The Leading Voices in Food

Duke World Food Policy Center

The Leading Voices in Food podcast series features real people, scientists, farmers, policy experts and world leaders all working to improve our food system and food policy. You'll learn about issues across the food system spectrum such as food insecurity, obesity, agriculture, access and equity, food safety, food defense, and food policy. Produced by the Duke World Food Policy Center at wfpc.sanford.duke.edu.

  1. NOV 25

    E287: Food policy insights from government agency insider Jerold Mande

    In this episode, Kelly Brownell speaks with Jerold Mande, CEO of Nourish Science, adjunct professor at the Harvard School of Public Health, and former Deputy Undersecretary for Food Safety at the USDA. They discuss the alarming state of children's health in America, the challenges of combating poor nutrition, and the influence of the food industry on public policy. The conversation explores the parallels between the tobacco and food industries and proposes new strategies for ensuring children reach adulthood in good health. Mande emphasizes the need for radical changes in food policy and the role of public health in making these changes. Transcript So, you co-founded this organization along with Jerome Adams, Bill Frist and Thomas Grumbly, as we said, to ensure every child breaches age 18 at a healthy weight and in good metabolic health. That's a pretty tall order given the state of the health of youth today in America. But let's start by you telling us what inspired this mission and what does it look like to achieve this in today's food environment? I was trained in public health and also in nutrition and in my career, which has been largely in service of the public and government, I've been trying to advance those issues. And unfortunately over the arc of my career from when I started to now, particularly in nutrition and public health, it's just gotten so much worse. Indeed today Americans have the shortest lifespans by far. We're not just last among the wealthy countries, but we're a standard deviation last. But probably most alarming of all is how sick our children are. Children should not have a chronic disease. Yet in America maybe a third do. I did some work on tobacco at one point, at FDA. That was an enormous success. It was the leading cause of death. Children smoked at a higher rate, much like child chronic disease today. About a third of kids smoked. And we took that issue on, and today it's less than 2%. And so that shows that government can solve these problems. And since we did our tobacco work in the early '90s, I've changed my focus to nutrition and public health and trying to fix that. But we've still made so little progress. Give us a sense of how far from that goal we are. So, if the goal is to make every child reaching 18 at a healthy weight and in good metabolic health, what percentage of children reaching age 18 today might look like that? It's probably around a half or more, but we're not quite sure. We don't have good statistics. One of the challenges we face in nutrition is, unfortunately, the food industry or other industries lobby against funding research and data collection. And so, we're handicapped in that way. But we do know from the studies that CDC and others have done that about 20% of our children have obesity about a similar number have Type 2 diabetes or the precursors, pre-diabetes. You and I started off calling it adult-onset diabetes and they had to change that name to a Type 2 because it's becoming so common in kids. And then another disease, fatty liver disease, really unthinkable in kids. Something that the typical pediatrician would just never see. And yet in the last decade, children are the fastest growing group. I think we don't know an exact number, but today, at least a third, maybe as many as half of our children have a chronic disease. Particularly a food cause chronic disease, or the precursors that show they're on the way. I remember probably going back about 20 years, people started saying that we were seeing the first generation of American children that would lead shorter lives than our parents did. And what a terrible legacy to leave our children. Absolutely. And that's why we set that overarching goal of ensuring every child reaches age 18 in good metabolic health. And the reason we set that is in my experience in government, there's a phrase we all use - what gets measured gets done. And when I worked at FDA, when I worked at USDA, what caught my attention is that there is a mission statement. There's a goal of what we're trying to achieve. And it's ensuring access to healthy options and information, like a food label. Now the problem with that, first of all, it's failed. But the problem with that is the bureaucrats that I oversaw would go into a supermarket, see a produce section, a protein section, the food labels, which I worked on, and say we've done our job. They would check those boxes and say, we've done it. And yet we haven't. And if we ensured that every child reaches age 18 at a healthy weight and good metabolic health, if the bureaucrats say how are we doing on that? They would have to conclude we're failing, and they'd have to try something else. And that's what we need to do. We need to try radically different, new strategies because what we've been doing for decades has failed. You mentioned the food industry a moment ago. Let's talk about that in a little more detail. You made the argument that food companies have substituted profits for health in how they design their products. Explain that a little bit more, if you will. And tell us how the shift has occurred and what do you think the public health cost has been? Yes, so the way I like to think of it, and your listeners should think of it, is there's a North star for food design. And from a consumer standpoint, I think there are four points on the star: taste, cost, convenience, and health. That's what they expect and want from their food. Now the challenge is the marketplace. Because that consumer, you and I, when we go to the grocery store and get home on taste, cost, and convenience, if we want within an hour, we can know whether the food we purchased met our standard there. Or what our expectations were. Not always for health. There's just no way to know in a day, a week, a month, even in a year or more. We don't know if the food we're eating is improving and maintaining our health, right? There should be a definition of food. Food should be what we eat to thrive. That really should be the goal. I borrowed that from NASA, the space agency. When I would meet with them, they said, ' Jerry, it's important. Right? It's not enough that people just survive on the food they eat in space. They really need to thrive.' And that's what WE need to do. And that's really what food does, right? And yet we have food, not only don't we thrive, but we get sick. And the reason for that is, as I was saying, the marketplace works on taste, cost and convenience. So, companies make sure their products meet consumer expectation for those three. But the problem is on the fourth point on the star: on health. Because we can't tell in even years whether it's meeting our expectation. That sort of cries out. You're at a policy school. Those are the places where government needs to step in and act and make sure that the marketplace is providing. That feedback through government. But the industry is politically strong and has prevented that. And so that has left the fourth point of the star open for their interpretation. And my belief is that they've put in place a prop. So, they're making decisions in the design of the product. They're taste, they gotta get taste right. They gotta get cost and convenience right. But rather than worrying what does it do to your health? They just, say let's do a profit. And that's resulted in this whole category of food called ultra-processed food (UPF). I actually believe in the future, whether it's a hundred years or a thousand years. If humanity's gonna thrive we need manmade food we can thrive on. But we don't have that. And we don't invest in the science. We need to. But today, ultra-processed food is manmade food designed on taste, cost, convenience, and then how do we make the most money possible. Now, let me give you one other analogy, if I could. If we were CEOs of an automobile company, the mission is to provide vehicles where people can get safely from A to point B. It's the same as food we can thrive on. That is the mission. The problem is that when the food companies design food today, they've presented to the CEO, and everyone gets excited. They're seeing the numbers, the charts, the data that shows that this food is going to meet, taste, cost, convenience. It's going to make us all this money. But the CEO should be asking this following question: if people eat this as we intend, will they thrive? At the very least they won't get sick, right? Because the law requires they can't get sick. And if the Midmanagers were honest, they'd say here's the good news boss. We have such political power we've been able to influence the Congress and the regulatory agencies. That they're not going to do anything about it. Taste, cost, convenience, and profits will work just fine. Couldn't you make the argument that for a CEO to embrace that kind of attitude you talked about would be corporate malpractice almost? That, if they want to maximize profits then they want people to like the food as much as possible. That means engineering it in ways that make people overeat it, hijacking the reward pathways in the brain, and all that kind of thing. Why in the world would a CEO care about whether people thrive? Because it's the law. The law requires we have these safety features in cars and the companies have to design it that way. And there's more immediate feedback with the car too, in terms of if you crashed right away. Because it didn't work, you'd see that. But here's the thing. Harvey Wiley.He's the founder of the food safety programs that I led at FDA and USDA. He was a chemist from academia. Came to USDA in the late 1800s. It was a time of great change in food in America. At that point, almost all of families grew their own food on a farm. And someone had to decide who's going to grow our food. It's a family conversation that needed to take place. Increasingly, Americans were moving into the cities at that time, and a brand-new industry had sprung up to feed peopl

    33 min
  2. E286: How 'least cost diet' models fuel food security policy

    NOV 4

    E286: How 'least cost diet' models fuel food security policy

    In this episode of the Leading Voices in Food podcast, host Norbert Wilson is joined by food and nutrition policy economists Will Masters and Parke Wilde from Tufts University's Friedman School of Nutrition, Science and Policy. The discussion centers around the concept of the least cost diet, a tool used to determine the minimum cost required to maintain a nutritionally adequate diet. The conversation delves into the global computational methods and policies related to least cost diets, the challenges of making these diets culturally relevant, and the implications for food policy in both the US and internationally. You will also hear about the lived experiences of people affected by these diets and the need for more comprehensive research to better reflect reality. Interview Summary I know you both have been working in this space around least cost diets for a while. So, let's really start off by just asking a question about what brought you into this work as researchers. Why study least cost diets? Will, let's start with you. I'm a very curious person and this was a puzzle. So, you know, people want health. They want healthy food. Of course, we spend a lot on healthcare and health services, but do seek health in our food. As a child growing up, you know, companies were marketing food as a source of health. And people who had more money would spend more for premium items that were seen as healthy. And in the 2010s for the first time, we had these quantified definitions of what a healthy diet was as we went from 'nutrients' to 'food groups,' from the original dietary guidelines pyramid to the MyPlate. And then internationally, the very first quantified definitions of healthful diets that would work anywhere in the world. And I was like, oh, wow. Is it actually expensive to eat a healthy diet? And how much does it cost? How does it differ by place location? How does it differ over time, seasons, and years? And I just thought it was a fascinating question. Great, thank you for that. Parke? There's a lot of policy importance on this, but part of the fun also of this particular topic is more than almost any that we work on, it's connected to things that we have to think about in our daily lives. So, as you're preparing and purchasing food for your family and you want it to be a healthy. And you want it to still be, you know, tasty enough to satisfy the kids. And it can't take too long because it has to fit into a busy life. So, this one does feel like it's got a personal connection. Thank you both for that. One of the things I heard is there was an availability of data. There was an opportunity that seems like it didn't exist before. Can you speak a little bit about that? Especially Will because you mentioned that point. Will: Yes. So, we have had food composition data identifying for typical items. A can of beans, or even a pizza. You know, what is the expected, on average quantity of each nutrient. But only recently have we had those on a very large scale for global items. Hundreds and hundreds of thousands of distinct items. And we had nutrient requirements, but only nutrient by nutrient, and the definition of a food group where you would want not only the nutrients, but also the phytochemicals, the attributes of food from its food matrix that make a vegetable different from just in a vitamin pill. And those came about in, as I mentioned, in the 2010s. And then there's the computational tools and the price observations that get captured. They've been written down on pads of paper, literally, and brought to a headquarters to compute inflation since the 1930s. But access to those in digitized form, only really in the 2000s and only really in the 2010s were we able to have program routines that would download millions and millions of price observations, match them to food composition data, match that food composition information to a healthy diet criterion, and then compute these least cost diets. Now we've computed millions and millions of these thanks to modern computing and all of that data. Great, Will. And you've already started on this, so let's continue on this point. You were talking about some of the computational methods and data that were available globally. Can you give us a good sense of what does a lease cost diet look like from this global perspective because we're going to talk to Parke about whether it is in the US. But let's talk about it in the broad sense globally. In my case the funding opportunity to pay for the graduate students and collaborators internationally came from the Gates Foundation and the UK International Development Agency, initially for a pilot study in Ghana and Tanzania. And then we were able to get more money to scale that up to Africa and South Asia, and then globally through a project called Food Prices for Nutrition. And what we found, first of all, is that to get agreement on what a healthy diet means, we needed to go to something like the least common denominator. The most basic, basic definition from the commonalities among national governments' dietary guidelines. So, in the US, that's MyPlate, or in the UK it's the Eat Well Guide. And each country's dietary guidelines look a little different, but they have these commonalities. So, we distilled that down to six food groups. There's fruits and vegetables, separately. And then there's animal source foods altogether. And in some countries they would separate out milk, like the United States does. And then all starchy staples together. And in some countries, you would separate out whole grains like the US does. And then all edible oils. And those six food groups, in the quantities needed to provide all the nutrients you would need, plus these attributes of food groups beyond just what's in a vitamin pill, turns out to cost about $4 a day. And if you adjust for inflation and differences in the cost of living, the price of housing and so forth around the world, it's very similar. And if you think about seasonal variation in a very remote area, it might rise by 50% in a really bad situation. And if you think about a very remote location where it's difficult to get food to, it might go up to $5.50, but it stays in that range between roughly speaking $2.50 and $5.00. Meanwhile, incomes are varying from around $1.00 a day, and people who cannot possibly afford those more expensive food groups, to $200 a day in which these least expensive items are trivially small in cost compared to the issues that Parke mentioned. We can also talk about what we actually find as the items, and those vary a lot from place to place for some food groups and are very similar to each other in other food groups. So, for example, the least expensive item in an animal source food category is very often dairy in a rich country. But in a really dry, poor country it's dried fish because refrigeration and transport are very expensive. And then to see where there's commonalities in the vegetable category, boy. Onions, tomatoes, carrots are so inexpensive around the world. We've just gotten those supply chains to make the basic ingredients for a vegetable stew really low cost. But then there's all these other different vegetables that are usually more expensive. So, it's very interesting to look at which are the items that would deliver the healthfulness you need and how much they cost. It's surprisingly little from a rich country perspective, and yet still out of reach for so many in low-income countries. Will, thank you for that. And I want to turn now to looking in the US case because I think there's some important commonalities. Parke, can you describe the least cost diet, how it's used here in the US, and its implications for policy? Absolutely. And full disclosure to your audience, this is work on which we've benefited from Norbert's input and wisdom in a way that's been very valuable as a co-author and as an advisor for the quantitative part of what we were doing. For an article in the journal Food Policy, we use the same type of mathematical model that USDA uses when it sets the Thrifty Food Plan, the TFP. A hypothetical diet that's used as the benchmark for the maximum benefit in the Supplemental Nutrition Assistance Program, which is the nation's most important anti-hunger program. And what USDA does with this model diet is it tries to find a hypothetical bundle of foods and beverages that's not too different from what people ordinarily consume. The idea is it should be a familiar diet, it should be one that's reasonably tasty, that people clearly already accept enough. But it can't be exactly that diet. It has to be different enough at least to meet a cost target and to meet a whole long list of nutrition criteria. Including getting enough of the particular nutrients, things like enough calcium or enough protein, and also, matching food group goals reasonably well. Things like having enough fruits, enough vegetables, enough dairy. When, USDA does that, it finds that it's fairly difficult. It's fairly difficult to meet all those goals at once, at a cost and a cost goal all at the same time. And so, it ends up choosing this hypothetical diet that's almost maybe more different than would feel most comfortable from people's typical average consumption. Thank you, Parke. I'm interested to understand the policy implications of this least cost diet. You suggested something about the Thrifty Food Plan and the maximum benefit levels. Can you tell us a little bit more about the policies that are relevant? Yes, so the Thrifty Food Plan update that USDA does every five years has a much bigger policy importance now than it did a few years ago. I used to tell my students that you shouldn't overstate how much policy importance this update has. It might matter a little bit less than you would think. And the reason was because every time they update the Thrifty Food Plan, they use the cost target that is the inflation adjusted or the real cost of

    33 min
  3. Gut instincts, food, and decision making

    OCT 23

    Gut instincts, food, and decision making

    The gut is in the news. It's really in the news. Catapulted there from exciting developments coming from laboratories all around the world. Links of gut health with overall health are now quite clear and surprising connections are being discovered between gut health and things like dementia and Alzheimer's. But how does the gut communicate with other parts of the body in ways that make it this important, and where does the brain figure into all this? Well, there's some interesting science going on in this topic, and a leading person in this area is Dr. Diego Bohorquez. Dr. Bohorquez is the associate professor of medicine, of molecular genetics and microbiology and of cell biology at the Duke University School of Medicine. Interview Transcript Diego, your bio shows that you blend work in nutritional biochemistry, gastrointestinal physiology, and sensory neurobiology. It took me a little time to figure out just what these things are, but what this represents, to be a little more serious, is a unique ability to understand that the different parts of the body, the gut and the brain in particular, interact a lot. And you're in a very good position to understand how that happens. Let's dive in with the kind of a basic question. What got you interested in this interaction of the gut with the brain and why care about it? Yes. Kelly, I think that that's all technicalese for saying that we are at the interface of food, the gut, and the brain. Apart from the fact that we are what we eat and if we truly believe that then food will be shaping us. Not only our body, but also like our belief systems, our societal systems, and so on and so forth. I don't think that that is anything new. However, what is new is the ability of the gut to guide our decision making. And it was interesting to hear in your introduction that now the gut is all in the news. In 2005 when I came to the United States, and I was at North Carolina State University, and I joined a graduate school. I remember taking a graduate course in physiology in 2007. And when the professor opened the session on gastrointestinal physiology, he said the gut is one of the most misunderstood and mysterious organs. It has almost as many neurons as the spinal cord, or more. But honestly, we don't give a lot of respect to the gut. We only think that it does some digestion and absorption, and we judge it more for the value of its products of digestion than what it does for the entire body. And fast forward almost 20 years later now, partly my laboratory and other laboratories that have entered this field since some of our discoveries started to emerge, it's very clearly showing that the gut not only has its own sensory system that is behind what we call gut feelings. The gut feelings are actually real. But it actually can influence our decision making. Like specifically, we have shown that our ability to choose sugars and consume sugars and feel sugars and choose them over sweeteners, it can be pinpointed to a specific set of cells in the intestine called neuropod cells and specific receptors in those cells. And the intestine is right after the stomach. And this is where these cells are exposed to the surface of the gut and detect the chemical composition of food to guide our decision making. Let's talk about that a little bit more. So, you've got this axis, or this means of communication between the gut and the brain going on. And let's talk about how it affects what we eat. You just alluded to the fact that it's pretty important. What does it tell us? What to eat, how much to eat? What we like to eat? When we're hungry, when we've had enough? How does this affect our eating? We are beginning to understand how much it affects this eating. And obviously we are departing from understanding, right? And an understanding is cognitive. In the 1500s is when the idea of 'we think therefore we are,' came online. And we needed to think things before we actually will understand them. But well before thinking them, we actually feel them. And you probably have noticed that. If anybody offers you maybe a cup of water at 5:00 AM, 6:00 AM, it will be very welcome. Especially with it's a little bit warm. If they offer you a steak at 5:00 AM you will run away from that. But in fact, you'll create distress I think unless you are like severely jet lagged. And a lot of those feelings not only come from the experience, but even if you blind are blindfolded, your gut will be able to evaluate what you just ingested. And it is because the intestine, it is the point where those molecules in the meal or in the drink, will be either absorbed to become part of who we are, or will be excreting and expelled. And that absorption of who we are is dependent on the context. Like for instance, the part of the month, morning versus afternoon, health status, age, will influence specifically like at the molecular level, what it is that we need to continue to thrive. It sounds like there's lots of potential for the gut and its interaction with the brain working in concert with the rest of the body. Things are in balance and working like they should be. But there are lots of things going on out there that disrupt that. Tell us more about that and how it affects eating. For example, the levels of obesity have risen so much in the past decades. How does the gut figure into that, for example. Could there be environmental things like the microplastics or exposure to toxins like pesticides and things that might be affecting the gut that throws the system off? I think that that is a very timely question for the days. Over the last 10 years, we have documented that the gut has its own sensory system. And in fact, it's one of the most ancient sensory systems. At the very beginning, 600 million years ago, when cells started to coalesce into animals, multicellular organisms, they needed to eat. And they needed to not only find the food but create a sensory representation of the food. What do I mean by that? Eating algae is very different than eating bacteria, for instance. And the gut needed to have these sensors to be able to rapidly create first a representation, this is bacteria. And then put out the molecules to digest that bacterium or those bacteria. And then ultimately absorb them, turn them into metabolites and continue to thrive, right? Perhaps reproduce, coalesce and so on and so forth. This is a very important concept because our reality, the reality that you and I are having right now, it is guided by our senses. And we have multiple senses. Like for instance, we are able to communicate partly because of the sound that is going through our ears. And then there are inner hair cells that are picking up those waves. Passing that information to the brain, decoding it, and then the brain coalesces with everything else and saying like, 'okay, Diego, you're in a podcast. Make sure that you say something hopefully reasonable, right?' What the gut is doing, as a true sensory system, is also detecting the food that we have ingested, creating a rapid representation. It's not the reality itself. It is a representation of the reality. Because when we eat an apple, ultimately the gut, what it's doing is creating a representation that was an apple and not an orange. And then telling the brain, look, you're going to get some glucose, some fiber, a little bit of a skin. And you may need to adjust it with water, right? And then that will trigger the desire to, 'oh, maybe I should have also a cup of water.' Why does that have to do with, the societal issues that we are facing? Since the 1970s, we learned to disentangle the sensory experience of food, not only as humans or scientists, but also that was extrapolated to the society. So, if you go and look, and it is not a secret, it has been very well documented. For instance, the ability to put artificial sweeteners out there. It has really changed the health landscape. And it was just a normal progression of how it is that we humans think. We thought well, people consume sugars because they're sweet. If we take out the calorie and we just leave the sweetness, it will be totally fine because it's benign. You're not consuming anything else. However, the gut, you have promised the gut something sweet. That it has always, or almost always, invariably, been associated with a nutritional value. Then the gut is fed this information that is skewed. Then it has to go and adjust. And we actually have demonstrated that in the laboratory that when the neuro pods detect a non-caloric sweetener, they actually release a different neurotransmitter that communicates to the brain that artificial sweeteners have arrived at the gut, as opposed to glucose, which triggers the release of glutamate. And that glutamate is essential for the organism to know that we have consumed sugar. Is it safe to say then that the body has evolved to be able to have effective signaling and feedback systems with things that are found out there in nature, like sugar or an apple or an orange. But when you start introducing things that don't exist in nature, like the artificial sweeteners, then bad things can happen. Yes. Because imagine right now your brain will swap the reality and you will transport yourself or the beach. You may not even have the clothing ready to confront the breeze of the beach, right? Or the salt. You would have not been prepared, right? We evolved around nature because nature was there before us. Therefore, we had gradually adjusted to what nature had to offer. Eventually we introduced fire, and we were able to transform simple or complex carbohydrates into something digestible. And then the body had the ability to adjust to it. And not only the body, but also the microbiota in the gut. Now we are talking about like the transformation of foods. And especially I think in the last 30 years we have been able to transform those foods. Beverages have sweeteners now. We have energy drinks tha

    20 min
  4. The Science of How Food Both Nourishes and Harms Us

    OCT 16

    The Science of How Food Both Nourishes and Harms Us

    An avalanche of information besets us on what to eat. It comes from the news, from influencers of every ilk, from scientists, from government, and of course from the food companies. Super foods? Ultra-processed foods? How does one find a source of trust and make intelligent choices for both us as individuals and for the society as a whole. A new book helps in this quest, a book entitled Food Intelligence: the Science of How Food Both Nourishes and Harms Us. It is written by two highly credible and thoughtful people who join us today.Julia Belluz is a journalist and a contributing opinion writer for the New York Times. She reports on medicine, nutrition, and public health. She's been a Knight Science Journalism Fellow at MIT and holds a master's in science degree from the London School of Economics and Political Science. Dr. Kevin Hall trained as a physicist as best known for pioneering work on nutrition, including research he did as senior investigator and section chief at the National Institutes of Health. His work is highly regarded. He's won awards from the NIH, from the American Society of Nutrition, the Obesity Society and the American Physiological Society. Interview Transcript Thank you both very much for being with us. And not only for being with us, but writing such an interesting book. I was really eager to read it and there's a lot in there that people don't usually come across in their normal journeys through the nutrition world. So, Julia, start off if you wouldn't mind telling us what the impetus was for you and Kevin to do this book with everything else that's out there. Yes, so there's just, I think, an absolute avalanche of information as you say about nutrition and people making claims about how to optimize diet and how best to lose or manage weight. And I think what we both felt was missing from that conversation was a real examination of how do we know what we know and kind of foundational ideas in this space. You hear a lot about how to boost or speed up your metabolism, but people don't know what metabolism is anyway. You hear a lot about how you need to maximize your protein, but what is protein doing in the body and where did that idea come from? And so, we were trying to really pair back. And I think this is where Kevin's physics training was so wonderful. We were trying to look at like what are these fundamental laws and truths. Things that we know about food and nutrition and how it works in us, and what can we tell people about them. And as we kind of went through that journey it very quickly ended up in an argument about the food environment, which I know we're going to get to. We will. It's really interesting. This idea of how do we know what we know is really fascinating because when you go out there, people kind of tell us what we know. Or at least what they think what we know. But very few people go through that journey of how did we get there. And so people can decide on their own is this a credible form of knowledge that I'm being told to pursue. So Kevin, what do you mean by food intelligence? Coming from a completely different background in physics where even as we learn about the fundamental laws of physics, it's always in this historical context about how we know what we know and what were the kind of key experiments along the way. And even with that sort of background, I had almost no idea about what happened to food once we ate it inside our bodies. I only got into this field by a happenstance series of events, which is probably too long to talk about this podcast. But to get people to have an appreciation from the basic science about what is going on inside our bodies when we eat. What is food made out of? As best as we can understand at this current time, how does our body deal with. Our food and with that sort of basic knowledge about how we know what we know. How to not be fooled by these various sound bites that we'll hear from social media influencers telling you that everything that you knew about nutrition is wrong. And they've been hiding this one secret from you that's been keeping you sick for so long to basically be able to see through those kinds of claims and have a bedrock of knowledge upon which to kind of evaluate those things. That's what we mean by food intelligence. It makes sense. Now, I'm assuming that food intelligence is sort of psychological and biological at the same time, isn't it? Because that there's what you're being told and how do you process that information and make wise choices. But there's also an intelligence the body has and how to deal with the food that it's receiving. And that can get fooled too by different things that are coming at it from different types of foods and stuff. We'll get to that in a minute, but it's a very interesting concept you have, and wouldn't it be great if we could all make intelligent choices? Julia, you mentioned the food environment. How would you describe the modern food environment and how does it shape the choices we make? It's almost embarrassing to have this question coming from you because so much of our understanding and thinking about this idea came from you. So, thank you for your work. I feel like you should be answering this question. But I think one of the big aha moments I had in the book research was talking to a neuroscientist, who said the problem in and of itself isn't like the brownies and the pizza and the chips. It's the ubiquity of them. It's that they're most of what's available, along with other less nutritious ultra-processed foods. They're the most accessible. They're the cheapest. They're kind of heavily marketed. They're in our face and the stuff that we really ought to be eating more of, we all know we ought to be eating more of, the fruits and vegetables, fresh or frozen. The legumes, whole grains. They're the least available. They're the hardest to come by. They're the least accessible. They're the most expensive. And so that I think kind of sums up what it means to live in the modern food environment. The deck is stacked against most of us. The least healthy options are the ones that we're inundated by. And to kind of navigate that, you need a lot of resources, wherewithal, a lot of thought, a lot of time. And I think that's kind of where we came out thinking about it. But if anyone is interested in knowing more, they need to read your book Food Fight, because I think that's a great encapsulation of where we still are basically. Well, Julie, it's nice of you to say that. You know what you reminded me one time I was on a panel and a speaker asks the audience, how many minutes do you live from a Dunkin Donuts? And people sort of thought about it and nobody was more than about five minutes from a Dunkin Donuts. And if I think about where I live in North Carolina, a typical place to live, I'm assuming in America. And boy, within about five minutes, 10 minutes from my house, there's so many fast-food places. And then if you add to that the gas stations that have foods and the drug store that has foods. Not to mention the supermarkets. It's just a remarkable environment out there. And boy, you have to have kind of iron willpower to not stop and want that food. And then once it hits your body, then all heck breaks loose. It's a crazy, crazy environment, isn't it? Kevin, talk to us, if you will, about when this food environment collides with human biology. And what happens to normal biological processes that tell us how much we should eat, when we should stop, what we should eat, and things like that. I think that that is one of the newer pieces that we're really just getting a handle on some of the science. It's been observed for long periods of time that if you change a rat's food environment like Tony Sclafani did many, many years ago. That rats aren't trying to maintain their weight. They're not trying to do anything other than eat whatever they feel like. And, he was having a hard time getting rats to fatten up on a high fat diet. And he gave them this so-called supermarket diet or cafeteria diet composed of mainly human foods. And they gained a ton of weight. And I think that pointed to the fact that it's not that these rats lacked willpower or something like that. That they weren't making these conscious choices in the same way that we often think humans are entirely under their conscious control about what we're doing when we make our food choices. And therefore, we criticize people as having weak willpower when they're not able to choose a healthier diet in the face of the food environment. I think the newer piece that we're sort of only beginning to understand is how is it that that food environment and the foods that we eat might be changing this internal symphony of signals that's coming from our guts, from the hormones in our blood, to our brains and the understanding that of food intake. While you might have control over an individual meal and how much you eat in that individual meal is under biological control. And what are the neural systems and how do they work inside our brains in communicating with our bodies and our environment as a whole to shift the sort of balance point where body weight is being regulated. To try to better understand this really intricate interconnection or interaction between our genes, which are very different between people. And thousands of different genes contributing to determining heritability of body size in a given environment and how those genes are making us more or less susceptible to these differences in the food environment. And what's the underlying biology? I'd be lying to say if that we have that worked out. I think we're really beginning to understand that, but I hope what the book can give people is an appreciation for the complexity of those internal signals and that they exist. And that food intake isn't entirely under our control. And that we're beginning to unpack the science of how those interactions wor

    34 min
  5. Taylor Hanson's Food On The Move

    SEP 24

    Taylor Hanson's Food On The Move

    Interview Summary You know I really like the innovative nature of Food On The Move, and I'm eager for you to tell us more about what it involves. But before we do that, how does a young, highly successful musician turn to battling food insecurity? What led you to create Food On The Move? It took me years to say I even created it. I didn't even use the term founder because I really had this sense of partnership that was a part of how it came to be. But I did found or 'start' Food On The Move because I have just a deep sense of gratitude in my life experience and also maybe a calling? I call it the tap on the shoulder that said there's more for you to do. There's more for me to do. And I didn't really know what that meant. I wanted to invest in Oklahoma and where we're from because as a musician, first you travel, you leave, you go out, you connect with people all over the world. But there's something about building and doing well for your community from the town you're from. And I was inspired by a former US ambassador. A man named Edward Perkins, who was an incredible representative of our country. He worked in some of the most difficult parts of the world representing the US and working with other nations. And his story struck me so deeply because he found ways to partner and transform communities as an ambassador. And I got to know him after his time as an ambassador because he was teaching as a professor at OU (Oklahoma University), in Oklahoma. And I asked him, I said - I want to honor your life. I want to learn from you. If I was to begin to really impact my community, Oklahoma where I'm from and maybe beyond, where would you begin? And he said, I would start with food. That's so interesting. You know, your concept of partnership is so interesting. I'd like to dive into that a little bit deeper in a little bit. But first, tell us about your organization and what it does, how it works, what it tries to accomplish. Yes. So, inspired by Ambassador Perkins' example, we set out to ask the right questions more than have the answers. And in 2014, I just basically cold called everyone in the community that worked in food - from the food bank to the food pantries and said 'help me understand the gaps.' Help me understand where it's hard to accomplish change. And the term food desert began coming up more and more. And food deserts are communities without grocery stores. So, think of it as the canary in the mine. Sort of when a grocery store goes, the neighborhood is declining. Because they're small margin organizations they have a hard time staying afloat and when they go it's hard to bring them back because you need either a company like a big chain or a small business that doesn't have a lot of resources. And oftentimes that decline continues, and it impacts the community. So, with Food On The Move I basically brought together partners to create an access point in food deserts where it's was all in kind. From food trucks that could bring great, tasty food and give people dignity and excitement and energy, to partners that are doing food safety training and teaching people to cook. And places like Oklahoma State University extension where they train people about how to prepare food because they may not know. And so, all these partners came together, and we basically spent five years just learning and serving people in those communities. And focusing on an environment that was not about raising a bunch of money; it was really about who is already in this space that we can garner relationships with and get to know the communities. And now those events continue to be flagships. We call them food and resource festivals. They are a pay-as-you-can. You show up, you get access to fresh produce, you have food trucks, you have wraparound services. You have people that are in the community, in different nonprofits, for-profits, and government organizations that we all collaborate with. And we reach people where they are while serving and getting to know them and learning from them. And through those relationships, through those events - which we still do - what it's brought us to is the innovation and education side, and ultimately transformation. We realized in order to change food deserts, end food deserts, bring grocery stores back, that we had to get to the heart of the food system. Which is we had to be teaching people to grow things again, rebuild the local foundation of farmers being trained, use new, innovative systems like indoor growing and aquaponics, hydroponics. And basically, we had to kind of build the foundation back that's been lost since post World War II in our community, like many places. And that means a food hub to bridge farmers to distributors. That means training those farmers for the future. And it ultimately means building a new model for a grocery store. So, we are at the heart of that now with a project we call Food Home, where we are building a campus that is like a microcosm of the food system. Hopefully could be the end of this year, we'll see. Construction is always tricky. But, for sure by the start of first quarter next year, we'll be opening a 10,000 square foot urban farm, which is a training facility, and producing hundreds of thousands of pounds of food every year, and this is really the launchpad for future farmers. My God, I mean, and one of those things you mentioned would be wonderful to dive into and talk about a lot. Because I mean, each is impressive in its own right. But you bring them together, you're probably doing some of the most extensive, impressive things I know of around the country. Let me ask how you address the fundamental issue that we've actually faced ourselves. So communities often feel set upon by outsiders coming in to help. You know, it could be a philanthropy, it could be universities, it could be somebody, you know, who's just coming in well-meaning, wanting to help. But nonetheless may not know the communities or understand the realities of day-to-day life and things like that. And people from communities have often told us that 'we're in the best position to come up with solutions that will work for the members of our own community.' How did you work through those things? Well, this is always why my story elevator pitch tends to be too long. Because I want to actually talk about that element. It's not super elevator pitchy because what it involves is building relationships and trust and what I first learned from Ambassador Perkins. I'll tell you a small story of his example and it really rocked me. I asked him where would you start if you wanted to change community? Because I'd learned from his story that he had actually done it. He was sent to South Africa at the heart of the Apartheid Movement to with a mission from at the time President Ronald Reagan, to free Nelson Mandela from prison and help dismantle the Apartheid system. This is about as high a mark as anybody could have. And he had no policy. They said you're going to make policy. And what he did was so extraordinary, and I think is the mark of his success. And that's, to answer your question, he said, I recognized that every ambassador had held court. You are one step away from the president of the United States, which means you're always the most powerful person in the room. And other ambassadors, he'd ask them to come to him. But you had this deep divide between Black and white, deep divide between economics. And so, what he did was he told his team when he went to South Africa, he said, put the American flags on the front of the car, roll the windows down and take me to the townships. Take me to the neighborhoods. They need to know I'm here. And he took the time to build real relationships and build trust with communities. Black, white, rich, and poor, you know, old and young. He really did the time. And so that model, though obviously South Africa is a deeply entrenched community that, you know, especially that time. And this is kind of world politics, but I listened to that. And I thought, wow, we have a divide in our own community. And it's true of so many American cities. And where people, they see an area and they say that's not my community. They're going to come to me. And so, Food On The Move is built on we will build a partnership-based foundation which is like a block party where you walk up, and I'm a musician, I'm a DJ. So, we have a DJ playing music, we have food trucks. It smells great. You have smiling faces. You have a feeling that when you go there, you're not there, like, I need help and I'm in a soup kitchen. It's like there's a community party and you get invited and everyone's available to go there because if you want to give, you can go. If you don't have a dollar in your pocket, you go. And everybody leaves with the same treatment. And that foundation, the way we go about building those relationships, that is the heart and soul of how we are getting to the question and then trying to answer: we need more grocery stores, and we need more farmers. Because we heard it from the neighborhood. And I'll wrap up the answer a little bit which is to say we have multiple community farms as well as our own training farms. And we've worked in middle schools to teach young people to grow things with high-end aquaponics. You know, statistically the worse school in the city. But we've seen it just rocket people to engagement and better education and being fired up to come to school. But the community grow beds are the real test because you can't just drop a community grow bed and say, 'Hey, isn't this awesome? Here's your grow bed.' You have to stay engaged with community, but you also have to invite them to be participants. And so, we work with our neighbors. We treat one another as neighbors, and you are right, it is wrought with pick your cliche. You know, the complex of the outsider coming in with money. The contrast between racial issues and economic issues. It's so wrou

    33 min
  6. Are healthy, environmentally sustainable diets economically achievable for everyone?

    SEP 19

    Are healthy, environmentally sustainable diets economically achievable for everyone?

    In today's episode, we're discussing the complex and urgent topic of global food demand. The United Nations Sustainable Development Goals, or SDGs, ask countries to make measurable progress in reducing poverty, achieving zero hunger, and supporting every individual in realizing good health. While also mitigating climate change, sustaining the environment and responsible consumption and production habits. Researchers have recommended sustainable diets - planetary health diets. For example, the Eat Lancet Planetary Health Diet. However, others have criticized some of these diets for not addressing the economic and social impacts of transitioning to such diets. Is it possible to balance changing diets, rising incomes, and economic growth with economic feasibility, environmental impact, and long-term sustainability? Well, that's what our goals are today. Our guests today are Andrew Muhammad of the University of Tennessee Institute of Agriculture, and Emiliano Lopez Barrera from Texas A&M. They are my co-authors on a new paper in the Annual Review of Resource Economics entitled Global Food Demand: overcoming Challenges to Healthy and Sustainable Diets. Interview Summary Andrew let's begin with you. Why is it important to study the economics of dietary habits and food choices in a global context? Well, it's important for several reasons, right? When we think both about food security as well as environmental outcomes and maintaining biodiversity, in keeping both human beings and the planet healthy, we really do need to think about this in a global context. One could see agriculture as a global ecosystem where decisions in one country clearly have impacts on outcomes in others. While at the same time, we need to see food as a means by which we satisfy the demands of a global community. Whether it be through our own domestic production or international trade. And then the last thing I'll say, which is really most important are all the actual things we want to tackle and mitigate and correct, fix or improve. Whether it be the environmental issues, global food security outcomes, individual diets, mitigating obesity issues globally, right? It's pretty clear that most of the things affecting human beings in the environment as it relates to agriculture are global in nature, and there's an economic component that we need to consider when addressing these issues in a global context. Thank you for sharing that. And I am interested to understand what the role of economics in dietary habits is as we explored it in this review paper. In economics, this is a pretty long history, one could say going back centuries, right? This idea of how income growth impacts food spending on a household or individuals, as well as what economic affluence in development does to sort of how diets transition. And so, for example, it's been long established, right, as individuals get richer, a smaller and smaller share of their income is spent on food. So therefore, food dynamics become less important in [a developed, rich country versus a developing country where a large percentage of income is still spent on food. And what does that mean? That means that while I may find price shocks annoying, and while I may find higher grocery prices annoying, in a developing world that clearly has some implications on the nutritional needs and food decisions far more than it would have on me, for example. But the other thing which is something that has been highlighted for quite some time, and that is this transition from basic staples - from rice, grain, corn, cassava, potatoes, etc. - to more complex food products like high protein dense meat products, fish, milk, dairy, and even highly processed products that are deemed unhealthy. But the point is, as we look at the full spectrum of countries from least developed to most developed, you see this transition from basic staples to these protein dense products as well as complex processed products. This is a really important point about what are the trends across countries and over time as incomes change and as global prices affect choices. And I do appreciate what you're saying about those of us in, say a country like the United States, where we may be able to absorb some of the shocks that may happen with food prices, we also recognize that there are folks from lower income households where those kinds of price shocks can be really challenging. That's true. But this is a different story when we're then talking about developing countries and some of the challenges that they face. Thank you for sharing that. I'm also interested in understanding what do economists mean by a nutritious and sustainable food demand, especially in the context of global or cross-country comparisons. What are some of the things that you uncovered in this review? Yes, and I think the main thing, which is particularly interesting, is how early diets transition. How quick countries go from being staple dependent to sort of relying more on protein in consumption and demand. And that happens pretty early and so long before you get to say, countries like the United States with a per capita income of around $50,000 per person, you start seeing transitions quite early, right? Whereas income goes from say less than a $1,000 per person to maybe $5,000 and $10,000, you see these transitions right away. And in fact, you begin to see things level off. And what that means is when we think about, for example, animal protein production, which is in the context of dairy and beef, which is considered relatively more harmful to the environment than say poultry production. What you do find is that in these developing countries, they really do transition right away to meat with just minimal income growth. Whereas at the same time, when you start seeing income growth at the higher end of the spectrum, you don't see that much of a change. Now, something that's also unfortunate, what you find is that with income growth, you do see decrease in consumption of vegetables. A part of that is that some staples are counted as vegetables, but another part of that is that wealth and influence doesn't necessarily lead to improved diets. And that's something that's unfortunate. And what it says is that interventions are possibly needed for these improved diets. But to really get back to your question, this idea when we say sort of a nutritious diet, obviously we're thinking about diets that satisfy the nutritional needs of individuals. While at the same time mitigating unhealthy outcomes. Mitigating obesity, cardiovascular disease, etc. But then coupled with that is this whole notion of sustainable agricultural production. And I think one of the difficult things about both nutritious and abundant food as well as environmental outcomes, is we really are thinking about sort of trade-offs and complementarities. Then I think economics gives us a real keen insight into how these things play out. Andrew, you make me worry that we're locked in. That is as soon as income start to rise, people move to more animal protein-based products. They move away from some fruits and vegetables. And knowing that the environmental consequences of those choices and even the health consequences, my question to you is what kinds of interventions or how do you think about interventions as a way to shape that demand? Is that an appropriate way to think about this? Alright, so there's a few things. One is just sort of provide nutrition education globally. Having countries and their governments sort of understand these outcomes and then making a concerted effort to educate the public. The other thing is what you often do see is incentivized, for example, fish consumption. Incentivizing poultry production. And you do actually see a lot of incentives for poultry and egg consumption. And I think of like the Gates Foundation in that One Egg a Day initiative to help with child stunting and child growth in the developing world. And so, they're clearly protein alternatives to bovine type products. And I have to be clear here. Like I'm only speaking about this in the context of what's being said, in terms of the environment and animal production. But the other thing I think, it's probably even more important, right? Is this idea that we really do need to rethink how we, both in the developing world as well as in the developed world, rethink how we think about nutrition and eating. And that's just not for developing countries. That's for all countries. And obviously there's one last thing I'll highlight. You do have to be sort of concerned about, say something like taxes. Which would be clearly regressive in the developing world, and probably much more harmful to overall consumer welfare. The point is that taxes and subsidies seem to be the policy instruments of choice. Great. Thank you for that. Andrew has just shared with us some of the issues of what happens as incomes rise and the changing patterns of behavior. And that there are some implications for sustainable diets. Emiliano, how can we use the type of data that, Andrew talked about to model food systems in terms of health and nutrition. What can we learn from these models and, what should we do with them? Emiliano – Yes, thank you. Andrew really pointed to like many very important issues, aspects. We see some worrisome trends in the sense that current diets are going in the direction of showing less nutritious. Also, we are looking at a lot of issues in the environmental externalities, embedded resources. A lot of that within the current diet trajectory. Economic models, they have this advantage that they can connect these things together, right? Each time that we decide what we are purchasing for eating each day we are deciding in a combination of these resources embedded in the food that also some potential nutritional outcomes or health outcomes related to that diet. And the models help to connect these things very well. We can t

    32 min
  7. Is ultra-processed food still food?

    AUG 28

    Is ultra-processed food still food?

    Lots of talk these days about ultra-processed foods (UPFs). Along with confusion about what in the heck they are or what they're not, how bad they are for us, and what ought to be done about them. A landmark in the discussion of ultra-processed foods has been the publication of a book entitled Ultra-processed People, Why We Can't Stop Eating Food That Isn't Food. The author of that book, Dr. Chris van Tulleken, joins us today. Dr. van Tulleken is a physician and is professor of Infection and Global Health at University College London. He also has a PhD in molecular virology and is an award-winning broadcaster on the BBC. His book on Ultra-processed People is a bestseller. Interview Summary Chris, sometimes somebody comes along that takes a complicated topic and makes it accessible and understandable and brings it to lots of people. You're a very fine scientist and scholar and academic, but you also have that ability to communicate effectively with lots of people, which I very much admire. So, thanks for doing that, and thank you for joining us. Oh, Kelly, it's such a pleasure. You know, I begin some of my talks now with a clipping from the New York Times. And it's a picture of you and an interview you gave in 1995. So exactly three decades ago. And in this article, you just beautifully communicate everything that 30 years later I'm still saying. So, yeah. I wonder if communication, it's necessary, but insufficient. I think we are needing to think of other means to bring about change. I totally agree. Well, thank you by the way. And I hope I've learned something over those 30 years. Tell us, please, what are ultra-processed foods? People hear the term a lot, but I don't think a lot of people know exactly what it means. The most important thing to know, I think, is that it's not a casual term. It's not like 'junk food' or 'fast food.' It is a formal scientific definition. It's been used in hundreds of research studies. The definition is very long. It's 11 paragraphs long. And I would urge anyone who's really interested in this topic, go to the United Nations Food and Agricultural Organization website. You can type in NFAO Ultra and you'll get the full 11 paragraph definition. It's an incredibly sophisticated piece of science. But it boils down to if you as a consumer, someone listening to this podcast, want to know if the thing you are eating right now is ultra-processed, look at the ingredients list. If there are ingredients on that list that you do not normally find in a domestic kitchen like an emulsifier, a coloring, a flavoring, a non-nutritive sweetener, then that product will be ultra-processed. And it's a way of describing this huge range of foods that kind of has taken over the American and the British and in fact diets all over the world. How come the food companies put this stuff in the foods? And the reason I ask is in talks I give I'll show an ingredient list from a food that most people would recognize. And ask people if they can guess what the food is from the ingredient list. And almost nobody can. There are 35 things on the ingredient list. Sugar is in there, four different forms. And then there are all kinds of things that are hard to pronounce. There are lots of strange things in there. They get in there through loopholes and government regulation. Why are they there in the first place? So, when I started looking at this I also noticed this long list of fancy sounding ingredients. And even things like peanut butter will have palm oil and emulsifiers. Cream cheese will have xanthum gum and emulsifiers. And you think, well, wouldn't it just be cheaper to make your peanut butter out of peanuts. In fact, every ingredient is in there to make money in one of two ways. Either it drives down the cost of production or storage. If you imagine using a real strawberry in your strawberry ice cream. Strawberries are expensive. They're not always in season. They rot. You've got to have a whole supply chain. Why would you use a strawberry if you could use ethyl methylphenylglycidate and pink dye and it'll taste the same. It'll look great. You could then put in a little chunky bit of modified corn starch that'll be chewy if you get it in the right gel mix. And there you go. You've got strawberries and you haven't had to deal with strawberry farmers or any supply chain. It's just you just buy bags and bottles of white powder and liquids. The other way is to extend the shelf life. Strawberries as I say, or fresh food, real food - food we might call it rots on shelves. It decays very quickly. If you can store something at room temperature in a warehouse for months and months, that saves enormous amounts of money. So, one thing is production, but the other thing is the additives allow us to consume to excess or encourage us to consume ultra-processed food to excess. So, I interviewed a scientist who was a food industry development scientist. And they said, you know, most ultra-processed food would be gray if it wasn't dyed, for example. So, if you want to make cheap food using these pastes and powders, unless you dye it and you flavor it, it will be inedible. But if you dye it and flavor it and add just the right amount of salt, sugar, flavor enhancers, then you can make these very addictive products. So that's the logic of UPF. Its purpose is to make money. And that's part of the definition. Right. So, a consumer might decide that there's, you know, beneficial trade-off for them at the end of the day. That they get things that have long shelf life. The price goes down because of the companies don't have to deal with the strawberry farmers and things like that. But if there's harm coming in waves from these things, then it changes the equation. And you found out some of that on your own. So as an experiment you did with a single person - you, you ate ultra-processed foods for a month. What did you eat and how did it affect your body, your mood, your sleep? What happened when you did this? So, what's really exciting, actually Kelly, is while it was an n=1, you know, one participant experiment, I was actually the pilot participant in a much larger study that we have published in Nature Medicine. One of the most reputable and high impact scientific journals there is. So, I was the first participant in a randomized control trial. I allowed us to gather the data about what we would then measure in a much larger number. Now we'll come back and talk about that study, which I think was really important. It was great to see it published. So, I was a bit skeptical. Partly it was with my research team at UCL, but we were also filming it for a BBC documentary. And I went into this going I'm going to eat a diet of 80% of my calories will come from ultra-processed food for four weeks. And this is a normal diet. A lifelong diet for a British teenager. We know around 20% of people in the UK and the US eat this as their normal food. They get 80% of their calories from ultra-processed products. I thought, well, nothing is going to happen to me, a middle-aged man, doing this for four weeks. But anyway, we did it kind of as a bit of fun. And we thought, well, if nothing happens, we don't have to do a bigger study. We can just publish this as a case report, and we'll leave it out of the documentary. Three big things happened. I gained a massive amount of weight, so six kilos. And I wasn't force feeding myself. I was just eating when I wanted. In American terms, that's about 15 pounds in four weeks. And that's very consistent with the other published trials that have been done on ultra-processed food. There have been two other RCTs (randomized control trials); ours is the third. There is one in Japan, one done at the NIH. So, people gain a lot of weight. I ate massively more calories. So much so that if I'd continued on the diet, I would've almost doubled my body weight in a year. And that may sound absurd, but I have an identical twin brother who did this natural experiment. He went to Harvard for a year. He did his masters there. During his year at Harvard he gained, let's see, 26 kilos, so almost 60 pounds just living in Cambridge, Massachusetts. But how did you decide how much of it to eat? Did you eat until you just kind of felt naturally full? I did what most people do most of the time, which is I just ate what I wanted when I felt like it. Which actually for me as a physician, I probably took the breaks off a bit because I don't normally have cocoa pops for breakfast. But I ate cocoa pops and if I felt like two bowls, I'd have two bowls. It turned out what I felt like a lot of mornings was four bowls and that was fine. I was barely full. So, I wasn't force feeding myself. It wasn't 'supersize' me. I was eating to appetite, which is how these experiments run. And then what we've done in the trials. So, I gained weight, then we measured my hormone response to a meal. When you eat, I mean, it's absurd to explain this to YOU. But when you eat, you have fullness hormones that go up and hunger hormones that go down, so you feel full and less hungry. And we measured my response to a standard meal at the beginning and at the end of this four-week diet. What we found is that I had a normal response to eating a big meal at the beginning of the diet. At the end of eating ultra-processed foods, the same meal caused a very blunted rise in the satiety hormones. In the 'fullness' hormones. So, I didn't feel as full. And my hunger hormones remained high. And so, the food is altering our response to all meals, not merely within the meal that we're eating. Then we did some MRI scans and again, I thought this would be a huge waste of time. But we saw at four weeks, and then again eight weeks later, very robust changes in the communication between the habit-forming bits at the back of the brain. So, the automatic behavior bits, the cerebellum. Very conscious I'm talking to YOU about this, Kelly. And the kind of addiction rewar

    48 min
  8. Industry user fees could fix a food safety loophole for FDA

    AUG 25

    Industry user fees could fix a food safety loophole for FDA

    The Food and Drug Administration or FDA regulates roughly 78% of the US food supply. This includes packaged products, food additives, infant formula, ultra-processed foods, and lots more. However, an analysis by the Environmental Working Group found that 99% of new food ingredients enter our food supply through a legal loophole that skirts FDA oversight and seems, to me at least, to be incredibly risky. Today we're speaking with two authors of a recent legal and policy analysis published in the Journal Health Affairs. They explain what this loophole is and its risks and suggest a new user fee program to both strengthen the FDA's ability to regulate food ingredients and address growing concerns about food safety. Our guests are Jennifer Pomeranz Associate Professor of Public Health Policy and Management at New York University School of Global Public Health and Emily Broad, director of Harvard Law School Center for Health Law and Policy Innovation. Interview Summary So Jennifer, let's start with you, help our listeners understand the current situation with food ingredient oversight. And what is this legal loophole that allows food companies to add new ingredients without safety reviews. Sure. So, Congress passed the Food Additives Amendment in 1958, and the idea was to divide food additives and generally recognized as safe ingredients into two different categories. That's where the GRAS term comes from generally recognized as safe? 'Generally Recognized As Safe' is GRAS. But it circularly defines food additives as something that's not GRAS. So, there's not actually a definition of these two different types of substances. But the idea was that the food industry would be required to submit a pre-market, that means before it puts the ingredient into the marketplace, a pre-market petition to the FDA to review the safety. And then the FDA promulgates a regulation for safe use of a food additive. GRAS ingredients on the other hand, initially thought of as salt, pepper, vinegar, are things like that would just be allowed to enter the food supply without that pre-market petition. The problem is the food industry is the entity that decides which category to place each ingredient. There's no FDA guidance on which category they're supposed to ascribe to these ingredients. What has happened is that the food industry has now entered into the food supply an enormous amount of ingredients under what we call the GRAS loophole, which is allowing it to just bring it to the market without any FDA oversight or even knowledge of the ingredient. So, in essence, what we're having now is that the food industry polices itself on whether to submit this pre-market petition for a food additive or just include it in its products without any FDA knowledge. When you said 'enormous number of such things,' are we talking dozens, hundreds, thousands? Nobody knows, but the environmental working group did find that 99% of new ingredients are added through this loophole. And that's the concerning part. Well, you can look at some ultra-processed foods and they can have 30 or 40 ingredients on them. That's just one food. You can imagine that at across the food supply, how many things there are. And there are these chemicals that nobody can pronounce. You don't know what's going on, what they are, what they're all about. So, what you're saying is that the food industry decides to put these things in foods. There's some processing reason for putting them in. It's important that the public be protected against harmful ingredients. But the food industry decides what's okay to put in and what's not. Are they required to do any testing? Are there criteria for that kind of testing? Is there any sense that letting the industry police itself amounts to anything that protects the public good? Well, the criteria are supposed to be the same for GRAS or food additives. They're supposed to be meeting certain scientific criteria. But the problem with this is that for GRAS ingredients, they don't have to use published data and they can hold that scientific data to themselves. And you mentioned food labels, the ingredient list, right? That doesn't necessarily capture these ingredients. They use generic terms, corn oil, color additive, food additive whatever. And so, the actual ingredient itself is not necessarily listed on the ingredient list. There is no way to identify them and it's unknown whether they're actually doing the studies. They can engage in these, what are called GRAS panels, which are supposed to be experts that evaluate the science. But the problem is other studies have found that 100% of the people on these GRAS panels have financial conflicts of interest. Okay, so let me see if I have this right. I'm a food company. I develop a new additive to provide color or flavor or fragrance, or it's an emulsifier or something like that. I develop a chemical concoction that hasn't really been tested for human safety. I declare it safe. And the criteria I use for declaring it set safe is putting together a panel of people that I pay, who then in a hundred percent of cases say things are. That's how it works? I can't say that in a hundred percent of cases they say it's safe, but a hundred percent of the people have financial conflicts of interest. That's one of the major concerns there. Well, one can't imagine they would continue to be paid... Exactly. This sounds like a pretty shaky system to be sure. Emily: I wanted to add a couple other really quick things on the last discussion. You were saying, Kelly, like they're using a panel of experts, which indeed are paid by them. That would be best case in some cases. They're just having their own staff say, we think this is generally recognized as safe. And I think there's some examples we can give where there isn't even evidence that they went to even any outside people, even within industry. I think that the takeaway from all of that is that there's really the ability for companies to call all the shots. Make all the rules. Not tell FDA what they're doing. And then as we talked about, not even have anything on the label because it's not a required ingredient if it's, used as part of a processing agent that's not a substance on there. So I was feeling pretty bad when Jennifer is talking about these panels and the heavy conflict... Even worse. Of interest, now I feel worse because that's the best case. Totally. And one other thing too is just you kind of warmed this up by talking about this loophole. When we put an earlier article out that we wrote that was about just this generally recognized as safe, the feedback we got from FDA was this isn't a loophole. Why are you calling this a loophole? And it's pretty clear that it's a loophole, you know? It's big enough to drive thousands of ingredients through. Yes, totally. Emily, you've written about things like partially hydrogenated vegetable oils, trans fats, and red dye number three in particular. Both of which FDA has now prohibited in food. Can you walk us through those cases? You asked about partially hydrogenated oils or trans-fat, and then red dye three, which are two examples that we talk about a little bit in our piece. Actually, one of those, the partially hydrogenated oils was allowed in food through the generally recognized as safe definition. And the other was not. But they are both really good examples of another real issue that FDA has, which is that not only are they not doing a good job of policing substances going into food on the front end, but they do an even worse job of getting things out of food on the backend, post-market once they know that those substances are really raising red flags. And you raised two of the prime examples we've been talking about. With partially hydrogenated oils these are now banned in foods, but it took an extremely long time. Like the first evidence of harm was in the mid-nineties. By 2005, the Institute of Medicine, which is now the National Academies, said that intake of trans fat, of partially hydrogenated oils, should be as low as possible. And there was data from right around that time that found that 72,000 to 228,000 heart attacks in the US each year were caused by these partially hydrogenated oils. And on FDA's end, they started in early 2000s to require labeling. But it wasn't until 2015 that they passed a final rule saying that these substances were not generally recognized as safe. And then they kept delaying implementation until 2023. It was basically more than 20 years from when there was really clear evidence of harm including from respected national agencies to when FDA actually fully removed them from food. And red dye number three is another good example where there were studies from the 1980s that raised concerns about this red dye. And it was banned from cosmetics in 1990. But they still allowed it to be added to food. And didn't ban it from food until early this year. So early 2025. In large part because one of the other things happening is states are now taking action on some of these substances where they feel like we really need to protect consumers in our states. And FDA has been doing a really poor job. California banned red dye about 18 months before that and really spurred FDA to action. So that 20-year delay with between 72,000 and 228,000 heart attack deaths attributable to the trans fats is the cost of delay and inaction and I don't know, conflicts of interest, and all kinds of other stuff that happened in FDA. So we're not talking about something trivial by any means. These are life and death things are occurring. Yes. Give us another example, if you would, about something that entered the food supply and caused harm but made it through that GRAS loophole. The example that I've talked about both in some of the work we've done together and also in a perspective piece in the New England Journal of Medicine that really focused on why this is an issue. There was

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The Leading Voices in Food podcast series features real people, scientists, farmers, policy experts and world leaders all working to improve our food system and food policy. You'll learn about issues across the food system spectrum such as food insecurity, obesity, agriculture, access and equity, food safety, food defense, and food policy. Produced by the Duke World Food Policy Center at wfpc.sanford.duke.edu.

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