University of Minnesota

Center for Science in the Public Interest: M. Jacobson Seminar, 2001

[ed. Mike Jacobson directs the non-profit Center for Science in the Public Interest (CSPI), an educational and activist organization using media and promotion strategies to create awareness and encourage change in the production and consumption of foods, toward a more healthy pattern.

This seminar at the University of Minnesota retains its topical relevance and provides insights into the strategies of industry and the outmanned counter strategies influencing eating behaviors nationally.]

MJ: I’m going to talk today about nutrition and the politics of food. It’s a pleasure to be here. I get to the Twin Cities every once in a while and I always have a wonderful time. I actually got my start as a food activist here in 1972 when I attended the Institute of Food Technologists’ Convention. That was in the heyday of food co-ops and so on. So we organized demonstrations. We had one, I don’t remember what it was, the old Armory or something, which was a couple of blocks from the Wonder Bread plant. We held a press conference threatening to bury the plant in whole wheat flour. It got into the newspaper. We had other kinds of fun.

HB: And you’ve been a trouble-maker ever since.

MJ: Ever since. That was the first year of our “Garbage Can Award.” Remember Bon Vivant vichyssoise soup? “Bon Vivant Vichyssoise Memorial Award” to the biggest junk food company of the year and that continued for several years.

I run the Center for Science in the Public Interest, which does a lot of education and advocacy. We publish The Nutrition Action Health Letter, copies of which …. hopefully you’ve taken a copy. We have 800,000 subscribers in the U.S. and Canada and that’s our main way of surviving and also our main way of getting information out to the public and also our main way of exploring new areas. Where one of the writers will look into something or other and sometimes it’s just an article and sometimes it turns into a major lobbying campaign, a petition to the government to do something. What we’ve tried to do is look at the science and understand that and then look at corporate practices and government policies. And if there’s a mismatch and the issue is significant enough then we’ll try and change the corporate practices or the government policies in a more salubrious direction. We have a staff of 60 people, three in Canada, all the rest in Washington, DC.

Generally, the subject is called “nutrition and politics of food” and I want to talk somewhat about nutrition and then move on to the politics. We’ve worked on nutrition since 1973 when I felt it was such an important issue, even back then, that the evidence was indicating very strongly that diets high in salt, cholesterol, saturated fat were contributing to cardiovascular diseases and possibly others. In general, CSPI tries to work on major issues that have received too little attention from advocacy organizations. So nutrition is our main project, food safety, food borne illnesses is another project. Alcoholic beverages is another one. Antibiotic resistance is another one.

This indicates why we chose some of our projects. These are leading contributors to premature death. Diet and physical activity, according to the Department of Health and Human Services is way up there on top, right along with tobacco. Now I think if you ask the average person on the street what’s more important to health, smoking or diet? Most people would say smoking. And obviously, for the three-fourths of the public that doesn’t smoke, diet is clearly the most important contributor to premature death. And alcohol is number three. It kills about 100,000 people a year. As well as destroying untold numbers of lives due to alcoholism where people’s whole lives are ruined academically, in the workplace, and so on.

With diet and health the major concerns in cardiovascular disease and somewhat cancer, obesity was kind of an afterthought. Yeah, Americans are overweight. But in the last 20 years, rates of obesity as I’m sure you all know, have skyrocketed.

These are CDC slides showing the increased rates of obesity, state by state. In this slide, the whole central section of the country there are no data. So don’t be misled by that. Other than that, look for the red. I’m going to go every five years, so this is 1985, 1990…. See all the red up there? 1995 and 2000 and it’s just astonishing to see the spread of obesity. Bill Dietz at CDC I think put together these slides. The estimates of obesity, the costs of obesity range greatly according to the researcher and similarly, the costs of chronic disease vary greatly. The Department of Agriculture estimated that the dollar costs of diabetes, stroke, heart disease, and cancer are at least $70 billion a year. Some people put the costs of obesity and lack of physical activity at about $150 billion a year. Some people have said that obesity kills 300,000 people a year and different epidemiologists, I’m sure, will look at those numbers and say that’s a crock, that’s a gross exaggeration, underestimate. Whatever it is, the numbers are extraordinarily large.

This shows obesity rates in kids in the last 30 or 40 years. They were moderately stable from the early 60s to the late 1970s, but since then both in young children and teenagers the obesity rates have climbed very substantially. This shows rates of obesity and overweight in adults. Again, in obesity only, that’s roughly a doubling in the obesity rate. If you throw in overweight it’s gone from 42% or something to 61% in 40 years. With much of that increase coming in the last 15 years or so.

Where will this end? Are we all destined to become overweight? I don’t think so. Some of us are lucky genetically and then we exercise and do all the right things. But, I think the numbers are going to continue to go up.

There’s a lot of talk in Washington and the academic community, a lot of hand-wringing, “What are we going to do? It’s so difficult, it’s such a big problem.” The Surgeon General issued a report and it’s something that I think politicians have latched on to because it allows them to talk about something that doesn’t stimulate obvious political answers that will cost money or political capital.

Obesity is a very difficult thing to deal with, to fight. Because I think it’s really engineered into our society. It’s a natural outcome of the society that we and other technologically advanced nations have created on both the physical activity side and the nutrition side. We don’t do manual labor anymore, we don’t walk anywhere. In suburbs very often there are no sidewalks or if there were, there’s no place to walk to, no shops to go to. Television of course. PE is being lost in schools. Even something like air conditioning, who would want to live without air conditioning in the summer? I don’t know about up here, but in most civilized parts of the United States air conditioning is essential for a comfortable life, especially in the South. It keeps people indoors, it keeps them away from just going outside and running around as people used to.

And on the food side, there’s junk food everywhere, huge portions, heavy advertising to encourage us to eat especially the kind of foods we shouldn’t be eating. Training kids to eat those kind of foods. Because a lot of this food is high in saturated fat and cholesterol and sodium, it contributes to cardiovascular diseases as well. It’s certainly no secret in policy circles or in the academic community what the real culprits are in nutrition. It’s the saturated fat and so on and it translates into meat, whole milk, cheese, hydrogenated fats that are high in trans fat that act like saturated fat. And for sugar, soft drinks are really the big culprit.

Once you move from the nutrients to the foods, then you start getting into touchy territory. When it comes to industry, you start stepping on toes more heavily when you talk just about nutrients. If I were to estimate the harm caused by different nutrients, I’d put saturated fat on top. The Heart Association has been talking about that for many years.

I’d like to talk briefly about trans fat and sugar, which in a way, are two of the newer concerns. Do you all know about trans fat? OK. In 1994, we petitioned the FDA to include trans fat in with saturated fat on food labels. Currently, trans fat does not show up on a food label when the fats are broken down into saturated, monos, and polys. It’s just absent. So if you add up saturated, mono and poly, it doesn’t add up to total fat, which does include trans fat. So we petitioned the FDA to include trans fat in with saturated and have the grounds of trans fat go towards that percentage of a daily value. The FDA, as it usually does, takes it’s sweet time to do anything. But five years after our petition, which isn’t extraordinarily great in FDA terms, November 1999, the FDA published a proposal to require labeling of trans fat pretty much as we suggested, including it in with saturated fat, maybe having an asterisk saying how much is trans and it asked for public comments. The FDA estimated that just labeling trans fat, not banning it from any product, just labeling it would save 2,000-5,000 lives year. Just from the labeling. And that the benefits economically outweighed the costs by 50 or 100 to 1. Just an enormous benefit. This is what the label would look like if it went into effect. Saturated plus trans fat, total 5 grams, 20% of the daily value. And without the trans fat, maybe it would be 3 grams or 2 grams. And hopefully, this would give people a better sense of just how much fat there is in a particular serving of food.

So November, 1999 the FDA issues its proposal, gives people a few months to file comments and then the FDA reads the comments. And we wait and we wait and we call the FDA. And the FDA says, “It will be out in a few months. In a few months, in a few months, end of the year, next year, early next year, late next year, change in administration.” It’s mired in politics now. The main opponent is the Institute of Shortening and Edible Oils. There’s an institute of everything in Washington. There’s a Popcorn Institute, everything. They’re saying the science isn’t in yet, that maybe small amounts of trans fat, like a gram or two per serving don’t cause any harm at all. So you shouldn’t list that on the label. Moreover, there are First Amendment issues. The industry says, “The First Amendment says you don’t have the authority to force us to list that one or two grams of trans fat on a label because you haven’t proven that it’s harmful.” Moreover, the industry is concerned about the ability to make health claims. So it would like to say that a food is low in saturated fat, even though it has several grams of trans fat. It’s a true statement it’s low in saturated fat. And they say the First Amendment gives them the right to say “low in saturated fat” even though it has a lot of stuff that causes the same problem as saturated fat.

So what did the FDA do? So far it has punted. It’s punted first to the National Academy of Sciences, which has a committee that is meeting on macronutrients and trans fat will be one of the things it considers. So the FDA said, “We’d look pretty silly if we required labeling and the NAS comes out three months later and says ‘Hey, no problem with trans fat.’” So the FDA is waiting on that. Depending on that, if the NAS says it has real concerns about trans fat including one or two grams per serving, then the FDA has to go on to the First Amendment issues. If it can address those issues, then it may have to do another cost/benefit analysis because one of the right wing think tanks is saying that the cost/benefit analysis wasn’t well done, the FDA exaggerated the benefits and minimized the costs. So NAS report in the middle of 2002. Maybe the FDA can deal with First Amendment and cost/benefit analyses, say be the middle of 2003. Then it will probably have to issue another proposed regulation in 2003 or 2004 getting comments and then studying those comments. Maybe it could come out with a regulation in 2005. A final regulation giving industry another year or two to actually put the information on the label. So what is that, 2006 or 2007, I think, at the earliest before we’re going to see nutrition trans fat on nutrition labels? That’s what’s going on while the science mounts.

I mentioned sugar as the second nutrient that is of increasing concern. Back in the Seventies sugar was probably the number one nutrition bugaboo. Parents were most concerned about sugary breakfast cereals, soft drinks, Kool-Aid, and that kind of stuff. Sometimes I think nutritionists, and I beg your pardon, have one slot in their mind for a problem. Sugar was it in the Seventies, then saturated fat filled that in subsequent years, replacing sugar. In the past 20 years, sugar consumption has increased by 30%. This is refined sugars, you know, high fructose, corn syrup, sucrose and so on. Between the mid-Seventies and the mid-Nineties, the percentage of calories the average American gets from refined sugars increased from about 12% of total calories to 16%. Twenty-five percent of teenagers get 25% or more of their calories from refined sugars. A lot of people are consuming a lot of sugar.

The USDA has recommended that people limit their intake to 10 teaspoons per day on a 2000-calorie diet. Less if you consume fewer calories, more if you consume more calories. So 40 grams, 10 teaspoons a day. USDA food consumption statistics, which underestimate sugar intake, show that Americans eat roughly twice what USDA recommends, roughly 20 teaspoons a day. The frequent consumption of sugars certainly contributes to tooth decay, even though tooth decay has been declining in some people, especially low-income people it’s still a significant problem. It’s like having a foot on the break and the accelerator at the same time. Fluoridation of water, fluoride toothpaste, better dental care holding down tooth decay. It’s a tremendous amount – continuous exposure to sugars increasing it. Some people sugars, especially liquid sugars contribute to obesity. And something that’s more subtle to look at is how sugary foods replace more nutritious foods from the diet.

Shawnty Bowman at the Department of Agriculture looked at food consumption statistics. She did an interesting study, I thought, where she divided the population, and this is the entire population ages two and above, into light consumers of refined sugars (less than 10% of their calories) and people who consumed 10-18%, and then the heavier consumers (18% of calories or more). And I’m just comparing the lighter to the heavier consumers of sugar. Then she looked at their characteristics, calories per day. It probably wouldn’t surprise people that heavy consumers of sugars also consumed more calories than light consumers of sugar. But what’s more interesting is even though the heavy consumers consumed more calories, they actually consumed less of a variety of nutrients by varying amounts. So vitamin A – quite significantly less; foliate – just a tiny, tiny bit less; calcium – significantly less; magnesium – quite a bit less. And this squeezing out of nutrients can have all kinds of ramifications in terms of osteoporosis, immune function, cardiovascular diseases, and who knows what. And this shows some of that displacement of sugary foods replacing more nutritious foods.

You hear more of the politics of the nutrition. Nutritionists have known for many years and have urged people to cut down on refined sugars and soda pop, on butter, on cream, on whole milk, and cheese, on hamburgers, on steaks, all of that stuff. And some nutritionists even urge people to eat whole grains. Most of the education focuses on individuals. You know, it’s consulting dieticians or your doctor we hear advice. Doctors should tell people how to eat. And there’s certainly good in some of that. People read books. But as in the obesity slide I showed earlier where our society is so totally conducive to obesity, it’s also conducive to bad eating.

We live in a sea of influences to affect our thinking about diet and nutrition and to affect our food choices. You go to a dentist once or twice a year and the dentist may say, “OK, kid, cut out the sugar.” That sort of thing. And then there may be a little container of sugary treats in the dentist’s office even. Our whole society is affected by industries’ efforts to market foods that are bad for our health. And different industries. The orange juice industry doesn’t have a problem in this regard. But many other industries do.

I made this slide up to indicate the spheres of influence. This dot may be the individual in our society. I wanted to try and explain how industry exerts its influence. First, of course, is the food industry itself spending enormous amounts of money on advertising to encourage us to eat certain foods, most of it heavily processed, high in salt, high in fat, and with very little countervailing advertising. But probably, even more important than advertising is simply the sheer availability of junky foods. There are three million soft drink vending machines in this country. I even saw two right now on your first floor. And Coca Cola’s goal is to make sure there’s a Coca Cola almost within arms reach of everybody on the planet at all times. And they’re getting there. Some of it’s through three million vending machines. There are 100,000 fast food restaurants peddling their junk. So it’s not just the advertising, it’s just that wherever you go there is the stuff available. And not just on suburban street corners, but downtown in office buildings, in hospitals, I dare say, probably some buildings in Minneapolis that have fast food restaurants. It’s hard to get away. And most of the foods in these restaurants are junky foods.

I wrote a book on fast foods in 1986 and after it came out I talked to a fast food executive, I think at Arby’s, who said to me, “Yeah, yeah. But you think our food is bad? You ought to look at table service restaurants sometime.” And it took us a while to figure out, but then we began looking at them and these are some of the foods we found at fast food restaurants. Take a look at the calorie and fat content: 151 grams of fat in an order of cheese fries, a porterhouse steak dinner – 107 grams of fat, one Cinnebon – 34 grams of fat. The saturated fat is probably half of the total fat in many of these dishes. And then think that the government’s recommended daily limit is 65 grams of fat. So you’re getting it in one meal without the appetizer and desert and buttered roll and all that. Just enormous quantities of calories in restaurant foods. Nobody has any idea how many calories are in a restaurant meal. We even did a survey of 200 dieticians and showed them the average tuna fish sandwich and a few other items. Milk they nailed. They knew exactly how much fat there was in a glass of whole milk. But when it came to a tuna salad sandwich and a few other foods, they typically underestimated the calorie and fat content by about 50%. Even dieticians who work with this stuff every day have no idea. When we showed them the food they could feel the heft and they grossly underestimated.

Advertising, though, is a factor. Coca Cola, one company, spends $355 million a year on media advertising and then hundreds of millions on other things like ….. Coca Cola will pay McDonald’s or Wendy’s for some of the advertising they do because the ads say, “Come on in and get hamburger, fries, and a Coke.” And McDonald’s makes Coca Cola pay for that. It may be $100 million a year, that sort of thing. Over an 11-year period the four biggest soft drink companies and Coke and Pepsi are far and away the biggest, spend almost $7 billion, $7 billion on media advertising. The figure is unfathomable. Could you imagine what you could do with $7 billion? Can you imagine what you could do with $7 million? That’s a lot of money, you’re talking serious bucks! That’s the kind of influence that Americans, and this is only in the United States, by the way, that Americans and kids in particular are exposed to. And we respond to the advertising.

This is what’s happened to soft drink consumption in the past 55 years. In 1942, when consumption was even less, the American Medical Association published a warning urging people to cut back on soft drinks because they were taking too big a place in the average diet. Now Americans are consuming about 8 or 10 times as much as they did back then. A lot of this increase, I think, is due to serving sizes. In the 1950s serving sizes were 6 ounces and a family size Coke was 26 ounces, four servings. Now, a 20- ounce Coke is gradually becoming more standard. And it has a handy screw cap you can suck on that all day and dentists love it. You’ve got to save the dental profession.

The food industry does a lot of marketing. It also has its lobbyists in Washington. It has people employed who can write letters to Congress or government agencies about any particular issues, “Don’t crack down on us because we’ll lose our jobs.” And that’s very influential. Beyond the companies themselves, companies form alliances called trade associations like the Institute of Shortening and Edible Oils, the National Soft Drink Industry, the Salt Institute, the Sugar Association, the Meat Institute, the National Pork Producers Council. You name it, there’s a trade association for practically everything. And they do lobbying and individual companies who don’t want to expose their brand names hide behind these trade associations. And a lot of times in debates or on television it’s the trade association that speaks out so companies don’t have to embarrass themselves individually. And these trade associations have professional staffs of scientists, economists, and many, many lawyers who lobby Congress on whatever affects their industry. But everybody knows that the National Soft Drink Association is sponsored by the National Soft Drink Industry. So people are skeptical about what such an association might state. So industry sets up innocuous sounding organizations to do lobbying like the International Life Sciences Institute. What could sound more wholesome and academic? Or the International Food Information Council to provide journalists with information about food. Sometimes these associations don’t even disclose their food industry backing. And a lot of times industries will put forward these organizations to talk to journalists or debate activists on television or radio. Then even cleaner than setting up their own organizations is to give funding to bona fide, non-profit organizations like the American Heart Association or Cancer Society or Medical Association. And that funding very often can silence an organization, can prevent it from speaking out on some issue or sometimes encourage it to take an inappropriate stance. The Beef Industry has contributed generously to the American Heart Association. And I think that that kind of an influence does not help an organization be terribly bold in its statements. There’s always a fear of, “Our we going to get a renewal of that grant?” That’s a constant factor in an organization’s mind.

This is an excerpt from a letter that the Sugar Association recently sent to Marian Nestle, a professor at New York University. Blah, blah, blah, “If not, the only recourse available to us will be to legally defend our industry and its members against any and all fallacious and harmful allegations.” One of the crimes that Marian Nestle committed was to say that soft drinks contain sugar. Could you imagine that? And the Sugar Association, which represents cane and beet sugars gets all in a huff about that. They say, “Soft drinks do not contain sugar. They contain sugars. They contain high fructose corn syrup, which is mostly glucose and fructose. They do not contain sucrose.” And Marian Nestle mislead the public into thinking that soft drinks contain sucrose. That’s what this outfit had to stoop to in hiring a law firm to threaten her with a law suit to shut up. Then they also accused her of saying things like….. She’s on a radio show and they said, “Your remarks could be interpreted to mean that sugar promotes obesity.” Something like that. She didn’t even say it. It was just that they could interpret her comments in a certain way. Just utter malarkey. And this big industry hires a big law firm to throw its weight around and try to frighten a professor into silence.

This doesn’t happen all that often. Usually industries are more subtle and typically professors if they receive a letter like this, they’ll write an abject apology and not hand it out to the press and others.

How many of you are members of the American Dietetic Association? Great. I hope you become activists within that organization. It is almost an arm of industry. It publishes all these fact sheets. They had an Olestra fact sheet, Henry, that you know well, sponsored by Procter and Gamble. Their fact sheet on MSG is sponsored by Angenamoto. Their fact sheet on soft drinks is sponsored by the National Soft Drink Association. The Journal of the American Dietetic Association, unlike some journals like The British Medical Journal, does not disclose author’s corporate affiliations. I remember one review of sugars and sweeteners was co-authored and one of the co-authors a few years ago was the chief consultant to the Canadian Sugar Institute. The professor, G. Harvey Anderson, is at the University of Toronto, but his key affiliation is his affiliation with the sugar industry, not disclosed. And members of the Dietetic Association should try to force the Association to always disclose corporate affiliations. Whether it’s at their annual conference or in their journal or wherever, their fact sheets do disclose the corporate affiliation. But it’s shameful that these fact sheets are published by the ADA, they’re written by the PR firms for these companies and then the ADA says it reserves the right to edit this. But it’s just terrible to have an association taken over to that extent by industry.

Then finally, I may be stepping on more toes, the outer ring here are academic consultants. Who has more credibility than the distinguished professors from the University of Toronto or Harvard or the University of Minnesota, and so on? And all too often professors speak out in defense of an industry without disclosing their corporate connection to the industry. The examples are countless. We have a website called “Integrity in Science” that lists some of these affiliations. We have a couple of thousand professors as well as 100 or so non-profit organizations. I don’t want to imply that every professor who takes corporate funding is a prostitute. Far from that. And I think it’s appropriate that industries get the best advice they can get and often times that will be from a distinguished professor. And we’re not saying they shouldn’t. But the least one can ask for is disclosure in academic journals, at conferences, press conferences, media reports. And it’s something that scientific organizations, universities, scientists, and the media should be on top of.

A couple of years ago we got The Washington Post to adopt a policy of disclosure of these corporate connections and The Post, I think, does better than most other newspapers. Today’s New York Times provides a classic example of how a journalist can slant the public perception of an issue. There’s an article by Gina Kolata about acrylimide. Are you all familiar? You know, the newly discovered carcinogen in foods discovered by Swedish scientists and not yet confirmed, the paper isn’t published. But the Swedish scientists generally know how to do science and they’re probably correct. So there’s an article that quotes Dr. Steven Safe from Texas A & M University saying, “No problem.” No mention that he consults with the Chemical Manufacturers of America, also the Electrical Power Research Institute, drug companies and I don’t know who else. Another person who I don’t know at all, his name is, I think, John Boyce who is identified with the International Epidemiological Institute. And frankly, I don’t know about the Institute. But I suspect that many of its clients are corporate clients who need epidemiological research to pull them out of a hole and they may do other research as well. The American Council on Science and Health is quoted and at least for that one, it’s acknowledged in the article that it does get funding from industry. Lois Sworsky Gold, she’s at the Berkeley Group. What’s her boss’ name? Anybody remember what lab she’s in? Using microbial testing to estimate the potency of carcinogenic substances?

HB: Ames.

MJ: Bruce Ames. I don’t think they take any industry money, but she can be counted on to say there’s no problem with acrylamide. In this article she compares it to smoking say, “Smoking is what people should be focused on. Not little contaminants like acrylamide.” Acrylamide, I estimate that using Swedish and UPA numbers, may cause 3000 cancer deaths a year. That assumes Swedes consume as many French fries and potato chips as Americans do, of which I’m skeptical. But assume in the low thousands of cancers per year. That’s something that should be reckoned with and not just pushed off the table. Especially 75% of Americans don’t smoke. So diet is a very substantial factor, including substances like acrylamide. And the Swedish scientists had a very different reaction. They said we should be happy that this was found because whether we found it or not, it would still be there. Now that we found it, maybe we can do something by cooking these foods at different temperatures or maybe there’s some additive or different ingredients. Someway to hold down this number, then live with the inevitable and not stick our heads in the sand. So, I think, Gina Kolata intentionally chose all of these so-called experts whose opinions she knows well in advance, to create an impression that this stuff was not a problem. She also quoted me to sort of balance it a little. But 4 to 1 is not much of a balance.

This happens all the time in the media and this is the reason industry loves to fund non-profits and academics because very often many of them can be counted on to give a pro-industry line without any nudging at all.

So it’s a grim situation. Obesity can’t do anything about it. Our kids are in a sea of advertising for junk foods. Junk foods are everywhere, literally everywhere. What can we do about it? And I wanted to suggest some very modest things that you can do. And what I hope is that eventually universities will serve as nuclei for support of policies that can actually change the American diet in little ways and big ways.

One of the biggest things is to counter all that industry advertising and get consistent information out to the public. One way to do it is with promotion of things like….. You all know the Five-a-Day Program? Eat five or more fruits or vegetables a day you see in the supermarkets occasionally, not much else. It receives about $5 million a year in funding, $5 million. It sounds like a lot of money. If each of us had a million dollars it would spread over 280,000,000 people it doesn’t amount to very much. McDonalds spends that much money in eight hours promoting its products. There should be a budget of $50 million a year roughly for something like Five-a-Day.

When we went to Capitol Hill and said, “Give $5 million a year to Five-a-Day.” Some people said, “What’s your evidence that marketing or promotion or something would actually change the American diet?” And there isn’t a lot of evidence on that. I mean it’s patently obvious that you can do some things to change diet. So we decided to do some tests and we pulled together a little nest egg of about $25,000 and we created an ad. Actually two ads, I only show one. And we bought air time in small towns in West Virginia, population 50 to 100,000 – Clarksburg, Wheeling, a few other places. And we had a control town where we didn’t do anything. West Virginia is a small mountainous state with individual media markets where you can actually do tests. And I want to show you the ad that we ran. They issue we chose was milk. Can we switch people from high- fat to low-fat milk, from 2% or whole milk to 1% or fat-free milk?

AD: There’s an exercise you can do right in the supermarket that’s good for the whole family. Just move your hand from whole milk or 2% to 1% or skim. From here to here. This one glass of whole milk has the artery-clogging fat of five strips of bacon and 2% is not much better. But with 1% or skim, you get great taste and all the vitamins with little or no fat. Exercise you judgment. Move to 1% or less. Yes!

MJ: These were not public service announcements. Public service announcements are virtually worthless. They get on at 2:00 in the morning once or twice and that’s it. Basically no effect. For $25,000 per city we blasted these cities with these ads. They saw them when they were watching Oprah, the Today Show, the soap operas, evening news. This is another one.

AD: If you love your heart you want to be nice to it. But when you drink a glass of whole milk you get the artery-clogging fat of five strips of bacon. That’s not nice. And 2% milk? Three strips of bacon. You can do a lot better. Switch to 1%. With skim milk you get all the vitamins with little or no fat. Please take this message to heart. Switch to 1% or less. Yes!

MD: We supplemented that with publicity. We got the mayors of the towns to be at a press conference kicking off this effort and we put them next to 400 lbs. of hydrogenated fat representing the amount of fat somebody wouldn’t consume, the average person wouldn’t consume if they drank fat-free instead of whole milk over their life time using USDA consumption figures. So there’s this huge amount of fat, 400-450 lbs, 1.3 million calories. This campaign lasted just six weeks. Couldn’t afford to continue it forever. This shows the results of the study. [ed. It worked]

The holistic advice that I would give at this point, is try to encourage people to eat a more plant-based diet. Get people to go eat green for two reasons: one is all the health reasons we’ve talked about here, cardiovascular disease, cancer, diabetes, obesity, tooth decay. If we ate a more plant-based diet, and I don’t mean Twinkies and soda pop, our health would improve. Look at vegetarians at the extreme. Look at vegetarians versus the average omnivore; vegetarians are generally healthier. Even those that eat cheese. And then there are a whole other slew of benefits that fall out. If we ate less meat and poultry we’d certainly have less food-borne illnesses in this country, e coli, camphylobacter, salmonella. Seventy-five million food-borne illness cases a year, 5,000 people die every year according to the CDC. Cut back on that. And then we use less antibiotics in agriculture, cutting back on the problem of antibiotic resistance. Then a whole variety of environmental benefits, fewer feedlots, less pollution from manure, less use of fertilizer to grow feed grains, less use of pesticides to grow feed grains. I mean safer for farmers and cleaner streams, less soil erosion. There’s atrazine in water supplies in many areas. A whole bunch of environmental benefits, which are good in their own right. But their environmentalism is a wonderful motivating force for a lot of people who don’t care that much about health. And I think a lot of teenagers who are switching toward a vegetarian diet are doing it for these kinds of environmental reasons and they enjoy the health benefits. And, of course, animal welfare is an issue for many people also. Fewer animals, less misery for those animals. So this may be a more holistic message that may be able to get results faster in some cases and have, perhaps, unexpected benefits.

So let me stop here. Do we have time for discussion?