#123 | Unsavory Truth
By Marion Nestle
Intro: Welcome to the Cookery by the Book podcast with Suzy Chase. She's just a home cook in New York City, sitting at her dining room table, talking to cook book authors.
Marion Nestle: I'm Marion Nestle. I'm Professor of Nutrition, Food Studies, and Public Health Emerita in New York University, and author of the recently published Unsavory Truth: How Food Companies Skew the Science of What We Eat.
Suzy Chase: Professor, you are a consumer advocate nutritionist, award-winning author, and an academic. I'm sure I'm leaving so many things out. But to sum it up, you are our public health hero, and I'm honored to have you on my podcast.
Marion Nestle: Glad to be here.
Suzy Chase: You love the intellectual challenge of figuring out what we eat, and how diets affect our health. How hard was it to separate the truthful information from the lies?
Marion Nestle: Well, I've been at this for a really long time, so it didn't happen immediately, but I started out as a basic scientist, and approached the study of nutrition from the standpoint of somebody trained in science. And so I looked, right from the beginning, at what is the science that backs up dietary advice? And I could se immediately that there was going to be a big problem in that, because it is impossible to do the kinds of studies about diet and health that we really need in order to come to firm and compelling conclusions. And so this gets us into a gray area, which I like very much and find very exciting and intellectually challenging, is how do you find out what people eat, and how do you find out how diets that are extraordinarily complicated affect our health? Big questions.
Suzy Chase: So in Unsavory Truth, you kick off the book with story after story about Coca-Cola. Give me some examples of how Coke influences nutritionists, journalists, and other researchers.
Marion Nestle: Well, it's interesting that you mention that, because in today's New York Times, there's a front page story about how Coca-Cola worked with scientists in China-
Suzy Chase: In China.
Marion Nestle: ... of all places, to make sure that Chinese policy focused on physical activity rather than diet as a leading cause of obesity. Obesity is the result of calories that you consume in food, and calories that you expend in physical activity. But because physical activities doesn't take nearly as many calories as you think, and it's really easy to overeat, if you wanna lose weight, you've gotta eat less. There's really no other way to do it. And what these scientists who were funded by Coca-Cola and worked very closely with Coca-Cola, through an organization called the International Life Sciences Institute, or ILSI, what they did was get the Chinese government to focus on physical activity as a way to prevent obesity. Physical activity is hugely important for health, but for body weight, not so much.
Suzy Chase: Do you feel like Coke is kind of losing their grip in America, so they need to find other markets? Is that this whole Chinese thing, do you think?
Marion Nestle: Oh, there's no question about that. Sales of sugar-sweetened beverages started falling in about the year 2000, and have fallen steadily since then, so that they're now at least a third below what they were in the year 2000. That's a huge loss in sales. And in order to make up ... And the reason for that loss is that the public health message about sugar-sweetened beverages is out there. Everybody knows you're not supposed to drink your calories, and you're not supposed to eat a lot of sugar. That's really quite well known across the general population. So for Coca-Cola to keep its sales up, it has to find other markets, and it has gone into the developing world big time, even though people in the developing world don't have a lot of money, they've got enough to buy sugar-sweetened beverages. And they can make it up in volume. And the major soda companies have invested billions of dollars in marketing in Asia, Africa, the Indian subcontinent and so forth. And I wrote about all of that in my book, Soda Politics, that came out in 2015, and that's very well-known. And it's been interesting to watch what's happened with Coca-Cola since.
I take on Coca-Cola a lot in Unsavory Truth, mainly because its activities have been so visible. And the activities of the other companies which may be equivalent, are not as visible. They're quieter, they're just not made public. One of the reasons why we know so much about Coca-Cola's activities has to do with investigations like the one that's reported in the Times today, but also because of emails that emerged in various ways over the last couple of years that demonstrate Coca-Cola's very close involvement with researchers, its focus on research to demonstrate that physical activity is more important than what you eat or drink, and what you way, that any evidence to the contrary that links sugar-sweetened beverages to type II diabetes, obesity, and other such diseases is so badly flawed that you don't have to pay any attention to it. And that in fact, there's no evidence that links sugar-sweetened beverages to obesity, type II diabetes, or any other problems. And those research studies, which ... And we know they were funded by Coca-Cola, because the investigators have to say that in the papers that they write, and there have now been many analyses of Coca-Cola's funded research as compared to equivalent studies done by independent researchers to show that industry-funded research almost invariably comes out with results that favor the interest of the sponsor.
So we know a lot more about Coca-Cola than we do about other companies, and I'm sure they're quite unhappy about that.
Suzy Chase: Well, and now they've launched their whole transparency thing on their website. And I was reading that, and they gave more than $2 million to the Boys & Girls Clubs of America. Now, are they trying-
Marion Nestle: Isn't that nice of them? Isn't that nice of them?
Suzy Chase: They're so thoughtful and generous. Is that them trying to get brand loyalty from children?
Marion Nestle: Oh, of course.
Suzy Chase: Oh.
Marion Nestle: Of course. If you're selling a product, it doesn't matter what the product is, you want an audience for it. You want people asking for it. You want children asking for it. You want children to understand that Coca-Cola's a treat from the time they're very, very young. You want them asking their parents for it. You're wanting them to associate Coca-Cola with wonderful, entertaining, fun activities with music that you like, with sports that you like, so that it becomes a normal part of your childhood, something that you're going to look back on with great fondness when you're an adult, and hopefully drink the product through your entire life.
Suzy Chase: God, that's so insidious.
Marion Nestle: It's normal business practice.
Suzy Chase: So you mentioned some emails. How do you feel being monitored by Coke?
Marion Nestle: Well, I start Unsavory Truth out with story that just completely blew me away.
Suzy Chase: Me, too.
Marion Nestle: In 2015 and '16, when there was the election of, when Donald Trump was running against Hilary Clinton for President, and there was all of this business about getting the Russians involved and the Russians' hacking of Hilary Clinton's emails as part of her campaign. While all that was going on, the emails were being posted on the Wikileaks site, but also there was a set of them that got posted on a brand new site called DC Leaks. And I heard about that. I wasn't paying that much attention to the email, but I got messages from two people who knew about my work, who wrote me and said, "Marion, you're in the Hilary Clinton emails!" And I thought, "That's impossible. How could that possibly be?" I didn't have anything to do with Hilary Clinton's campaign. But in the emails that had been picked up, there was a cache of emails from a person who worked with Hilary Clinton, a woman named Capricia Marshall, who, while she was helping Hilary Clinton with her campaign, was also consulting for Coca-Cola and getting a retainer of $7,000 a month from the company, for whatever work she was doing with them.
And those emails, amongst other things, talked about ... They were emails between her and an executive of Coca-Cola, and they talked about a lecture that I had given at the University of Sydney in Australia, when I was working as a visiting scholar at the University of Sydney in early 2016, just beginning the research for Unsavory Truth. I had just published Soda Politics, and I gave a lecture on that book to the Nutrition Society of Australia, and I remember that somebody came up to me, and it was a small group, it wasn't a very big group, but somebody came up and said, "You know, there's a representative from Coca-Cola here. Is that a problem for you?" And I said, "Of course not." I had just published this book about the sugary drink industry, and I assumed there was somebody from that industry in every talk I gave. They would be interested in what I was saying. Well, it turns out, this person took notes, very good notes, actually, on my talk, and sent them up the chain of command and they landed, the notes on my lecture landed in these emails.
Suzy Chase: Wow.
Marion Nestle: And the notes were accompanied by a recommendation that Coca-Cola monitor my activities in Australia and also monitor the activities of Lisa Bero, the scientist at the University of Sydney that I was working with. So that was kind of amazing. That's how I started the book. And those emails also talked about Coca-Cola's attempts to influence journalists, attempts to influence researchers and other kinds of things that are germane to the things I discuss in the book.
Let me just say one other thing about the emails, 'cause this came out much later, was that the DC Leaks site that had all those emails was taken down, but before it was taken down, it was copied and all of those emails are available at the University of California at San Francisco, in their food documents library. So that was a lucky break, that they copied them just in time.
Suzy Chase: Oh, totally. Did that make you think, "Okay, I'm doing some really, really good work. It's all paying off since Coke is monitoring me?"
Marion Nestle: Oh, I was just terribly flattered.
Suzy Chase: Yes, totally.
Marion Nestle: You know, "Really? I turned up in Hilary Clinton emails? That's amazing!"
Suzy Chase: Little old me?
Marion Nestle: Yeah, little old me, really? The idea that anybody thought I was important, you know, I'm an academic! I teach students. I thought it was just amazing that anybody thought I was important enough to track.
Suzy Chase: So even Hershey and the Almond Board of California funded a study promoting dark chocolate and almonds in the Journal of the American Heart Association. So I guess chocolate went from candy to a health food?
Marion Nestle: Well, I think everybody thinks that dark chocolate is healthy and good for them. I mean, I ask audiences about this all the time, and say, "Is dark chocolate good for you?" Every hand goes up. And it's really Mars that spent a fortune trying to demonstrate that chocolate is a health food. It's a plant extract, after all. Nevermind the sugar and other things that get added to it. And the effort to market chocolate as a health food, it seems to me, to be a very good example of how industry funding skews this kind of science. Mars did hundreds of millions of dollars worth of studies over years to demonstrate that the anti-oxidant flavonols in cocoa had anti-oxidant activity that would reduce heart disease risk, and they never could really prove that. And they certainly couldn't prove that eating chocolate had the same effect, particularly because the flavonols are destroyed in cocoa processing into chocolate. And then eventually, they found a way to stop the flavonols from being destroyed, and they're now marketing flavonol supplements derived from cocoa, and have changed their marketing so they're no longer marketing chocolate as a health food, and instead, are trying to market these supplements.
But that's a long story that the FDA got involved in, but the word is out, and everybody believes that dark chocolate is good for you. Well, it might be if you ate pounds of it, but then that wouldn't be so good in other ways.
Suzy Chase: In the 1950s, the tobacco industry executives were aware of the link between cigarettes and lung cancer.
Marion Nestle: Well, this is an old story, and a very depressing one. When the information started to come out that cigarette smoking raised the risk for lung cancer, and that information was available in the early 1950s, the tobacco industry got together and said, "We gotta fight this." And the first thing you do, is you cashed out on the science. So they funded their own studies to show that no, cigarette smoking didn't have anything to do with cancer. And then they did other things. They funded scientists, they funded professional associations, they funded arts organizations, they funded physical activity associations. They did everything they possibly could to redirect attention away from cigarettes as a risk factor for cancer, and sort of made the whole thing confusing and muddy, and it was decades before the research was so overwhelming that everybody had to accept the idea that that cigarettes were harmful.
So I think the cigarette industry was responsible for a great deal of illness during that period, and they were perfectly well aware of it. There's a huge amount of documentary evidence also at the University of California at San Francisco, which collects this sort of thing that demonstrates that the cigarette companies were well aware of the problems, which simply gets much more complicated, because people don't eat just one food, they eat many, many different kinds of foods. Diets vary from day to day, from week to week, and differ enormously from person to person. So it's very hard to pin down a health problem on one particular food or ingredient. But this has certainly been the attack of Coca-Cola, which is a sugary beverage, to deflect attention from the sugar. That was certainly an aim of a lot of that research.
And now, we see a vast amount of research coming from healthy foods that are simply trying to get a marketing advantage by funding research that will show that they have appropriate health properties.
Suzy Chase: How dos nutrition research differ from food science?
Marion Nestle: Well, food science is about making and selling food products. It's about studying the ingredients of food and what they do, and developing food ingredients that can be put into processed foods that people will eat it. I mean, it's a much ... It's a food industry. It's actually an arm of the food industry. It's the food industry's research arm to help it develop products that they can sell. At least, that's what it's been, historically. Only recently have food scientists started to look at food ingredients in health, which gets them much more into the nutrition research area, and puts them at risk of conflicts of interest.
Nutrition research is about how to make people healthier through diet and finding out what the health properties are of ingredients. So these are two different fields. They're almost always in different academic departments, and sometimes different schools in universities. And attempts to unite food science and nutrition departments have never worked very well.
Suzy Chase: In terms of the latest dietary guidelines, how accurate are these guidelines, and can we take them at face value?
Marion Nestle: Well, I'm not sure accurate is the right word to use to describe dietary guidelines. These are meant to be general statements of principle about what healthful diets include, and these principles are so simple that the journalist Michael Pollan can do it in seven words: Eat food, not too much, mostly plants. I mean, it's really that simple. You wanna advise a largely plant-based diet. And dietary guidelines have always promoted eating more fruits, vegetables, and whole grains. And when they are talking about what you should eat more of, they talk about food. But when they talk about what you should eat less of, salt, sugar, saturated fat, they refer to the nutrients, not the foods that are the main sources of them, because if they talk about those foods, they get into too much trouble. It's just politically impossible to suggest to the American public that eating the main sources of saturated fat, which are animal products, it would be better if people ate less meat and dairy foods, that's not gonna go over very well, because there are groups that are responsible for raising dairy cattle and beef cattle in every state in the Union. And every state in the Union has two senators, and they have a lot of power. These lobbying groups have a lot of power.
So the dietary guidelines are stated in euphemisms, when it comes to what you should eat less of.
Suzy Chase: At the end of Unsavory Truth, you have ides on what needs to be done with researchers, food companies, reporters, and eaters. What is your advice for us eaters/consumers?
Marion Nestle: Well, first of all, recognize that who funds the research has a great deal of influence on what the outcome of that research is. The general findings about industry-funded research are that industry-funded studies generally come, not always, but most of the time, come out with results that favor the sponsor's interest, that that the size of the gift matters, the more funding you have, the more likely you are to produce results that favor the sponsor's interest, and that the influence, and this is the really tricky part, the influence is unconscious, largely. People don't realize that they're being influenced. Researchers who take food industry money don't believe that it has any effect on the way that they design, conduct, or interpret the research, even though lots and lots of evidence shows that the influence is there, whether they recognize it or not. That makes it really difficult to deal with.
So I say for the public, if you see a study that has a result that seems miraculous, it's probably not, because science doesn't work that way. If the results of a study favor a single food or a single ingredient, you wanna raise the question of who paid for the study, because useful studies about diet and health don't focus on individual nutrients or individual foods, they focus on dietary patterns, the collection of foods that people eat on a day to day basis. And if, whenever you hear, everything you thought you knew about nutrition is wrong, that one should send a huge red flag in the air to be especially skeptical, because again, that's not how science works.
Suzy Chase: What are some of your food predictions for 2019?
Marion Nestle: Oh, 2019, we're gonna have lots of politics, clearly. And there will be continued efforts to relax any kind of discussion on what people would be better off not eating. The big food issues are what's gonna happen to SNAP, formerly the Food Stamp program, the one program that we have left that supports food assistance for the poor, that's gonna be a big one. We're gonna have new dietary guidelines, and committees being appointed. And there will be a lot of discussion once that committee is appointed, about what that committee is going to do, and how it is going to review the research. I expect to see lots about that. And food will continue to be a front page story, as it has been. A full employment act, for me, I'm happy to say.
Suzy Chase: You're not retired.
Marion Nestle: No, I'm not, actually.
Suzy Chase: Now, to my segment called My Last Meal. What would you have for your last supper?
Marion Nestle: Oh, dear. Well my favorite food is ice cream. What can I say? Vanilla, but a really good one.
Suzy Chase: Perfect. Where can we find you on the web and social media?
Marion Nestle: My website is foodpolitics.com, and I do a blog post once a day, almost everyday during the week, where I talk about food issues of various kinds, and that goes out automatically to my Twitter feed, @marionnestle. And that's the extent of my social media, these days.
Suzy Chase: Well, this has been so informative. I cannot thank you enough for coming on Cookery by the Book podcast.
Marion Nestle: My pleasure.
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