No Purveyor of Unhealthy Products Wants the Public to Know the Truth

In 2011, Denmark introduced the world’s first tax on saturated fat. “After only 15 months, however, the fat tax was abolished,” due to massive pressure from farming and food company interests. “Public health advocates are weak in tackling the issues of corporate power…A well-used approach for alcohol, tobacco, and, more recently, food-related corporate interests is to shift the focus away from health. This involves reframing a fat or soft drinks tax as an issue of consumer rights and a debate over the role of the state in ‘nannying’ or restricting people’s choices.” I discuss this in my video The Food Industry Wants the Public Confused About Nutrition.

“The ‘Nanny State’ is a term that is usually used in a pejorative way to discourage governments from introducing legislation or regulation that might undermine the power or actions of industry or individuals…Public health advocacy work is regularly undermined by the ‘Nanny State’ phrase.” But those complaining about the governmental manipulation of people’s choices hypocritically tend to be fine with corporations doing the same thing. One could argue that “public health is being undermined by the ‘Nanny Industry’…[that] uses fear of government regulation to maintain its own dominance, to maintain its profits and to do so at a significant financial and social cost to the community and to public health.”

The tobacco industry offers the classic example, touting “personal responsibility,” which has a certain philosophical appeal. As long as people understand the risks, they should be free to do whatever they want with their bodies. Now, some argue that risk-taking affects others, but if you have the right to put your own life at risk, shouldn’t you have the right to aggrieve your parents, widow your spouse, and orphan your children? Then, there’s the social cost argument. People’s bad decisions can cost the society as a whole, whose tax dollars may have to care for them. “The independent, individualist motorcyclist, helmetless and free on the open road, becomes the most dependent of individuals in the spinal injury ward.”

But, for the sake of argument, let’s forget these spillover effects, the so-called externalities. If someone understands the hazards, shouldn’t they be able to do whatever they want? Well, “first, it assumes individuals can access accurate and balanced information relevant to their decisions…but deliberate industry interference has often created situations where consumers have access only to incomplete and inaccurate information…For decades, tobacco companies successfully suppressed or undermined scientific evidence of smoking’s dangers and down played the public health concerns to which this information gave rise.” Don’t worry your little head, said the nanny companies. “Analyses of documents…have revealed decades of deception and manipulation by the tobacco industry, and confirmed deliberate targeting of…children.” Indeed, it has “marketed and sold [its] lethal products with zeal…and without regard for the human tragedy….”

“The tobacco industry’s deliberate strategy of challenging scientific evidence undermines smokers’ ability to understand the harms smoking poses” and, as such, undermines the whole concept that smoking is a fully informed choice. “Tobacco companies have denied smokers truthful information…yet held smokers [accountable] for incurring diseases that will cause half of them to die prematurely. In contexts such as these, government intervention is vital to protect consumers from predatory industries….”

Is the food industry any different? “The public is bombarded with information and it is hard to tell which is true, which is false and which is merely exaggerated. Foods are sold without clarity about the nutritional content or harmful effects.” Remember how the food industry spent a billion dollars making sure the easy-to-understand traffic-light labeling system on food, which you can see at 4:26 in my video, never saw the light of day and was replaced by indecipherable labeling? That’s ten times more money than the drug industry spends on lobbying in the United States. It’s in the food industry’s interest to have the public confused about nutrition.

How confused are we about nutrition? “Head Start teachers are responsible for providing nutrition education to over 1 million low-income children annually…” When 181 Head Start teachers were put to the test, only about 4 out of the 181 answered at least four of the five nutrition knowledge questions correctly. Most, for example, could not correctly answer the question, “What has the most calories: protein, carbohydrate, or fat?” Not a single teacher could answer all five nutrition questions correctly. While they valued nutrition education, 54 percent “agreed that it was hard to know which nutrition information to believe,” and the food industry wants to keep it that way. A quarter of the teachers did not consume any fruits or vegetables the previous day, though half did have french fries and soda, and a quarter consumed fried meat the day before. Not surprisingly, 55 percent of the teachers were not just overweight but obese.

When even the teachers are confused, something must be done. No purveyor of unhealthy products wants the public to know the truth. “An interesting example comes from the US ‘Fairness Doctrine’ and the tobacco advertising experience of the 1960s. Before tobacco advertising was banned from television in the US, a court ruling in 1967 required that tobacco companies funded one health ad about smoking for every four tobacco TV advertisements they placed. Rather than face this corrective advertising, the tobacco industry took their own advertising off television.” They knew they couldn’t compete with the truth. Just “the threat of corrective advertising even on a one-to-four basis was sufficient to make the tobacco companies withdraw their own advertising.” They needed to keep the public in the dark.

The trans fat story is an excellent example of this. For more on that, see my videos Controversy Over the Trans Fat Ban and Banning Trans Fat in Processed Foods but Not Animal Fat.

Isn’t the Fairness Doctrine example amazing? Just goes to show how powerful the truth can be. If you want to support my efforts to spread evidence-based nutrition, you can donate to our 501c3 nonprofit here. You may also want to support Balanced, an ally organization NutritionFacts.org helped launch to put this evidence into practice.


More tobacco industry parallels can be found in Big Food Using the Tobacco Industry Playbook, American Medical Association Complicity with Big Tobacco, and How Smoking in 1959 Is Like Eating in 2016.

Want to know more about that saturated fat tax idea? See Would Taxing Unhealthy Foods Improve Public Health?.

Also check:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Crowding Out Strategy to Eating Healthier

It may be more expedient politically to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.

The World Health Organization has estimated that more than a million deaths “worldwide are linked to low fruit and vegetable consumption.” What can be done about it? I explore this in my video Is it Better to Advise More Plants or Less Junk?

There’s always appealing to vanity. A daily smoothie can give you a golden glow as well as a rosy glow, both of which have been shown to “enhance healthy appearance” in Caucasian, Asian, and African skin tones, as you can see at 0:24 in my video.

What about giving it away for free?

A free school fruit scheme was introduced in Norway for grades 1 through 10. Fruit consumption is so powerfully beneficial that if kids ate only an additional 2.5 grams of fruit a day, the program would pay for itself in terms of saving the country money. How much is 2.5 grams? The weight of half of a single grape. However, that cost-benefit analysis assumed this minuscule increased fruit consumption would be retained through life. It certainly seemed to work while the program was going on, with a large increase in pupils eating fruit, but what about a year after the free fruit program ended? The students were still eating more fruit. They were hooked! Three years later? Same thing. Three years after they had stopped getting free fruit, they were still eating about a third of a serving more, which, if sustained, is considerably more than necessary for the program to pay for itself.

There were also some happy side effects, including a positive spillover effect where not only the kids were eating more fruit, but their parents started eating more, too. And, although the “intention of these programs was not to reduce unhealthy snack intakes,” that’s exactly what appeared to happen: The fruit replaced some of the junk. Increasing healthy choices to crowd out the unhealthy ones may be more effective than just telling kids not to eat junk, which could actually backfire. Indeed, when you tell kids not to eat something, they may start to want it even more, as you can see at 2:20 in my video.

Which do you think worked better? Telling families to increase plants or decrease junk? Families were randomly assigned to one of two groups, either receiving encouragement to get at least two servings of fruits and veggies a day, with no mention of decreasing junk, or being encouraged to get their junk food intake to less than ten servings a week, with no mention of eating more fruits and veggies. What do you think happened? The Increase Fruit and Vegetable intervention just naturally “reduced high-fat/high-sugar intake,” whereas those in the Decrease Fat and Sugar group cut back on junk but didn’t magically start eating more fruits and vegetables.

This crowding out effect may not work on adults, though. As you can see at 3:12 in my video, in a cross-section of over a thousand adults in Los Angeles and Louisiana, those who ate five or more servings of fruits and veggies a day did not consume significantly less alcohol, soda, candy, cookies, or chips. “This finding suggests that unless the excessive consumption of salty snacks, cookies, candy, and sugar-sweetened beverages”—that is, junk—“is curtailed, other interventions…[may] have a limited impact….It may be politically more expedient to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.” In most public health campaigns, “messages have been direct and explicit: don’t smoke, don’t drink, and don’t take drugs.” In contrast, food campaigns have focused on eat healthy foods rather than cut out the crap. “Explicit messages against soda and low-nutrient [junk] foods are rare.”

In the United States, “if one-half of the U.S. population were to increase fruit and vegetable consumption by one serving each per day, an estimated 20,000 cancer cases might be avoided each year.” That’s 20,000 people who would not have gotten cancer had they been eating their fruits and veggies. The U.S. Department of Agriculture recommends we “fill half [our] plate with colorful fruits and vegetables,” but less than 10 percent of Americans hit the recommended daily target. Given this sorry state of affairs, should we even bother telling people to strive for “5 a day,” or might just saying “get one more serving than you usually do” end up working better? Researchers thought that “the more realistic ‘just 1 more’ goal would be more effective than the very ambitious ‘5 a day’ goal,” but they were wrong.

As you can see at 4:56 in my video, those told to eat one more a day for a week, ate about one more a day for a week, and those told to eat five a day for a week did just that, eating five a day for a week. But here’s the critical piece: One week after the experiment was over, the group who had been told to eat “5 a day” was still eating about a serving more, whereas the “just 1 more” group went back to their miserable baseline. So, more ambitious eating goals may be more motivating. Perhaps this is why “in the US ‘5 a day’ was replaced by the ‘Fruits and Veggies—More Matters’ campaign…in which a daily consumption of 7–13 servings of fruits and vegetables – FVs –  is recommended.” However, if the recommendation is too challenging, people may just give up. So, instead of just sticking with the science, policy makers evidently need to ask themselves questions like “How many servings are regarded as threatening?”


For more on appealing to vanity to improve fruit and vegetable consumption, see my videos Eating Better to Look Better and Beauty Is More Than Skin Deep.

What does the science say about smoothies? See:

The flipside of free fruit programs is to tax instead of subsidize. Learn more by checking out my video Would Taxing Unhealthy Foods Improve Public Health?

For more on the paternalistic attitude that you don’t care enough about your health to be told the truth, see my videos Everything in Moderation? Even Heart Disease? and Optimal Diet: Just Give It to Me Straight, Doc.

I explore this same patronizing attitude when it comes to physical activity in How Much Should You Exercise?

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Does Aspartame Cause Lymphoma?

The approval of aspartame has a controversial history. The Commissioner of the U.S. Food and Drug Administration (FDA) concluded that “there is a reasonable certainty that human consumption of aspartame: (1) …will not pose a risk of brain damage resulting in mental retardation, endocrine [hormonal] dysfunction, or both; and (2) will not cause brain tumors.” However, the FDA’s own Public Board of Inquiry withdrew their approval over cancer concerns. “Further, several FDA scientists advised against the approval of aspartame, citing…[the aspartame company’s] own brain tumor tests…” Regardless, the Commissioner approved aspartame before he left the FDA and went on to enjoy a thousand-dollar-a-day consultancy position with the aspartame company’s PR firm. Then, the FDA actually prevented the National Toxicology Program (NTP) from doing further cancer testing. As I discuss in my video Does Aspartame Cause Cancer? we were then left with people battling over different rodent studies, some of which showed increased cancer risk, while others didn’t.

This reminds me of the saccharin story. That artificial sweetener caused bladder cancer in rats but not mice, leaving us “to determine whether humans are like the rat or like the mouse.” Clearly, we had to put the aspartame question to the test in people, but the longest human safety study lasted only 18 weeks. We needed better human data.

Since the largest rat study highlighted lymphomas and leukemias, the NIH-AARP study tracked blood cancer diagnoses and found that “[h]igher levels of aspartame intake were not associated with the risk of…cancer.” Although the NIH-AARP study was massive, it was criticized for only evaluating relatively short-term exposure. Indeed, people were only studied for five years, which is certainly better than 18 weeks, but how about 18 years?

All eyes turned to Harvard, where researchers had started following the health and diets of medical professionals before aspartame had even entered the market. “In the most comprehensive long-term [population] study…to evaluate the association between aspartame intake and cancer risk in humans,” they found a “positive association between diet soda and total aspartame intake and risks of [non-Hodgkin’s lymphoma] and multiple myeloma in men and leukemia in both men and women,” as you can see at 2:12 in my video. Why more cancer in men than women? A similar result was found for pancreatic cancer and diet soda, but not soda in general. In fact, the only sugar tied to pancreatic cancer risk was the milk sugar, lactose. The male/female discrepancy could have simply been a statistical fluke, but the researchers decided to dig a little deeper.

Aspartame is broken down into methanol, which is turned into formaldehyde, “a documented human carcinogen,” by the enzyme alcohol dehydrogenase.The same enzyme that detoxifies regular alcohol is the very same enzyme that converts methanol to formaldehyde. Is it possible men just have higher levels of this enzyme than women? Yes, which is why women get higher blood alcohol levels than men drinking the same amount of alcohol. If you look at liver samples from men and women, you can see significantly greater enzyme activity in the men, so perhaps the higher conversion rates from aspartame to formaldehyde explain the increased cancer risk in men? How do we test this?

Ethanol—regular alcohol—competes with methanol for this same enzyme’s attention. In fact, regular alcohol is actually “used as an antidote for methanol poisoning.” So, if this formaldehyde theory is correct, men who don’t drink alcohol or drink very little may have higher formaldehyde conversion rates from aspartame. And, indeed, consistent with this line of reasoning, the men who drank the least amounts of alcohol appeared to have the greatest cancer risk from aspartame.

A third cohort study has since been published and found no increased lymphoma risk associated with diet soda during a ten-year follow-up period. So, no risk was detected in the 18-week study, the 5-year study, or the 10-year study—only in the 18-year study. What should we make of all this?

Some have called for a re-evaluation of the safety of aspartame. The horse is kind of out of the barn at this point with 34 million pounds of aspartame produced annually, but that doesn’t mean we have to eat it, especially, perhaps, pregnant women and children.


For more information on the effects of aspartame, watch my videos Aspartame and the Brain and Aspartame-Induced Fibromyalgia. Interested in learning more about the effects of consuming diet soda? See, for example:

What about Splenda? Or monk fruit sweetener? I have videos on those, too—watch Effect of Sucralose (Splenda) on the Microbiome and Is Monk Fruit Sweetener Safe?.

I also do a comparison of the most popular sweeteners on the market, including stevia and xylitol, in my video A Harmless Artificial Sweetener.

Perhaps the best candidate is erythritol, which you can learn about in my video Erythritol May Be a Sweet Antioxidant. That said, it’s probably better if we get away from all intense sweeteners, artificial or not. See my video Unsweetening the Diet for more on this.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: