I almost had a conversation on Wednesday on MSNBC's Morning Joe program with Michael Moss, the New York Times journalist whose work on addictive junk food graced the cover of the paper's magazine this week. Alas, at the time Michael did the segment without me, I was still in the back of a limo, stuck in horrible traffic approaching the Triborough Bridge, and muttering unrepeatable things under my breath. I once missed Anderson Cooper's show under similar circumstances (dreadful weather, awful traffic), and I'm quite sure the effects on my blood pressure are very bad for my health. Oh, well.
Had I gone on, I would first and foremost have told Mr. Moss that his work in general, and this week's piece in particular, is truly outstanding, blending incisive journalism with cogent writing. Of course, Michael has no need to hear this from me -- his work has been recognized with a Pulitzer Prize. But I would have said it just the same.
And with the platitudes out of the way, it would have been time for substance.
Michael's exposé this week reveals that academic debate about whether or not food is addictive is at best a sideshow, and at worst a boondoggle. Large food companies know full well that food can be, in all the ways that matter, addictive -- and engage experts in everything from biochemistry and neuroscience to mathematical modeling to make it so. When they tell us "betcha' can't eat just one," they've done their homework, and know full well they can take it to the bank.
Nor is Mr. Moss the first to drag such trade secrets from boardroom shadows to the bright glare of investigative journalism. A four-part exposé in the Chicago Tribune that ran from late 2005 into early 2006 revealed similarly unsettling insights. That team, referencing documents subpoenaed from the Philip Morris Company, described food and tobacco industry scientists collaborating in the use of functional MRI scans to determine what flavor combinations (in food and in cigarettes) would prove most irresistible. I have always been surprised there was no national outrage when that series ran; perhaps we weren't quite ready to get the memo. We seem more ready now.
Michael's piece this week runs to nearly 10,000 words, so I refer you to the article itself for all the rich detail. The full read is something of an investment, but the return makes it very worthwhile. For those wanting to put more in and get more out, I recommend the book from which the current article was excerpted, as well as a brand-new book by another investigative journalist, Melanie Warner, entitled Pandora's Lunchbox. It seems the day of dietary truths has arrived!
My errand here limits me to highlights, but I do want to call out one in particular.
There is a reference in Mr. Moss' article to a phenomenon called "sensory-specific satiety." The term isn't widely known, but the experience certainly is. In one direction, sensory-specific satiety accounts for such aphorisms as "variety is the spice of life," and "what -- meatloaf again?" We like variety, and not just attitudinally. The appetite center in our hypothalamus is hard-wired to reward us when we consume a variety of foods with a variety of flavors. When we keep eating the same thing, it expresses its bored disappointment by signaling to us that we've had enough.
Sensory-specific satiety is why virtually no one tends to binge on simple, wholesome foods. It is why everyone overeats at an all-you-can-eat buffet. It -- and not a hollow leg or extra stomach -- is why everyone still has room for dessert at the end of a holiday feast, and immediately after saying, "I couldn't eat another bite..."
But Mr. Moss indicates that sensory-specific satiety, in the hands of the experts, is just so much more grist for the mill that churns out addictive junk food. While single, salient flavors that tend to characterize simple foods direct from nature help turn our appetite off, complex flavor combinations can be engineered into foods to do just the opposite. In Mr. Moss' words:
This contradiction is known as "sensory-specific satiety." In lay terms, it is the tendency for big, distinct flavors to overwhelm the brain, which responds by depressing your desire to have more. Sensory-specific satiety also became a guiding principle for the processed-food industry. The biggest hits -- be they Coca-Cola or Doritos -- owe their success to complex formulas that pique the taste buds enough to be alluring but don't have a distinct, overriding single flavor that tells the brain to stop eating.
The food industry brings in serious muscle to bully us into eating too much of all the wrong things, while someone counts the cash. Any conversation about personal responsibility* or public policy that fails to acknowledge this reality is either disingenuous, or uninformed. We have not a shred of evidence that the average, loving, busy parent of today is intrinsically less responsible than the average, loving, busy parent of yesterday. Yet that parent of today is far more likely to be obese and/or diabetic, and to have children who are obese and at risk for diabetes -- and Mr. Moss and others are telling us a good deal about where the responsibility lies.
The time-honored food industry response to all of this is: We are just trying to keep the customer satisfied! Yes, guilty as charged: We make food people like to eat. The problem with that self-serving defense of the status quo is that people like to eat the foods they know. If foods engineered to be addictive, or nearly so, prevail, then we habituate to them. If we eat ever more salt and ever more sugar, we need ever more to be satisfied. If we eat foods enhanced with mathematically-determined flavor combinations and artificial flavor enhancers often enough, our taste buds acclimate to them, and come to prefer them. The food industry all too often pretends it is merely satisfying the prevailing demand. The reality is: They created it, and not by accident.
So we are, indeed, being bullied. What to do?
We can, in fact, defend our own bodies -- and in some ways, doing so is very simple -- even though it may not be easy. Some of the best advice in this regard is courtesy of one of Mr. Moss' predecessors as New York Times Magazine cover story author, Michael Pollan. In his 2007 piece entitled "Unhappy Meals," Pollan distilled a 13,000-word manifesto into these memorable seven: "Eat food. Not too much. Mostly plants."
In some of his writing since, Pollan has told us comparably sage and pithy things, such as: If you are not hungry enough to eat an apple, you aren't hungry. And -- if your grandparents wouldn't recognize it as a food, it's not food!
There is a lot of actionable counsel here. We all do exercise the power of choice -- we are bullied, but not helpless. And if we pick natural foods, they preclude food industry mischief. It doesn't matter how clever a food scientist is -- she can't do much to adulterate that apple, or broccoli, or blueberries, or walnuts direct from nature. There are no harmful additives in true foods to which nothing has been added.
I would then presume to append my own version of pithy wisdom to Michael Pollan's: Taste buds are malleable little fellas. When they can't be with the foods they love, they pretty readily learn to love the food they're with.
This is not idle opinion -- it's an established fact of both observational epidemiology and intervention trials. In the Ni-Ho-San study, for instance, Japanese changed their diets -- and dietary preferences -- as they emigrated from Japan to Hawaii, and the mainland U.S. Genes and taste buds didn't change, but taste preferences did -- in accord with the prevailing cultural norms. Fortunately, interventions like the Iowa Women's Health Study show the process works just as well in reverse -- people can learn to prefer healthful, wholesome foods. You can, in essence, rehabilitate your taste buds.
And once you do, the food industry manipulations become easy to resist. I have not had a soda in literal decades, and not because I'm an ascetic fanatic. I hate soft drinks. Both sugar- and artificially-sweetened varieties are sickeningly sweet to my taste buds. Many popular breakfast cereals are overtly salty. And so on.
Does this make me virtuous? No! This is not about morality -- it's about a balance of will-power (I have my share, but not more) and skill power (this is my field of expertise, so I have more than most). Eating well in the modern world requires a commitment to trying, and then a set of skills to get there from here. Most people have the first, few have the second.
For example, Mr. Moss points out in his article that pasta sauce is often a concentrated source of added sugar. If you didn't know that, it would probably never even occur to you to look out for sugar in your pasta sauce. But by eating sugar-laden pasta sauce, you are in fact propagating the very same sweet tooth that makes you want to drink soda, or have that extra helping of dessert. I noted this same thing in a book I wrote some years back, devoted entirely to the importance of sensory-specific satiety.
That book (a bit too gimmicky due to pop culture pressures, but all of the fundamentals are completely valid, and the recipes, courtesy of my wife, are excellent) details how to simplify snacks, meals, and even food choices such as pasta sauce to avoid the food industry's additions of stealth sugar, salt, and so on. I have since devoted years of effort to nutrition guidance systems for supermarkets and schools, all intended to empower the easy identification of those better choices. Make better choices for a while, and you come to prefer them. It's not about a choice between food that's good, or health that's good -- it's about coming to love the food that loves you back. My family and I live there -- you could, too.
And while the elements in the food industry profiled by Mr. Moss make it harder than it should be, others can help. There is a true food coalition out there, made up mostly of relatively small companies committed to doing all the right things -- such as Nature's Path, Kind, and a start-up called Wholesome Goodness, for which I serve as an advisor.
But for now, such companies are the exception rather than the rule. Should you really have to work so hard to have wholesome, non-addictive foods populate your grocery cart or kitchen table? I don't think so. And this is where the body politic comes in.
The principal argument against regulation and public policy related to our food choices derives from libertarianism: We are autonomous adults, and don't want to be told what to have for breakfast! Right we are, except that we are being told what to have for breakfast, lunch, and dinner -- just not by elected officials accountable to us. We are being manipulated by the willful machinations of big companies accountable only to shareholders. We might all benefit from chewing on the real implications of autonomy, as we sip a gallon-sized something designed to be addictive, and pause to take our medication and check our blood glucose.
For now, we may hope that knowledge is power. Part of a proud tradition that includes Michael Pollan, Melanie Warner, David Kessler, Brian Wansink, and many others -- Michael Moss has given us eye-opening knowledge. In a context of both will for better health, and the skills to help us get there -- we can and should use it to defend our bodies.
But there is a case to be made that the ultimate defense of the human body resides largely with the body politic. And that body, too, could commit to better health. We may need to change our food demand to get a better food supply; but we need a better food supply to help us find our way back to true foods, through the briars and brambles of willfully addictive junk. There is a win/win opportunity if we can share that taste -- for much-needed change.
*Please see entries in the "Personal Responsibility for Health Chronicles" at http://www.huffingtonpost.com/david-katz-md/
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