A 19-year-old male walked into my office with a BMI of 49.5 (obese is > 30) and a diagnosis of fatty liver (NAFLD).  His weight issue began at age 5. Who can blame him?  He ate what he was given, what his mom thought was healthy, and what the schools offered.  This is not the first time I encountered this challenge.  I routinely saw 300-pound children aged 12-16 years when I worked in a pediatric specialty clinic.  Food recalls included brightly colored cereals for breakfast, chips/cookies for snacks, packaged food at school, fast food for dinner, all washed down with colas or juice.  This is called FOOD and can be purchased via  government subsidies. 

I met Julie in an IFT online discussion group. I was surprised at how an IFT member could have such a different perspective on processed food. We didn’t agree on much of anything, but I admired her spunk and willingness to stick up for her beliefs. She is also a registered dietitian. Note the differences in our perspectives. Is there any common ground between us?—RLS

I originally accepted this blog invitation with the intent of beginning a dialogue about how we can have access to better food everywhere at affordable prices, but it cannot happen until there is agreement across between the food and health industries that this is a common goal. I am a dietitian that believes food choices are linked to health, I am also a veteran of the chemical industry and an IFT member, so I have some insight into how industry operates.  Perhaps food scientists are sometimes blind to the effect of how food is altered by science? Perhaps the health industry thinks there is a pill for everything?  I recently read Food Routes by Robyn Metcalfe and followed it with Pandora’s Lunchbox, by Melanie Warner .  These deep dives into how food moves around and how food is created behind the factory doors only underscored my resolve to support change of the US food system.  Let me tell you why.

I believe our food supply is 1) too far from real food to serve our health needs, 2) perpetuated by industry and their lobbyists, and 3) supported by biased and compromised nutritional research.

The fact is that people get sick much earlier.  6 in 10 adults in the US has a chronic disease and 4 of those have two or more. Contributing to this development was President Nixon’s expansion of CHEAP food in the 1970’s, still implemented today, that presented the trifecta of health, economic, and environmental crises. After the 1973 farm bill, subsidized foods became less expensive. One dollar purchased 1,200 calories of cookies, but only 250 calories of carrots.  Farmers growing subsidized crops saw success while 63% of small farms closed, changing rural landscapes and economies (1).  Then deforestation, higher greenhouse gases, and increased fertilizer and pesticides use contaminated water sources and accumulated in the food chain. As intended, Nixon’s policy lowered food prices, but not without problems. 

I do not buy the argument that we need acres and acres of GMO corn, beans, and wheat to feed the world.  These crops only serve the bottom line of Monsanto, Cargill, and farm conglomerates – not nutritional needs.  Of the US corn grown, only 17% is consumed by humans, and mostly in processed corn and corn syrup products. The rest goes to ethanol, export, and feeding animals that get sick and fat from it.  Is it the only reason?  I think not, but it does set a stage for financial support of ingredients that do not foster health.

I am not here to point fingers at processed foods.  Not all processed food is bad and technically we can either process some foods in a factory or in our kitchen in many of the same ways, for convenience.  A working demographic needs convenience in food preparation. Duping the public about what they are buying, however, is problematic.  A mother expecting chicken nuggets from actual chicken, instead of a chicken-like combination of extruded substances, is just wrong.  The feeding and handling of “food” animals is also troubling—you are what they eat. Then there is ultra-processed food (UPF), which is simply calories without benefit. The best definition I have seen for UPF is from Brazil’s Carlos Monteiro and his NOVA classification: unusual combinations of multiple components, flavor enhancers, dyes, binders, & additives.  I will add sugars to that list.

People are misled, in my opinion, of what is and is not in their food.  In general, I believe UPFs are food-like substances for an occasional indulgence, made from cheap, subsidized franken-grains and added sugars that are loaded with chemical substances driving an insulin response in the body and clogging the liver. In my view this is the foundation of chronic disease.  Further, I have not seen any research to support continued use of these chemicals and non-food additives after accounting for long term accumulation in human tissue.   Whom can we believe anymore?  Nutrition science has been compromised and heavily biased by industry funding (2). 

When people are diagnosed with disease, they typically change their diet to green salads, grass-fed meat/wild fish, and they avoid UPFs.  I recall how my partner Bob chuckled when we used to go to the monthly pot-luck at our sailing club.  We brought healthier options, and most times our dish was the only one in 2 tables full of food that had any significant color.  “Just wait, they will come around”, he would say.  “We are just ahead of them”.  As predicted, when folks aged, got sick, or became health conscious, the table became more and more naturally colorful.

Real food has the amazing ability to heal and nourish our bodies. For better or worse, eating is also very personal, based on culture and what we were taught in childhood. Early dietary patterns form our immune systems by building our microbiome (3). It frames our likes and dislikes. Getting kids to adopt better food habits early is imperative. And let’s be honest, dietitians should rethink their acceptance of this calorie in-calorie-out nonsense. 

If we can use the “stop smoking” campaign as a model, we can slowly wean from this industrialized diet and use our food scientists to dish up some better options. Start with schools, educate pregnant women, reach out to parents of our young, before the kids are hooked on colorful breakfast cereals. I never want to see a 110-pound 5-year-old again hooked on juice and sugared snacks.  And for goodness’ sake, educate our doctors!  Many know very little about nutrition. Subsidize the food that does not fuel chronic disease; this will help our restaurants and institutions afford to offer better options, provided we can create a demand for it.  If you are seeking healthier options in most towns across America, it is hard to dine out without making significant compromises.

A big challenge, however, is reworking the food supply chain.  Our intellectuals in the food spaces can make that happen with incentives to engineer food channels with products that support health, not compromise it.  And let’s rethink seasonal foods.  Do we really need to have strawberries in December?  We must also understand where this new technology fits that can create proteins in the lab.  I am not sure about what this will do to body systems.  The bottom line, though, is that it took 60 years to destroy our food landscape, we can reverse it in the next 60. 

Changing food choices can correct or relieve issues associated with obesity, diabetes, cancer, heart disease, autoimmunity, GI problems, or mood imbalances.  These are all caused by our diet and lifestyle and this point is no longer debated (4,5). To my patients that have a chronic disease diagnosis or such symptoms, I suggest elimination of things I do not consider food.  ALWAYS, I get results. 

I am looking for common ground.  Agreement between our food scientists, industry leaders and nutrition professionals.  We can change our food – it is not too late. Who is with me?

References

(1) Dimitri, C., A. Effland, and N. Conklin, 2005. The 20^th century transformation of US Agriculture & farm policy. USDA Economic Research Service Economic Information Bulletin EIB-3 USDA ERS – The 20th Century Transformation of U.S. Agriculture and Farm Policy

(2) Fabbri, A., T.J. Holland, and L.A. Bero, 2018. Food industry sponsorship of academic research: investigating commercial bias in the research agenda. Public Health Nutrition 21(18):3422-3430.

(3) Lambring, C.B., S. Siraj, K. Patel, U.T. Sankpal, S. Mathew, and R. Basha, 2019. Impact of the microbiome on the immune system. Critical Reviews in Immunology 39(5): 313-328.

(4) Poti, J.M., B. Braga, and B. Qin, 2017. Ultra-processed food intake and obesity: what really matters for health—processing or nutrient

(5) Fiolet, T., B. Srour, L. Selem, E. Kesse-Guyot and 11 others, 2018. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. The BMJ 360 (K322).

Julie Carlson is a Registered and Licensed Dietitian as well as a veteran of the Fortune 500 food ingredient industry, holding various titles from Engineering to Product Line Director.  She earned her RD after experiencing how changing nutrition can lead to beneficial health outcomes. She spent 5 years practicing in public health and specialty clinics before returning to industry.

Next week: Pandora’s Lunchbox: How Processed Food Took over the American Meal