Obesity in the Headlines

July 26, 2004 - Los Angeles Times

Obesity fuels their fervor
Three well-known nutrition activists take business, science, the government and us to task.

By Johanna Neuman, Times Staff Writer

To their critics, they are known as the food police. That's the polite term. Other sobriquets include "the cookie cops," "the grease Gestapo" and, given the times, "the vegetarian Taliban."

But the academics, scientists and consumer activists who have targeted the evils of unhealthy foods for decades are used to the name-calling. With American obesity a growing health hazard - two-thirds of adults, according to the national Centers for Disease Control and Prevention, are now overweight - the food crusaders are energized. Where once their ideas seemed far-fetched, they now believe they are knocking on the door of the mainstream.

Kelly Brownell, a Yale University psychologist, suggested in 1994 that Americans should get more exercise, that schools should get rid of soft drinks and vending machine snacks and that government should subsidize healthy foods like fruits and vegetables by taxing undesirable ones. This was promptly dubbed the Twinkie Tax by the media, and Brownell's life has never been the same.

"The tax idea became a lightning rod," he said, recalling the epithets from conservative commentator Rush Limbaugh. Now, he thinks, "we're reaching the tipping point" in food politics.

John Banzhaf III, a law professor at George Washington University, agreed. With a 30-year record of suing tobacco companies, Banzhaf now is plying that expertise to the cause of blaming the food industry for America's expanding waistlines. "This is the way movements start," he said. At first, "Brown vs. Board of Education seemed to many a frivolous case," he said of the landmark lawsuit that launched efforts to end racial segregation in public schools, "but it helped bring on the civil rights movement."

Not everyone is convinced that the food crusaders have the answer to excess poundage. At the American Council on Science and Health, a New York-based consumer education consortium, Dr. Elizabeth Whelan and her colleagues favor "variety, balance and moderation" in eating. "Twinkies and milk after school is not a crime when it is a snack in an otherwise balanced diet," she said. "But food has become very mystical. Everybody who eats three times a day thinks they are an expert."

The food industry has responded to the food crusaders by setting up its own Washington, D.C.-based organization &- the Center for Consumer Freedom - dedicated to exposing what it says are their distortions.

"These people are creating hysteria about foods, like movie popcorn," said Richard Berman, the center's executive director. "Why are we heavier? Is it food or a sedentary lifestyle? We believe in freedom of choice and the concept of personal responsibility. The zealots are distorting science."

Still others, far from the high-stakes lobbying in Washington, marvel at the power of the advocates, believing the solution is much closer at hand. Chazz Weaver, an economist in Costa Mesa, was so annoyed by film director Morgan Spurlock's documentary "Super Size Me" that he mounted a counter-campaign to demonstrate that exercise is far more important than food in maintaining weight. Now he is getting a degree in nutrition, eager to burnish his credentials and join the debate full time.

If this is a food fight, the warriors for intervention are a varied lot. One is a scientist who eats mostly whole grains and vegetables, fish, fat-free dairy products, a bit of sugar and is "not afraid of flavored yogurt." Another is a psychiatrist, a committed vegan who believes that a no-meat, low-fat diet can cure many ills, including diabetes. A third is a California-trained nutritionist who believes that government health policy has been corrupted by food industry greed.

What they share is a certainty that we are what we eat, that we are conditioned by culture and capitalism to consume more than we need, that somebody should do something about it.

- Michael Jacobson: His exposes have targeted hidden risks, and when he fought for nutrition labels, he won

No one has been proselytizing for longer and with more zeal than Michael Jacobson, the microbiologist who was one of the founders of the Center for Science in the Public Interest in 1971, back when calorie-counting and the new diet soft drink Tab were all the rage.

Asked about obesity, Jacobson talked passionately during a 90-minute interview about the "tremendous barriers" that feed the beast. In his worldview, the culprits are many: a wealthy, technologically advanced culture that produces cheap food and discourages exercise; a "nation of sloth and gluttony" that prefers to overeat while waiting for a miracle cure for fat; scientists who would rather win a Nobel Prize finding a medication for obesity than warn against overeating; big businesses that develop new products because "basic commodities are low in profit" and then spend $35 billion a year enticing consumers to eat bad foods; and finally, politicians who - if given revenue from taxing junk food - would spend it not for bike paths and free fruit for all but on highways, prisons and schools.

The great divide in food politics is over personal responsibility - whether the individual or the culture is largely to blame for an obesity rate that the CDC says has risen 74% since 1991. Asked about his organization's role, Jacobson grows defensive.

"We're not out there chiding people," he said. "We're certainly not arresting people. We see ourselves as detectives, ferreting out information." And, "we have interesting facts."

His facts arrive most often in the mail in his organization's Nutrition Action Healthletter, which reaches 850,000 homes and warns subscribers about the dangers of the saturated fat in popcorn, the high fat content of ice cream, the hidden calories in snack foods.

Jacobson put the center on the map by dramatizing the coconut oil in popcorn, the fat and sodium in Chinese food, and Olestra, the fat substitute. He currently is sponsoring campaigns to get manufacturers to stop using trans fat, to get schools to ban soft drinks in vending machines and to get chain restaurants to label food contents on their menus.

He embraces all tactics in the public advocate's arsenal - including taxes on foods such as meat and cheese. And he sometimes surprises those who would paint him with stereotypes, showing an openness to consider genetically modified foods to improve crop yields or reduce pesticides.

Critics argue that Jacobson is selling fear, not information.

"This is a game of hysteria and sound bites," Berman said of the industry-sponsored Center for Consumer Freedom. "Saying that fettuccini Alfredo is a heart attack on a plate distorts science."

But Jacobson, who delights in showing a visitor his greatest media hits, which are proudly displayed in photographs along a wall of fame, makes no apology for his showmanship.

"I like visuals," he said, pointing to one photo of a news conference in which the Center for Science in the Public Interest brought in 868 cans of soda to demonstrate that teenage males consume that much soda on average each year. "Food is easier to demonstrate than free speech or aviation."

Jacobson is proudest of the center's work in winning nutritional labeling on food, banning the most dangerous uses of sulfites and discouraging industry experimentation with Olestra. "We've accelerated changes. Eventually the government would have instituted labels. We speeded up the process."

- Neal Barnard: An advocate of low-fat eating, he has railed against the Atkins diet and animal foods

A psychiatrist by training, Neal Barnard is a faculty member at George Washington University's medical school by occupation and a vegan by conviction. Eschewing fats and all animal foods, including dairy products, he eats a diet of vegetables, fruits and grains.

"Cheese is like a drug," he said in an interview, noting that his view is shared by a growing number of scientists. "It has the same addictive qualities as sugar, chocolate or meat."

His scientific case is based on studies showing that cow's milk and human milk contain morphine. In his book, "Breaking the Food Seduction," Barnard wrote that cheese contains proteins called casein, which break apart during digestion, releasing "a whole host of opiates."

Tall and lanky (5-foot-11 and 150 pounds ) Barnard, who runs the Physicians Committee for Responsible Medicine, is passionate about his cause, eager to talk about what he says are well-established principles: Animal protein is bad for the kidneys and bones, and saturated fat and cholesterol are bad for the heart.

Raised in a family of cattlemen in North Dakota, Barnard said he was not hostile to meat-eaters and understood the culture that encourages meat-eating. But he said he was unhappy about the high-protein, low-carb craze and made no apology for leaking the medical examiner's report on Dr. Robert Atkins' death to the Wall Street Journal.

"Science has caught up with the rhetoric, and even the most ardent skeptic has to take notice…. ," he said. " I do not object to [Atkins] describing his health inaccurately, but I do object to his encouraging people to imagine that it's safe to eat steak, lobster and cream. That's a dishonest message. That's not the way to go."

Atkins' wife, Veronica, has blasted Barnard for publicizing the examiner's report that claimed Dr. Atkins' weight had ballooned to 258 pounds before his death and that he had a history of serious heart problems.

"These things are lies," she said on "Dateline NBC." "They're the vegetarian Taliban. Oh, I mean, I shouldn't insult vegetarians. But they're like the Taliban, these people. They're nasty."

For his part, Barnard finds the popularity of low-carb eating all the more remarkable because it comes just as researchers have made it "abundantly clear" that red meat leads to a higher risk of colon cancer and breast cancer. "There's nothing magical about lard," he said. "It's a craze because it encourages indulgence."

Barnard blames government, science and industry for not encouraging low-fat eating.

"The average American is pummeled by advertising and seductive products," he said. "Smoking causes one-third of all cancers. It's only a matter of time before we realize that food causes one-half or more."

He is pioneering work on the connection between meat-eating and diabetes, which is increasing so rapidly that Barnard said a Latina born in 2000 had more than a 50% likelihood of developing the disease.

And he blames a take-a-pill society for ignoring the healing effects of diet. "Dietary contributors to the disease are easily swept aside, as our culture assumes it's normal to be chronically medicated to regulate cholesterol, blood pressure and blood sugar," he said.

In 2000, Barnard sued the U.S. Department of Agriculture over the composition of the committee that developed its new food pyramid, arguing that members were too beholden to industry. A judge ruled that the government had erred in conducting the discussions behind closed doors. A similar battle is in play this year, as Barnard is back in court trying to get the government to disclose financial ties between committee members and industry interests.

- Marion Nestle: Her focus on government guidelines takes a hard look at industry influences

Perhaps no one knows more than Marion Nestle about industry pressures on the USDA. Her book, "Food Politics," includes a damning chart from the 1992 fight over government food guidelines, in which industry urged that the pyramid be replaced with a bowl, since the rounded shape would give the appearance that all the food groups - including meats and milks - were equally important.

Nestle, former chairwoman and now the Paulette Goddard professor in the department of nutrition, food studies and public health at New York University, said she believes the federal government, kowtowing to industry pressure, regularly recommends foods not because they are healthy but because they are abundant. At fault, she said, is business.

"If people are going to eat less, it will be bad for business," she said. "We produce 3,900 calories per person. That's almost twice what most people need." Because food companies' stocks are tied to their growth, she argued, the incentive is to find new products and push to sell them. In her view, advertising to children "crosses the ethical line. It has to be stopped."

Nestle, who earned a master's in public health and a doctorate in molecular biology from UC Berkeley, said her interest in industry's role was sparked in 1988, when she served as editor for the Surgeon General's Report on Nutrition and Health. "The extent of the industry lobbying was extraordinary," she said. "On my first day on the job, I was told that no matter what the research showed, we should never say 'Eat less meat' or 'Eat less sugar' but to use euphemisms like 'Choose lean meat.' I was pretty shocked."

In 2002, she was stunned by a letter from the sugar industry that came just before her book was published criticizing her claim that industry pressured the USDA to change its 2000 recommendations on sugar intake. In fact, the USDA did change the guidance — instructions to "lower your intake of added sugars" was changed to "moderate your intake of sugars." The industry said the change was made because guidelines require "a preponderance of scientific evidence." Nestle said it was changed because of industry pressure.

Nestle points to the public's embrace of her book as evidence that she and others are making progress in calling attention to the role of the food industry.

Nestle has recently teamed up with Yale's Kelly Brownell to warn about the dangers of sugar and its role in the nation's obesity problem. In recent columns, they have urged the government "to create a wall between itself and the food industry when establishing nutrition and public health policy."

Brownell, author of "Food Fight: The Inside Story of the Food Industry, America's Obesity Crisis, and What We Can Do About It," said public opinion is tipping toward the food crusaders in part because of the Enron and Tyco scandals.

"There's a basic American distrust of big business," he said in a recent interview. "The public is no longer willing to give the industry a free pass."

But Dr. Ruth Kava, a nutritionist who works with Whelan at the American Council on Science and Health, said she thinks much of the zeal is misguided. To tax so-called junk foods, she argued, ignores the issue of calories and balance.

"There's a bandwagon on vending machines in schools, but unless you're putting in water and diet soda, it's misleading," she said. "Eight ounces of juice has 120 calories, just like eight ounces of cola." And to sue food companies or restaurants for their products, she said, ignores the fact that eating is different from smoking.

"There's a difference between food and tobacco," she said at a recent National Press Club debate on food and personal responsibility. "Nobody needs tobacco to live."