Conversation with Marion Nestle PhD

Marion NestleMarion Nestle, Ph.D., M.P.H., is Paulette Goddard Professor and former Chair of the Department of Nutrition, Food Studies and Public Health at New York University. Her research focuses on analysis of the scientific, social, cultural, and economic factors that influence federal dietary guidance policies and their acceptance by the public, particularly food industry marketing. Dr. Nestle's recent books include Food Politics: How the Food Industry Influences Nutrition and Health and Safe Food: Bacteria, Biotechnology, and Bioterrorism, published by the University of California Press in 2002 and 2003; she is also co-editor of Taking Sides: Clashing Views on Controversial Issues in Food and Nutrition, published by McGraw-Hill/Dushkin in 2004.  Her latest book is What to Eat: An Aisle by Aisle Guide to Savvy Food Choices and Good Eating, published in May 2006 by North Point Press (Farrar, Straus & Giroux). Dr. Nestle is a veteran of debates about government nutrition policy, and the role of the food industry in promoting unhealthy diets.

SKAPP’s Polly Hoppin caught up with Marion Nestle a day after she had returned from The World Economic Forum in Davos, where she had been invited to speak on the politics of science, organic foods, and obesity. Other speaking engagements in the past year - she has cut down to about 50 annually - range from family practitioners to food executives to farmers. To some audiences, Marion Nestle is a hero: a scientist with strong academic credentials who has called the food industry to account for tactics that threaten public health. To her critics, Nestle has crossed what they perceive as a bright line that should separate science from politics. In this interview, Dr. Nestle talks about her career, her perspective on the responsibilities of scientists in public policy, and her latest forays into the realm of “food politics.”

Polly Hoppin, SKAPP: Your work in the last fifteen years or so has centered on food policy and politics. How did you come to this focus?

Marion Nestle: My interest in these issues goes back a long way. I was trained in molecular biology, and my first teaching job was at Brandeis University where I was a biology teacher. The department had rules that anybody who was on the faculty had to teach whatever was needed, whether they were trained in it or not, and that you could only teach the same course for three years. My three year term of teaching cell biology was up and I was assigned a nutrition course.  This, as it turned out, was like falling in love.

SKAPP: What was so appealing about nutrition?

MN: One of the things that attracted me so much about it was that you could go from science to politics in one fell swoop. I could tell right away that this would be a great way to teach undergraduate Biology, because students could relate to it.  When I tried to teach general biology students the elements of molecular and cell biology, their eyes just glazed over - it was just so abstract. But everybody eats, so it is easy to teach the science because it is so closely related to the way people eat and live.

SKAPP: And after Brandeis?

MN: I moved to the University of California San Francisco School of Medicine dean’s office, and taught clinical nutrition to medical students on the side. Then I went to public health school, got interested in nutrition policy, and went to Washington, DC, as Senior Nutrition Policy Advisor to the Office of Health Promotion and Disease Prevention. There, my primary job was to edit the 1988 Surgeon General's Report on Nutrition and Health.

SKAPP: What was that experience like?

MN: It was such a politicized process. I had the opportunity to see first hand how food companies and food trade organizations attempt to influence dietary advice, and to understand their level of worry about what the government might say about the nutritional value of a particular product or commodity. At that time, the big issue was meat. I had some experiences with the cattlemen’s associations that were really scary and unpleasant.   I was just a staff person and didn't have much control or power, and even so was astonished by the amount of pressure put on me.

SKAPP: You left the government in 1988, and went to NYU. How did you develop these interests there?

MN: Soon after I went to NYU, I was invited to speak at a conference on cancer prevention run by former Surgeon General C. Everett Koop and the National Cancer Institute. At that conference I saw the presentations of leading anti-smoking advocates who for years and years had researched the way the cigarette industry pushed people to smoke. They showed slide after slide of images of cigarette marketing, particularly those aimed at children, from remote areas of Africa and the Himalayas. When they were finished, I realized we ought to be doing this same kind of analysis with Coca Cola. I had never seen this kind of descriptive analysis before and had never paid much attention to the ubiquity of those images. After that meeting, I began focusing on food marketing and writing about it, starting with an analysis of the withdrawal of the U.S. Department of Agriculture's Eating Right Pyramid in 1991, under pressure from cattelemen’s lobbying groups.

SKAPP: What was that story?

MN: A USDA staff person I’d known in Washington called soon after the Pyramid was withdrawn, saying that colleagues were under a gag order and were not allowed to talk to the press. This person had documents proving that the Secretary of Agriculture was lying to the public about the reasons for stopping release of the Pyramid, and could I help get those documents to the press. Nothing could be easier. I put together a press kit based on documents and mailed them out. The documents started arriving in unmarked brown envelopes, hotel fax machines, or other  untraceable public sources. They showed that the decision had been made because of pressure from meat and dairy lobbying groups, not because, as the Secretary had said publicly, it was “confusing to children.” After this, the more I learned about the power of food companies and trade associations, the more fascinated I became in the ability of lobbying groups to influence public health policy.

SKAPP: In 2002, you published Food Politics, and since then, you’ve been viewed with some ire by representatives of the food industry. You’ve been called a junk scientist. What has that been like?

MN: I have never taken comments personally, and don't get hurt if people representing food company interests say rude things. They are just doing their job. But I am troubled by some of it—by what the Center for Consumer Freedom does, for example. This is not because of the personal attacks, but because I think this outfit—really a P.R. firm for the restaurant, alcohol, and tobacco industries--gets away with being perceived as independent, which it most certainly is not.

When Food Politics was first published, it was hugely attacked. This played out on Amazon.com, where the first reviews -- before the book came out and before anyone could possibly have seen it - were extremely hostile. But then Sheldon Rampton (whom I have never met) came to the rescue with an analysis of the attackers and said if I had enemies like these the book must be pretty good. So I never had to respond to those reviews. In retrospect, this was an example of “if you don’t like the message, attack the science.”

Another factor that has made it easier is that I have tenure at NYU. My research also does not require much in the way of funding so I don’t need grants. And I have a hard money salary, so I don't owe anybody anything. The university has always seemed fine about the work I do. No one at NYU has ever, ever said, "You're going too far." And after Food Politics won all those prizes, they think I walk on water. In a sense, I am very protected.  And these days, I am frequently invited to talk to food companies. I've just come back from Davos and the World Economic Forum; I thought that was pretty amazing. And I have endless invitations to speak to corporate food executives.

SKAPP: And what is the tenor and substance of those conversations?

MN: I give my Food Politics speech, or some version of it, and they argue with me that obesity is really about personal responsibility, not theirs. Or they defend what they are doing. Or they come up with new arguments, some of which I've never heard of, and basically they end up saying, "What do you want us to do?" Later, I hear that they take my comments seriously and are thinking about how they might institute reforms—but still stay in business, of course.

SKAPP: Do you see movement by any individual company?

MN: I see huge movement. On the obesity issue, they're all scurrying. It isn't just me who's criticizing them. My book came out at a point at which a lot of things were happening.  People tell me that the book provided an academic base for the kinds of things that advocates wanted to do anyway. The lawyers who were interested in obesity litigation, for example, credit Food Politics for getting them started on it. I don't know whether I should be flattered or upset by that! The book also stimulated research analyses by three very large investment companies in Europe of the vulnerability of the companies to consumer backlash over the obesity issue or to the lawsuits. Between critics like me, the threat of the lawsuits and the outcomes of the investment analyses companies have felt they needed to move, and they're all making changes.

Whether they can do anything that's reasonable or not is another matter. There's really not much junk food products can do that I will applaud. I don't think that putting whole wheat flour into Cocoa Puffs is really a good idea... or that adding vitamins to soft drinks makes them better, so there's a problem there.

I find myself having very sophisticated conversations with high level people in important food companies about, of all things, capitalism. They know that’s what’s at stake. I was criticized by food industry executives at a meeting in Rome once for not understanding how capitalism works because I didn’t refer to it directly. So now I do, straight out.  Our version of capitalism requires companies to grow and report growth to Wall Street every 90 days. This puts the pressure on short-term, not longer term, profits. I see that as at the root of a great deal of difficulty in the obesity problem. If companies have to grow, they’re going to have to produce and sell more food, not less. But all of them can’t succeed in that because we already have too much food—3,900 calories per day per capita in the U.S., twice average need. There’s nothing they can do about it—this is the system that they’re in. They can make better food, but it doesn’t sell as well, it’s more expensive to make, and those cheap food products are immensely profitable. Food companies have a real problem, and I don’t know how to solve it for them.

SKAPP: You mention Cocoa Puffs. Sugar is at the center of many of these debates, isn't it?

MN: It is. Attention to the obesity epidemic has raised the problem of soft drinks, which are a major source of sugars in the American diet. The sugar industry is scared that people will cut down on sugars. Indeed they threatened to sue me because I said that if I were advising someone to lose weight, I would suggest elimination of soft drinks - because they contain "sugar" and nothing else. The sugar manufacturers objected because soft drinks actually contain corn sweeteners, not sucrose; they relented when I agreed to use “sugars” rather than “sugar” in any future commentary.

SKAPP: Almost a year ago, the World Health Organization and the UN’s Food and Agriculture Organization released a report: “The Expert Consultation on Diet, Nutrition and the Prevention of Chronic Disease,” which included the recommendation that people limit their sugar consumption. The sugar lobby expressed concern about this report. Can you describe their response, and that of the US Government?

MN: This was a tempest in a sugar bowl, but a serious one. The recommendation was to limit added sugars to 10% of daily calories. This was not new. The USDA Pyramid recommended that amount. But, the industry demanded that WHO remove from its website an early draft of its report, and promised to use "every avenue available to expose its dubious nature," including asking members of Congress to challenge the United States' $406 million in contributions to the WHO. Worse, sugar lobbyists got the US Department of Health and Human Services to challenge the science of the report.  The Department issued a line-by-line critique, calling for greater transparency in the scientific review process, using the exact language in previous sugar trade association documents.   All this over a recommendation that was neither new nor aggressive; it had been a standard recommendation made by many countries for decades. DHHS’ response focused on the “science” but was really about pandering to the sugar industry.

SKAPP: Having watched the issue of the role of science and of interest groups in policy evolve over your career, how would you describe the state of the relationship today?

MN: It is pretty shocking - and the change over the years is even more shocking. There has always been intense lobbying, but now it is much more out in the open, and much more successful.  Nutrition science is never black and white; it is always in shades of grey and open to interpretation (and, therefore, bias). I was on the Dietary Guidelines Committee in 1995. We were instructed to review the science to the best of our ability and to interpret it to provide the best advice that we could possibly give the public.  In 2005, in contrast, the Committee was instructed to take a “science-based” approach, meaning exactly the opposite. By science-based, it meant that the committee was not to give any advice unless science absolutely backed it up, which of course it never can do. This was largely about sugar.  If DHHS attacked the 10% guideline, the Dietary Guidelines could hardly put it back. There’s a different tone to lobbying now.  It’s more open, more anti-science, and more aggressive.

SKAPP: What would you say are the most important trends affecting the role of science in public decision-making?

MN: I’m concerned about two things: first, the lack of science training in the general public. Mention anything about science to students, and they act like deer caught in headlights. Most of them have no science background, and they’re frankly and openly terrified of it. If you’re going to have an educated public - a public that can understand what the issues are and recognize when economic or political interests are using science cynically to support their agendas - we need to do a better job with science education.  The training has to be designed to reassure students that science is something they really can understand. Most of it isn’t all that complicated, conceptually. We’ve brought this on ourselves, to some extent, through our use of language, which is often completely obfuscating. I could not bear the jargon in molecular biology, much of it cute but impenetrable. But basic chemistry can be explained in ways that people can “get.” And it’s important they do because it’s hard to explain what calories are about without it.

SKAPP: And the second concern?

MN: Industry funding of research. Many scientists have made liaisons with companies for research purposes, and this has corrupted their integrity in the same way that nutritionists get corrupted when they work for food companies. You can’t expect people to do objective research if they’re being paid for it by an entity that has a stake in the outcome. I can count on the fingers of one hand the number of studies paid for by food companies that come out in any way contrary to their economic interests.  Nutrition professional associations are corrupted in the same way, and so are journals unless they build firewalls between editorial and marketing departments. Unless there is a firewall between the economic interest and the science, there are too many opportunities for downplaying what the science tells you, and spinning a message that is palatable to those whose economic interests are at stake.

SKAPP: And what is your latest book about?

MN: It’s called What to Eat, but it’s really about how to think about food choices. After Food Politics came out, people started telling me how hard it was for them to go to supermarkets and balance scientific issues of nutrition, health, and safety against social, environmental, and economic concerns: organics, fair trade, price, and the like. I went through supermarkets section by section addressing all of those issues and have never had so much fun writing a book.

SKAPP: Thanks so much, Dr. Nestle.

MN: My pleasure.