A super-sized problem: a top nutrition expert's view on food, fat and cultural politics

eVEN IF YOU YOURSELF TRY TO EAT RIGHT, IT'S HARD not to notice that most Americans don't--or that it's sometimes difficult even for the health-conscious to avoid foods that are full of unhealthy ingredients. How did we get into this predicament? If anyone has the answer, it may be Marion Nestle, PhD, chairwoman of the department of nutrition, food studies and public health at New York University. Nestle has been a member of the FDA Food Advisory Committee and Science Board, and the USDA/DHHS 1995 Dietary Guidelines Advisory Committee. She's also the author of Food Politics: How the Food Industry Influences Nutrition and Health (University of California Press, 2002) and Safe Food: Bacteria, Biotechnology, and Bioterrorism (University of California Press, 2003). HERS asked Nestle what she thinks is at the root of the recent obesity epidemic and what athletic women need to know about getting a nutritional edge.

Q Americans seem to hunger for everything big: big cars, big houses and now, big food portions. Is this cultural bent part of why we have a health crisis on our hands?

A Oh yeah, lots of people have talked about that. But I look at it a different way. We have an enormously competitive food system and that within that competitive food system, marketers have to sell food. And the way they've done that is not just by advertising and marketing but also--I think inadvertently, I don't think this was a deliberate choice--by setting up a different food environment, changing social norms so that it's now acceptable to eat in ways that were absolutely not acceptable when a lot of us were growing up.

Q In your view, how are we eating differently?

A We're eating everywhere, not eating regular meals, eating larger portions, snacking, eating in places where food didn't used to be appropriate. Eating in libraries and bookstores is the best example. You weren't allowed to take food into libraries, and now there are cafes in libraries! You go into Barnes & Noble and there are people sitting at the cafe reading books and eating. The way of feeding children has also changed from something that was under fairly stringent parental control to something where kids are advertised to deliberately and directly and are calling their own shots. So these are societal changes that are all designed to encourage people to eat more food, not less. And most people are completely unaware of it because it's in the air, it's in the environment, it's not something that they're supposed to be aware of and, in fact, much of this kind of thing is deliberately done in a way that you don't notice it. Of course, larger portions are the most obvious things. It's become OK to eat these really humongous quantities of food to the point where it's expected that food portions will be very large and people feel cheated when they don't get them.

Q What do you think is needed to address the obesity issue?

A We have a very sedentary society and a lot of effort has gone into making people increasingly sedentary. We also have a very overfed society, and it's going to take a lot of changes to fix that or people have to become much more aware of the way they're being sold on these things and take steps to fix it.

Q Do you think government policies could facilitate change?

A Of course. The government has a huge number of policies that support the current system and those would just need to be tweaked. Probably the most serious issue is the issue of food pricing, because the cost of junk food is so low. One thing that could be done is to subsidize different kinds of foods instead of the ones that make people fat.

Q So, in essence, junk food prices would increase and prices of healthy foods would decrease. It sounds like a strategy similar to the one used to get people to stop smoking by driving up the price of cigarettes. Did that have an impact?

A There's no question about it. That policy has worked for everybody but the hardcore smokers.

Q Do you have a sense of why it's hard for people to eat healthfully on an individual level? Why, in other words, is it difficult for the average person to resist double cheeseburgers?

A Because they're being marketed to the tune of $34 billion a year in ways that they're not supposed to notice, and don't. If you put large amounts of food in front of people, they'll eat more unless they're paying extremely close attention and are really conscious of it. It's just normal to eat more when more food is put in front of you. It's also normal to eat more when you eat more often. Those are very human characteristics that marketers take advantage of in order to sell more food. We're acting unconsciously within our own nature. In order to do something about that, you have to be really conscious of it. And most people don't want to be conscious of that when they're eating. They just want to enjoy it. That's also human.

Q The readers of HERS are very athletic and are always looking for something that will give them a nutritional edge. What's your advice?

A My feeling is that food is what it's about. And the rest of it--foods that are specially formulated for athletes--it's very, very difficult to separate real effects from psychological effects. Most of the stuff is harmless so if people feel like they get an edge from it, there's not anything wrong with it. But those things like sports bars and sports drinks have calories and if that's the way people want to get their calories, they need to know that.

Q What about fortified foods? Do we need them?

A Well, you can't avoid them. If you're going to buy packaged foods at all, they are all fortified now, so that's adding even more [vitamins and minerals]. Is that a good idea? I don't think so. But it sells food. It's about selling food. That's its purpose.

Q So if you're trying to be aware of what's being sold to you, should you try to stick to non-processed foods?

A There is so much fresh food that comes packaged now that at least for people who live in big cities, it's not very hard to choose healthfully.

OBESITY EPIDEMIC: Marion Nestle, PhD, has some answers.

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