Wednesday, May 20, 2009

I Want you ….to get fat

By Suz Redfearn Men’s Health Magazine

It's amazing what you'll find in presidential impeachment testimony. On Presidents' Day 1996, Monica Lewinsky was standing in the Oval Office, listening to President Bill Clinton explain why he didn't think their relationship was such a good idea, when the phone rang. The person on the line was Alfonso Fanjul, a prominent sugar grower in Florida. Clinton stopped trying to let Lewinsky down easy and went on to speak with Fanjul for about 20 minutes. The reported subject? Vice President Al Gore's recently announced plan to tax Florida growers of sugar crops and use the revenue to help restore parts of the Everglades polluted by agricultural runoff. Needless to say, Clinton and Lewinsky's relationship lingered on long after that day. The proposed sugar tax, on the other hand, did not. That the U.S. food industry is in bed with the government--almost literally, in this case--shouldn't surprise anyone. Whether through soft-money contributions or hard-nosed lobbyists, nearly every major business interest in America attempts to pull political strings. So why not the folks whose business it is to sell food? What troubles many nutritionists is the reach of organizations like the American Sugar Cane League, especially since such groups' ability to manipulate the masses into consuming more "product" is measured most accurately with a bathroom scale. And nowhere, critics argue, is the potential for politically engineered harm to our waistlines (and our hearts) more evident than in the Dietary Guidelines for Americans. The guidelines, which are issued every 5 years by the U.S. Department of Agriculture and the Department of Health and Human Services (HHS), are supposed to represent the summit of scientifically backed advice on eating for optimal health. But instead, the newest set, released on January 12, 2005, may represent something else entirely: how enmeshed our government is with an industry whose sole goal is to keep Americans eating.
Don't let Uncle Sam shove this down your throat
Until 1977, no one really cared what Americans ate, as long as they ate enough to survive and didn't develop nutrient-deficiency diseases, like scurvy. But that year, Senator George McGovern issued a report stating that nutrition had a major impact on health, a concept that, though common sense today, was a pioneering idea at the time. Three years later, the Carter administration produced the nation's first Dietary Guidelines, which told Americans exactly what to eat every day. (Among the plainspoken recommendations: "Avoid too much sugar.") As the government's interest in our diets grew, so did the presence of food-industry lobbying groups in Washington. They swelled from just a handful in 1950 to about 80 in 1984. And although the 1985 sugar guideline remained the same, the 1990 version showed signs that the lobbyists were hammering away at its hard-line stance: The committee softened the language to "Use sugars only in moderation." By 1995, the guidelines even went so far as to adopt a slightly positive tone, advising consumers to "choose a diet moderate in sugars." " 'Eat less sugar' sent sugar producers right to Congress," says Marion Nestle, Ph.D., a professor of public health at New York University and the author of Food Politics: How the Food Industry Influences Nutrition and Health. "But that industry could live with 'choose a diet moderate in sugars.' " That is, until 2000, the year the guidelines underwent their fourth revision. This time, exactly what you'd imagine might happen to an enemy of the sugar industry befell the recommendation: It lost all its teeth. Each person was now urged to "choose beverages and foods to moderate your intake of sugar." Apparently, the decision makers at HHS had a simple rationalization for this seeming sellout. "The mantra that's constantly repeated is 'All foods are good,' " says Carlos Camargo, M.D., D.P.H., an associate professor of medicine and epidemiology at Harvard medical school and a member of the 2005 Dietary Guidelines committee. "You know that's driven by economic and political interest. Nobody wants to say that a company's product is unhealthy." And the people who do choose to speak out? They may find themselves under the same kind of government gag order Nestle says she experienced in 1986. That year, she left her faculty position at the University of California at San Francisco school of medicine and moved to Washington, D.C., to manage editorial production of the first Surgeon General's Report on Nutrition and Health. It was an ambitious government effort to summarize all the research linking diet to chronic diseases. On the first day, recalls Nestle, her superiors instructed her that no matter what the studies showed, the report could not say "eat less meat," "eat less sugar," or eat "less" of anything. Turns out the agency she was toiling for, the Public Health Service, was nervous that food producers would complain to Congress and attempt to block the publication of future reports. And thus, when the report came out in 1988, the offensive four-letter word was absent. It was also the only Surgeon General's Report on Nutrition and Health ever issued, despite a congressional mandate that one be composed every 2 years. "The government abandoned the project, ostensibly because the science base had become increasingly complex," Nestle says. "Since then, I've become convinced that many of the nutritional problems of Americans--not the least of which is obesity--can be traced to the food industry's imperative to encourage people to eat more in order to generate sales and increase income." Comments such as these have made Nestle a favorite target of the Center for Consumer Freedom, a nonprofit organization whose Web site proclaims "Promoting Personal Responsibility and Protecting Personal Choice." Its spokesmen describe her as, among other things, a "food cop" and "queen of the food scolds." Of course, you have to consider the source (of the center's funding): "restaurants, food companies, and more than 1,000 concerned individuals."

The Food-Industry FraternityAs far as we know, the fraternity of food-industry lobbyists doesn't have a secret oath. But if it did, Jeff Nedelman, a former lobbyist for the Grocery Manufacturers of America, one of the country's largest food-industry trade groups, would say it goes something like this: "The goal of every single [food-industry] association, large or small, is to maintain the status quo," he says, "to delay, to fight, to lobby to obscure the facts until its member companies have found a competitive way to reposition their products or to bring out new products to compete for new consumer demand." Money, of course, is the primary means to these political ends. The Center for Responsive Politics (CRP), a nonpartisan watchdog group that follows money trails around Washington, estimates that in 2004, representatives of food and agriculture groups spent more than $48 million lobbying politicians (and that figure doesn't include other agricultural concerns, such as tobacco and forestry). (continued below...) Specifically, the CRP's ledger shows that lobbyists for the Altria Group (owner of Kraft Foods) spent $1,142,997, while PepsiCo dropped $426,380 and American Crystal Sugar and the American Sugar Cane League sweetened the pot with $846,164 and $402,750, respectively. And that was just the money they were required to reveal. Much more is given anonymously to individual members of Congress through political action committees, soft-money contributions, and gifts. When dollars don't work, the food industry employs less-subtle methods of persuasion. "You break arms," says Nedelman. The United Nations-sponsored World Health Organization (WHO) bore the full brunt of food-industry muscle in 2003, just as the U.S. Dietary Guidelines committee's work was getting under way. In response to the growing worldwide obesity epidemic, WHO assembled an independent panel of academics and medical professionals to review the scientific literature and develop recommendations for people to eat more healthfully and lose weight. One of those ways included limiting sugar consumption to 10 percent of daily calorie intake. The Sugar Association, a consortium of sugar producers whose aim is to "promote the consumption of sugar," poured resources into fighting the report, demanding that WHO undertake another scientific review. The association also vowed to "use every avenue available to expose the dubious nature" of the report, including asking members of Congress to challenge the $406 million in U.S. contributions to WHO. The funding remained intact, but the cochairmen of the Senate Sweetener Caucus, senators John Breaux (whose home state of Louisiana is the nation's second-largest producer of sugarcane) and Larry Craig (of Idaho, the second-largest producer of beet sugar), asked Health and Human Services to quash the report. HHS, in turn, produced a 28-page critique calling into question the studies that WHO had used to support its recommendations, even though the research was carried out by internationally known scientists. The result: WHO leaders appear to have shelved the report, which has yet to be implemented. "What the United States did was unambiguously shameful," says Nestle. "But there's been a steady history of this." When we contacted Breaux to determine why he felt so strongly that sugar consumption was not connected to weight gain, he declined to comment. And, actually, it's now former Senator Breaux: He currently works as senior counsel for Patton Boggs, one of Washington's largest lobbying firms, whose clients include Dole Food and Mars. The Spirit of PartnershipIf anyone in the USDA or HHS feels at all self-conscious about the food industry's involvement in the creation of the 2005 Dietary Guidelines, you'd never know it from the sound bites. "The food industry has spent a great deal of time and money appearing at and observing all of the negotiations that went into compiling the guidelines" is what Tommy Thompson, then-secretary of HHS, told a roomful of journalists, nutritionists, and policy makers when introducing the new guidelines earlier this year. In fact, he said, industry representatives met with him and secretary of the USDA Ann Veneman regularly during the 2-year-long process to determine what Americans should eat. "Our president believes in partnerships," says Cristina Beato, Ph.D., HHS's acting assistant secretary of health. "Two-thirds of Americans are overweight or obese. The role of government? To turn it around. We really need to bring in the power of those individuals who know how to sell food, those individuals who make the food, those individuals who know what American consumers choose and who help educate those consumers every day." It was with this spirit of partnership, says Beato, that HHS approached the development of the new Dietary Guidelines, which began in September 2003 with the selection of a 13-member committee of academics and research scientists. "The charge to the committee was very specific," Beato recalls. "It was 'Your job as experts of science is to stick to the sciences. Do not venture into communications, and do not venture into policy--that is the job of this department.' " And yet, despite this directive, HHS did little to insulate committee members from the influence of food-industry representatives, who apparently did consider policy their job. "At some level, throughout the process, you're constantly made aware of the food industry, the beverage industry, and the economic impact of decisions," says Dr. Camargo. One frequent strategy was for industry reps to send boxes of publicity materials and reams of point-by-point responses to minutes of the committee's meetings. "Almost weekly, we'd get a big FedEx box of materials to review," says Russell Pate, Ph.D., a professor of exercise science at the University of South Carolina school of public health, who served on the committee. Another food-industry tactic was simply to show up. "Anytime more than half of the members of the committee met, those needed to be public meetings," says Pate. "They were announced in advance and available to the media and whoever else wanted to sit in. They took place in large rooms where there were 200 or 300 seats available for non-committee members." Not surprisingly, few in the general public could take time to attend these meetings, whereas groups like the National Food Processors Association made sure they filled as many seats as possible and eagerly approached committee members during breaks. "If there's a food group in America that was not represented, I'd be surprised," says Dr. Camargo. "Every single little element of the American diet had an advocate." While both Dr. Camargo and Pate feel confident that the committee remained above the influence of outside interests, the same can't be said for the recommendations their work produced. The committee doesn't write the Dietary Guidelines that are released to the public; it merely suggests what these guidelines should be. The final decision rests with the politically appointed HHS and USDA secretaries, i.e., the "partners" of industry. "The committee is impaneled, does its thing, and finalizes a report, and we all sign off," says Pate. "Then it's turned over to the two agency heads, and we're decommissioned. As a committee, we're not privy to the conversations that took place in the agencies after we finished our jobs." In this case, the final published guidelines differed from the committee's report in several ways. For example, the committee unanimously voted to reduce trans fat intake to 1 percent or less of total calories, but the final guidelines removed that figure. "I think it was just too big a step for the federal government," says Dr. Camargo. "Putting a number on it would have been such an earthquake in the food industry that I just don't think there was the will to do that." Think about it: Assigning a number would have resulted in a Daily Value percentage posted on the Nutrition Facts panel of every single packaged food. When trans fat figures finally begin appearing on labels next year, what consumer would knowingly buy a pack of cookies that will exceed his daily intake of trans fat by 300 percent? But the first bite out of the food industry's bottom line would probably come from school cafeterias. Because the nation's school-lunch programs are federally funded--to the tune of $7.1 billion annually--they're required to meet the current Dietary Guidelines, which means that a concrete figure for daily trans fat consumption would immediately force food manufacturers to modify their existing product lines. If not for the timely publication in the Journal of the American Medical Association of a Harvard study that strongly linked consumption of sweetened beverages to weight gain and an increased risk of diabetes in women, added sugar might not have been mentioned at all, says Dr. Camargo. He recalls a May meeting of the committee during which the preliminary recommendations for carbohydrates were reviewed. "It was 'grains, grains, grains,' but no mention of sugar," he says. Although the debate about linking added sugar to weight gain was vociferous (some committee members didn't feel that the published scientific evidence was strong enough), the Harvard study helped tip the balance, resulting in a recommendation to "reduce intake of added sugars." Although this conclusion wasn't quashed outright, HHS and the USDA don't give it much play. The "key" finding about carbohydrates simply encourages consumers to "choose [them] wisely." Learning how to do so requires more reading. Only in the chapter on carbohydrates do consumers learn more about how to reduce their sugar intake--by avoiding sweetened beverages, for example. But, as with trans fats, the guidelines don't provide a measure for ideal intake, even though the brochure developed to introduce the guidelines to the public bafflingly states, "know the limits on fats, salt, and sugars." "The guidelines are not very explicit about the 'how-to,' " says David Katz, M.D., a professor of medicine, epidemiology, and public health at the Yale University school of medicine and the author of The Way to Eat. "Most authorities recommend that added sugars make up less than 10 percent of total daily calories. And the agreement on trans fat is even more robust: It should be as close to zero as possible. No trans fat, period." That lack of specificity is crucial when dealing with consumers, who may not be able to tell the difference between a food that will help clear their arteries and one that will help clog them. "Most people don't go to the supermarket and look for the trans fat aisle," says Dr. Camargo. "We reduce foods to nutrients, then we study the nutrients and how they relate to health. But we need to put [the process] in reverse and go back to people and say, 'These are the foods that have more or less of these nutrients.' But that piece is always the one that is so hard for the government to do."
"Most-Improved" Nutrition GuidelinesIt's been several months since the release of the 2005 Dietary Guidelines, and by now, most of the major nutrition associations and organizations have had a chance to weigh in. And if you think you can guess what their collective opinion is, you'd probably guess wrong. The American Dietetic Association, which states that it "serves the public by promoting optimal health, nutrition, and well-being," quickly endorsed the new guidelines. Even the ordinarily hypercritical Center for Science in the Public Interest, a nutrition-policy watchdog group, was pleased, calling them "the most health-oriented ever." The logic behind lauding the guidelines is simple, though far from sound: They're better than any other guidelines that preceded them. In other words, HHS and the USDA are being praised for producing the "most-improved" nutrition guidelines, when their charge was to produce the best. Sure, the new guidelines do recommend daily exercise for the first time. And it's
true that they mince no words in recommending whole grains, fruit, vegetables, and reduced-fat dairy foods. But we also know that HHS and the USDA could have helped control two of the biggest dietary demons facing Americans, and yet chose not to. Will the guidelines ever go from good to great? Some experts suggest that if the experiences of another big industry during the past decade are any indication, things won't get better until consumers get fed up. "Tobacco-industry change occurred only once public opinion had become so galvanized, the politicians could no longer side with the industry that was paying them," says Kelly Brownell, Ph.D., a professor of psychology at Yale University and coauthor of Food Fight: The Inside Story of the Food Industry, America's Obesity Crisis, and What We Can Do about It. In the meantime, if you can make a meal out of crumbs, then by all means dive into the new Dietary Guidelines. But if you want the whole cake--no trans fat, very little sugar, thank you--then you'll want to take your appetite for honesty somewhere else.

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