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Book Reviews

Voting With Our Forks

"Get ready for Prozac" should be the subtitle of Marion Nestle’s new book, Food Politics. Nestle, a professor of nutrition and food studies at New York University, paints a sorry picture of how our current system of nutritional health policy has been unduly influenced by the food industry. Food scientists have been pawns in the game. In painful, depressive detail that shouts to its accuracy, Nestle describes the forces that have brought nutrition recommendations to their current standing.

Nestle pounds out a convincing argument that through effective lobbying, health policies of dietary recommendations have revised statements from "choose less of this" to "choose more of that." This subtle change, combined with other food industry messages, brings new harmony to the theme "More is better." Her view is sobering. It garners support from other sordid aspects of U.S. business life, including the rise and fall of dot-com companies and the arrogance and greed of Enron/ Andersen. Based on my own experiences, I have no doubt that Nestle has accurately depicted the worst side of food politics.

In her relentless pursuit of the issue, however, Nestle names names, not all of which represent the worst side of nutrition politics. I happen to be one of those named as an example of the co-opting of nutritional professionals (p.118): Nestle cites my research evaluating variation in response to a cholesterol-lowering diet. On the one hand, it was a no-brainer "insight" of Nestle’s: The Margarine Manufacturers and the Soybean Industry didn’t fund the study for its scientific purpose; they funded it because they wanted proof of something that was already known: Vegetable-based low trans margarine lowers total and LDL cholesterol levels more than butter does. This intention was not hidden in their subsequent advertisement. Was I "co-opted" or, better yet, "purchased" by the industry? I don’t think so. I designed the study to evaluate why individuals have a wide range of responses to a cholesterol-lowering diet. I designed two diets that differed only in the primary fat source: butter versus margarine. I showed in a randomized dietary trial—never done in families—that 40 percent of the cholesterol-lowering response was attributable to familial factors (genes plus environment). Obesity was the single most powerful, modifiable predictor of a lack of response to diet. That the sponsors of the study took out an ad highlighting the result that "settled the butter versus margarine debate" is part of the freedom of our press. It was not an egregious misuse of science, nor was it an example of co-opting nutrition professionals. It was an advertisement.

Nestle admits that extensive mixing of industry with education occurs, but she submits that everyone can rise above conflicts of interest if they consider the moves that she has made to define an unwavering line of what she can do and what she cannot do. She cites examples of organizations such as Oldways Preservation and Exchange Trust that also have risen above the conflicts. Having been to several Oldways functions, I fail to see the distinction. Oldways accepts money from food manufacturers to produce conferences that highlight the use of these foods in the diet. I accepted research funding to produce a clinical investigation in families. Oldways celebrates foods and delights in their positive aspects. A positive aspect of substituting margarine for butter is lower LDL cholesterol levels. Oldways uses money to promote preservation of the variety in our dietary choices; I used money to answer a scientific question.

This book is not for the faint-hearted, as Nestle deals her blows with a heavy hand. It raises uncomfortable questions as to where our world has been and where it is going. Who would have imagined that the farming industry, once so essential to middle America, would now be owned and operated by corporations? Who would have imagined that pigs would grow up in stinky concrete-floored pig barns, where their purpose in life—to become the source of "the other white meat" for humans—is so precisely and efficiently designed that they can’t even play in a pig wallow before slaughter? What ever happened to the America that Norman Rockwell painted?

Nestle concludes her book by proposing a series of actions by different groups to force a change in today’s food politics. Her again heavy-handed recommendations smack of "big government" and contradict her accurate analysis that the world would not be where it is today without the influence of special-interest groups. How, then, can big-government laws and regulations rise above these lobbying pressures?

Nestle has a surprisingly light-handed approach when she commends grassroots efforts on the return of small farmers to produce locally grown organic produce for use by local restaurants. However, the stark contrast in tone brings up the question as to why these actions are so noble when others are so foul. It would have been better if she had left us to ponder by ourselves how to get out of food politics as we know it.

While I agree that the food industry has had undue influence on the deployment of nutritional policy, I do not agree that it commands how consumers make food choices. People vote with their own forks; consumers are fickle, and the food industry is only as powerful as the money it earns from producing popular foods. Consumers today respond quickly to the immediate paybacks from their food choices (convenience and taste); our lifestyles necessarily dictate that long-term paybacks of health take a back seat to more immediate, pressing needs. Introduction of an "eat less, exercise more" campaign will only be successful if food choices maintain their convenience and flavor.

Margo Denke

Editor's Notes

 
Margo Denke is professor of food politics in the Center for Human Nutrition, University of Texas Southwestern Medical Center, in Dallas.

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