As a nutritionist, I cannot go anywhere without being asked why nutrition advice is so confusing. If it were not for public confusion, it would be difficult to explain to any rational person why dietary guidelines matter so much and why this book begins with an historical account of how the food industry affects them. As I will explain, dietary recommendations for prevention of chronic diseases have hardly varied for the past half-century, but the consistency of such advice is a well-kept secret. Americans may recognize theFood Guide Pyramidof the U.S. Department of Agriculture (USDA), but hardly anyone...

The u.s. government has been telling people what to eat for more than a century, and the history of such advice reflects changes in agriculture, food product development, and international trade, as well as in science and medicine. In 1900, for example, the leading causes of death were infectious diseases such as tuberculosis and diphtheria made worse by the nutrient deficiencies and overall malnutrition that were especially prevalent among the poor. Life expectancy at birth for both men and women barely exceeded 47 years. To overcome nutritional deficiencies and related disorders, government nutritionists urged people to eat more of a...

Late in april 1991, I received a phone call from Malcolm Gladwell, then a reporter at theWashington Post, asking for an opinion on the latest furor over dietary advice. The recently appointed Secretary of the U.S. Department of Agriculture (USDA), former Congressman Edward R. Madigan, had just blocked the printing of the Department’s latest food guide—theEating Right Pyramid—because it was “confusing to children.” That guide is illustrated in Figure 8. Unlike theBasic Four, which presented the food groups in squares of roughly equal size (see Figure 6), thePyramidis explicitly hierarchical; it illustrates a...

As noted earlier, despite the constantly recurring themes of dietary advice for health promotion—eat more plant foods and less of animal and processed foods—many people feel confused about what they should be eating. Because public discussion of nutrition issues tends to focus on single nutrients and on the distinctions between one set of guidelines and another, the fundamental similarity of five decades of dietary advice becomes hopelessly obscured. The contradiction between the constancy of the advice and the public’s confusion can be explained in part by deliberate or unconscious efforts to undermine “eat less” precepts. Pressures from food...

Food companies use every means at their disposal—legal, regulatory, and societal—to create and protect an environment that is conducive to selling their products in a competitive marketplace. To begin with, they lobby. They lobby Congress for favorable laws, government agencies for favorable regulations, and the White House for favorable trade agreements. But lobbying is only the most obvious of their methods. Far less visible are the arrangements made with food and nutrition experts to obtain approving judgments about the nutritional quality or health benefits of food products, and the personal connections made with legislators or agency officials who...

To understand how food companies are able to exert disproportionate influence on government nutrition policy, we must begin with a discussion of lobbying and its integral position in American political processes. Lobbying is anylegalattempt by individuals or groups to influence government policy or action, a definition that explicitly excludes bribery. Historically, lobbying always has involved three elements: (1) promoting the views of special-interest groups, (2) attempting to influence government laws, rules, or policies that might affect those groups, and (3) communicating with government officials or their representatives about laws, rules, or policies of interest.¹ Food lobbyists, therefore, are...

The efforts of food companies to influence dietary advice to the public and to establish an image of their products as nutritious extend well beyond lobbying Congress and government agencies. They go right to the heart of nutrition as a profession. Indeed, co-opting experts—especially academic experts—is an explicit corporate strategy. A guide to such strategies explains that this particular tactic “is most effectively done by identifying the leading experts … and hiring them as consultants or advisors, or giving them research grants and the like. This activity requires a modicum of finesse; it must not be too blatant,...

We have seen how food interest groups gain access and exert influence upon elected officials through donations of money, both hard and soft. Such transactions are legal, publicly disclosed, painstakingly tracked by advocacy groups and investigative reporters, and readily apparent to any interested person with access to the Internet. Far less visible are more subtle lobbying activities directed toward officials of federal agencies and other people likely to wield influence. Such activities do not necessarily involve money or other “things of value.” Even when they do, the amounts can be quite small. This kind of lobbying involves forming friendships, doing...

When advertising, public relations, arrangements with experts, outright lobbying, and the other efforts discussed in previous chapters are insufficient to protect the sales environment, food companies resort to more heavy-handed methods. This chapter illustrates two ways in which companies use “hardball” strategies. To counter suggestions that their products might have adverse health, safety, or environmental consequences, food companies engage in litigation: they sue critics for libel or other reasons. And to avoid the unwanted consequences of freemarket competition, some companies use a strategy that crosses the line from legal to illegal: they conspire to fix prices. This chapter presents some...

During the twentieth century, the nutritional health of American children improved dramatically in some ways—but not in others. Early in the century, many children died from the complications of infectious diseases made worse by diets limited in calories and nutrients. As scientists learned more about how diets could protect against disease, they introduced measures that virtually eliminated classic signs of severe undernutrition among American children. Fortification of foods with iron, for example, helped reduce rates of iron-deficiency anemia to their present low levels, and school lunch programs kept many children from going hungry. These accomplishments count among the greatest...

Whereas concerns about children’s nutrition once focused on dietary insufficiency, the most serious dietary issue affecting today’s American children is obesity—the result of eating more food than is needed, rather than too little. Obesity rates are rising rapidly among children and adolescents, especially those who are African-American or Hispanic. By the early 1990s, for example, 23% of white girls aged 6–11 were overweight, compared to 29% of Mexican-American girls and 31% of black girls.¹ Pediatricians report seeing children with high levels of serum cholesterol, high blood pressure, and “adult”-onset diabetes at earlier and earlier ages—all consequences of...

I had never heard of “pouring rights” until late in 1998 when I received a telephone call from a representative of the New York State School Food Service Association, inviting me to comment on that topic at its next meeting. She explained that the term referred to a recent development in food marketing: large payments from soft drink companies to school districts in return for the right to sell that company’s products—and only those products—in every one of the district’s schools. I was aware that colleges and universities had negotiated vending contracts with soft drink companies, and I...

We now turn to a new topic: how a relatively minor segment of the food industry—the makers and sellers of dietary supplements—convinced the public and Congress that its products did not need to be regulated according to the strict standards applied to conventional foods or to drugs. Supplement makers do not need to demonstrate that their products are safe and effective before selling them. What is left of supplement regulation is based on the assumption that supplements are safe until proved otherwise, and Congress places the burden of responsibility on the beleaguered Food and Drug Administration (FDA) to...

Early in 1999 i took a European visitor, newly appointed as director of his country’s equivalent to our Food and Drug Administration (FDA), on a field trip to my local health food store. I thought that he might be interested in the vast array of dietary supplements and the benefits claimed for them, as indeed he was. His home agency demanded proof that supplements were safe and effective before permitting them to be sold as health remedies, and his country (like others in Europe) does not permit misleading health claims on product labels or in advertisements.¹

Like most health food...

No person making a first visit to a health food store today, perhaps bewildered by the vast array of supplements and the statements made about their purported purposes, could possibly imagine that as recently as 1990, claims about health benefits were strictly prohibited. Until then, if the labels suggested that supplements might be useful for preventing or treating a specific condition, the FDA considered them drugs and demanded evidence that they were beneficial as well as safe. To the supplement industry and to supplement users, the FDA’s science-based regulation seemed inappropriate, if not downright obstructive. Makers and sellers of supplements...

Following enactment of the Dietary Supplement Health and Education Act of 1994 (DSHEA), the results of its lowest-commondenominator regulatory approach were apparent almost immediately. Most evident was the remarkable growth of the supplement industry; this, of course, had been the point of the industry’s efforts in pushing for the legislation. As this chapter relates, however, DSHEA led to additional consequences, some intentional and some unintentional. Food companies seeking similar increases in growth began to produce supplement-enhanced foods that could be marketed using health, nutrient-content, and structure/function claims. Pharmaceutical companies began adding herbal and vitamin supplements to over-the-counter drugs. Furthermore, companies...

As we saw in the last chapter, the nutritional attributes of foods are a natural selling point, and the advertising of health benefits increases sales. Food companies are vitally interested in the ways that they might take advantage of three approaches used by government and health officials to promote better diets: education, supplements, and fortification or alteration of foods to make them “healthier.” Part I of this book explained how the food industry protects its interests by influencing federal dietary advice to the public. Part IV discussed how makers and sellers of dietary supplements worked the system to obtain a...

In developing techno-foods fortified with essential nutrients and designed to be “healthier,” food companies were responding not only to the marketing advantage of such products, but also to the demands of federal health officials, in what appeared to be a win–win situation. By the late 1980s, consensus about the health benefits of recommended diets—those that followed theDietary Guidelines—seemed almost universal. Because Americans were spending an ever-increasing proportion of their food dollars on products and meals prepared outside the home, nutritionists and health officials believed that the industries responsible for pre-prepared foods should join homemakers as primary...

Becauseallfoods and drinks include ingredients (calories, nutrients, or water) that are essential for life, any one of them has the potential to be marketed for its health benefits. Many vitamins and minerals participate in energy-yielding biochemical reactions, and the phrase “contains vitamins essential for energy” would accurately describe just about any food except pure sugar, starch, or alcohol (which have calories, but no nutrients). Accordingly, when Congress in 1990 instructed the Food and Drug Administration (FDA) to consider authorizing certain claims for the health benefits of conventional foods and then in 1994 demanded that it permit less restrictive...

I was no longer a member of the FDA’s Food Advisory Committee during the years when it was considering approval of Procter & Gamble’s (P&G) fat substitute, olestra, but I followed its deliberations closely. On June 17, 1998, the committee confirmed a judgment that it had made more than two years earlier. Once again, it agreed that olestra was reasonably certain to cause no harm as a food additive. The members did, however, advise the FDA that foods containing this substance should carry a warning statement: “This product contains olestra. Olestra may cause abdominal cramping and loose stools. Olestra inhibits the...