Food Ethics for Everyone by Paul Thompson

“Ethical dilemmas impact the way we shop for food. Should we buy orancic or local? Should we care how farm animals are raised? For people who aren’t trained in ethics, it’s sometimes hard to think about these things, and this book can help you delve into them.”

Organic Struggle: The Movement for Sustainable Agriculture in the United States by Brian K. Obach

“For me, the discussion of the development of the organic standards is the most interesting part of this book. It explains why it’s so important to maintain strict organic standards, and why there’s such intense conflict about them. In fact, the biggest issue facing the organic industry is confidence in the standards.”

Afro-Vegan: Farm-Fresh African, Caribbean & Southern Flavors Remixed by Bryant Terry

“Terry is an extraordinary cook. He’s really concerned about the health of African Americans, who tend to have much higher levels of chronic disease, so he sets out to demonstrate that it’s possible to cook a healthier, vegan diet using the ingredients of traditional African cuisine, like collards, grits, and okra. I’ve never seen a book like this before.”

Lentil Underground: Renegade Farmers and the Future of Food in America by Liz Carlisle

“Carlisle is an incredible author (and Michael Pollan’s protégé). To write the book, she simply went to talk to farmers in Montana to find out what they were doing. It’s very lively. I attended her book tour, and she actually brought the farmers with her – it was clear she was really passionate. Everyone is always talking about how farmers are failing, but this is a success story. It’s inspiring.”

Breadlines Knee-Deep in Wheat: Food Assistance in the Great Depression by Janet Poppendieck

“I have special interest in this one – I wrote the foreword. The author is fabulous, and this book is particularly well done. Anyone who wants to really understand the Farm Bill and the fight about food stamps needs to read this book. We’re seeing enormous congressional fighting over SNAP right now, and those same issues were there from the very beginning.”

Lethal but Legal: Corporations, Consumption, and Protecting Public Health by Nick Freudenberg

“This book is compelling because it draws out the parallels between food issues and things like cigarettes, guns, and alcohol. Food producers use the same corporate strategies as these other industries to enrich themselves at the expense of public health. I believe advocacy is the only way to beat the system, and Freudenberg writes about ways for organizing against coporate power to create a healthier environment.  organize against corporate power for a healthier, more sustainable environment.”

Mar 24 2016

Beverage Daily’s Special Edition: Calorie-Cutting Initiatiatives

One of the newsletters I subscribe to, BeverageDaily.com, has a special edition—a collection of its articles—on what the industry is doing to address its biggest problem: reducing sugar.

What is the beverage industry doing to cut calories?

Health and wellness is at the forefront of consumers’ minds, and sugar gets plenty of bad press. Obesity is as big a concern as ever, and soft drinks are in the firing line.

What is the beverage industry doing to reduce calories? How are market leaders reformulating and revamping their portfolios; and what healthier brands are appearing?

From alternative sweeteners to packaging sizes, we look at what the industry is doing to cut calories – and how well these initiatives are working.

From reformulation to nutritional labeling, the non-alcoholic beverage industry has adopted a variety of strategies to reduce the calorie content of drinks. We look at how different strategies from around the world are being implemented. .. Read

You can see why the industry has a problem.  Sugar tastes good.  These other things not so much.

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