In ancient times, an invading army might poison the food or water supply in an effort to conquer the enemy’s army. Now, suppose that a foreign power conspired to overpower America, economically and militarily, with a similar strategy. But instead of contaminating a water reservoir or food store—actions that would be easily identified and countered with modern public health surveillance systems—our adversary planned to gradually degrade the food supply. Teams of secret agents infiltrated key segments of society and worked insidiously to undermine the national diet so that the public would increasingly succumb to diabetes and other disabling obesity-related conditions. Their scheme targeted the following areas:
• Devise long-term agricultural policies that favor production of low-nutritional-quality commodity grains over nutrient-rich vegetables, fruits, legumes, and nuts1
• Provide free junk food and sugary beverages—amounting to billions of dollars each year—through nutrition assistance programs like SNAP (previously known as Food Stamps)2
• Restrict funding for nutrition research, the school lunch program, and childhood-obesity-prevention initiatives3
• Underinvest in public transportation (including walking and bike paths) relative to the national highway system, restricting opportunities to offset poor diet with physical activity
• Produce an overwhelming variety of extremely low-quality food products derived predominantly from cheap grain commodities and artificial additives4
• Aggressively market those products throughout society, especially to children (ensuring brand loyalty from early in life)
• Make fast food, junk foods, and sugary beverages convenient and affordable, but nutritious whole foods much less so
• Offer empty promises of change when the public becomes concerned about poor food quality, while working to subvert public health5
• Close budget gaps by lowering the quality of foods provided through the school lunch program, franchise the cafeteria to fast-food companies, and sell junk food in vending machines
• Reduce or eliminate physical education classes and after-school recreation programs
• Accept funding from the food industry for research, sponsorships, product endorsements, preferred access to “thought leaders,” and other collaborations—despite evidence that such relationships create scientific bias and undermine public health credibility6
Though any one of these conspiratorial actions might have caused limited damage, their combined effects on society were devastating. Rapidly rising medical costs from diet-related disease, approaching $1 trillion annually, and declining worker productivity produced massive budget deficits. The looming fiscal crisis provoked political infighting and legislative paralysis. As financial resources for education, research, transportation, and other critical long-term investments dwindled, the national infrastructure deteriorated, crippling America’s economic competitiveness. The Pentagon feared that young people had become too unhealthy to serve in the military, should the need for a large-scale deployment arise.7 For the first time in a century, America’s status as a superpower seemed to be threatened… exceeding the wildest expectations of our adversary.
Of course, the foreign conspiracy is imaginary. But this frightening scenario may well come to pass for an entirely domestic reason—the systematic political failure to put public health and societal needs ahead of special interests and short-term profit. We all share responsibility for this failure—by condoning a culture that values the temporary convenience and fleeting pleasure of highly processed industrial foods over health. But the food industry has played the leading role.
Food companies and their advocacy groups spend tens of millions of dollars a year in political donations, lobbying, and related activities, gaining in return immense influence over food policies at the national, state, and local levels.8 In the last decade, aggressive industry lobbying has:9
• undermined school lunch standards (for example, defining pizza as a vegetable)
• hindered reform of federal nutrition-assistance programs (for example, mandating inclusion of white potato in WIC benefits, against the advice of the Institute of Medicine)
• blocked taxes on sugary beverages
• impeded restrictions on food advertisements aimed at children
• weakened food labeling standards (for example, involving GMOs)
• swayed dietary guidelines related to sugar and other commodities
• affected many billions of dollars in federal spending for agricultural subsidies
In response to growing concern about obesity, especially among children, food companies have launched expensive campaigns to create the perception that they are good corporate citizens, sincere in their efforts to be part of the solution. But how can we trust food companies, asked Michele Simon, when they “lobby vociferously against policies to improve children’s health; make misleading statements and misrepresent their policies at government meetings and in other public venues; and make public promises of corporate responsibility that sound good, but in reality amount to no more than a public relations campaign?”10
All things considered, the food industry isn’t immoral, and its actions are, for the most part, entirely predictable. As described by Marion Nestle in Food Politics,11 food companies have a fiduciary responsibility to their stockholders to maximize profit. In the unregulated marketplace, those profits come primarily from promoting consumption of highly processed, commodity-based products. An executive may have the best of intentions, but if the competition markets junk food to children, his company will be at a competitive disadvantage unless it resorts to those tactics as well.
Deflecting attention from this inherent conflict—to produce healthy foods versus healthy profits—the industry argues that it’s all a matter of personal responsibility. Food companies don’t force people to buy junk food. People are free to make their own decisions, and live with the consequences. But this argument fails for two fundamental reasons. First, political manipulation by the industry has grossly distorted the free market and, consequently, the food environment. Processed industrial foods are plentiful, convenient, and cheap relative to whole foods, in part due to government policies. How does someone exert personal responsibility in a whole food desert and junk food oasis? According to a report from the Institute of Medicine in 2000:
It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural and physical environment conspire against such change. If successful programs are to be developed to prevent disease and improve health, attention must be given not only to the behavior of individuals, but also to the environmental context within which people live.12
Second, the long-term consequences of an industrial food diet don’t fall entirely to the individual. Society pays directly through Medicare and Medicaid, and indirectly through Supplemental Security Income and other disability benefits. Indeed, every business that purchases employee medical insurance, and anyone who pays for private insurance, shoulders this burden.
With most public health issues, we wouldn’t create a false distinction between personal, corporate, and government responsibility. Imagine what would happen if government deregulated automobile safety, allowed the industry to market dangerous cars, and expected consumers to sort things out for themselves? Shared responsibility is taken for granted with all sorts of consumer products, from toys to toaster ovens. Why not food?
Unless we change course, diet-related chronic diseases will cause tremendous suffering, shorten life expectancy,13 drain the economy, and undermine our international strength. But this major threat to our national security can be averted, with a comprehensive (if politically difficult) action plan, as summarized below.
The food industry has acted constructively sometimes and outrageously other times. Supporters and critics can always find examples to argue that that the industry is either essentially “good” or essentially “bad.” But that would miss the point. In a market-driven economy, industry tends to behave opportunistically to maximize profit. It’s the government’s responsibility to regulate the market so that industry will profit from serving the needs of society, not undermining them.
And the food industry must bear in mind that public health is in everyone’s best interests. A healthy food supply forms the foundations of a strong society—as argued a half century ago by the American food scientist George Stewart:
If we do not pay proper attention to the nutritional problems associated with food technology we run the risk of eventually producing an abundance of palatable, convenient, stable foods that are not capable of meeting man’s nutritional needs. In other words, we run a risk of undermining the nutritional well-being of our nation… It is my contention that every food technologist has a moral responsibility to help provide the public with nutritious [not just] palatable foods.19
But ultimately, it’s up to us. Until we can re-create a society in which the wholesome choice is the easy choice, we must take full responsibility for our health, and the health of our children. We can say no to seductive ads for junk food, knowing that the diseases they cause—including most cases of diabetes—are anything but convenient and pleasurable. The purpose of this book is to empower you on this journey to optimal health.