Dr. Marion Nestle on Childhood Obesity
*Watch* our interview / Transcript below
*Watch* my interview with NYU Department of Food Studies founder Dr. Marion Nestle talking about her memoir "Slow Cooked," An Unexpected Life in Food Politics. She explains how children's weight has grown over the years, the risks that come with obesity drugs like Ozempic, and touches on the chilling of speech on college campuses. At 86, Dr. Nestle is a force in food politics and we are thrilled to share this special interview with you. The transcript follows below.
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Thank you for joining Restore Childhood. I'm Natalya. And today, I'm really honored to welcome Dr. Marion Nestle, who was my professor at NYU when I was in the Department of Nutrition and Food Studies almost 20 years ago. Dr. Nestle is the Paulette Goddard Professor of Nutrition, Food Studies and Public Health Emerita at NYU.
I was there in 2003 to 2007, and I loved every minute of it and have found every possible excuse to go back and organize alumni and just be in touch with the department. This department was the first of its kind. It's now 27 years old. Dr. Nestle is the one who founded it.
She first joined the program in 1988 as the chair of the Department of Home Economics, which then evolved into other iterations in food and food management. And then in 1996 became the Department of Food Studies, which has an undergraduate and graduate program. (I was in the graduate program). Dr. Nestle is an award winning writer, who has written 15 books on food, politics and food policy, including her 27th book, which came out when I was in the program, a very exciting time, called Food Politics, which has now been published in many languages and several editions.
It explores the wide reaching implications of what and how we eat, from production to marketing to the possibilities of a fairer distribution of resources. Some of her other books are Unsavory Truth: How the Food Companies Skew The Science of What We Eat. She's also written Pet Food Politics, which is a book that I turned to when my dog, 15 years ago, was poisoned in the melamine scandal when Chinese melamine was put into dog and cat food, and many animals fell ill and ultimately died.
So that was an incredible resource. And then she's written so many other books, but here is her most recent one, Slow Cooked: An Unexpected Life in Food Politics, which is an autobiography that I'm really enjoying. I think it's incredible to hear about her story and also just her slow ascent to where she is now, which is really a resource for everyone in the food industry. And an incredible, trusted, independent voice.
NM: Thank you, Marion, for being here.
Dr. MN: Well, thank you. It's always good to see you.
NM: It's good to see you, too. So I want to talk about your time at the Department of Health and Human Services. You co-authored the Surgeon General's guidelines on healthy eating back in 1988. Can you tell us a little bit about what that report said and how the guidelines have evolved over the past 30 years?
Dr. MN: Yeah, I mean, this is the first report on nutrition and it was meant to be a consensus document about everything that was known about diet and chronic disease, risk of heart disease, cancer, diabetes and so forth. It was a very lengthy project. I took it over. It had already been underway for several years when I took it over and my job was to try to finish it off.
I ended up writing most of it and it said what dietary guidelines said: Choose foods with less saturated fat, salt and sugar. Eat more fiber, eat more fruits and vegetables. I mean, there was nothing particularly radical or dramatic about it. It was just that it was a big government consensus report. And there was another one that came out of the National Academy of Sciences the next year that said exactly the same thing.
And both of these were enormous blockbuster books, hundreds and hundreds of pages.
NM: What happens with those guidelines after they come out? How are they disseminated?
Dr. MN: Well, they're not really. I mean, the research in it was the underpinnings for the 1990 dietary guidelines. And so the guidelines that came out in 1990 said basically the same thing because they had all this research support for it. And the guidelines never change. I mean, they all say the same thing, eat your veggies and don't eat too much junk food.
Basically, is what it boils down to but at the time it was very controversial because it was the first government report that did this. And there were a lot of people who thought that not eating junk food would be very bad for business.
NM: Right. So can you talk a little bit about that? I remember in Food Politics, you talked about the fact that the stakeholders, like the beef industry or the sugar lobby would object vociferously if you said eat less of this. So it was always, you know...
Dr. MN: Yeah, it’s un-American to tell people not to eat things. But the major source of saturated fats in American diets is meat. But the dietary guidelines will never say eat less meat. They say eat lean meat or choose low fat meat or eat less saturated fat. And so you have to know that those are all euphemisms for eating less meat…
Because you can’t say eat less meat or the meat industry gets too upset and they're pretty good at getting what they want. So, you know, I was told on my first day on the job at the Surgeon General's that you could never say eat less meat because it would make the cattle producers too upset and they would complain to the Department of Agriculture and the Department of Agriculture would complain to Congress, and the report would never come out.
And, you know, that was not a paranoid fantasy, it was a statement of reality.
NM: Do you think that the guidelines are helpful to Americans or do you think that using these catch phrases or terms that most Americans don't understand may actually be more confusing and leave more room for…
Dr. MN: Yeah, I mean, I think they would be more useful if they were more direct and said what they meant. But in any case, the food industry has put fortunes into making people doubt the guidelines. I mean, look, dietary advice is so simple that Michael Pollan can do it in seven words, “Eat food. Not too much. Mostly plants.”
Really, that's all there is to it. You don't need to know anything else except that by food he means real food, not foods that are now called the ultra processed foods. A lot of industrially produced food that can't make themselves. They have a lot of junk in them. But it's really very simple. It never changes. It never, never changes.
But the government advice, the wording changes. Or the way it's presented changes or, you know, it's under enormous pressure from food companies that don't want the government to say less of what they're making. You know, I mean, they're not interested in public health. They're interested in selling products. They don't want the government to do anything that’s going to reduce sales of their products.
NM: Can you talk about the Farm Bill? We hear a lot about the Farm Bill. I'm not sure the average American or even parents know very much about it and how it influences what we eat.
Dr. MN: Well, nobody knows anything about the Farm Bill because it's way too big… it’s hundreds of pages in tiny, tiny print, all of which refer to previous bills… they're not readable. You really have to know a lot of history to be able to understand what's going on.
The Farm Bill is a shotgun marriage and it has to be understood as that. It's a shotgun marriage between agricultural supports on the one hand and food assistance programs on the other, because the Supplemental Nutrition Assistance Programs SNAP is in the Farm Bill, and it's in the Farm Bill because President Johnson knew that he could get neither agricultural supports or food assistance passed unless he could get a vote, unless he could get some senators and congressional representatives to understand that they couldn't have what they wanted without the other one.
It's a classic log roll. So once you understand that a lot of what's in the Farm Bill makes a little bit more, since 80% of the funding goes to SNAP, 20% goes to agricultural supports, and the agricultural supports go to industrial agriculture, corn, soybeans, cotton, those kinds of things. They do not go to fruits and vegetables. So if you look at what happens to all the corn produced in the United States, roughly 45% of it goes to feed for animals. Roughly 45% of it goes to ethanol these days, leaving about 10% for the food. That's our agricultural system in a nutshell.
NM: And how do you think that impacts what our children eat?
Dr. MN: Well, it doesn't do anything to make fruits and vegetables more available, accessible and affordable. It does nothing on that. There are a few little teeny programs in the Farm Bill that promote fruits and vegetables among certain groups of people and some others. But we don't have an agricultural policy that is aimed at making people healthier and maybe making the environment healthier. That's not what our food system is doing. Our food system is there to support large industrial agricultural producers.
NM: Are there other countries where they are doing it right?
Dr. MN: The Scandinavian countries do it all. But it's always difficult because the power in the agricultural system is in states that grow corn, soybeans. And that's what everybody in most states does. And so those animals are really only interested in supporting their constituents. Iowa used to be like California years ago. Iowans like California. It grew all the fruits and vegetables for the country. And now it only grows corn and soybeans, to the great detriment of the environment and a lot of other things.
So there are pressures from people who think this should all be changed but whether they get anywhere, I don't know.
NM: And meanwhile, we keep hearing that more and more children are obese. I think the number I was seeing was 14.4 million children and adolescents affected by obesity. It continues to grow. During the pandemic children moved less and spent more time sedentary. I know at one point the Center for Science in the Public Interest had an advocacy campaign about food manufacturers advertising to children via online platforms, which is very troubling.
It's almost worse than it's ever been. You and I have discussed the new American Academy of Pediatrics guide guidance for treating children with obesity and overweight, and part of that treatment includes surgery and a lifetime of drugs. Diabetes drugs that have severe side effects. What do you think about those guidelines? You said it very well on your blog that this was a downstream solution and we needed upstream solutions.
Can you talk a little bit about that?
Dr. MN: Yeah, you know I'm a public health person. In public health, we talk about upstream and downstream. By downstream, public health people mean it's working with individuals. I mean, there's an analogy that's always given of babies floating down the river and people downstream are catching all the babies. And then when somebody says where are all these babies coming from, maybe we ought to stop the source.
That's the upstream analogy. So you've got, you're working with, individuals and physicians who work with children who are heavily overweight, don't have a lot that they can do. And so these drugs are being looked at by a lot of medical people as a solution to a problem that they haven't been able to fix any other way, whereas it would be much healthier for the population as a whole if we can find a way to get kids to eat more healthily, and be more active like they were when I was a kid and when my kids were kids.
You know, I mean, when even when my kids were kids, you look at their class pictures, they look skinny. There's hardly anybody in their classes when my kids were in grammar school who were overweight or pudgy, certainly not obese, and now it's completely normal. And so this requires a societal change if we’re going to prevent this, we certainly don't want millions of kids on drugs that they have to take for their entire lives. Maybe the drug companies would like that, but I don’t think anybody else will.
NM: Yeah, I do think that's really disturbing. And also the fact that I think we're really working hard to normalize overweight. And I absolutely agree that we shouldn't stigmatize anyone who is overweight. But...
Dr. MN: Well it is normal. It’s three quarters of American adults who are overweight. That makes it normal, by definition. The average adult is overweight, not necessarily defined as obese, but certainly overweight. And the reasons for that are really pretty obvious. We're eating more. I mean, there's plenty of evidence that people are taking in more calories now than they used to.
A lot more calories and plenty more calories are certainly enough to account for the average increase in weight that occurred in the population since 1980. So how do you reverse that? That's really difficult when junk food, if you put it that way, has become normal.
NM: It's also the way they eat right on the go without sitting down and talking. I just saw a study about families that spend an extra 10 minutes eating together and…
Dr. MN: Yeah right.
NM: Who's got 10 minutes. Right.
Dr. MN: I remember and this is a very long time ago, I would say probably in the early nineties going to a nutrition meeting in which somebody sat me down and gave me some raw data. Questionnaires that had been filled out by adolescents in a program she was running and she had asked these adolescents to write down everything they ate for a couple of days and list the times at which they were eating and what they were eating and specific times.
And what was absolutely amazing about those dietary records was that there were no meals. It was snacking from morning, it was a little of this and a little of that, and maybe ten times a day. And also no organized meals at all. Rarely do they eat more than one food at a time. And that was the first time I had ever seen anything like that.
And these were not necessarily poor kids. Some of them were from middle class families. They weren't rich, but they were certainly from some income distribution. And I thought, well, okay. And the rules are that the more times of day you eat, the more calories you take in, the larger the portion, the more calories you take in.
And then, of course, portion size has become the story. Because single food portions are much bigger now than they used to be. Restaurant meals are bigger than they used to be. And so, of course people are taking in more calories, and everyone, no exceptions, gains weight if they take in more calories than they need. Where genetics comes in is that some people gain more weight than others.
But genetics didn't change in 1980 when everybody started putting on weight, the environment changed.
NM: Well, that's why it's so disingenuous for the American Academy of Pediatrics to say this is an issue of genetics.
Dr. MN: They don't say that. They talk in that paper about the environment, about the environmental issues. I mean, genetics is part of it. But, you know, it used to be I mean, really life has changed for kids so much. There’s all this talk now about helicopter parents, you know, and people calling the police if they see kids walking to school by themselves, that kind of thing… My kids went to school by themselves when they were six and seven.
Everybody did. There were parents stationed on the corners to make sure that they didn’t get hit by cars. And that was it. But of course, kids walked to school. How else would they get there?
NM: I read the Ramona Quimby books by Beverly Cleary to my now almost nine year old. And Ramona was going to school by herself in the fifties when she was five.
Dr. MN: Right? Yeah. It's over there. Go. Right. And when I was a kid, which is really a long time ago, I lived in New York City, I had piano lessons in The Village. We lived on the Upper West Side, on 115th St. I took the subway by myself when I was eight years old.
You never see kids that young now. You just don’t… There’s no evidence that it's worse now.
NM: No, I think the perception in the media is, you know, hyper vigilance about showing parents how…
Dr. MN: But I mean, it's also part of the new parenting, the new parenting techniques. You know, people at NYU Student Affairs Office complain that they're dealing with parents about their kids’ grades all the time at college. You know, fortunately, they're allowed to, but they're still dealing with parents who are concerned about their kid’s grades in specific classes. Come on. Let these kids grow up and figure out how to deal with this stuff on their own.
NM: That's a really interesting conversation, considering that the parents’ rights movement is considered so fringe, Republican and conservative, like the parents who want to say what the curriculum is in public schools across the country. There's this whole debate about should parents have a say, the unions say no. The parents say they absolutely need that say. But then you have the college parents talking about grades to the universities. It just seems like an interesting juxtaposition.
Dr. MN: The kids, I mean, it's just but it's a different parenting style. And, you know, when I was, you know, I just couldn't wait to get my kids out of the house, go outside, play, don't come back until dinner. That doesn't happen like before phones. Phones have made an enormous difference.
NM: They have.
Dr. MN: I don’t think it’s easy to be a parent now.
NM: And when people say, just take the phone out of your kid's hand…
Dr. MN: Oh yeah, right.
NM: First of all, it's not easy to do that. But secondly, you ostracize your kid like they're the only ones now who don't have it. And all their friends are chatting and they are left out of it. So that is not a solution.
Dr. MN: I think being a parent now is much harder.
NM: Now it is. I think it is really hard and it's, you know, I have an almost 13 year old and a nine year old, and I have to say it's gotten progressively harder over the past couple of years, especially since the pandemic. Parenting has become so politicized.
Dr. MN: Good luck.
NM: One more question I wanted to ask you was about freedom of speech on university campuses. I was struck by the fact that you said that when you were hired at NYU, you were a tenured professor who always had the freedom of speech and was able to be, not intentionally controversial, but an independent voice who was never silenced.
What do you think is going on on college campuses now and how do you see the future?
Dr. MN: Well, I think what we're seeing is enormous sensitivity among young people about issues of identity. And they play out in very complicated ways in the university...So, I mean, that's what we're seeing…where students are extraordinarily sensitive to the kinds of things that they used to just shrug off, you know internalize, but they would shrug off. I think there are some things about it that are really good and some things about it that are not. And it's going to take a while for it to play out.
NM: But do you think that there is a chilling of speech for faculty/staff.
Dr. MN: Oh, well I don’t think there’s any question. I mean in some ways if it’s about somebody’s gender or something like that, you have to be careful about what you're saying, how you’re saying it and why, and I think there are some good things about that and some things that really are very difficult.
But for people who've been teaching for a long time and have their ways of doing things, finding these kinds of responses to things that you've always talked about can be quite difficult. And I certainly experienced this myself the last time I taught where I was talking about the rising prevalence of obesity and its causes and how it's measured.
And there were students who were in class who were extremely sensitive to the idea that the body mass index (BMI) is an imperfect measure. It has racial connotations, and they reacted to it quite strongly. I mean, I found a way to deal with it, that seemed alright and got everybody calmed down. But, as I said, it's mixed.
There are things about it that I think are, I think the kinds of issues that are being raised are worth raising. But it's how you raise and it's whether you raise in a way that's respectful of other people's opinions, or not, or assume that there's only one way of looking at these things. These are complicated issues.
NM: Thank you so much, Marion, and I really appreciate your time and I love the book.
Dr. MN: Thank you.
NM: Thank you so much for writing your story. I think it's so valuable to see your path. It is inspiring to others and to feel like it's okay. Like you can do things on your own timeline. I'm 51, so I'm kind of late to much of this too. So it's great to know that you went first. Thank you.
Dr. MN: As always, a pleasure talking to you
Marion’s latest book “Slow Cooked,” is a must-read. You can buy it here.