by Marion Nestle

Currently browsing posts about: Let’s Ask Marion

Jan 9 2013

Let’s Ask Marion: Can It Really Be Healthier To Be Overweight?

Every now and then, Kerry Trueman challenges me with a difficult question about some current topic.  Our most recent exchange, published yesterday in the Huffington Post, is about the so-called “obesity paradox” (defined below).

Trueman: There’s a brouhaha in the blogosphere over Paul Campos’ NY Times op-ed in which he claims that our current definition of what constitutes a ‘healthy weight’ is dead wrong. Campos cites a new analysis from The Journal of the American Medical Association claiming that overweight or obese individuals have a lower mortality rate than people whose weight is ‘normal.’

He speculates that our obsession with obesity is a misguided and manufactured controversy foisted on us by the multibillion dollar weight loss industry and Big Pharma. Marion, you’ve been called a lot of things over the years, but have you ever been accused of being in cahoots with Jenny Craig and Eli Lilly?

Nestle. I love it when people invoke conspiracy theories to deny that obesity raises disease risks.

Paul Campos is a lawyer. He views matters of diet and health from a legal perspective. From that viewpoint, if a statistical analysis shows little effect of obesity on mortality except among very obese people, then nobody need be concerned about weight gain except at the extreme.

If only the science of diet and health were that simple. Scientists, alas, must struggle with a number of vexing questions about such studies:

  • Does a finding of statistical significance necessarily imply clinical or biological significance?
  • Do statistical findings based on populations necessarily count for individuals?
  • Do statistical associations provide guidelines for behavior?
  • Are the methods used in statistical studies adequate to draw conclusions about behavior?

We are talking here about a huge meta-analysis of 97 studies of obesity and mortality carried out by Katherine Flegal and her colleagues at the National Center for Health Statistics.

When I read papers by excellent statisticians published in prestigious, peer-reviewed journals, I start by taking the results at face value. Then I ask critical questions about what the results might mean.

I found the figures in the paper difficult to follow so I’ve summarized the results below:

RELATIONSHIP OF WEIGHT CATEGORY TO THE RISK OF MORTALITY.

WEIGHT CATEGORY BMI RANGE MORTALITY RISK (RELIABILITY)
Normal 18.5 – 25 1.00
Overweight 25 – 30 0.94 (95% CI, 0.91-0.96)
Obesity, Grade 1 30 – 35 0.95 (95% CI, 0.88-1.01)
Obesity, Grades 2 and 3 >35 1.29 (95% CI, 1.18-1.41)

My interpretation: Compared to people with BMI’s in the normal range, those with BMI’s considered overweight or somewhat obese display no increased risk of mortality. Indeed, those in the obesity grade 1 category may have a slightly reduced risk. The study only finds an increased risk of mortality—by 29%—when the BMI exceeds 35.

My first reaction? This is not news.

Since this is a study of previous studies, we’ve seen results like this before. Flegal herself published a similar analysis in JAMA in 2005. In that paper, she presented the results in a way that is easier to visualize:

RELATIONSHIP OF BMI TO MORTALITY AT VARIOUS AGES

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These earlier results show what is called a “J-shaped” curve, meaning that the risk of mortality increases at BMI’s below as well as above the normal range.

The new study is consistent with these earlier—and equally controversial—results.

But the earlier results point to some of the difficulties in interpretation.

  • What’s going on at the lower end of these curves?
  • Are mortality results skewed by people who are ill and weigh less?
  • Is BMI an adequate indicator of health status?

At the moment, there is no way to answer these questions at a level of precision that might satisfy legal thinkers.

What we do know is that obesity above the normal range sometimes—never always—raises the risk for chronic diseases like type 2 diabetes, heart disease, and others. Risk is about probability. Risk never implies legal certainty.

It seems clear that for some people—perhaps many—having a chronic disease does not cause a decrease in lifespan. Since 1970, people throughout the world have gained slightly more than ten years of life expectancy overall, but are now spending many more years living with injury, illnesses, and disabilities—conditions caused by cigarette smoking, excessive alcohol consumption, and poor diet.

With respect to overweight, this is sometimes called the “obesity paradox,” understood as the survival benefits of modest overweight and obesity for people who already have a specific medical condition.  For them, many studies—not all—show that survival is modestly better at higher weights.

The Flegal study deals only with the statistical significance of the mortality survival component of the paradox. It does not deal with issues related to the effects of obesity on quality of life.

As a result, some of my colleagues have made harsh comments about the study, calling it “a pile of rubbish.”

I wouldn’t go that far. The study is what it is—a statistical meta-analysis. It’s up to scientists and clinicians to figure out whether statistics like these have meaning in the real world.

In the real world, it doesn’t take much overweight to induce type-2 diabetes in susceptible individuals, and many people—not all—with type-2 diabetes can completely eliminate symptoms by losing a few pounds.

Campos may be willing to let his weight go to where it will and take his chances that statistics are on his side. That’s his choice.

As for me, I’d prefer to avoid weight-related illnesses for as long as I can. I’m hedging my bets and continuing to watch my weight.

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Dec 18 2012

Let’s Ask Marion: Beyoncé’s Bubbly Branding Falls Flat

It’s been awhile since Kerry Trueman posed an “Ask Marion” question, but here’s her latest Q and my A  as posted on Civil Eats.

By  on 
Q. From the moment Beyoncé strapped on those silly stilettos to bounce around in the “Move Your Body” video, she’s been a wobbly spokesperson for Michelle Obama’s “Let’s Move Campaign.” Now she’s signed a $50 million dollar deal with Pepsi, which will presumably entail her exhorting her millions of young fans to baste their bodies in bubbly high fructose corn syrup.

Apparently, she didn’t get the childhood obesity/diabetes epidemic memo. Do celebrities with Beyoncé’s massive influence on young kids have a moral obligation to consider the horrendous impact of excessive soda consumption in our culture when they mull over megabuck branding opportunities?

A.  From my privileged position as a tenured, full-salaried faculty member at NYU, the answer is an unambiguous yes. Beyoncé will now be marketing sugar-sweetened beverages, products increasingly linked to childhood obesity, especially among minority children.

This linkage is not a coincidence. Pepsi and other makers of sugary sodas deliberately and systematically market their products to low-income, minority children.

Beyoncé will now be part of that targeted marketing campaign.

If Beyoncé’s mission is to inspire young people of any color to look gorgeous and rise to the top, as she has done, she is now telling them that the way to get there—and to get rich—is to drink Pepsi. This untrue suggestion is, on its own, unethical.

Pepsi must think that getting this message out, and putting Beyoncé’s photo on its soda cans, is well worth $50 million.

For PepsiCo, $50 million is trivial. According to Advertising Age (June 2012), PepsiCo sold $66.5 billion worth of products in 2011, for a profit of $6.4 billion. Pepsi sales in the U.S. accounted for $22 billion of that.

PepsiCo’s total advertising budget funneled through advertising agencies, and therefore reportable, was $944 million. Of that amount, $196 million was used to market Pepsi alone. The rest went for Gatorade ($105 million), Mountain Dew ($23 million) and PepsiCo’s many other Quaker and Frito-Lay products.

One other relevant point: half of PepsiCo’s annual sales are outside the United States. Like other multinational food companies, it is focusing marketing efforts on emerging economies. This means that Beyoncé will also be pushing sugary drinks on people in developing countries. PepsiCo just spent $72 million to sponsor cricket tournaments in India, for example.

Fifty million dollars seems like an unimaginable amount of money to me. If PepsiCo offered it to me, I would have to turn it down on the grounds of conflict of interest. But this is easy for me to say, because the scenario is so unlikely.

What $50 million means for Beyoncé I cannot know. Some sources estimate her net worth at $300 million. If so, $50 million adds a substantial percentage. And the Pepsi deal will give her phenomenal exposure.

But from where I sit, Beyoncé has crossed an ethical line. She is now pushing soft drinks on the very kids whose health is most at risk. And her partnership with Pepsi will make public health measures to counter obesity even more difficult.

This is a clear win for Pepsi. And a clear loss for public health.

Beyoncé has now become the world’s most prominent spokesperson for poor diets, obesity and its health consequences, and marketing targeted to the most vulnerable populations.

Sad.

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Jul 12 2011

Eating Liberally: unhealthy food obsessions?

Every now and then, Kerry Trueman (“KAT”) poses a question, usually about something challenging.  Her challenge today:

Let’s Ask Marion: Is it Possible to Have an Unhealthy Obsession With Healthy Eating?

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(With a click of her mouse, EatingLiberally’s kat, aka Kerry Trueman, corners Dr. Marion Nestle, NYU professor of nutrition and author of What to Eat, Food Politics, and Feed Your Pet Right):

KAT: As one of our most influential advocates for healthier food choices, you must be pleased to see that more and more Americans are rethinking the way we eat and demanding better options. But is it possible to take a concern for healthy eating to an unhealthy extreme?

I have a friend whose son has become so fixated on what foods he thinks he should or should not be eating that he could be a textbook case of “orthorexia nervosa,” a supposed eating disorder characterized by an unhealthy obsession with healthy eating. Do you think this is a real disorder, and if so, how does one address it?

Dr. Nestle: “Orthorexia nervosa”? I’m not convinced it deserves inclusion in the DSM (Diagnostic and Statistical Manual of Mental Disorders) but let’s leave that to the shrinks. One thing is for sure. If you think people have it, you need to deal with them in the same way porcupines make love–very carefully.

Nothing is more intimate than food. It goes inside our bodies. Nothing could be more personal than food choices. Unless what people eat is doing them serious harm, I would not dream of commenting.

When people are chronically hungry, all they want is food, any food, and right now. But we live in an age in which food is so abundant and so easily accessed that it’s hard for those of us who are pretty well off to remember what hunger feels like.

For us, food is no longer about relieving hunger and getting basic nourishment. For many people, it isn’t even about traditional culture or, heaven help us, pleasure. Food is just there for the eating.

For some people, this means food is the enemy. If they do not vanquish food, food will vanquish them.

Vanquishing means being in control. Healthy diets may be about variety, balance, and moderation, but food fighters—or “orthorectics” if you prefer—are not comfortable with moderation or balance. If saturated fat raises blood cholesterol levels, don’t eat any fat at all. Whether high fructose corn syrup is worse than sugar or not, avoid it at all costs and never feed it to kids. Carbohydrates, trans fats, and color additives are bad for you when eaten in excess? Never touch them.

This may sound extreme but I can’t think of anything wrong with not eating these things. And I know lots of people who feel better when they don’t eat junk food and are actively controlling what goes into their bodies.

If your health food-obsessed friends are adults and their diets are reasonably varied, balanced, and moderate, they are probably doing just fine and don’t need an intervention. If they aren’t, and you think their dietary obsessions are harmful and causing them to lose too much weight, you can try an approach along the lines of “I love you and I want you to be healthy” and see if you can get them some professional help.

And if they are imposing extremely unvaried, unbalanced, and immoderate diets on children, you will want to get them some help right away.

Short of that, eating healthfully seems like a good thing to do and I have a hard time thinking of it as obsessive. What if eating healthfully were considered normal? As it should be, no?

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Apr 13 2011

Let’s Ask Marion: Does Factory Farming Have a Future?

This is one of a series of occasional Q and A’s from Eating Liberally’s Kerry Trueman.

Submitted by KAT on Wed, 04/13/2011 – 9:12am.

(With a click of her mouse, EatingLiberally’s kat, aka Kerry Trueman, corners Dr. Marion Nestle, NYU professor of nutrition and author of Pet Food Politics, What to Eat and Food Politics🙂

KAT: We talk a lot about the factory farms that provide most of our meat, poultry, eggs, and dairy products, but most Americans have no idea what really goes on inside a CAFO, or Concentrated Animal Feeding Operation.

You, however, saw a number of these fetid facilities firsthand when you served on the Pew Commission on Industrial Farm Animal Production a couple of years ago. And industrial livestock production’s role in degrading our environment, undermining our health, abusing animals and exploiting workers in the name of efficiency has been well-documented, most recently in Dan Imhoff’s massive, and massively disturbing, coffee table book CAFO: The Tragedy of Industrial Animal Factories.

Given all the problems inherent in industrial livestock production, do you see a future for factory farming?

Dr. Nestle: I do not think factory farming is going away. Most people like meat and want to eat it, and do so the minute they get enough money to buy it.

I think a more realistic question is this: Can factory farming be done better? The interesting thing about the Pew Commission’s investigations was that we were taken to factory farms where people were trying to do things right, or at least better. Even so, it was mind-boggling to see an egg facility that gave whole new meaning to the term “free range.” And these eggs were organic, yet. The hens were not caged, but there were thousands of them all over each other. This place did a fabulous job of composting waste and the place did not smell bad. But it did not in any way resemble anyone’s fantasy of chickens scratching around in the dirt.

Factory farming raises issues about its effects on the animals, the environment, the local communities, and food safety. As someone invested in public health and food safety, I care about all of those. The effects on the animals are obvious, and those will never go away no matter how well everything else is done.

But the everything else could be done much, much better. The first big issue is animal waste. It stinks. It’s potentially dangerous. Most communities have laws that forbid this level of waste accumulation, but the laws are not enforced, often because the communities are poor and disenfranchised.

The second is antibiotics, particularly the use of antibiotic drugs as growth promoters. This selects for antibiotic-resistant bacteria and is, to say the least, not a good idea.

The factory farming system could be greatly improved by forcing the farms to manage waste and restricting use of antibiotics. This will not solve the fundamental problems, but it will help.

I’m hoping that more environmentally friendly meat production will expand, and factory farming will contract. That would be better for public health in the short and long run.

NOTE: If you’re in the NYC area, please join Eating Liberally and Kitchen Table Talks this Thursday, April 14th at NYU’s Fales Library, 6:30 p.m. to hear Dr. Nestle, Dan Imhoff, and Pulitzer prize-winning New York Times investigative reporter Michael Moss address the question “What’s the Matter with Mass-Produced Meat?” The discussion will be moderated by Paula Crossfield of Civil Eats. Event details here.

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Jan 21 2011

Eating Liberally: What about those smarmy Monsanto ads?

Every now and then, Eating Liberally’s Kerry Trueman, aka kat, writes an “Ask Marion,” this one titled, “Let’s Ask Marion Nestle: Is Monsanto’s Warm & Fuzzy Farmer Campaign Just A Snow Job?”

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KT: Now that the Supreme Court has declared that corporations are people, too (happy birthday, Citizens United!), Monsanto is apparently out to put a friendly, slightly weatherbeaten, gently grizzled face on industrial agriculture (see above photo, taken at a DC bus stop just outside USDA headquarters.)

This guy looks an awful lot like Henry Fonda playing Tom Joad in The Grapes of Wrath, which seems only fitting since Agribiz may be helping to create a 21st century Dust Bowl.

After decades of boasting about how fossil-fuel intensive industrial agriculture has made it possible for far fewer farmers to produce way more food, Monsanto is now championing the power of farming to create jobs and preserve land. Does this attempt by a biotech behemoth to wrap itself in populist plaid flannel give you the warm and fuzzies, or just burn you up?

Dr. Nestle: This is not a new strategy for Monsanto. Half of my book, Safe Food: The Politics of Food Safety (University of California Press, 2010), is devoted to the politics of food biotechnology. I illustrated it with a Monsanto advertisement (Figure 17, page 182). The caption may amuse you:

In 2001, the biotechnology industry’s public relations campaign featured the equivalent of the Marlboro Man. Rather than cigarettes, however, this advertisement promotes the industry’s view of the ecological advantages of transgenic crops (reduced pesticide use, soil conservation), and consequent benefits to society (farm preservation). In 2002, a series of elegant photographs promoted the benefits of genetically modified corn, soybeans, cotton, and papaya.

Last year, Monsanto placed ads that took its “we’re for farmers” stance to another level:

9 billion people to feed. A changing climate. NOW WHAT?
Producing more. Conserving more. Improving farmers’ lives.
That’s sustainable agriculture.
And that’s what Monsanto is all about.

That’s sustainable agriculture? I’ll bet you didn’t know that. Now take a look at the Monsanto website–really, you can’t make this stuff up:

If there were one word to explain what Monsanto is about, it would have to be farmers.

Billions of people depend upon what farmers do. And so will billions more. In the next few decades, farmers will have to grow as much food as they have in the past 10,000 years – combined.

It is our purpose to work alongside farmers to do exactly that.

To produce more food.

To produce more with less, conserving resources like soil and water.

And to improve lives.

We do this by selling seeds, traits developed through biotechnology, and crop protection chemicals.

Face it. We have two agricultural systems in this country, both claiming to be good for farmers and both claiming to be sustainable. One focuses on local, seasonal, organic, and sustainable in the sense of replenishing what gets taken out of the soil. The other is Monsanto, for which sustainable means selling seeds (and not letting farmers save them), patented traits developed through biotechnology, and crop protection chemicals.

This is about who gets to control the food supply and who gets to choose. Too bad the Monsanto ads don’t explain that.

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Dec 10 2010

Food is political? Indeed it is.

Every now and then, I enjoy answering questions posed by Eating Liberally’s Kerry Trueman.  Here’s one for today.

Let’s Ask Marion: How Did Junk Food and Obesity Become a Red State/Blue State Debate?

(With a click of her mouse, Kerry Trueman, aka kat, corners Dr. Marion Nestle, NYU professor of nutrition and author of Feed Your Pet Right, Pet Food Politics, What to Eat, Food Politics, and Safe Food):

kat: The “agri-culture war” that’s long been simmering is coming to a boil now, as recently noted in The Washington Post, The Daily Dish, and elsewhere in the blogosphere.

The Palin/Beck/Limbaugh axis of egos is vigorously defending junk food, lamenting the passage of the food safety bill, and decrying all efforts to address our obesity epidemic, even as David Frum, a rare voice of reason (sometimes) on the right, tells CNN that obesity poses a greater threat to our national security than, say, openly gay soldiers.

You yourself are under fire yet again (sigh) from those uber-astroturfers at the Center For Consumer Freedom for having the audacity to question whether our cherished principle of free speech entitles Big Food to emblazon the labels of its edible food-like substances with Big Lies (i.e. dubious, unproven health claims).

Why do you think that the issues of junk food and obesity have become so incredibly politicized?

Dr. Nestle: Politicized? Of course they are politicized. Junk food and obesity are key indicators of political divisions in our society. For starters, junk food is cheap and obesity is more common among low-income populations. So right away we are into divisive issues of income inequality and class and, therefore, who pays for what and which sectors of society get government handouts.

The minute we start talking about small farms, organic production, local food, and sustainable agriculture, we are really talking about changing our food system to accommodate a broader range of players and to become more democratic. Just think of who wins and who loses if $20 billion in annual agricultural subsidies go to small, organic vegetable producers who are part of their communities rather than to large agricultural producers who do not live anywhere near their corn and soybeans.

The issue at stake is who gets to decide how food is grown and what people eat. For as long as I can remember, big agriculture and big food were in control, in close partnership with congressional agricultural committees and the USDA. Today, the food movement–democracy in action, if you will–is challenging their authority and power. No wonder defenders of the status quo don’t like the challenge. It is only to be expected that they are fighting back.

I see the intensity of the debate (and, alas, the personal attacks) as a clear sign that the movement is making headway. The system is clearly changing. It has to change if we are to address obesity, climate change, and the other unsustainable aspects of our present ways of doing food business.

Anyone who is working to reduce income inequity and to make healthier food available to every American has to expect to encounter the methods corporations always use to fight critics: personal attacks, claims of junk science, invocation of personal responsibility, cooptation, and plenty of behind-the-scenes lobbying.

Telling truth to power has never been popular. But I’m convinced it’s worth doing.

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Nov 7 2010

Let’s Ask Marion Nestle: Could The USDA Get Any Cheesier?

Eating Liberally’s kat (a.k.a. Kerry Trueman) asks one of her inimitable “Ask Marion” questions, this one about Michael Moss’s blockbuster story in today’s New York Times about dairy lobbying.

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KT: Sunday’s New York Times has a disturbing exposé by Michael Moss about the USDA’s efforts to aid the dairy industry by encouraging excessive cheese consumption. Can the USDA ever reconcile its two mandates? On the one hand, the USDA has the task of tackling the obesity epidemic by encouraging healthier eating habits. Yet it must also promote the interests of U.S. agriculture. As Moss documents so well, these two missions are in total conflict.

Dr. Nestle: And so they are, have been, and will be until public outrage causes some changes in Washington. In two of my books, Food Politics and What to Eat, I wrote about how dairy lobbying groups, aided and abetted by the
USDA, convinced nutritionists that dairy foods were equivalent to essential nutrients and the only reliable source of dietary calcium, when they are really just another food group and one high in saturated fat, at that.

The USDA is still at it. As Michael Moss notes:

The department acknowledged that cheese is high in saturated fat, but said that lower milk consumption had made cheese an important source of calcium. ‘When eaten in moderation and with attention to portion size, cheese can fit into a low-fat, healthy diet,’ the department said.

So let’s talk about “moderation,” a word that I find hard to use without irony. The pizza illustrated in Michael Moss’s article is described as a “thin-crust medium pie.” The diameter is not given, but one-fourth of the pie contains 430 calories, 12 grams of saturated fat (20 is the daily recommended upper limit), and 990 mg sodium (the upper limit is 2,300).

Who eats one-quarter of a pizza? Not anyone I know. So double all this if you share it with a friend. If you eat the whole thing–and why do I think that plenty of Domino Pizza customers do?–you are consuming more than 1700 calories, nearly 4,000 mg sodium (that’s 10 grams of salt, by the way), and 48 grams of saturated fat. This is enough to make any nutritionist run screaming from the room.

So why is USDA in bed with dairy lobbying groups? That’s its job. From its beginnings in the 1860s, USDA’s role was to promote U.S. agricultural production and sales, with the full support of what was then a largely agricultural Congress. Only in the 1970s, did USDA pick up all those pesky food assistance programs and capture the “lead federal agency” role in providing dietary advice to the public.

Much of Food Politics is devoted to describing the USDA’s severe conflict of interest in developing dietary advice to “eat less” of basic agricultural commodities. As Times reporter Marian Burros put it in one of her articles about the fights over the 1992 Pyramid, which visually suggested eating less meat and dairy, “the foxes are
guarding the henhouse.”

This is what Mrs. Obama is up against in her efforts to reduce childhood obesity and bring healthier foods into America’s inner cities.

How to change this system? One possibility might be to move dietary guidance into a more independent federal agency, NIH or CDC for example. Another might be to recognize the ways in which corporate lobbyists corrupt our food system and do something about election campaign laws.

A pipe dream? Maybe, but I never thought I’d live to see the editors of the New York Times consider an article about USDA checkoff programs to be front-page news, and in the right-hand column yet, marking it as the most important news story of the day.
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Oct 27 2010

Eating Liberally asks Marion: Is stealth the way to healthy eating for kids?

Every now and then, Kerry Trueman tosses a “Let’s Ask Marion” question at me, and these are invariably a challenge.  Today’s: “Is stealth the way to healthy eating for kids?”

(With a click of her mouse, Eating Liberally’s Kerry Trueman, aka kat, corners Dr. Marion Nestle, NYU professor of nutrition and author of Feed Your Pet Right, Pet Food Politics, What to Eat, Food Politics, and Safe Food):

KT: NPR’s Morning Edition ran a story today about “stealth” strategies that some schools and researchers are employing to get kids to eat healthier foods–for example, by sneaking pureed vegetables into a line of cafeteria foods being marketed under the name “Hidden Healthies.”

But doesn’t this approach reinforce the perception kids have that vegetables taste lousy? David Just, co-director of the Cornell Center for Behavioral Economics in Child Nutrition, pointed out that “Taste is a suggestion more than anything else. If you think something is going to taste really good — if you’ve been told by others that it tastes good — you build that into your head when you eat it.”

A researcher who’s experimenting with enhanced cafeteria lighting to make healthy foods appear more appealing to kids told NPR, “We got to figure out some things so that the last thing in the world they know is that we’re trying to get them to eat well.”

We know that kids (and plenty of grown-ups!) turn up their noses at foods that are presented to them as healthy. Kids have also come to expect that their preferences should be catered to, which is why carrot and apple growers have begun packaging their products to resemble snack foods like potato chips.

In short, veggies have a serious pr problem. Do these strategies strike you as a good solution?

Dr. Nestle: Oh no! Not stealth again. I thought we were done with that in 2007 when we had to live through the plagiarism fight between Jessica Seinfeld’s Deceptively Delicious, and Missy Lapine’s Sneaky Chef, both of them pushing stealth strategies.

I remember being given hamburgers as a kid and how betrayed and condescended to I felt when they turned out to contain ground spinach—a vegetable I detested at the time but now think is terrific, especially when young and tender. Kids’ tastes do change, and should be encouraged in an honest way.

That is why I am so intrigued by the approach shown in the New York Times “Lunch Line Redesign” op-ed last week. Check out the way that Brian Wansink and his colleagues suggest redesigning lunch lines. These do nothing draconian or deceitful. Instead, they gently nudge kids to made healthier choices on their own.

How? By doing such things as putting salads near the cash register, using bowls instead of trays, and describing the foods more attractively. My favorite of these strategies is simply to ask the kids whether they would like a salad. All of these increase kids’ selection of healthier food choices.

But will the kids eat the foods? Of course they will. From my observations of school meals, the single most important indicator of whether the kids are eating healthfully is if the school food service people know their names and talk to them about what they are choosing. It helps a lot if the food tastes good, but kids respond to adults who care about what they eat.

When I hear parents say that the kids won’t eat anything healthy, I suspect that I’m talking to someone who isn’t willing to take adult responsibility for what kids eat and finds it easier to be stealthy than direct. Kids need to trust the adults in their lives and food should be used to instill trust, not destroy it.

This exchange appeared on the Huffington Post website on October 25 and elicited a response from Missy Chase Lapine, the original Sneaky Chef herself (reproduced with permission):

Dear Dr. Nestle,

I understand you had a bad experience with sneaky spinach as a child, but I respectfully disagree with your position that sneaking healthy food in kids’ meals is a bad idea. As the author of the Sneaky Chef cookbooks, I receive thousands of testimonials from parents to the contrary. They are thrilled that their kids are finally eating veggies–and most of the kids are in on the secret and love it.

The reason sneaking is needed is highlighted in the recent CDC report showing that all of the efforts and billions of dollars spent on nutrition education has failed. Everyone now knows that they SHOULD eat their veggies. The problem is HOW to get them to do it. Teaching alone is conclusively insufficient–we need to sneak and teach. They work hand in hand.

Sneaking veggies gives people an easy way to experience the benefits of eating veggies, yet lets them enjoy their favorite foods, like spaghetti and meatballs–-only now they’re loaded with spinach, broccoli, peas, wheat germ and cauliflower. This direct experience opens the door to learning.

Parents from around the world write me letters like this:

“Every time I use one of your healthy (and sneaky) tips or wonderful recipes, I just want to scream with joy because they eat it.” –Mindi B., TX

The bottom line is: combining “sneaking and teaching” works for everyone.

Respectfully,
Missy Chase Lapine, The Sneaky Chef

Not exactly everyone, if I may respectfully submit.  But I’m glad she wrote.  OK, readers: opinions, please!

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