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Sandro Galea.  Well: What We Need to Talk About When We Talk About Health.  Oxford University Press, 2019.

I blurbed this one:

A superb account of how money, power, politics, and the luck of the draw affect the health of individuals and populations. It should inspire us all to follow Galea in championing public health as an essential public good, and in treasuring and preserving the core values of public health—fairness, justice, and compassion for all.

Galea is the dean of the school of public health at Boston University and a prolific writer on public health topics, including food on occasion.  I am a big fan of his work.  I like his focus on social, economic, and environmental determinants of health and his consistent promotion of the core values of public health.  If you don’t really get what public health is about, this book is a great place to start.

Here is a brief sample from the chapter titled “Choice.”

We imagine our choices to be, for the most part, beyond the reach of outside influence and that, when we choose, we do so from an unlimited array of options; no one tells us what to eat, whether or not we are permitted to exercise, or who we must embrace as a life partner.  For this reason, much of our conversation about health has to do with “lifestyle”—making the correct choices for ourselves, choices which, we believe, will lead to better health.

…Yes, we can choose the food we eat, but our options are limited by what we can afford and by what kinds of food are available for purchase near our home.  These factors, in turn, depend on the quality of our neighborhood and the size of our income, which depends on larger socioeconomic forces over which we have little control.  Likewise, we can only choose to exercise if we live near parks, walkable streets, or athletic facilities, and we can only choose a person to marry from among the individuals we encounter within our community.  Place, power, money, politics, and people—all the forces we discuss in this book—shape the variables that ultimately influence our health.

I was invited to review two books about NAFTA’s effects on foods systems for The Lancet Diabetes & Endocrinology:

• Gerardo Otero’s The Neoliberal Diet: Healthy Profits, Unhealthy People
• Alyshia Gálvez’s Eating NAFTA: Trade, Food Policies, and the Destruction of Mexico (noted earlier on this site).

The journal titled the review “How neoliberalism ruins traditional diets and health.”  You can read it here.

Helen Tangires.  Movable Markets: Food Wholesaling in the Twentieth-Century City.  Johns Hopkins Press, 2019. 

Why did Paris destroy Les Halles?  Why did New York City move the Fulton Fish Market to the Bronx?  People who remember these places still mourn their loss. 

This book explains why such moves were inevitable.  They happened as a result of concerns about sanitation and crowding, the introduction of trucks, the need for parking, and the high cost of inner city real estate, and that’s just for starters.

I did a blurb for this one:

In investigating the social, economic, and political forces behind the removal of beloved city food markets—Les Halles in Paris, New York’s Washington Market, for example—to more efficient but far less colorful out-of-town locations, Helen Tangires has given us a refreshingly new take on the history of twentieth-century food systems.

Anne Murcott.  Introducing the Sociology of Food & Eating.  Bloomsbury Academic, 2019.

I read an early draft of the manuscript of this book and recommended publication.  The publisher used my remarks as a blurb (with my permission, of course):

An interesting approach by a well-qualified and experienced author.  The book takes on controversial issues of great interest to students using an entertaining writing style.

This is a textbook that aims to teach critical thinking about current food issues.  By “interesting approach” I was referring to the way Murcott structures the chapters.

The chapter titles state some common idea about food—for example, “The family meal is in decline.”  The chapters examine what the issue is about, describe the methodological and other biases that led to such conclusions, and then go on to explain how sociologists think—theoretically and practically—about each issue, and how they approach studying such issues.

Murcott says she wrote the book to encourage readers to think differently about food issues with which they are already familiar, “and to continue thinking differently.”

This works well for that purpose.

Nico Slate.  Gandhi’s Search for the Perfect Diet: Eating with the World in Mind.  University of Washington Press, 2019.  

Let’s start with my blurb:

Nico Slate’s fascinating account reveals Gandhi as an evidence-based, self-experimenting nutrition guru who tried one diet after another—vegan, raw, calorie restriction–in his quest for physical and spiritual health.  Above all, Slate explains Gandhi’s use of fasting as a political means to inspire India to achieve independence.

Gandhi, it seems, was a food faddist well ahead of his time.  The author says:

As his commitment to vegetarianism deepened, Gandhi grappled with whether he should also forgo eggs and milk.  Ultimately, he became convinced that he should become vegan, and renounced all animal products.  Living without eggs was relatively easy.  Doing without milk, by contrast, proved to be one of the greatest challenges of his life.  He experimented with almond milk, peanut milk, and other vegan alternatives.  In 1914, he vowed to abstain from all dairy products.  But after contracting a serious illness, he decided that his pledge did not include goat’s milk. [p. 47]

The book explains how Gandhi’s dietary choices were tightly linked to his politics.

The social potential of a raw diet led Gandhi to explore the cheapest source of sustenance for the poor: wild food…The greatest ethical challenge stemmed from the limitations of wild food as a remedy for poverty.  If the goal was to end hunger, changes in diet would be insufficient if they were not linked to changes in land ownership and the distribution of wealth—change that seemed as impossible as eating ginger nonviolently. [ p. 97]

And one more:

In a world marred by inequality, charity could only do so much.  Ultimately, Gandhi did not want to help the poor; he wanted to end poverty.  Over time, he developed a deeper understanding of the link between famine and imperialism.  “India suffers from starvation because there is dearth not of grain,” he explained, “but of purchasing power.”  The absence of purchasing power was, in turn, a direct result of the economic structures of British rule…Recognizing famine as a result of empire inspired Gandhi to demand India’s freedom. [p.127]

Kevin D. Walker.  The Grand Food Bargain and the Mindless Drive for More.  Island Press, 2019. 

I did a blurb for this one:

A former USDA insider’s account of what our Grand Food Bargain—a system focused on ever-increasing production of cheap food—actually costs Americans in poor health, environmental degradation, and loss of agrarian values and community.  Walker’s views are well worth reading for his insights into how our food system needs to be transformed

Some snippets:

• Early farm bills, sold to the public by promising more food with less uncertainty, were designed to stabilize food prices and increase farm income.  Eight decades later, new farm bills are still being enacted despite average farm income long ago surpassing non-farm income and continuing food surplus.  Each new bill is an increasingly costly grab bag of subsidies and protections, which invariably attracts more interest groups and lobbying.  Other than loose connections to agriculture, no coherent policy direction exists (p. 91).
• Narrow [scientific and technical] expertise alone, for example, does not address the connections among rising rates of obesity, exhaustion of fossil waters, escalating nitrous oxide in the atmosphere, noxious weeds immune to legacy pesticides, growing antibiotic resistance—all the result of how the modern food system operates and how society now lives (p. 114).
• As sophisticated financial strategies are grafted onto the modern food system, more mergers and acquisitions by ever-larger multinational companies follow.  Food is no longer valued for its ability to sustain life, but only for its ability to generate profits.  Whether higher returns come from squeezing farmers under contract to grow pigs or poultry, creating a monopoly on seeds that can be doused with chemicals, or selling food laden with cheap calories makes no difference (p. 141).

Walker’s remedy?  Let food be our teacher.  It’s worth reading what he means by this.

Jonathan Marks.  The Perils of Partnership: Industry Influence, Institutional Integrity, and Public Health.  Oxford University Press, 2019.

I blurbed this one:

Jonathan Marks is the go-to expert on the hazards of public-private partnerships.  His account of the perils reads easily, is well referenced, is clear and to the point, and applies to partnerships with drug, food, and any other corporations.  Anyone who cares about the ethical implications of such partnerships for public health will find this book invaluable.

The book is about industry partnerships in general, but Marks uses food-company examples such as the American Beverage Association’s gift to the Children’s Hospital of Pennsylvania in what seemed to be a direct exchange for the city’s dropping a soda tax initiative, and the USDA’s promotion of cheese.

Marks concludes that

Public-private partnerships, multistakeholder initiatives, and other close relations with industry are premised on a positive conception of consensus, compromise, and collaboration.  But the “three C’s” are not inherently good.  On the contrary, tension between regulators and corporations is ordinarily necessary to protect public health.  And achieving common ground with industry may put off the table measures that might promote public health.  The default relation between industry and government should be arm’s lengths relations involving institutional tension, “struggle,” and direct conflict.

The point: the agenda of corporations is to promote profit, not public health.  This creates an inherent tension, not easily resolved.

Nestle M.  Foreword to Sheldon Krimsky.  GMOs Decoded: A Skeptic’s View of Genetically Modified Foods.  MIT Press, 2019.

You might notice that I wrote the Foreword to this book.  Here’s what I said:

GMO’s Decoded is a gift to anyone confused about genetically modified foods.  In this latest addition to Sheldon Krimsky’s prolific output of books about how societies interact with new technologies, he takes on a formidable challenge–to examine the science of GMOs as a basis for dealing with the ferocious politics they incite.  I use “ferocious” advisedly.  Positions about GMOs appear polarized to the point of outright hostility.  Krimsky wants détente.   If we understood the science better, we might be able to achieve more nuanced views of the risks and benefits of GMOs and of the genetic techniques used to create them.

To anyone familiar with Krimsky’s previous and ongoing work, this book may come as a surprise.  Trained in physics and philosophy, Krimsky is a sharp critic of the role of technology in society with particular interests in the ethical implications of genetics and biotechnology and in risk communication.  I have long admired his work for its firm grounding in science and its clear delineation of the ways in which political, cultural, and other societal factors color perceptions of the safety and other risks of new technologies.

In GMO’s Decoded, Krimsky takes a deep dive into the science of food biotechnology on its own, separate from issues related to how the science is used by the companies producing and profiting from GMOs, or is interpreted by proponents, critics, or the general public.  An attempt to discuss the science of GMOs distinct from its politics may appear foolhardy, if not impossible, and Krimsky deserves much praise for taking this on.

I speak from experience.  My book about food biotechnology, Safe Food, first published in 2003, began with a reference to C.P. Snow’s two-culture problem—what Snow called the “gulf of incomprehension” between scientists and nonscientists over matters of technological risk.  To greatly oversimplify: scientists argue that if GMOs are safe, they are fully acceptable and no further criticism is justified.  But to nonscientists, safety is only one of many concerns about GMOs and not necessarily the most important.   Holders of this broader view argue that even if GMOs are safe, they still may not be acceptable for reasons of ethics, social desirability, unfair distribution, nontransparent marketing, or inequitable and undemocratic control of the food supply.

What I observed in discussing those issues, and continue to observe, is the discounting of anything other than safety by extreme proponents of GMOs who perceive even the slightest question about nonsafety issues as an attack on the entire industry.  This has forced critics of GMOs to focus on safety issues rather than the far less quantifiable issues of social desirability, pushing critics into positions that deny the possibility of any benefit of GMOs.  The result: Snow’s gulf of incomprehension.

Is the gulf bridgeable?  Krimsky argues yes.  From the perspective of the science, GMOs can either benefit or harm society.  It behooves us all to try to understand what the science is about as a basis for coming to more informed opinions about the uses, value, and risks of GMOs—the politics.

But before getting to what Krimsky does in this book, I want to make one point about GMO politics: the GMO industry brought the polarization on itself.  As I explained in Safe Food, the first GMO food, the FlavrSavr tomato, was intended to be marketed transparently as a triumph of American technological achievement (I still have itss label in my files).  British supermarkets sold tomato paste prominently labeled as genetically modified without opposition.  That changed under industry pressure for nondisclosure.  I was a member of the FDA’s Food Advisory Committee in 1994 when the agency ruled against labeling GMOs, despite evidence that trust requires transparency.  The GMO industry fought labeling then, and won, and continues to spend fortunes fighting labeling.

The industry also promised that food biotechnology would feed the world and create new foods that would solve problems for the developing world, such as those able to withstand poor soil conditions, excessive heat, and limited water.  But instead, the industry concentrated on far more profitable insect- and herbicide-resistant first-world crops, a strategy criticized for the effects on society of its monoculture, patented seeds, heavy use of herbicides, herbicide-resistant weeds, and destruction of beneficial insects.  The potential for foods with consumer benefits remains, but has been largely unrealized.  Trust requires fulfilled promises.

As readers of Krimsky’s previous books surely know, he cares about such issues and others related to the politics of GMOs and their societal impact.  But in this book, he wants readers to realize that the risks and benefits of GMOs depend on understanding the state of their science.  Here, he takes on the scientific questions, one by one, clearly and dispassionately.  This must have taken courage and a great deal of work.  The science of GMOs is complicated and occurs at the level of molecules–DNA, RNA, and protein, of course, but also a host of less familiar molecules responsible for making genetic modifications work.

Fortunately, Krimsky writes clearly and succinctly about such things, his descriptions are easy to follow, and he defines terms as they are needed.  He begins by asking whether GMOs differ from foods produced by traditional breeding and if they do, whether the differences matter.  He wants to know how GMOs affect health and the environment, whether they really are more productive than conventional crops, and whether they use fewer pesticides and herbicides.  He asks whether they GMOs have nutritional or other benefits for consumers, and whether and how they should be labeled.  He deals with these questions in short chapters, along with others, that examine methods and risk assessment, review what expert committees say about such matters, and use Golden Rice as a case in point.

Krimsky’s presentation of the divergent viewpoints about what the science means is exceptionally fair and even-handed.  He insists that:

“This book is not about taking sides.  My experience in studying scientific controversies that have public policy implications is that there are often truths, falsehoods, exaggerations, assumptions, fear-mongering, and uncertainties in the claims found on multiple sides of an issue.  This book will succeed if it…demystifies the science and shows where there is consensus, honest disagreement, or unresolved uncertainty. ”

I think it succeeds admirably.  Krimsky is straightforward about his own assessments.  For example–spoiler alert—he concludes that evidence supports a qualitative difference between traditional and molecular breeding of food plants.  On other questions, when he assesses the science as inconclusive, he says so.  He wants readers to understand the complexity of the scientific issues, to be skeptical of arguments from either extreme in the debates, and to adopt nuanced positions on GMOs.  Some aspects of GMOs may be worth opposing, but some may well be worth promoting.  We all need to know the difference.

Krimsky tells us that in researching this book, his own positions became less polarized and more nuanced.  Reading it, mine did too.  Now it’s your turn.

–Marion Nestle, New York, August 2018