The Leading Voices in Food: Recent Episodes

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Today we're talking with Kevin Hoban and Jordie Simkovic, the creators and starring characters of Captain & Cat, a popular YouTube kids show with 200,000 subscribers and over 200 million views. The educational show for preschoolers tells stories using entertaining songs and narratives. They've just launched a new series called Explorasaurus: Healthy Food and You, aimed at teaching kids about healthy food and how it's grown. Their first episode about SugarBee apple growers in Washington State has over 500,000 views on YouTube.

Interview Summary

So, for people who aren't familiar with your show, for those few people out there who may not be, tell us about Captain & Cat, the characters, what they do, and how did you guys get started doing this?

Kevin - Gotcha. Well, Jordan and I have been best friends since college. We went to Northwestern University in Chicago, and we were in a band together. We would perform live on campus, in the streets. And we realized that kids would stop and really enjoyed what we were doing. And I think that was the seed of the whole thing was, "Hey, maybe our act that we have, this two-man show is something for kids." And then we graduated. We both moved out to LA. Jordan came out here to act. I moved out here to produce TV shows, and on the weekends, we started performing for kids.

Jordie - Yeah. Actually, we did a show called The Bubble Show. And we were doing probably six to eight shows a weekend for about 10 years. And then during the pandemic we started putting our stuff online because all live performances stopped. And for about three years it was nothing and crickets, and really just our parents watching. And then we won the award for best kid song of the year in 2023. And then that kinda put us on the radar of YouTube Kids who invited us to be one of the featured channels on their platform. And for a while we were doing jingles and music and educational songs and stuff like that. And then towards the end of last summer, we had connected with SugarBee Apples and that whole kind of growing cooperative out there about doing an apple song. And they actually were like, "You know what would be even cooler than that? Why don't you come out here and meet the farmers and see the harvest in action?" And we're like, "Whoa, this is really cool." And honestly, it was a life-changing experience. We now say that we have aunts, uncles, and cousins out in Central Washington. And honestly, I grew up in Miami, I went to college in Chicago, and then I've lived in Los Angeles ever since. I had never stepped foot on a farm, really, in any significant way. And just to be able to get exposure to this incredible pocket of people that otherwise I would have never had a chance to see and meet was completely eye-opening.

Kevin - I would say I went out there thinking, "This is a huge apple company. They sell them all across the country in every grocery store." I went out there thinking, "Well, this is sort of like a big industrial corporate farm," right? Must be just one giant farm with robots harvesting apples. And what we found was it was a co-op of family-owned farms. Smaller families. We met the families. We met the grandparents, the parents, the kids, the grandkids. And we learned so much about apples and how you grow them. That every apple is picked by hand, first and foremost.

Jordie - We honestly expected there was going to be like a machine just going around and shaking the apples off, you know. Because you have no idea. And there's been so much dialogue around factory farming, which has become kind of like the negative word. And honestly, yeah, as Kevin was saying, we expected just a giant faceless corporation there. And it was the exact opposite.

Can I ask you guys a question? I'd like to dive in a little deeper than this, because you're saying something that resonates with me very personally. When I moved to North Carolina from Connecticut, I was offered the opportunity through the North Carolina Farm Bureau to do a tour of farms. Two-day intensive tour of farms in Eastern North Carolina. And we went to a blueberry farm that harvests millions of pounds of blueberries a year. Soybeans, corn, hog farmers, chicken. I mean, we did everything. And it was incredibly interesting. And there was the technology part of it, or the lack of technology that I was learning about, just as you related. But there was also a very moving human part of this. The people, I thought, were really interesting. And the generational nature of farming and all. So, tell me a little bit more about the people part of it. How much that affected you.

Jordie - We met the farmer who like seven generations back, their family introduced the Granny Smith apple to the United States, you know? It's going back and we literally see it's a whole family working and living very close to where they farm. And so, kind of just, it's Uncle Farmer Peoples now, you know? And so, we were kinda talking to him about chemicals and pesticides and stuff like that off the record because we're like, "All right, so now tell us how much you spraying on these?" He's like, "Why would I ever do anything destructive to this land? This is where my family and I live."

Kevin - Yeah. And I think you also picked up on the pressure that these farmers feel to carry on the farm itself. It's been in their family for generations. They need to keep it running. And all of the pressures and anxieties that come with that just to keep this farm afloat. Because again, it's not some huge corporation, it's a family farm that's part of this co-op of other family farms. And they've all kind of banded together to pool their resources to keep everything going, which is just a wonderful... It's a wonderful lesson, I think. These farms rely on people working together day in and day out for their own collective good.

Jordie - The guy who runs the packaging facility is the brother-in-law of one of the growers. So, we thought that they were pranking us, because literally every car that drove by, they're like, "Oh, that's my brother-in-law. Oh, that's my aunt. That's my niece," in this little town right off Lake Chelan. And you really see the impact. We actually were just there last week again to film a new segment about apple blossoms and pollination and stuff like that. And one of the coolest experiences we had there was we went to an elementary school. One of the families in the co-op had donated shoes to a lot of the kids in the elementary school, and we helped go distribute them there. It's honestly so cool to see that the same way that LA is built around the film industry, there they're literally built around the apple and cherry industry, and pears. Ever since we went there, I off-camera would not, you would not catch me eating anything other than a SugarBee. And that's the truth.

You know, so interesting to hear you talk about this and your experience with the apple production facility and the people being related to one another. It's exactly what I found on a sweet potato farm here. North Carolina's the largest producer of sweet potatoes, and I visited a very large farm owned by a man and his daughter. I mean, they really ran this business. And they were farmers at their heart, but this was $100 million a year business. And they're looking at international trade markets and deciding when to release the sweet potato. I mean highly sophisticated financial decisions they were making. But at the end of the day, they were related to their land, and that's what this was all about. I mean, to say it was a spiritual relationship doesn't... I don't know what word captures it. But it was something very special in that sometimes you think about farmers exploiting the land, and that happens with the big factory farms. But in these cases, you find farmers want to be at peace with their land. And I heard it many times, that they wanted to turn the land over in better condition to their children than it was turned over to them. It's obvious from affectively and emotionally the way you're talking about it and the way I'm talking about it, something very special is occurring here. How do you communicate that in a video, especially to children?

Kevin - Well, I think for us, we always lead with the enthusiasm that we have, but then also trying to tease out the enthusiasm that the farmers have themselves. Because some of them are not used to being on camera, and certainly not on a YouTube Kids show. But once we ask the right questions and probe a little bit of, for an example, we just shot with them last week. And we asked for students that we work with around the country to submit questions. And one of the questions was, "Does the farmer talk to his apples?" And we asked one of the farmers that, and he lit up, and you just saw all the sudden that passion that he really does have for his apples. And I think the more that we can bring that out of the farmers, show kids and families how passionate and excited they are about the fruit, that hopefully that will get the kids excited as well.

You can imagine the farmer talking to an apple when it's falls from 30 feet on his head.

Jordie - They're pretty sturdy up there, honestly. And I think another way to kinda communicate the care is to show how much work goes into it. Because literally, this was informative for us just because going from the blossoms, they go through and prune by hand. And hand select it because there are so many variables involved. And what we found is the confluence of this incredible intergenerational wisdom and technique and craft that has been passed down and honed. Also, kind of meeting within the packaging facility. The technology there is honestly mind-blowing. And I think it's only getting more and more advanced.

We shot an episode at a dairy farm. And one of the farms we visited recently had AI milkers - AI robotic milkers. And we're like, "Oh, does this make it so that the cows have a different and negative relationship with you since they're used to robots?" And they're like, "Actually, it's the exact opposite. Now, they're much friendlier with us because they know that we're not coming to do anything, you know. We're not coming to milk them." It's incredible to see. And I recommend everybody getting a chance to go visit a farm and see where their food is made, because it changes your relationship with how you eat, I think.

You know, I can see why your offerings to children and their parents would be so popular. Because you guys have this neat sense of wonder. You know, you learn, you're out there, you're meeting interesting people, and these interactions sound like they mean the world to you. And of course, the wonder is something amazing that children have naturally. And if that can keep invigorated for as many years as possible, hooray.

Kevin - Yeah. You asked earlier whether you should refer to us as Captain and Cat or Kevin and Jordan. And I think the truth is they've become one in the same. I mean, when we go out there and we film these episodes. Sure, we're in costumes and we're wearing bright colors. But for the most part it's just us, Kevin and Jordan. They're excited to learn about whatever we're talking about or talking to. And there is a natural curiosity that I think we both have. We're not acting, we're not faking it. To go to these farms and see, down one row of apples they're harvesting hundreds of thousands of apples. And they've got to get it done within a matter of weeks. You don't have to pretend, that's just impressive. Yeah. That is just impressive to us.

Jordie - And the world is cool out there, honestly. I don't put on anything. We actually pride ourselves on not talking to kids in a silly voice. I talk in our episodes exactly the way I'm talking now. We don't dumb down our content, and we love having kind of complex words and complex ideas, which we then take upon ourselves to translate into simile that helps our audience understand. You know? We're processing all this in real time. And Kevin and I come from an educational background. I'm a teacher at heart, and I've always have been. And it's just amazing to be able to receive and absorb this information, and at the same time relate it to an audience that we believe will catch up with us if we use the right words.

Tell me how you remain optimistic. So, let's talk about kids and food. The average child is exposed to tens of thousands of messages over a period of time that are mainly for unhealthy food. They're being given food in schools and elsewhere that is engineered to hijack the brain chemistry to keep them coming back for more. You know, Tony the Tiger is not on plain cornflakes, and the Trix Rabbit is not on an unsugared cereal. And you can go on and on. They're obviously exposed to a very tough environment. Are you optimistic that can get turned around?

Kevin - I'm optimistic just based on what we've seen with what we're doing with healthy foods and produce. I think we are trying to, in some sense, be the Tony Tiger of apples, right? We want to be there going, "Hey, apples are really exciting because they're healthy, and they're good for you, and they're sweet." And if we can get kids excited about it, we feel like we've done our part. And what we've seen by this classroom program, we're working with classrooms around the country where we're sending in our content, but we're also sending apples with the help of SugarBee. And then the kids and the teachers have been filming videos and sending it to us about how excited they are to eat apples. And I think kids are wonderful. I have two of them of my own. And they will get excited about what you get excited about as an adult. If you say, "Apples are the coolest, most fun thing I've seen," they get excited about it, too. And they wanna learn, and they wanna share, and they wanna talk about it.

Jordie - There's also a really cool, I think, trend that's happening within the produce industry which we've noticed. And we've noticed that since we've gotten in, which is that it's not enough to just be on the shelf anymore. You want to have a branding, and you want to have a logo, and you want to have a messaging, and you want to have connotations around your brand. And I think produce companies are starting to catch up and use a lot of the same marketing tactics and strategies that kinda junk food was using for a long time. And you know what I always say? It's this. If you actually take the time to bite into an apple and really enjoy it, there's nothing sweeter and more nuanced, in my opinion, than that. I think the more we can change the relationship with how and when we eat, the more we'll start to appreciate food that's of a different quality. And I think bringing attention to that, we're obviously swinging since probably the 1950s, maybe even earlier than that, in terms of just mindless, quick-to-go eating. But I think you see that we're changing the way that we think about how and when we eat. And I think that will favor the swing back towards it. And that's why, honestly, I think we're just optimistic people no matter what. If we went out there and did a despairing series about healthy foods, then that's not going to work, you know? But we love what we do, and we really believe in it, so that's our cause for hope.

You mentioned interacting with classrooms. So, you could just post your material out there and not get involved with actual children and actual classrooms. Why the decision to do that? And tell us how that works. How do you interact with classrooms, and are teachers responsive? What kind of reaction are you getting?

Kevin - Well, this actually came out of a conversation we had with the people at SugarBee. They said, " We would love to get into classrooms to teach kids about healthy foods. We've been asked before to send our apples to classrooms, but we just don't know what to do or how to do that necessarily." And so, we took it upon ourselves to start reaching out to teachers one by one on email, Instagram, TikTok, and say, "Hey, we have this healthy food episode. And we're going to create a worksheet for kids, so they learn how apples are grown. And SugarBee has generously said that they will send a bag of apples to every classroom that wants to be participate in this." And we didn't know how teachers were going to react, if they had the time for that or interest, and the response was overwhelmingly, "Yes, please, and thank you." I think teachers are looking for new lesson plans, interactive lesson plans, and obviously want to encourage kids to be eating healthy. And the fact that we can facilitate this to hundreds of classrooms around the country, it was a win for all sides really. And then we didn't ever ask anybody to film anything or post anything on social media. That's not part of the program. But they took it upon themselves to film videos of either the teachers or the kids thanking us. Thanking Sugarbee for doing this. It was more rewarding than I think we even realized going into this.

Jordie - There have been people who reached out to us and got back to us, and they're like, "We just want you to know somebody's offering us a scam of free apples using your name." And we're like, "Actually, that's not a scam. That's a real thing." And I think we all see a huge opportunity. And one of our guiding philosophies and what we've realized is this: at home, you're very set in your ways, and you've created your habits around eating. And it's very hard at that point to disrupt it because at home, you're rebelling against your parents, you're set in your ways, you're not willing to try anything. And that becomes a position or in a place where you kinda dig your heels into the ground and say, "This is what I like, and that's it." But in school, we found that everybody is so open to trying new things. I remember growing up, I would just, anything that they'd put out at snack for me, I would eat. And, because it was a nice break from being in school, you know? And we think that hitting them in this environment is actually much more effective even than hitting them at home with this. And if we're looking to create lasting habits and changing the narrative around these healthy foods. The last thing we want to do is make it feel like you should eat this. Because the second someone tells you what you should do, that becomes the last thing in the world you want to do.

Can you give us a peek at what kind of foods you might be wanting to take on next?

Kevin - Ooh, spoilers. Yeah, we got some cool ones. We just released an episode this month about Sunkist mandarins. We went to Mandarin Farms in Central California. Same thing, we filmed with the farmers. It's also a co-op, all family farms. We went to the processing plant where they wash the mandarins and sort them and bag them and ship them. And so those mandarins are going to go out to classrooms in the next couple of weeks, and then we've got some really fun stuff planned. So basically, our goal with this is honestly to create a healthy food/product of the month club that we would send into participating schools. It's going to be very, very seasonal because we kind of want to create that sense of it. And luckily, we've got a lot of different brands signed on already. Our summer is looking pretty busy, which is a blessing for us. And really a blessing for the kids that we hope will be learning about this and receiving new foods.

It's not too hard to get kids to like the idea of eating something sweet like an apple or mandarins. What about things like broccoli and cauliflower and Brussels sprouts and asparagus? Will you turn your attention to those at some point?

Kevin - Absolutely. Yeah.

Jordie - Absolutely.

Kevin - We're up for the challenge. I know from my own experience with my five-year-old, if you dip anything in ranch, they'll like it.

Or, or do a deep fry it. Or deep fry it.

Jordie - Right? But it's a pairing issue, you know what I mean? And it's a context issue. So, it's the way you eat it. So raw broccoli is probably not your gateway broccoli. You know what I mean? Right. But you can always find different ways, whether or not it's incorporating it into a smoothie, incorporating it into a sandwich, or anything like that. It's kind of a gateway thing. And there's also a cool thing we're doing. So, for example, we are talking to a potato company. We don't want teachers to have to go home and make mashed potatoes, right? Because that's a barrier to entry, and that's kind of a pain. But what we found is a little workaround with a few of these is like, oh, there's an opportunity to send potatoes into classrooms and have them grow their own potato and get a sense of how it goes. It's not only about trying the food, because honestly, nothing has given me more appreciation for blackberries than trying to grow blackberries myself. You know? And so being part of the process and realizing, wow, the stuff that we're getting is remarkable. And remarkably effective and really delicious and gigantic, and the quantity of it is mind-blowing. So just there's so many different angles that we're getting kids into the idea of farming. And getting their hands dirty, and that's stuff that I feel like is really, really missing from modern society.

Your messaging is focusing on how delicious these foods can be, how interesting their story is, who grew them, where it came from, and things like that. Is part of the messaging what these foods do for you? That mean that they can make you run faster, jump higher, whatever. I mean, is there a functional part of what you're trying to communicate?

Kevin - Yes, absolutely. We try to say it gives you superpowers. And then with each food that we're working with, we do get into the science and try to present it in a way that's appropriate for young kids. But getting into even what flavonoids are in an apple, we just did a whole segment of that and all the nutritious benefits. We've partnered with nutritionists. We were just filming with one in Washington to try to expose kids to the ideas that there are, inside of an apple, all of these natural vitamins and things that can help them. And we've even been doing fiber. Now, trying to present fiber in a way that ... doesn't say poop.

Jordie - But we've started saying poop on our show, by the way. We're like, "You know what? We can say it as long as it's an academic context," you know?

Kevin - Yeah. Yes, exactly. We find the way to toe the line, and quite honestly, kids will lean in if they hear something that makes them giggle a little bit. But understanding, I mean, even for me as a grown adult, understanding that apples are a good way to clean out your digestive system. That fiber is good for that. It's even a good reminder for me at my age to be like, "Oh, yeah." If I'm feeling a little bit of indigestion, maybe I need some more fiber.

Jordie - And a cool thing we also did on our Sunkist episode, Captain and I actually dressed up as these ridiculous California surfer bro characters named Sonny Sunkist and Manny Mandarin, and the idea was that we were talking about why it's a perfect snack for surfing. But at the same time, we're also giving kind of the sugar pill treatment, which is like we're doing these ridiculous characters, but at the same time we're actually providing information about why they're so healthy for you. We're doing one about whey where Kevin and I are gonna go and hijack a LA Fitness and as these muscle bros and talk about why whey protein is so rich in protein and calcium and stuff like that. We're always evolving, and each episode ends up being different. But the one thing that we've found is like the story that we can tell of these is really infinite.

And will there be any part of your messaging that will talk about foods kids might eat less of? I mean, you're focusing very positively and optimistically, so the answer to this could very well be no, because it just becomes complicated. But you've got lots of kids eating sugared cereals and drinking sugared beverages and things like that. I'm just wondering if that's part of the picture. It needn't be, but I'm wondering if it is.

Kevin - I think up until now our thought has been if we can try to get them equally or more excited about the healthy options. Hopefully that's enough to sway them in that direction. And honestly, as a parent, I think just giving kids the idea of getting excited about produce, that they go home to their parents and then maybe the parents' job is just a little bit easier. Because I'm faced with that every day when my daughter says she wants a snack, and she wants candy, and I'm trying to say, "No, how about this apple over here?" If we can be on Team Apple, you know, if we can be the helper to the parents that's encouraging the kids to eat a little healthier, I think that we've done our job there.

Jordie - I think it's never about us wanting to disparage or discourage or make anybody feel bad about their habits, because I think a lot of the problem around our eating habits in this country is that there's a lot of shame involved in it. And you're not only getting a dose of those unhealthy foods that kind of give a quick release of dopamine or whatever. It tricks your body into thinking it's also you're getting a little dose of that shame. And the last thing we ever want to do is to turn into police, you know, and policing each other. Nobody wants to take advice from the police, you know? And nobody wants to feel disparaged or talked down to. It's interesting. We never really kinda thought about it, and obviously we just want to keep it an entertaining and enticing picture rather than any sort of daunting... because when you get into the facts of some of those unhealthy foods, it can really seem a little bleak.

And it is. Well, and making foods seem like fun and having] interesting characters associated with them is something the food industry has done successfully forever. It makes perfect sense to do that, but attach these things to the healthy choices.

Kevin - Let's use their tricks for good. Lord knows we're steeped in them, you know?

Jordie - Yeah. Let's wield that as a cause and weapon for good. I think that's what

we're trying to do.

Kevin - We've also been learning about the history, a little bit, of produce, of the produce business, and how for so long these companies looked at their products as commodities, right? It wasn't necessarily SugarBee apple, it was, "We're a company that sells apples. We're trying to be in as many grocery stores as you can." Which I understand. That makes sense. But I think what probably was lost in the process was if you're just a commodity and every apple is just a different Red Delicious or Golden Delicious. You're losing that opportunity to put a fun character behind it. And I think you're seeing now a lot more of these even different produce companies coming together. Like avocados from Mexico. I think is a great example that you see a lot more of their branding and their advertising where all of these avocado growers are coming together and saying " let's just market avocados. Let's get people excited about the food itself."

Jordie - I think there's also going to be an interesting trend away from going to physical grocery stores that will only continue in the future. So I think if we're ordering online from let's say a whatever warehouse, Amazon warehouse, right? And they have 20 different apples there, it's really important to have brand loyalty. And that becomes things that they're having to consider now. And we just happened to release this series at a really nice time, which they're all trying to do that. Because probably 10 years ago they would've been like, "We don't listen to apples. They sell themselves." You know? But now you're dealing with so much competition and so much branding and so many name things that It can be overwhelming. And at a certain point you might just disconnect unless you know what you're looking for.

What I found that historically is that the people selling these foods were pretty splintered. There would be a plum association and an apple association and a pear association. And, they're loosely grouped into a broader produce organization and things like that. But those organizations tend to not to be very well-funded or have a lot of clout because they were so splintered. I wonder if that's beginning to change. Do you see any evidence that the industry as a whole is beginning to unite effectively?

Kevin - It's funny. Just on Instagram alone, there are, like, places that it's like, " we just love cranberries so much." And then it's like cranberries from Wisconsin. That has their own little thing, you know? I feel like there hasn't been that coalescence, and I feel like also there's probably some sort of advocacy group. I think it's largely statewide policy as well from what I've gleaned off of this. They're each focusing on their own state policy.

Jordie - And then maybe there's a national organization. And this honestly, we are just scratching the surface on this because this is more complex than we could have ever imagined. And we are learning every single day in our talks. And we love to just go out to lunch with the people who are on the business side and straddling the business and the farming side. And the things that they are grappling with are fascinating because all these companies ship internationally. So, you're subject to international law, like weather, there are so many different variables that we're like, "I've never felt so connected to the weather in my life."

Well, before talking to you guys, I was having a day of my ordinary level of hopefulness, but it's gone way the heck up now.And you make me feel really optimistic about the future. And I love the work you're doing. And boy, you could have no two more perfect people doing this kind of thing. And also, I wanted to say, I've done hundreds of podcasts, and I think this is the first one ever where I haven't asked a single question from the prearranged script. It just flows so naturally with you two.

That's how we do this series, too. Oh, yeah. Farmers will be like, "Can you send us a script of what we got?" And we'll send them just the most generic questions of all time. But the things we end up talking about conversation that grows naturally, in my opinion, is by far the best one. So here we are just talking like old friends, you know?

That's nice. Yeah, and it's much more human that way. And that's what registers with people. So, in any event, thank you for the good work you do. And I just hope this incredible visibility you have just continues to grow, and that more and more kids are exposed to it. Congratulations.

BIOS

Jordie "Cat" Simkovic was born in Miami, FL and has worked in early childhood education for almost 20 years, specializing in children with ADHD and learning disabilities. He is a classical flautist and enjoys studying music, martial arts, and gardening. He majored in political science and international studies at Northwestern University, and was this close to applying to law school, but is glad he didn't, although he still teaches the LSAT. This new series about farming and healthy foods is the culmination of his interest in nutrition, education, and meeting new people all across the country.

"Captain" Kevin Hoban, born in Detroit, Michigan, has spent two decades travelling the world and producing content for networks like National Geographic and the Discovery Channel. As a lifelong camp counselor, he's always had a passion for teaching children in a fun, interactive (and often musical) setting. Captain & Cat's "Explorasaurus" series allows him to share his love of exploring and learning about the world with kids and families! Kevin lives in Los Angeles with his wife, two adorable daughters and his dog, Charlie.

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North Carolina is one of the nation's top agricultural producing states. And it is also a state where one in seven residents don't have the resources to provide food on their table every day. Today, I'm talking with Amy Beros, president and CEO of the Food Bank of Central and Eastern North Carolina - the state's largest food bank. Each year, this organization provides 95 million meals distributed through more than 700 partner agencies, food pantries, congregate meal sites, backpack programs. And they do this in 34 counties in the state. In our conversation today, we will explore the policy issues that this food bank and many food banks face.

Interview Transcript

Amy, I want to ask a really simple question about what got you to this place. So how in the world did you get involved in food banking?

Oh, gosh. Well, you know, when I was growing up, I didn't know what food banking was. But I knew that it was our responsibility to make sure that neighbors helped neighbors. So, I grew up volunteering what I know now is a partner agency of the local food bank in my hometown. And as I moved across the country, I found ways to get involved. When I moved here to North Carolina about 16 years ago, I found food banks. I've been working professionally in food banking for a little over 12 years now. But I believe that food is a basic human right, and it has been my life's work to make sure that we're doing everything we can to ensure everyone has what they need.

Thank you for sharing that. And I can imagine over the years, as I've also been involved in food banking but on the board side or as a volunteer, that this is a work that we sometimes think it's just about moving food and providing that. However, there's a whole policy framework that, sort of, surrounds and influences and shapes what food banking and what the work of the partner agencies, the food pantries on the ground, what they do. I wonder if you could help make this a little bit more real for us. Could you tell us a little bit about how policy becomes personal in your work? Can you share a moment when that really came true for you?

Oh, I think the most recent blinding moment was last year during the government shutdown. Well, one, there's a lot of noise on TV right now, right, and in the media, but you hear of these massive numbers, and we know that our elected leaders are looking at these numbers on spreadsheets. And we see the humans behind those numbers and their stories. And these are thousands and thousands of stories like the ones that we hear about each day. Last year, during the shutdown, a father of five reached out to me and said, "I have five children. I work at the federal prison. I'm missing my second paycheck. For the first time in my life, I don't know how I'm going to put food on the table." Or the SNAP delay and disruption that we had. For the first time in our history during that shutdown, a mother reaching out and saying, "I don't know what to do. I've told my children to eat everything they can at school because I don't know what we're going to have when we get home, if we don't have these benefits." And that's just two stories and one crisis. And so many of our neighbors are living a crisis every day. These systemic issues. And we see those humans and hear their stories each day. And I think that's when it becomes personal. These decisions, one stroke of a pen, impacts food for hundreds of thousands of neighbors.

Thank you for sharing that. I teach a class called the Economics of the Public Sector, and we often talk about policies that provide support to individuals. And it can be easy to talk about these policies as if they're just decisions that policymakers make, but there are real people who are dependent on these policies. And when they don't work or when rules change, it has significant implications for how people navigate. And so, I appreciate the work that you all are doing. I want to take a step back and talk about food banking. And while I know a lot of our listeners are familiar with food banking and food pantries, I do know that people kind of mix those two terms up. Amy, would you just tell us, broadly speaking, what's a food bank, and then what are the partner agencies. And how do they relate to one another?

Yes, absolutely. Our food bank serves 34 counties in North Carolina. And as you shared, we work with over 700 partners. We work with growers. We work with over 80 local farmers in North Carolina. We work with manufacturers in North Carolina. We work with all of the retail chains to get food out into the community. And we do that primarily through those partners because they are embedded into the community. And what we're really proud of here, and I think something of how food banking has changed, you know, many people still think of a food bank as a dimly lit church basement pantry. And that maybe was food banking 30 years ago. But today it is part of the modern food system. We are a critical piece of infrastructure within the food system as part of the charitable food system. And one of the things that I'm most proud of is we live in North Carolina, this beautiful agriculture state, and over half of what we distribute each year is produce and protein. And that is what neighbors are asking for, too. Because neighbors want the healthy fresh foods, and it's also the most expensive to buy. And food banking today is not just focused on moving calories and getting pounds of food out to the community. It's focused on meals and nutritious meals and how to provide that nutrition education to make meals healthier. To use the types of foods you would get in a food pantry. For instance, I just learned at one of our nutrition demos this past weekend, you can leave the peel on a sweet potato, blend it up, and make it into a pancake. You never notice that you left it on there, but you get so much more fiber. And we're doing these types of trainings to help people make meals more nutritious, make meals go further, too, that they're getting. It's really a holistic approach. It's about being alongside community partners that are embedded into the community that are providing holistic supports like workforce development, job training, housing support. And we're that food portion as part of those agencies and making sure they have the right food and enough food to get out into the community.

It's really helpful to hear the ways that food banking is adjusting. This idea you're no longer just this big organization that takes in a bunch of food and then distributes it through, you know, food pantries and what used to be called soup kitchens. But rather you're working with other community partners, you're working with farmers to find ways of moving food, but also providing opportunities and thinking about this almost as wraparound services. Are there other things that are being provided than just meals? I know I've been in pantries where there have been nurses, and there have been other support services like ways to sign up to SNAP. This is a sort of a series of overlapping and intersecting opportunities to help families meet their food needs, but more than that, their sort of broader set of needs. And I think this is a really critical way of understanding that food banking looks different than, like you said, grandmothers working in a church basement. I know that the work that food banks can serve as shock absorbers. When things go down, when things are problematic, food banks are there to sort of meet needs in a real way. We've seen a great deal of breakdown in policies over the last several months, and both at the state and at the national level. What does this shock look like to you and your partner agencies on the ground?

It has been a tough year. You know, our budget went from 27% government funding and support to less than 10% in one year just because of decisions that were made in an instant. And there was no feedback structure. And I think that's one thing that I really pride our food bank on is the community feedback. We're constantly trying to engage with neighbors facing hunger, understand nobody knows what people facing hunger need more than the people who are literally experiencing it every single day. We try to ground all of our decisions in what is the community saying they need of us. And I think that is one of the things that's been so frustrating to see the decisions made this past year at the federal level. There's been no feedback. It's just numbers on a paper. And within, you know, a stroke of a pen, North Carolina lost $30 million for food purchased from North Carolina farmers for schools and food banks. And that was just North Carolina. It was one billion across the nation. And we're impacting people facing hunger, we're impacting farmers at the same time, and we have farmers who are saying, "I don't know if I'm gonna keep my family farm open." With SNAP, you know, we have cuts coming this year for SNAP and changes that are going to be detrimental for so many of our neighbors. And the cost shift to the states that are not prepared to take that. There's not a transition plan place. And SNAP is an economic driver. For every one meal a food bank provides, SNAP provides nine. We can't replace SNAP if we lose those meals. There's no possible way for us to charitable food our way out of that. But I don't think people realize the ripple impact of those decisions. So yes, it's going to impact people facing hunger. And eight out of 10 of those people on SNAP are working families, seniors, people with disabilities, our most vulnerable neighbors. And at the same time, we're going to see rural grocery stores close. We're going to see more farms close because for every dollar of SNAP, it means $1.50 to $1.60 back into the local economy. And that's going to be a detrimental effect that we can't turn around quickly. It's going to be long-term health impacts for neighbors because of the loss of this nutritious food and the loss of jobs. And we can't just flip a switch and turn that back on because of how damaging it's going to be to so many pieces of our economy. And when I say we can't charitable food our way out of it, we were meant to be here in times of crisis to stabilize and to be an ongoing support for people in the community during that time. But we were never meant to replace the safety net. At the same time, we're having all of these changes at the federal level. We're the only state in the country without a budget. There was another multimillion-dollar loss for food banks and farmers that was invested by the state to purchase from local farmers to go back to neighbors in need. And because we have not had that budget, we've not received those funds. And so, it's really been hit after hit, and we're seeing each one increasing need at our pantries.

Right now, we know there's over 600,000 people facing hunger in our community, and we're hearing from our pantries 20% to 60% more than they're seeing last year. I think that 600,000 people number is actually very low, and we're going to see that continue to climb, unfortunately, because of all the changes we're experiencing this year.

Amy, this is pretty sobering. And I realize that we're talking about issues that are also highly political. And I know you are leading in spaces where you have people who have differences of opinion about what policy should be. But a lot of these people are coming to the work of the food bank, either on the board or in partner agencies or wherever, donors even, because they care about addressing issues around hunger, right? So, how do you build trust? How do you work across these differences to help achieve the goals that food banking is supposed to achieve?

I've never met a politician that told me they didn't like food banks or they didn't care about food banks. There's a lot on people's minds, and I think we need to be in front of our leaders more because there's so much coming at our elected leaders that it's hard for them to even understand everything that's happening in the community. It's hard for me to keep up with just what's happening in our sector, and I'm living it every day, because it's been so fast. I often say, you know, we can't be apolitical. We're nonpartisan, but food is political, so we can't be apolitical. But we'll always be nonpartisan, and we have incredible support from both political parties and all sides of the aisle. And I think we can go in, and we can argue all day long about what we disagree on, and there's much that people disagree on. It's filled in a time when everything feels like it can be political, and we're going to walk out, and we're both going to be mad, and neither one of us is going to change each other's mind. And so I think we have to walk into every conversation with what do we align on, and where can we do good together? Because there's always going to be things we disagree on, but I also know there's always things we align on. And how can we choose those things that we align on and do the most impact and the most good possible with that? Because nobody wants to see a child go hungry. No one wants a senior choosing between medicine and their food or their rent. And so how can we focus, and how can we be a voice to tell that human story that they might not be seeing or hearing enough of so that they understand those true impacts, and we can figure out a way to work together on those alignment?

Yes. I think those are wise words given just the difficulty we're facing right now to find that common ground. To find ways of working together. I'm grateful for the way you are trying to navigate those differences to achieve the bigger goal. The goals that I think many of us want to see achieved. And so that brings me to this last question I want to raise with you. This is a challenging moment that we're in. I want to know what gives you hope, and where do you see people making real difference, despite the challenges that we face?

This is bigger than me, this is bigger than you, this is bigger than the food bank. This is our community. This is the health of our community. And focusing on the health of our community, seeing what happened last year during the shutdown... the community responded in a way that was inspiring and breathtaking for neighbors, because they saw their neighbors hurting. And we are a community food bank. I might get emotional. I do get emotional often. Every day, and I can see them right outside my window right now, we operate because of thousands of volunteers who come here and choose to give their time to us. Thousands of donors who choose to give their money to make a difference in their community. Thousands of food partners who are choosing to work with us. And these more than 700 agencies, we are a community food bank. Our new strategic plan 2030 is called Rooted in Community. And it is grounded in what neighbors said they needed from the food bank, what we are uniquely qualified and able to provide for neighbors right now. And I think seeing that community aspect and seeing the community come together during times like this absolutely gives me hope. And we saw the impact on that on policy, too. During the shutdown, so many advocates reached out and said, "This is unacceptable." And Governor Stein's office invested $3.5 million in our food bank, $10 million across the state during that moment because he saw the need, but he, like we heard from the constituents. And I think seeing and watching how powerful people's voices are, it can't just be the food bank there. It has to be the community members saying, "This is unacceptable in our community." And when we see people come together and align on that, we see change, and that gives me hope. I also think our youth today gives me hope. I just watched a video on C-SPAN that our food bank participated in that two high school students here in Raleigh won an award about building food security in their community. I just talked with a Duke student last week, she's in a feminism and farm class, which is an incredible class that I want to take, I didn't know that existed. And talking about how we can make a change. And I see so many people coming together and truly aligning on what we agree on, and I think with that there comes a lot of power.

BIO

Amy Beros is President & CEO of the Food Bank of Central & Eastern North Carolina — among the largest anti-hunger organizations in the United States. Amy returned home to the Food Bank following several years of service with Feeding America, where she led nationwide efforts to build food banks' capacity to better serve people facing hunger and poverty. Throughout her career, Amy has maintained a firm commitment to holding the experiences of neighbors at the heart of every decision. She has applied this community-centered approach across critical efforts in food sourcing and access, disaster response, strategic partnerships, and philanthropy — including leadership roles with Inter-faith Food Shuttle, Easter Seals UCP, and Pillars Community Health. During Amy's prior tenure with the Food Bank, she led the multi-year campaign that established the organization's state-of-the-art Raleigh headquarters and ushered in a new era of systemic solutions to hunger in the region. A South Carolina native, Amy holds a Bachelor of Science from Clemson and an MBA from DePaul University. She currently resides near Raleigh, North Carolina with her husband, two children, and rescue dogs. Outside of work you can find Amy lifting weights, spending time with family, or sharing her love for Dolly Parton with anyone who will listen.

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For many people, the FDA-approved drug class called GLP-1s has been a game changer for managing type 2 diabetes and weight loss. An estimated one in eight US adults is using this type of drug, which mimics a natural gut hormone to regulate blood sugar, slow stomach emptying, and suppress appetite. Researchers and the public have been scrutinizing the pros and cons of taking these drugs for many years. One critical question that remains is does the use of GLP-1s translate into lower medical expenses for consumers, healthcare providers, insurance companies, and the government? Today, we're speaking with Duke University health economist Jonathan Zhang on the answer to these questions from his multi-year study of veterans who use GLP-1s. The results are surprising.

Interview Summary

Jonathan, first, let's talk broadly. Would you briefly describe the kinds of health benefits people are experiencing with GLP-1s, particularly in terms of changes in behavior and overall health?

Yes. So GLP-1s are medications that manage body weight and improve metabolic health. The primary health benefits are via better blood sugar regulation and weight loss via reducing appetite. But there's larger health benefits that are much broader. So, trials have also shown that they lower blood pressure, reduce strokes and heart attacks, among other cardiovascular benefits. Overall also improves, so things like obstructive sleep apnea, improvements in inflammation-related measures. And recently it was FDA approved to treat MASH, which is a form of fatty liver disease. Finally, people also report feeling less hungry. They get full faster, fewer cravings, and reduction in what is often called food noise, which can potentially help people make a range of better behavior decisions and changes relating to food and perhaps even beyond food. However, the evidence on that seems to be promising, but new and less strong.

Thank you for sharing those. I know a lot of our listeners have heard some of those issues and some of those points about how GLP-1s could change the way we behave, and some of the health outcomes. So, let's dig into your particular study. In your working paper for the National Bureau of Economic Research (NBER) you and your co-authors describe a natural experiment involving patients and doctors in the Department of Veteran Affairs, and their access to and use of GLP-1s. Would you lay out the general parameters of your study for our listeners?

Yes, absolutely. So, like many medications, what we know about GLP-1s primarily comes from randomized controlled trials, which have small sample sizes and often select for quite sick patients. As GLP-1s reach a broader population, the population becomes less pro-comparable to those in trials, so the real-world impacts become less obvious. Moreover, there are some outcomes such as healthcare utilization or spending costs that are incredibly important for policy but not directly studied in trials. We were interested in studying in a very large healthcare system, that is the VA, the Veterans Health Administration, the real-world impacts of GLP-1s using readily collected data from the healthcare system and a quasi-experiment. So that is we try to emulate a real experiment where some patients get GLP-1s from their primary care doctor and others do not. And the reason one patient might get it while the other doesn't is because their doctors differ in their likelihood or propensity to prescribe these drugs. And we focus on the Veterans Health Administration, the VHA, because the veteran population is quite diverse, at least in terms of comorbidities relative to the trials per se and also in age, say, compared to Medicare. And GLP-1s are provided in the VA to eligible patients at a pretty affordable cost. So, sort of a nice policy playground for us to think about what outcomes might look like when GLP-1s become readily available and affordable to all Americans.

Great. Thank you for sharing that because now we have a good sense of the quasi experiment that you all were able to exploit. That there were providers who had a high tendency to prescribe GLP-1s versus those who didn't. And looking at that difference, you were able to see how GLP-1s may have affected the outcomes that you were interested in. So now tell us a bit about the findings, and I think there's some surprising results here.

So, first we replicate many of the findings from the randomized trials for this diverse, veteran population. We see reductions in body weight, we see hemoglobin A1C blood glucose levels improve and blood pressure improvements as well. Even a reduction in heart attacks and strokes for patients with existing cardiovascular conditions, and even a small reduction in moderate drinking risk as well. The trial evidence seems to hold up in this large and diverse population of we have 1.4 million patients that we're studying. Second, despite these improvements though, we do not see a reduction in healthcare spending. This is actually excluding the cost of the medication, the GLP-1. It's not because GLP-1s are expensive. We're taking that out of the equation. Over four years, this is how long we're able to track these patients for, we're able to rule out reductions of more than 7% in healthcare spending. And we see no reductions in whether that's outpatient clinic or in inpatient hospitalization. We also don't see any reductions in emergency department visits more generally, despite seeing a reduction in heart attack and strokes for those patients with existing cardiovascular condition.

Jonathan, that sounds great, but it's a little hard to understand. So why is it that you're seeing no real changes in the consumer healthcare spending? What's going on?

Yes, we were a little surprised as well. We think there could be a myriad of potential reasons. But first, I want to note that there's also at least three other studies that use real-world data to look at a similar question, and all the studies find no statistically significant spending reductions. And in fact, all of us, we all find a slight positive increase. I think the first explanation is that while heart attacks and strokes are very expensive and obviously, very serious events, they are still thankfully quite rare and thus are not very common in our three to five-year period in which these studies are looking at. But perhaps over ten or twenty years, you could start seeing some healthcare spending materialize. I think that's totally possible. Most cost projection models, whether that's from the CBO or other organizations, they project healthcare spending reductions to accumulate over time. But these models also project immediate spending reduction, which is not yet supported by the data.

Another potential explanation is what I would call these behavioral responses. So, you can imagine that a patient sees some improvement in their health, and that changes their expectation of, "Oh, wow, I could actually make some changes to my health." And they actually go and get some more care. This can also be driven by the physician as well. So, sort of, "Look, things are working. This patient's seeing improvements. Maybe we should treat some of your other health problems and issues." This is what I would call sort of a behavioral response. A third explanation could be that some of these patients have conditions that have progressed to be irreversible even with metabolic health gains. So, for example, late-stage kidney disease would be a good example. We find some suggestive evidence that this might be happening in our study. In other words, for these patients where they have some potentially irreversible health conditions, the metabolic health improvements - that's not a primary reason for their healthcare spending.

This is helpful. That explains why we're seeing some of these challenges with healthcare spending. And I appreciate your point of taking a longer view may actually reveal some differences. And also, the responses of doctors and patients to the benefits that they gain and how that might expand opportunities for healthcare. So, thank you for sharing that. I want to shift focus a little bit. And it is taking a step beyond the paper, but I think it's a natural extension of the work. As you know, I'm an agricultural economist, and I've been interested in obviously food policy issues. And the fact that we're seeing weight loss, the fact that we're seeing better management of A1C suggests that there's something probably happening with food consumption and food patterns. I'd be interested to learn from you if you have any ideas about what this work suggests about the impact of GLP-1s on consumer food choices.

Yes, I think there's a fair amount of both trial and real-world grocery purchase evidence that GLP-1s are impacting consumer food choices. In the randomized trials, GLP-1s reduce, calories consumed, reduce the desire to eat sweet, salty, and savory foods and high fat fast foods in their meals. For example, these trials will look at what people eat for lunch. In real world data, there's a study out of Denmark that found that after patients' first GLP-1 prescription, their grocery store purchases went on to have fewer calories, sugars, saturated fats, carbohydrates, and more protein over the one-year period after they initiate GLP-1s. The share of ultra-processed foods also decreased. The effects were actually quite modest, so there was only about a one percent reduction in calories and a four percent reduction in sugar and a five percent increase in protein in the year after versus the year before in this Danish study. In the US, there's a similar study using kind of this transactional level data as well. And they find that households after they start GLP-1s also reduce caloric intake, fast food consumption, caloric dense processed foods. And there it's a little larger in the US by about five to ten percent. Then the question is, you know, are they shifting towards healthier foods or is it sort of a uniform reduction in calories across all different food classes? And there the evidence is a little less strong. There's some evidence that consumers are shifting towards healthier foods, but if that is the case, the shift is quite small. In both the Danish and the US study, it's roughly looking like a level shift for all different categories. And this is also in terms of not food so much anymore, but there's also been studies looking at alcohol consumption, which has been very interesting and promising. There's a phase two study pilot trial with only forty-eight participants, but the randomized control trial found that among patients with existing alcohol use disorder GLP-1s led to a reduction in the average number of drinks per day. No change in the number of days drinking, but conditional on drinking, the average number of drinks per day declines in the treatment group that get GLP-1s. And then for out of the 48 patients that are also smokers, there's also a reduction in smoking as well in that population. So, very promising early evidence there as well.

Jonathan, this is critical information, and I know some colleagues in the Ag econ profession, folks like Brian Roe, Tim Richards and Glenn Townsend have also worked in this space, and some of the work is showing some issues around the quality of protein or overall food spend is going down. And the choices or the responsiveness of people to prices when it comes to proteins. There's some evidence, some causal evidence to suggest GLP-1s are changing the way people are even looking at food markets. And so that raises a really important issue. If consumers are changing when they're exposed to GLP-1s, I have got to imagine that the food industry, grocery stores, food manufacturers, restaurants are making some adjustments. What have you to say on that particular point?

So, we're both economists, right? We both, of course, believe that producers and grocery stores are adjusting to demand. We do know a lot less about how the supply side is adjusting compared to the demand, and that's because there's just less data and fewer studies on patients. There's more data and more studies on patients and consumers than on grocery stores and restaurants. I've seen a lot of anecdotal evidence, often reported in the mainstream media or reports from various market research agencies that GLP-1s are having this large impact on the food industry. I've seen claims like GLP-1s are hurting Walmart sales or why are beer company sales down, like AB InBev, and range into things like why restaurants are reducing their portions or recently I actually also saw over the past couple weekends claims of why Coachella portions are smaller because everyone's on GLP-1s. So, the best estimates from last year are that one in eight Americans are using GLP-1s. And if each of these users are cutting back in consumption by 5% to 10%, as in those studies, it's totally plausible this leads to a large population reduction that the food industry just cannot ignore, right? I think it's important to note a couple things. First is that the long-term adherence of GLP-1s is generally quite low, with more than 50% discontinuing within a year in most of the studies I've seen in the US. And after discontinuation, most of these patients will gain back a large fraction of their weight. And in that US groceries transactional study I told you about, they find that after discontinuation, purchases at fast food, grocery, restaurants, et cetera, they go up beyond baseline, in fact. So, beyond six months prior to when they were on GLP-1s. It's still an open question to whether these 5% to 10% individual consumption reductions will become long-term and manifest in the population level, especially if adherence is not very high. Second is that up until very recently, there's been a very strong demographic and socioeconomic profile of these GLP-1 users, right? So, they tend to skew near elderly and also a little bit more female, and generally fall in the middle- or higher-income brackets because previously Medicaid, for example, did not cover GLP-1s, right? Until earlier this year. And it still does not cover it for many states. So, any food industry changes will likely be concentrated in the restaurants and the food chains that sort of have these consumer demographic and economic base. That's something to keep in mind. Certainly, there are examples like, you know, Smoothie King has introduced a GLP-1 smoothie. But even in these clear-cut cases where the producer is clearly trying to appeal to this demand shock, it's still very difficult to disentangle the producer's stated intent from general industry market trends, right? So, general trends like rising cost of living. There's been more demand for protein. You can see protein in everything now, right? Even water. Rise in sort of small plates or family-style tapas at restaurants. Feels like every restaurant's doing this now. Or for example, a decline in alcohol consumption or interest in alcohol consumption, especially among young people around the world. I think some of this is certainly happening. Producers are listening, but it's hard to disentangle the general trends from a specific GLP-1 impact.

I'm grateful for you taking some of the hype out of this and thinking through carefully what the economic implications are of this change and recognizing that there's some real important context that people don't stay on these drugs for long. Or there are certain types of folks who are more likely to use them, and therefore we can't assume that there's this massive wave of change that's going to happen, but that there are some responses. These are important ways of framing this discussion. I have one final question. Based on what you're seeing now with the use of GLP-1s and considering their use over time, what would you say is the key takeaway for policymakers?

I think there are a few takeaways. Most importantly, I think policy makers should think about the rapid change in profile of patients who are using this drug. Just because it's beneficial for sick patients doesn't necessarily mean it's going to be equally as beneficial for patients who are less sick. One of the findings in our paper is that as the veteran population that starts to initiate GLP-1s in the more recent years, these patients actually are healthier, so their treatment effects are not quite as strong as those who were initiated in the very early period who in our setting were among the sicker veterans. Policy makers shouldn't extrapolate the potential benefits to a broader population since there's so much demand for this drug, right? This also means that some of the downstream improvements like cost savings or even improved labor outcomes like absenteeism or being able to return to work, while these things might seem logical, it's not fair to assume that it's going to be automatic, especially at a population level. Related to that last point, we should encourage additional research on important socioeconomic outcome that might completely change the calculus of the cost benefit of these drugs, right? So, labor force participation, earnings, use of government transfer programs like disability insurance, even some interesting patterns of household formation and fertility. These are all fascinating and important questions. However, it is imperative to note that GLP-1s already have incredible health benefits for many people. While it's possible that these benefits might spill over to broader societal benefits, these benefits should not be presumed. And at the same time, we shouldn't be holding GLP-1s to a higher standard, say, to reduce healthcare spending or increase earnings just because we know that it does a bunch of wonderful things for a range of conditions. So, maybe it does this and this as well, and suddenly we're less excited if there's no evidence of that and that, right? These things have incredible health benefits. Let's appreciate them for that, and we shouldn't be holding them up to a higher standard just because it appears to do so many wonderful things.

BIO

Jonathan Zhang is a health economist at the Sanford School of Public Policy at Duke University and the Margolis Institute for Health Policy. He is a Faculty Research Fellow at the National Bureau of Economic Research and an evaluator at the Department of Veterans Affairs. He researches how policy can improve mental health and substance use outcomes using quasi-experimental methods.

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Interview Transcript

Kate - Welcome to the Leading Voices in Food podcast. I'm Kate Stanley, a researcher at the World Food Policy Center at Duke University. I'm joined today by my co-host, Katariina Koivusaari, a researcher at North Carolina State University. Together, we collaborate on policy research for the Bezos Center for Sustainable Proteins at NC State.

Katariina - Great to have you. Greg, you have been involved in food and agriculture policy in Washington, D.C. for several decades and have worked with both Democratic and Republican administrations. Are food policy politics caught up in party differences depending on which political party is running the executive branch?

A very relevant question right now. I guess it would be wrong to say that the political party in office doesn't make a big difference in the policies being carried out by the executive branch. However, in the food and agricultural space, and especially in the areas that I focus on, which is really around these new technologies in food and Ag and how do those get into the marketplace and adopted, that difference hasn't been so big. Let me give you an example or two. I'll take you back first to about 2000, and we had the Clinton administration. We have the regulation at FDA of biotech crops, and they had a voluntary consultation process and there were a number of stakeholders and others who felt that that wasn't sufficient. The Clinton administration interpreted the Food, Drug, and Cosmetic Act to try to turn that into what they called a mandatory consultation, and they proposed a pre-market notification rule. It didn't get finished in, before the end of the administration in January of 2001. Then we had the Bush administration come in, so we went from a Democrat to a Republican. And the Bush administration looked at the same law and looked at that same proposed regulation and said, "We don't have the legal authority to do that." And they withdrew that proposal, and so we still have to this day this voluntary consultation. And I give you that example for two reasons. One, I think what we've seen when it comes to food and policy regulation by different administrations is how they interpret the law. And I can say this in very general, the Democrats have tended to be a little more expansive in how they interpreted the law to try to find more legal authority to do things that they might want to do. And the Republicans have tended to look at that language much more restrictively or look at just exactly what that language said and not try to interpret anything into it. And so, you see that difference here between what happened in the Clinton administration versus what happened in the Bush administration.

I mention this example because as many of your listeners may know, right now in this administration, we have the question about voluntary GRAS and whether that's going to become mandatory or not. And some of us who have followed that know that the current FDA has submitted to OMB, to the White House, a proposed rule to make GRAS mandatory. Well, that is-- the regulatory process for those biotech crops is also a GRAS process. It's interesting now that we have a Republican administration who's finding the authority to do that, and we'll see what actually comes out and what the courts do with it. But I think this shows that sort of difference in policies between Democrats and Republicans. But overall, we haven't seen a lot of difference.

In this new administration, I think one of the questions people had was what would happen with a technology like cell-cultivated meat? Where would the regulation of it go forward? There's many in the MAHA movement, I think, that felt that that wasn't consistent with what they wanted. But we've seen that those approvals continue to happen. Similarly, pesticides have been an issue in many administrations. Sometimes Democrats have argued to be much more restrictive in the use of pesticides and to make the regulations much harder. And Republicans have oftentimes said to make those easier for the agencies. But what we see is pesticides have moved forward under both administrations. People understand the need for pesticides to produce agriculture. We have some differences in policy, but on the whole, in this area, I think, whether it's Democratic or Republican, they have generally supported following the law.

Kate - Greg, you shared some interesting examples of across administrations how we've seen different actions be taken. And I'm curious. Under this administration, for some of these areas you work in, like these novel technologies, what do you see as driving the new federal legislative actions in food policy?

The legislative area has generally always been more partisan than the executive branch to some extent. I mean, the executive branch is interpreting laws from Congress; the Congress is setting those. But I think again, in the area of food policy, we've seen many good laws come out that have been bipartisan. And when I look at how did those laws come to be, I sort of see a couple different scenarios. One, and I don't think this is unique to food policy or ag policy, we tend to see legislation when some crisis has occurred. The example I would give in the food space was the establishment of the Food Safety Modernization Act more than a dozen years ago. And to a large extent, that was reaction to a number of outbreaks: spinach outbreaks, peanut butter outbreaks, egg outbreaks. And people getting sick, and some people even dying from those outbreaks. And so that brought a bipartisan coalition together to say, "We need to give more authority to FDA to address our food supply and ensure it's as safe as it could be." So that's one way we've seen that.

A second way we see policy change is when a policy is old or that is no longer in favor. And the example I give there is most recently, in this Congress passed the whole Milk for Healthy Kids Act, and that is a definite change in policy from the Hunger-Free Kids Act of 2010. This changes what milks, whether they're flavored, and how much fat they can have and be in the school programs. And I think in both cases, those bills were relatively partisan at the time, and yet they do opposite things. So that would be another reason that we see changes in laws.

But the third way, and I wanted to focus a little more on this, is one way the federal government gets involved and Congress gets involved is when states start regulating an area, and we start getting different standards. And then there's a push at the national level to have some sort of uniformity, some sort of have national standard for markets to work properly, for efficiency's sake and so forth. And I can give several different examples. We can go all the way back to the National Organic Law that was passed back in 1990. You had a number of states who had defined organic; they had different organic labels. Congress came together and said, "Hey, let's set up a national organic standard." We had the same thing happen with the National Bioengineered Disclosure Law, that I think happened around 2017 or 2016. In which case you had a number of states proposing legislation. You had Vermont that had passed legislation requiring mandatory labeling of genetically engineered ingredients. And in fact, the law that was passed by Congress was passed, I think, within a week or two of when the Vermont law was about to go into effect. And people felt it was better to come together and have a national standard than have different states doing different things. Because the reality is, consumers and manufacturers don't just purchase things in one state or produce things for one state. They produce it for the nation. We're a nationwide market. And then we see even those kinds of things happening today, and I go back to the pesticide area as another example. We've had different states having pesticide laws or regulations that have been different than the federal situation. We have a Supreme Court case now that the Supreme Court is going to hear in April of this year about whether that's those state regulations are preempted by the federal law. But Congress and the Farm Bill has also put in language that would ensure that the federal standard is the standard that is applied, not having multiple different state standards. So that's been a way that we've seen a lot of things happen in this food and Ag space.

Kate - We've seen a lot of food policy action at the state level in the past few years. Katariina and I were on this podcast not long ago talking about state legislation aiming to restrict how cell-cultivated meat products are labeled or even banning those products altogether. We've seen action in a variety of other areas as well. Are there issues that states have started regulating where you think we could see federal action in the near future?

I do. I think that the MAHA movement in particular has really set up a situation where we see states taking the lead on a number of issues, and we'll see whether the federal government decides to come in, and particularly Congress, to address those at a national level. For example, in the area of synthetic dyes and food additives, I think there's some 30 states that have introduced bills. And a number of which have passed, either restricting those use at all in any foods, restricting their use in school lunches, having different labeling associated with many of those ingredients. And we've seen some of those laws pass, and we've already seen some court cases. A court case in West Virginia which said that those laws are preempted by federal law. One could envision either something at FDA or in Congress that would set some uniform standard for how this moves forward federally.

You mentioned cell-cultivated meat and the three of us were involved in a paper that looked at the state regulation in that area, especially around labeling. And again, if we don't have a lot of those products on the market yet, but as those products get closer and get on the market, I could definitely see a push again to have some uniform labeling. Either again from the federal executive branch or from the legislative branch. And also, in areas like ultra-processed foods is another one. California has passed a law defining how they're going to define ultra-processed foods. We've heard that FDA may issue a definition about ultra-processed foods, but I could also see Congress getting involved eventually and setting a standard.

Katariina - I'm sure that in working with US regulatory agencies for so long, you've seen trends develop and persist over time. What would you highlight right now for our listeners?

Well, as I said, I've worked very much in this space where we talk about new science, new technology, new kinds of products coming into the marketplace and how do we regulate that? What are the policies and regulations to ensure that that's safe for humans and safe for the environment, and that there's information and access that's necessary for those safe products to, to thrive in the marketplace. And when you look at that, I think I have some observations, I guess, about the US regulatory agencies and what they've done in this area. The first one is that the science tends to move faster in the private sector and in the research community, like you're both in, than it does in the federal government. And so generally, the people in the federal government, who I have the utmost respect for, the career people, tend to always be playing catch up on the science. That the science is moving faster and they're not there. An example I would give is cloned animals. When the industry went to FDA and said, "Hey, can we put these cloned animals into the m- into the marketplace?" FDA sort of said, "Well, wait. We need to look and see whether we need to do a risk assessment to see if there's any risks out there." And they spent a couple years doing that, and they asked for a voluntary moratorium while they were figuring that out. In the end, they figured out that for many cloned animals, there was no risk and there didn't need to be regulation, but they had to catch up. They had to catch up on the science. And I think that's the first thing. It's important for industry and public sector scientists like yourselves to make as much information about new technologies and new products available in the public realm so that those experts in the federal government can stay as close as possible to what is happening.

Second is, anytime you have a first-of-a-kind product. You talked about cell-cultured meat, Kate, a little while ago. We can talk about biotech crops. We can talk about a number of genetically engineered salmon. We can talk about a number of different new products of methane-reducing feed additives. The first-of-its-kind is always going to take a little longer to figure out what is that regulatory pathway. It's great to be the first into the marketplace. You get a lot of advantages, but I guess one of the disadvantages is that you probably have a little slower regulatory timeframe. That again bodes for that transparency for that additional information. The third thing I'd mention, and you would think, oh, this is something that is sort of a given and expected, and that is the level of transparency that we have in our federal government. But that's not true. I've traveled around the world, and many governments don't have that. But interestingly, most of our regulations are, you know, they're all publicly available. There's lots of guidance documents out there. We can go online today and see GRAS applications and decisions made at FDA. We can see what information was submitted for cell-cultivated meat crop, meat, meat products, and what decision the agency made on those. We can do that for genetically engineered animals and for genetically engineered plants. And so, we do have a fair amount of transparency, and I impress upon people to use that to their advantage. I think that builds trust for consumers, but also for people in the industry. It helps them learn so they can be as efficient as possible when they go through the regulatory process. And the final thing I might mention is it may look like from the outside the government moves slow all the time. But I think having been inside the government and in the role, I played as the Chief Regulatory Officer at USDA, that slowness, in part, is to make sure that the government speaks as a single voice.

We've been talking a lot about FDA, and we talk about USDA, but there are actually some 18 or 20 different agencies that actually regulate different parts of the food supply, for example. A decision made in one agency may have some indirect impact on a decision or a regulatory process in another agency. And so, it's important before major decisions are made or major regulations are promulgated, that we have an interagency review of those things to make sure that the government is speaking consistently with one voice about how they interpret laws; about how they apply risk assessments; about how they look at safety and so forth within the context of their laws. And that sometimes takes some time. It is a big bureaucracy, a big government, and again, that could be looked at upon negatively. But at the same time you can look at upon that positively as an opportunity to make sure that the decisions that are made in one place are consistent with other decisions and other statutes in another place.

Katariina - Thank you for sharing that. It's really helpful to get more insight into the policy process. Let me ask you one final question. For organizations seeking to navigate through state and federal regulations in order to bring a food product to market, what are the key, what are key takeaways you would highlight?

Well, there are a number of them. First, I would tell companies or public researchers, whoever is bringing a product to market, to be as transparent as possible. Put as much information about your product and your technology in the public record, especially if it's in peer-reviewed journals that are accessible to everybody. That is only going to come to your benefit. That's going to help the regulators. They know that information is out there. They know that other people have that information. They can utilize that to help make decisions about whether there is a food safety or a risk to the environment, and then how maybe to address those risks. So that would be my first response. The second one is, and I think, again, this is something that I thought was going to be universal when it came to interactions between the regulated community and the regulators, but it's not around the world, and that is to consult. All the agencies that I've worked for have open door policies where they say, if you have a question, as you're thinking of bringing a product to market, come in and consult with us. Come in and talk to us. Let us help you figure out what the regulatory pathway is going to be, what the data you are going to need is, why we need that data, and go through all of that. And, in my consulting business, that's one of the things I do. I help facilitate those conversations between one of the agencies and a client. And I think that just the earlier you do that and the more often you do that, the more efficient you will be, the less money you will spend, the quicker your review process will be. And while I have clients who don't always agree with the decisions by the agencies of what information they might need or what regulatory process they have, it's still better to know that upfront and earlier in the process than later in the process. The third thing I'd mention is to be a little creative. The regulators, you know, they're trying to ensure they're representing the public, and they're trying to make sure that a product is safe for human consumption, for animal consumption, for the environment. They don't always have all the answers, and sometimes they are fitting square pegs into round holes because new technologies come along that aren't exactly a perfect fit. But be creative. Try to help them. I think, you know, sometimes working with people like me or others to help think about what a good regulatory pathway would be, what are the potential risks that really need to be addressed here that can be really helpful. The fourth thing is, you know, that the devil is always in the details. The details and the science matter, and that is something that is very important. And so, we want to look for analogies of your product or your technology to other ones that have happened in the past, and that's always good. But also understand the differences. And so, really, I think, sometimes people think, "Oh, they don't need to engage with the regulators as much about exactly what I'm doing," or "They don't need to know all those details." Those details actually do matter, and I do think those are important. And then I would finally say that, you know, it does take time, especially when we're talking about new technologies and new products, to figure out what that regulatory process will be. And we don't have neat situations. Our laws are written a long time ago. We don't want to write a new law for every new kind of product or every new kind of technology. I'm not sure that's the most efficient way to do it. But by not doing that, we're sometimes, as I mentioned earlier, fitting square pegs into round holes. We have a law, for example, the Food, Drug, and Cosmetic Act, dealt with food, but it never envisioned genetically engineered crops. It doesn't talk about biotechnology. We have a meat law that regulates meat at USDA. Didn't think about cell-cultivated meat. And we have to think about how those fit together. And sometimes we can do that without the new laws, and sometimes you need new laws. When I was at USDA, we worked on methane-reducing feed additives. FDA regulates them, but they really don't fit very well. They're not a drug, but they're also not a feed because they don't have a nutritional benefit. And so how do we fit those into the regulatory system? FDA's come up with a temporary regulatory pathway, but there's also a bill in Congress to set up a more definitive regulatory pathway. And we see that for some of these new technologies that we might see some legislation. And then the final point I would just make is to temper everybody's view that a compromise is essential in this area. No one company or no one stakeholder gets everything they want. Governing and the government's job is to, you know, figure out what's the appropriate balance. They want to ensure safety, but they also want to make sure that safe products can get to market and that consumers can get to take advantage of those products, and we can get the benefits from those products. And so all of this is always a balancing. There will always have to be some sort of compromise. And I'm not saying that's a bad thing, just pointing it out as something that people should be conscious of.

BIO

Gregory Jaffe is President of Jaffe Policy Consulting, which provides strategic advice on national and international policies involving agriculture and food, with specific expertise in sustainability, climate, bioeconomy, biotechnology, PFAS, pesticides, food safety, and food loss and waste. He recently worked as the Senior Advisor for Regulatory Affairs in USDA's Office of the Secretary and the USDA's Chief Regulatory Officer. He managed a broad portfolio of policy issues, including bioeconomy, biotechnology, biofuels, pesticides, PFAS, food safety, sustainability, and scientific research and development. Before joining USDA, Greg worked for at the Center for Science in Public Interest (CSPI), a non-profit consumer organization working on food and nutrition issues. While at CSPI worked extensively in Sub-Saharan Africa and Southeast Asia on projects funded by USAID and the Gates Foundation. He worked with government officials and stakeholders helping them develop laws, policies and regulations that allow for the adoption of agricultural technologies, including biotechnology. He advised on agricultural policy, sustainability, and trade issues, conducted capacity building, and worked on international treaty implementation.

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Kelly Brownell interviews Jon-Paul Bianchi, Director of Systems Change at the W.K. Kellogg Foundation, about the foundation's systems-change approach linking food, health, early childhood, and family economic security to address inequities affecting children and families. Bianchi describes his path from PhD research to policy work and then to Kellogg, and explains how integrated grantmaking focuses upstream on policies, practices, resource flows, narratives, and long-term investment in people and relationships rather than isolated programs. He highlights Vermont's inclusion of food quality in childcare ratings and the foundation's Farm to Early Childhood efforts connecting procurement, regional food systems, and state policy, with examples from states like North Carolina, Iowa, and Wisconsin, and notes Brazil's national local purchasing policy as a model for success.

Transcript

As I was mentioning before we got started, I've long admired the work of the Kellogg Foundation. Working with the concept of food systems or connecting agriculture with nutrition and thinking about regenerative agricultures. There are a lot of places where your foundation was out front. So, I salute you and your colleagues for that. And it'll be interesting to find out what's happening right now. Tell us a little bit about yourself, and how did you get into the philanthropic work and your work with Kellogg in particular?

I'm Jon-Paul Bianchi. I'm the director of the Systems Change team at the W.K. Kellogg Foundation. And what that essentially means is I'm the director of national programs at the foundation. But we call it systems change because we really do see in the different areas of work that we focus on- health, family economic security, food, and early childhood- that these things are all interconnected by some distinct systems. But also, common systems that overlap across them. And so, that's the approach that we take. And I'll spend some time sort of diving into that today. You know, to answer the question of how I got here... you know, a master stroke of luck. I was set to be an academic researcher. I was working on my PhD at the University of Wisconsin. I was ABD and decided that I didn't want to be a researcher and I wanted to work in policy. And I moved to Colorado to take a job sort of sight unseen, being the policy director of an organization that worked in K-12 and children's health, and food and early childhood education. And did that for a few years and learned to translate research into practice; into policy. And was giving a presentation and got a tap on a shoulder from somebody that worked at the Kellogg Foundation who was interested in what I was saying. And we had one conversation, and six months later, I wound up having a new job and leaving Colorado and moving to Michigan. That was 15 years ago.

Well, you went into this with a great background having done the science as a graduate student and then into the policy world. And you're right, the intersection of those two is really where the magic can occur. You began talking about this, but let's talk about it a little bit more. So, when you say that there are systems that cut across different problems like food and health and economic security, etc., and I know you structured your team to reflect that cross-cutting kind of view of things. But tell us a little bit more about that. And how is this different than what's usually done, and how does it affect the way your work gets carried out?

So, big picture at the Kellogg Foundation, we envision a society where every child can thrive. But we know that there's too many kids and families that still can't access good food or quality childcare, or their parents can't find quality jobs because of inequities that are embedded in the policies and the practices and narratives that shape our systems. And so, having a multi-issue integrated grant making team, it's made us more effective by better understanding the points of intersection and collaboration across those bodies of work. So, our food systems program officers are in the same team, and they work closely with our program officers in early childhood and family economic security and health. And those collaborations strengthen the work in a variety of ways. We have experts in each of those areas, but because they're spending time with each other and working in the same team, they're exposed to, and they learn about each other's work and each other's worlds. And that creates powerful collaborations in the foundation, but more importantly, out in the field. And it helps us to see that we can't fix any of these systems, including food systems, with surface level or patch kinds of solutions. We really have to work together to get upstream and focus on policies, focus on practices, focus on resource flows and narratives that really sustain the inequities that we see. And so, the foundation partners with organizations to dismantle barriers in food systems in the other areas so that children and families can access quality food. But I think we also recognize that's about investing in people. And it's about investing in people over time to drive transformational change in any of these systems, including food.

For people listening to this who aren't in the world of philanthropy or academics or science or policy they might be saying, "Well, this kind of makes common sense. Isn't this the way it's usually done?" And in fact, it's not usually done to have this cross-cutting work accomplished the way you're doing it. It's actually a pretty impressive thing.

Yes, thank you. And I have a lot of respect for our philanthropic partners and peers, and we work very closely with a lot of large and small foundations. And I think the adage in philanthropy is you know one foundation you know one foundation. So, we do it this way and somebody else will do it differently. And I think there's a lot of connection for us back to our founder. You mentioned Will Keith Kellogg at the top of the call. He was ahead of his time in terms of understanding the interconnectedness between food and the land and opportunity and people's education. And a lot of that came out of his tradition as a Seventh Day Adventist. But also, I think just as a person coming up in the Depression and seeing what happened afterwards and really beginning to understand in his own community of how these things were sort of connected to one another. And so, for us, both inside and outside the foundation, systems change really means betting on people long term to reshape those systems from the outside in. But also, from the inside out. And that's really what we're striving for.

You mentioned the history of Dr. Kellogg. The history of that family is so interesting, and what went on in, you know, the sanitarium in Battle Creek, Michigan, and how the concept of breakfast cereals came about. And how the focus on natural foods was so important. It's worth spending a little time even on just Wikipedia to try to find out what that history is, because I find it fascinating. So, let's go back to food and go a little bit deeper and talk about what this systems approach looks like in practice. You're a philanthropic organization. You exist in the context of a capitalist society where businesses are out to do as well as they can. How is the foundation's work different from, say, funding a food pantry, launching a single nutrition program somewhere, which is what typically might be done?

Yes, I think what we intend to do and how I think our systems approach is a little different from, say, you know, funding a single nutrition program, is that we mean to design and redesign practice and policy based on how kids and families actually live their lives. Right? So, where food and health and early childhood and family economic security show up together in a community, right? Families experience these things simultaneously in their everyday lives. They don't experience these things in silos. And so, we try to have our team and our work reflect that. So, instead of treating food as a narrow problem to fix with one program, we try to think about how the entire system around a child and their caregivers works or doesn't work and find those opportunities and levers to move that whole system. I'll give you a concrete example that will bring in our colleague Linda Jo Doctor, who you mentioned at the top of the conversation. Early in my time at the foundation, I was a reviewer for the Race to the Top Early Learning Challenge Grant. This was an Obama era competitive grant process for building early childhood systems in states. And the state of Vermont did something really interesting that I had the good fortune to review as part of that team. They included the quality of food and access to fresh, healthy food in childcare centers as part of their quality rating and improvement system for childcare. They didn't just talk about teacher quality or curriculum or reflective practice. They actually said, "If we care about child development, then what children are eating every day in those childcare centers is part of what quality means." That's a systems approach. They connected food policy and procurement directly into early childhood policy and practice so that nutrition and education and child wellbeing were all being advanced simultaneously. I brought that back to the foundation and brought it back to Linda. And we had a really great conversation about it, and then another, and then another, and then another. And that experience helped shape how I think and how many people think about our work at the foundation. And it led to things like the expansion of our Farm to Early Childhood work, which again, leans heavily on procurement as the strategy to drive systems change, but connects it into early childhood policy.

Tell us about that. You know, the Vermont example you gave is a terrific one. And you talked about Farm to Early Childhood. What does that mean in practice?

In practice for the foundation, it really leaned heavily first on, sort of, understanding the landscape of where there was capacity to connect regional food hubs, farmers and producers and growers to systems of early childhood. At the same time that you have these burgeoning and developing systems of early care and education with regard to financing and sophistication, you have something similar going on in them in the food system movement, depending on the state that you're in. And so, we work diligently in a subset of states to really connect those policy levers, pull them together, and try to create essentially more situations like Vermont, you had partnership at the local community level, at the regional level, and then at the state systems level. So, syncing up the actual practice on the ground, syncing up how the relationships between different organizations are formed and maintained with regards to better food and early childhood. But then also trying to codify that into state policy and practice. And we did that for a number of years and had remarkable success in places like Iowa and Wisconsin and even in North Carolina, and a handful of other states. And we very much saw this as a build off our successful farm-to-school work, but doing it in a system that comparatively in terms of early childhood, was a little more fragile, right? And it wasn't necessarily as easy to do it, but all the more important and helpful because of the age and the vulnerability of the kids and families that we're talking about.

The systems approach is very powerful, and so I'm going to ask a question not to be challenging, but to in some ways give you a softball for proving the systems approach. If at the end of the day, the most important thing in a childcare setting is to get healthy food into the bodies of the children so they can thrive intellectually and medically and everything else. Couldn't you accomplish that by just giving a good shopping list, a Costco shopping list to the daycare directors, and they could go buy good foods? And why does it need to be connected with farmers and, you know, the broader connection into the community at large, why is that important?

Yes. Well, backing up, I wouldn't want to state, as an early childhood person, that the only thing that, you know, makes an early childhood program high quality would be the quality of the food and that that would, you know, lead to optimal child development and school readiness. I think, you know, there's other things in there that actually matter too. But this is definitely a key component. I would say, you know, to your question, that that system that you named already exists. We have the Child and Adult Care Food Program. We have the ability to subsidize the cost of food, and to have that good shopping list in play. But, I think, what the systems approach does is it asks different questions, right? It seeks to say, where does the food come from? How is it grown? Who is benefiting economically, right? How are schools and childcare centers and farmers and communities connected? And how do we strengthen those, connections and relationships so that we can begin to shift policy and practice so that children and families can reliably have access to good food. And they know that it's coming from the community in which they're situated. And the people on the side that are actually producing the food, the farmers and the folks doing procurement and others, that they're actually connected to it too. And they know where the food is going. And so there is this social kind of interstitial benefit to connecting those systems in a way that I think brings value beyond just you get a healthy meal today. I think it begins to shift culture. And if you could shift culture in the institutions that people are participating in, you can actually shift culture in people. So, you could see if a parent that potentially wasn't exposed to that before, or maybe didn't have access, or didn't know how to get access to that kind of food, if their expectations suddenly shifted because in their childcare program they're getting access to quality food, that then becomes an opportunity to engage in a different way. But it also becomes an opportunity for that parent to become empowered and to come together with other parents and other community members and begin to insist that's a reality in everyday life for them. That becomes a norm rather than an exception.

I really like your answer because, you know, in some ways, people in our country have become distant from their food. You know, it used to be you could just go to the store, and there might've been one agent between you and who grew the food. The farmer would deliver it to, and now there are factories and machines that process the food, and 10 steps, and it comes from different countries, and all that kind of thing. And what you're talking about is shrinking that gap again to decrease the distance, so people are more in touch. And you could easily see that if the food is coming from farmers and the daycare providers know that they're going to feel better about the food. They're more likely to tell a story about it to the children. The farmer might come to the daycare center, or the children go to the farm. And you could see there's a lot more going on here than nutrition, and that's the beauty of this systems approach, isn't it?

I mean, the children want to have a garden, right? I mean, how many times have we seen that? It seems like a small thing in early childhood, but just that simple act of having a garden and being able to understand how things are cultivated and grown. Even for a small child, and I have two small kids, we have a small garden in our backyard: it's meaningful. And it also, I think, establishes a norm that the tomato that you pick off the vine or the pole bean that you pick off, that you eat, that you find just unbelievably delicious, then that becomes normative for them. That's a normative experience, and kids are not as frightened by things when they encounter it. And I think we have a real opportunity in the early childhood space to link up those two systems to say, "Yes, we can affect change." And I think that, again, back to this notion of investing in people long term, the investment in those kids long term and what they come to expect will be the norm matters very much to how we think about our work at the Kellogg Foundation.

So you're talking about both practices and policies and a cross-sector approach to these things. And let's talk about policy for a moment. Where does policy typically break down? And what kind of people need to be at the table, and what sort of partnerships need to be established in order to have better food policy?

I think if we take seriously that food policy is cross-sector, I believe that we need to build tables that look like the food system. And that means not just public health experts or nutrition advocates or academics, but farmers and food workers, and those childcare providers and teachers, and leaders in K-12, and tribal leaders, community organizers, local state government officials, right? And the funders, right? The funders who are willing to invest in the long slow work of doing systems change. And, you know, one place I would highlight is in your home state of North Carolina. For years, there was significant investment that helped really build a dense ecosystem. You established regional food hubs and meat processing infrastructure, and anchor institutions into schools and early childhood centers. And a really strong network of organizers and philanthropic partners. And that made it possible to fully integrate farm to early childhood in your state's definition of early childhood.

And as an aside, I would say North Carolina was also one of the leading states back when I was first coming into the field of building out a high-quality system of childcare. North Carolina led that. And so, these two things converging is a very powerful example, but again, we're getting back to local sourcing. We're getting back to bigger things than just doing food education, right? Those things are now built into the system. And they're not just a side project of the system. They actually are the system.

So, you're talking about a foundation doing a lot more than getting proposals, seeing what needs to be funded, and then sending money out the door. You're talking about connecting people in innovative and unique ways. And building bridges that didn't exist before. And getting people to understand the systems change approach. And it just can lead to so many interesting and innovative things that just weren't possible using traditional models. So, really my hat's off to the work you do, and I can see why it's creating such powerful outcomes.

One piece I would be remiss if I didn't say this, right? What makes all those partnerships work or fall apart? Usually, it's not the brilliance of a single policy idea or practice idea. I. Sort of. Sound like a broken record, but I'm going to come back to this. Investing in that people infrastructure that sits underneath it is really important. And the places that we find that make progress in any of the issues we're talking about, family economic security, food, health, Medicaid, early childhood, K-12, right? The places that make progress really do have varied and diverse voices at the table, and they're able to build real trust. And they're able to cultivate champions and also the next generation of champions and the next generation of champions who can move between those sectors, right? And the funders are involved, but they really understand that they're financing relationships and governance and people. They're not financing programs. And I think as a grant maker, that's an interesting distinction to think about. Think we know it implicitly and we know it when we see it. It's a lot harder to stick it in a white paper and define it and disseminate it in Stanford Social Innovation Review, for example.

No, I totally agree. In the work that we've done over the years with, uh, community partners in Durham, it's been my impression that they get this systems thing from the very get-go. That they understand that if poverty is too severe, then nothing else is going to work, and if housing is a problem, then these other things are going to be affected in pretty serious ways. And they understand the importance of these. And in a way you're letting the flowers bloom. You're taking, I think, what some people understand intuitively and would like to accomplish, but they've been forced into silos. And then once a funder comes along and can allow this to prosper, I think it's sort of a natural thing that occurs.

I think so. And I think the tricky thing there is to not be seduced by the programmatic solution. Like, do you remember several years ago when the notion of collective impact was this very popular term that folks talked about? And it's a good thing. I mean, I think the framework and the model is powerful, and it's a useful thought exercise. But what I found in a lot of collective impact work was that it focused very much on aligning the programs. Sufficiently funding the programs and aligning the programs, but not the human side of design and redesign of how do those programs function, right? Who do they serve? Who's at the table when building them or rebuilding them? Do you have the ability to change them midstream if you feel that you need to? And I think a slightly different approach with systems change is you're sort of engaging in a loose hold of the policies and the practices and the issues to give people and the people infrastructure and the relationships time to come together and figure out how they want to move them individually, and how they want to move them collectively. And that's a subtle difference. That's a nuance that I think has really worked in our particular corner of the world.

One thing I bet some people are interested in is how the Kellogg Foundation might be distinct from Kellogg as a company. You've described beautifully the innovative work you're doing. The company is off doing what it does commercially. How do these two things intersect? And what's been the history of the connection between the foundation and the company?

Yes. So, when the foundation was founded in the 1930s, Will Keith Kellogg, as you said, he endowed the foundation and created it separate and apart from the company. So, it's an independent philanthropic organization. And so, while we bear the name of Will Keith Kellogg, the foundation does not have a formal connection or stake in the company any longer. As you may know, the company split into two companies a few years ago, one called Kellanova and one called the W.K. Kellogg Cereal Company. And since then, I believe both companies have been acquired. I think Mars now owns Kellanova, and Ferrero, an Italian company, owns W.K. At present, the W.K. Kellogg Foundation does not have any connection to either of those companies because they've been acquired by other groups. And aside from having some stock with the foundation, that was sold to support our endowment, we don't have any formal connections anymore.

But I think the proximity of the foundation to the company in Battle Creek, and I think the shared history of Battle Creek and the shared history of Mr. Kellogg's vision is actually important to note. And I think it does matter to how the two institutions are connected. I said this a little while ago in the conversation, but in the 1930s, Mr. Kellogg knew that you couldn't separate food from health and education, family economic security, and he knew this while he was making cornflakes, right? And so he helped make sure in the late 1930s that children in Battle Creek had access to fresh milk in schools at the same time that he was doing work in soil conservation and in building healthy land. And he had a sense of knowing that how the food is grown and how kids are nourished, it's part of the same story. And I think that DNA has pulled forward into the foundation, and it makes it a really special place to work because we still carry that memory of him, and we still carry that vision of him into the work that we do.

Thanks. You know, a long time ago, when I first became familiar with the Kellogg Foundation, I wondered about the history and the independence of the foundation from the company. And I pretty quickly came to learn that the foundation, as you said, is quite independent from the company. But you've enriched my knowledge even beyond what I've known over the years, so thank you. That's a fascinating history. So, let's end with one final question. If you fast-forward and kind of look ahead, what do you think is on the way? And what does success look like to you and your colleagues?

Yes, it's a good question. I mean, I think if we got this right, you know, 10- 20 years from now, success would look like children and families living in communities where good food is just a part of everyday life. It's normal and reliable and not something that folks are lucky to find. I talked a little bit about how Mr. Kellogg thought about this in the '30s, but we also see what's possible in other places, right? When that vision can become a reality in terms of policy and practice. So, we had done some work in the country of Brazil. And we see now that national policy in the country of Brazil now requires that at least 50% of school food be purchased from local sources, grown with high-quality standards, right? That one decision reshaped incentives all along the food chain. What farmers grow, what institutions buy, what kids eat. That's a powerful example of institutions using their everyday purchasing power to build healthier and a more just system. So, you know, 10- 20 years from now, if we've done our job, it would mean that the kinds of innovations in places like Brazil or North Carolina or even in Michigan with our 10 Cents a Meal program, that those types of things would have become the norm. That schools and early childhood centers and hospitals and tribal and local governments would be routinely buying good, locally rooted food. And that workers and farmers are earning a fair and stable wage, and they have incomes. And the communities most affected by hunger and inequity are actually at the core of leading and designing new systems. And food policy would no longer be a patch on top of the inequity. It would be one of the main ways that we build healthier and more equitable futures for kids and families.

BIO

Jon-Paul Bianchi is the Director of Systems change at the W.K. Kellogg Foundation (WKKF) in Battle Creek, Michigan. In this role, he leads WKKF's national grantmaking strategy focused on early childhood care and education, health equity, employment equity and food systems. As a longtime philanthropic leader and national expert with a focus on early childhood education, Bianchi provides strategic oversight to the foundation's national programmatic work to support thriving children, families and communities. Bianchi holds a doctorate of Education from Vanderbilt University's Peabody College of Education and Human Development, a master's degree in child development and a bachelor's degree in child and family studies from the University of Wisconsin-Madison. He helped found and currently serves on the board of Valley Settlement in Glenwood Springs, Colorado.

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I'm delighted today to be joined by Dr. Joseph Skelton, professor of Pediatrics, founder and director of Brenner Fit, a program at Wake Forest University School of Medicine. FIT stands for Families in Training, which is a family-based pediatric obesity program. He's the author of a new book on children and their weight, a topic we discussed in a separate podcast. But in this podcast, we're talking about something he teaches at Wake Forest, a course in culinary medicine. This is a fascinating, pioneering area of focus, so let's dig in.

Interview Transcript

There's a lot of language about medicine and nutrition now, so people talk about food as medicine. There's a move afoot to get more training and nutrition and medical education, and here you are doing culinary medicine. Tell me how all these things differ from one another.

Our interest in this here at Wake Forest School Medicine started a little organically with our program. A lot of what we do is focus on family meals. There are decades of research showing the benefits of family meals, not only for the nutrition and obesity risk, but the quality of nutrition, time spent together, parent child communication. Kids are less likely to get pregnant or do drugs and alcohol. All these things from just spending that time together over the meal. And I inherited a small teaching kitchen that was at a local organization that someone before me had gotten funding for. And we, sort of, took it over and used this opportunity to teach families how to cook. And a lot of families know how to cook but trying foods in different ways and to get kids involved and things like that. Then a couple years after that, the local YMCA approached us. They had some space and wanted to do this as a partnership. So I became a fundraising machine for a year or two and took a lot of dinners to raise the funds. And we built this gorgeous teaching kitchen, and we were mainly doing it in the efforts of sort childhood obesity treatment or prevention, getting families, teaching them new recipes, which then kind of extended to that whole key thing of getting families just to be comfortable in the kitchen and spending that time together. And we just started seeing these amazing things. We always say we've converted more kids to Brussels sprouts than I think any other effort of just getting them cooking it a different way. You and I were both probably raised with steamed Brussels sprouts, which I think is an abomination. If you really want to highlight the sulfur smell of a food, then you're going to steam it. And so, we really started to do that. And then students started volunteering. Actually, it was a student, Josh Patman, he's an emergency medicine physician now at East Carolina University, and he was a cook in a professional kitchen college. And he said, hey, could I help volunteer with that? And then more student medical students wanted to do it. And then we all found that you, much like I did, I'm a self-taught cook myself, and the more time you spend in that, the more you learn, the more comfortable you are. And the more you start to know, you know, I can teach med students nutrition all day, but that doesn't teach them how to get nutrition on their patients' plates, into their mouth. And so it really grew from there. And then I, kind of, stumbled upon what other people were doing. It started in New York, but the biggest program started was really Tulane School of Medicine that had it as a very focused way about teaching nutrition through cooking. Not just on a blackboard through PowerPoint slides and stuff like that of like hey, let's teach it in a different way. And the old-fashioned analogy, and actually the medical educators hate this, it used to be see one, do one, teach one. That was sort of the old surgical thing. And so, it's really you got to see how to make a recipe and you got to do it yourself. And what we found that when students start then teaching each other, or teaching patients or teaching community members, it really drives home and gives them a much deeper understanding of what nutrition in the real world is.

Let's talk about the need for this. If we go back in time and we think about your parents or my parents, you know, the likelihood is that meals were being prepared from the real foods rather than from a package, let's say, or in a micro. How are things different now for the modern parent that has kept people distanced from their food and where it comes from, and that's led families to be distant because they're not having meals together as much? What does that look like now?

Yeah, pulling from our own history, you know, Home Ec is not really a thing anymore. We did this study in our own med students. You know, most of their cooking, nutrition, the nutrition education they're getting tends to be the popular media. They're learning it from social media. Very few students have a degree in nutrition or took a nutrition class. And as much as we have to cram into medical student's education, there's not much room for it. They mainly learn to cook from their families. And what we know is families are cooking less and less for multiple reasons. They're much busier. Especially parents, actually parents of kids of all ages with that. And again, the marketing of food, you know, it's much easier to get ready made meals. And I'm not badmouthing those, you know. We're in talks right now of actually writing a cookbook for families, and one of the things that we promise is we're going to have a chapter on assembled meals. You know, having a pre-made salad with a rotisserie chicken, that's still going to be a better thing to do if you bring that home, sit at a table or at a bar or around a coffee table and eat that meal together. It's still going to be better for your family in multiple ways on multiple levels than eating out. And what I see, it really with families right now when it comes to actually raising "healthy eaters" or raising good eaters is when we... and again, I love a good restaurant, I'm not trying to badmouth that... but when you're going out to eat a lot of kids have endless choices and there's two issues. One is a paradox of choice. Whatever they get, they're always going to think that other thing might have been better. And it doesn't allow them to spread their palate and try different foods and get exposed to different things. And we always laugh... whenever in this field we want to play a drinking game where every time you say complex or complexity, you take a drink because, but it is such a complex issue with parents. You know, with kids and getting meals on the table. And hopefully finding some time, whether it's a breakfast or it's a dinner, but finding that time to come together around a meal.

You mentioned the paradox of choice. I was reminded at one point I downloaded this cute app called You Choose or something like that. And it would help you make a decision if you were undecided. It would flip a coin, it would roll a dice. It would do, yes, no, it would do rock, paper, scissors, it would do all these things. And I was at a restaurant once. I couldn't decide between two entrees, so I used it. I did rock, paper, scissors, or something, and I then it said, okay you should choose X. So I ordered X and the second I ordered it, I immediately thought I should have ordered Y. Alright, so tell us about culinary medicine. What does this course look like that you teach?

Yeah, the best way to think about it is applied nutrition. Because again, you can understand a ton about nutrition, but if that doesn't change into you getting the foods that you want in front of you, to me it's almost theoretical or scientific. It's applied nutrition. It's this idea of teaching some very basic cooking skills, and then including within that very core elements of nutrition. And for us, we tend to do it by the balanced plate. We think that works really well for families. But having it be very real world. You know, so again, we have recipes... in two weeks, I'm doing one... we're doing a rotisserie chicken and you're breaking it apart and making a chicken salad out of it. We were always teaching using microwavable rice and a couple of the students cornered me and said, this is very offensive to my culture. You need to teach people how to make real rice. But what it looks like for us is about a quarter, almost a third of med students will rotate through these classes. So, it's voluntary. Next year we're actually hopefully going to surpass half of the first-year med school class.

That's unbelievable. That's very impressive.

Well, especially up until last year I was doing this in my free time and paying for it with fundraising money. But yeah, Wake Forest is really behind this now. But about a quarter to a third of med students. They do five classes. And it's set up and again, that sort of theme of that family meal. They come in and we get stuff cooking. We get stuff in the oven; we get stuff on the stove top. We usually take some time out for a very short lecture. Again, tends to be very practical stuff. We include a lot about social determinants of health and food insecurity. Given what I do, we talk about picky eating. Very little do we go into details about Mediterranean diet and Dash diet and some of the really core things with that. We really just try to keep it about getting that balanced plate of a protein, a starch and a fruit or vegetable on the plate in front of you. They come back and usually finish what they're cooking, and then they sit down to eat together. And unlike when I was in med school and you were in grad school, or when you were teaching, a lot of students don't go to class anymore. A lot of students, they record the lectures so they can listen to them at one and a quarter speed and study in the best way for them. I love getting to know my students on a different level of sitting down. And that's what my really own exposure to medical student education anymore is really through this, which to me is just the ultimate. Being able to sit down, teach them some interesting things, eat a meal with them. Given my chemistry background, I love getting into the science of a lot of the stuff. And I think for them being, you know, sort of STEM kids, it makes a lot more sense. One of my favorite things is the science of grilling, you know, the science of garlic, you know, things like that. And it helps them sort of understand and helps them remember that, and also peppering it with the stories. It just tends to stick that much more when they know the science, they know the story, they know the culture behind it. So, it's five classes. It's all set up that way, that there's a short lecture. They're preparing everything they can and they're eating it. Again, we include some very easy stuff. One of the classes we do microwaveable vegetables because that's what a lot of what their patients are doing. The bagged vegetable medleys. And one, the important thing that we teach them is most of these don't have any seasoning. So yeah, you can microwave them, but you have got to teach your patients throw a bit of olive oil on there, throw a pad of butter, do some salt and pepper, add some other spices to it. And they go nuts with one group will do some more Indian spices. One group will do more sort of traditional, one to do more Asian flavorings to it in our teaching kitchen. It's really teaching very practical things like that. The fun part of that, that's really spun onto the other things that I'll tell you about, is about half of those students that do that- we have about 18 per semester- and about half those students end up volunteering with us. They come to the classes that we have that are community focused. Now some of the students are going through lead teacher training. They get Serve Safe Certified. It's awesome for me and my staff because it saves us a lot of time and overtime that they come in, they let themselves in the kitchen, they set up, they run the class, they clean up, and they can't get enough of it. They absolutely love it.

Now you do some celebration of different food cultures in your class. Tell, tell us about that. Including, as I understand, some of the food culture that you grew up with.

Yeah. Yeah. That, that's about, that was a big understatement right there. We just love that and that's a great thing. Wake Forest, being a private medical school, kids are from all over the country, from all different backgrounds. And so, we absolutely sort of herald that. One of the things I love doing is class three is a plant-based proteins class. The first class is a general cooking class. The second class has a focus on animal proteins, and again, we're always also cooking vegetables and fruits and starches. The third class is plant-based proteins, and I do that as Southern cooking. And I just love that sort of theme with that. So, we do pinto beans, you know, And the slow cooker. We tell them how to use instant pots, pressure cookers. We do black eyed peas. A lot of these kids don't know that you're supposed to eat that on New Year's Day. I do a vegetarian collard green recipe, taught to me by a local chef. And I think this is probably my number one post that I do in social media is cornbread night. And teaching them how to make cast iron skillet cornbread, which is the only way to do cornbread in my book. And letting them know, sort of, the background of a lot of the stuff. My wife is from South Carolina, so I teach them great thing about cornbread if you're a poor student, is you have a slice with your beans and your collard greens, and then for dessert you put honey on. Which is what I picked up in South Carolina. So, you know, really celebrating that stuff. We have a whole Spanish speaking program, and we have an article written, we just haven't found the right journal for it. It says, leave my tortilla out of this. Instead of, you know, saying, oh, you have to eat less tortillas, celebrate it. Why is that such an important part of not even that culture, but this family's food history and stuff like that. Because food is personal, it's cultural, its family, and it's to be celebrated.

We do a fourth-year elective, it's the last full elective of their fourth-year class and a very lucky 20 students get to do that class. And we always have one called Family Night where they bring a dish that's important to them and their family. And it could be like me, it was the roasted chicken that one of my classmates in med school cooked. And I just thought that was so exotic. You know, I never had a whole roasted chicken before. You know, we had a student that had spent the first part of her life in Australia, so she did pavlova and told the history about where the pavlova came from. Now that's considered sort of the national dessert of Australia. And I always remember this one student, he was going to emergency medicine, very quiet kid. And he's over there cooking these porridges. That's the only way I could describe it is just these porridges. We said, what are you doing? And he told the most amazing story. I almost tear up when I talk about it. His grandfather fled Saddam Hussein. He was Iraqi Christian and fled Saddam Hussein and his grandfather lived with them. And this was their afterschool snack. Was this Iraqi dish that his grandfather would make. And there was a sweet one and there was a savory one. And so just stuff like that is... it's fantastic. I just, I can't get enough of that. And they remember that. And so, as students leave us, and I just came from Match Day where they found out where they're spending the next three to seven years of their life. And I always say wherever you're going, learn something about that culture and that food. If you're moving to Cincinnati, you have got to learn about Cincinnati Chili and getta. take something from that. I did all my training in Wisconsin and the Wisconsin supper clubs and how you can tell what a fresh cheese curd is, and it's just... food is fantastic. And we can take that with us wherever we go. And it can give you a way to know your patients even better. And when I hear of a family that they're from West Africa, ah, you like Jollof Rice. And their face lights up and like, oh yeah, where'd you have Jollof rice? So, it's a great way to get to know more about people.

So, there's way more to it than cooking technique. I mean, there's, you know, you roast a chicken that this temperature for that long, or here's how long you microwave. It's really a lot more than that, isn't it?

It's just like medicine. It's science and an art. And you know that one of my most popular lectures I give does not have to do with obesity but has to do with barbecue and all the different styles of barbecue. And what is just amazing, despite what we know about the science of taking spareribs, which are an incredibly tough cut of meat, and you have to cook them low and slow to get that temperature up. I think it's 189 degrees or higher where you start to get the collagen that breaks down and they turn tender. So yeah, spareribs to be good tender and edible, you're talking four to six hours. But then you go to Tuscaloosa, Alabama and you go to Dreamland Barbecue. They do spareribs over live coals for an hour and a half. I sat there talking to the person doing it. I'm like, you must bake them ahead of time. Do you soak them? And he's just like, nope. And so again, I know the science of that. So how do these jokers do that for an hour and a half, and it turns out in what my opinion are the greatest bear ribs in the world.

Oh really? Oh, I'll have to try. I'll have to try that place out.

Yeah, there's several. Birmingham has two there. There's several in Southeast and they cook them for an hour and a half. Over live coals. Violating every scientific principle of low and slow. Don't get it. It's fascinating.

That sounds really good.

Yeah.

Well, Joey, thanks very much. One final question. Do you see this... is this a movement in medicine now or more and more people doing this?

Yeah, you know, it was really big for a while. Tulane had so much. You know, they were sharing their curriculum and they were doing some good research. And that's where a lot of what you see now as the food is medicine food is medicine or as medicine where hey, we need to find ways to get medically tailored meals in the patient's hands. There's really good evidence of that with diabetes and stuff like that. I think what you're seeing now is, I think especially with some of our efforts in the government right now, is sort of demanding more nutrition education in medical school. And I'm going to double down on culinary medicine because you know what? My students, myself, I don't need to know more about the biochemistry of carbohydrates. I need to know the biochemistry of cooking and how to do that quickly and safely to teach my patients. And also, with that, we have to forget, there's an entire field that's already doing this, you know? Dietetics and nutrition and there's professionals that probably are way better than us. But I think having this increased understanding, especially dwelling in that food space, is going to help us relate to them that much more. So even though I do a lot of nutritional counseling and talking, I still use my dieticians way more. I think they're going to be way better at that. So I think there is a lot of steam building towards that, but we don't need to turn doctors into junior dieticians. But I think we can give them deeper understanding of how food and nutrition affects their health and the broader aspects of that. It's not about the biochemistry of insulin secretion, it's about where are they accessing food and how can they make use of the food pantry near them. And let them know, hey, it's okay when you open a can of beans it's gonna smell like cat food initially, but you know what? You wash that off and actually it's not going taste like cat food. And you know, just kind of be able to work with them. Hey, canned beans are perfectly fine. Guess what? Canned beans now are coming in no salt added and low salt preparations. And here's an easy way that you could take these canned great northern beans, chop up some herbs with olive oil and a chunk of garlic and you can make some fantastic bean recipe that is incredibly filling and healthy and cheap as dirt.

Oh, that's really nice. Well, this is an exciting advance in the field and you're really at the forefront of it, and your students are lucky that they have this available to them. So, thanks very much for being with us and sharing your experience.

Well and what the big secret about this is, Kelly, is this is fantastic. I love doing it. Our med school really values it, but it's a lot of fun. That's the thing.

You can tell just by the way you're talking about it.

It is so much fun. And again, I just saw all my students that were graduating. And that some of these I hadn't seen in three years and they're like doing Doctors in the Kitchen and then seeing patients, they're cooking and being able to relate to them in those ways. I just have a text from one of my students going to family medicine, and she's like, this changed the trajectory in my career. And I'm not taking credit for that, but just the idea of giving that experience I think especially in my world to medical students, I absolutely love it. In the end it's a hell of a lot of fun.

BIO

Joseph A. "Joey" Skelton, MD, MS, FAAP, FTOS, DABOM is a Professor of Pediatrics, and of Epidemiology and Prevention, at Wake Forest University School of Medicine. He is the Founder and Director of Brenner FIT® (Families In Training), an interdisciplinary pediatric obesity treatment, prevention, research, and educational program. He serves as the Director of the Center for Prevention Science in Child and Family Health, Vice Chair of Research for the Department of Pediatrics, Associate Leader of Community and Stakeholder Engagement at Wake Forest University School of Medicine. He is the Editor-in-Chief of the journal Childhood Obesity. He is board certified in Pediatrics and Obesity Medicine. His research and clinical work has focused on the treatment of children with obesity. He has secured nearly $10 million in funding over the past 15 years, has given over 50 national and international presentations, and has over 130 peer-reviewed publications. He enjoys teaching cooking classes that are both fun and informative to anyone who will listen.

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So going back more than 30 years, I was involved in work on childhood obesity. It was a prevalent problem at the time, but little attention was being devoted to children and weight issues. And it was fair to say that the field, as it were, was an academic backwater. Little was known about short and long-term effects of childhood obesity. The social and emotional lives experienced by the children hadn't really been documented or studied much. There was very little known about treatment or strategies for parents, but thankfully, things are different now. Thanks in part to the work of a number of really innovative people in the field, and one of the most innovative is our guest today, Dr. Joseph Skelton. He's a professor of pediatrics and founder and director of Brenner Fit. FIT stands for Families in Training, which is the family-based pediatric obesity program at Wake Forest University School of Medicine. He's also editor of the Journal of Childhood Obesity is involved in clinical care, research, education, and community outreach. Dr. Skelton has just published what I think is a really important book through the American Academy of Pediatrics, entitled Your Child Is Not Their Weight: Parenting in a Size Obsessed World. I was asked to review the book and was delighted to see it before it was published and just was so happy to see that such a book existed at all, but such a good quality book at entering the picture. Really a very important advance in our field.

Interview Transcript

There have been some books about pediatric weight issues in the past. Who is this book for and how is it different than what's been out there?

I feel overall the big audience for this book is any parent, especially of my generation, that were raised during some really toxic diet culture in the '70s, '80s, and '90s. And so, I think the main folks that that's for is that parent: I want my kids to eat healthy, to be active, to lead healthy lives. But I don't want them to become concerned about their weight to feed into our culture's focus on the ideal body image. I don't want to feed into that. But you know I do want to pay attention to the health habits. How can I do this in a healthy way? How can I focus on health habits with my kid that's not a focus on weight and do it in a way that's backed up by science. You know, that's what parents always want to know. Am I doing this right? Am I causing harm? And it is actually who the book is dedicated to, you know, all those parents that were raised in a toxic diet culture and want to do things differently with their children.

So, in modern day America, what is life like for a child whose weight exceeds the standards that we know might be healthy, and for the parents who are raising those children?

From personal experience and 20 years of running a program, as well as what the research shows, it can be kind of rough. Despite a lot of the advances that we've made around weight bias we're still in a place that kids are trying to live up to this idealized body image. And then they have all these toxic messages when it comes to nutrition and body image. I think it's rough. We know that kids in bigger bodies tend to have a lower quality life. They tend to have more symptoms of depression, anxiety; and it's because of this world that we live in.

You mentioned messages that they might be getting from places like the media, but what are interactions like with peers and teachers and doctors and others in their lives that are affecting how they feel?

Yes. So, the adults in their life were raised in that toxic culture. They're my generation and the generation behind me that was raised in that. You know, there's the myth that a smaller body is healthier than a bigger body. And I think we can't break away from that. And I think that still sort of comes through. We still see this as a lifestyle issue, and everyone has an opinion. Everyone has a thought of, you know, well, I did this... and I lowered my cholesterol... I did this and I lost weight, you need to do it too. And I think in the medical profession, because of a lack of understanding, a lack of training - I think that still occurs. I don't do a ton of medical education. I'm getting more and more into it, especially when it comes to areas around nutrition. But that's what I'm trying to avoid in the next generation of healthcare providers and even actually a lot of our community collaborators, teachers, and stuff like that. To get away from that. This is not a simple issue, so don't share advice because sometimes that advice can be damaging or could be wrong. You know, good lord how much I hear about carbs on a weekly basis. And not the carbs I like to talk about, which is around dessert and Carolina Gold rice and all these other food stuff. But it tends to be around sort of demonizing certain foods and just really bad messages that still are floating around out there.

Let's dive in a little deeper about what you refer to as toxic diet culture that was especially pronounced in previous generations. What does that mean? Does it affect standards for what the ideal body looks like? What about messages about how much control you have over that yourself, and how responsible you are for your weight? How your self-image should be influenced by how you look? But tell us more about what you mean by that.

We wanted this to be a book that didn't necessarily dwell on weight so much, but actually one of the first chapters is to say let's cover how complex weight really is. We know that 50% or more of someone's weight is heavily, heavily influenced by their genetics. Where they live, you know. The amount that our lifestyle affects that is much, much smaller. It's the minority of what goes into our body size. And even that, our habits are so influenced by the world around us. But it's, you know, trying to get people to understand that, hey, body sizes are just different. I love this picture from the Olympics and it was a medalist in gymnastics- it was Simone Biles; you know, the huge media personality of Ilona Maher who is a bronze medalist in rugby; and then one of the women's basketball players. You're talking 4'9", 5'10" and pure muscle and six foot seven, all people at the top of their game. And not only different heights, different body types. And, you know, body type is a hard thing to talk about because there's not standard body types. We're all just built differently. And starting that message at a young age that people are just oftentimes built differently. There's very little control that we have over our weight. And even though there are things that we can do about weight, what you can do is you can focus on your habits for health. And that has just gotten lost. We talk about in the book the, we call it veiled weight talk, and it's basically where you're just substituting the word health for the word weight. And kids pick up on that. They know when their parents and others are talking about weight. And so, a really big thing we want to accomplish is like, Hey, you know, eating for health is important. Being active for health is important. In my world, and I did one part of my early research in this, and we always try to have that message as there's so much more to health than weight. In our medical world right now, our primary outcome on these lifestyle changes that people are making is weight.

You mentioned genetics as a contributing factor to who is affected by the problem. Tell me how you look at the food environment out there that people are exposed to now, and things like food marketing and the processing of foods. The availability of all these foods that are contributing to obesity and things. And the reason I ask is, you know, there was a time in our country when the prevalence of childhood obesity was probably close to zero. And there are plenty of countries around the world where that's still the case. But now in many countries there's large amounts of childhood obesity. And it's not as if the genetics have changed. When people move from other countries to the United States, their weight tends to go up. Their genes obviously don't change. There's something pretty toxic about the food environment that's driving this. So, thinking about things that way, does that help parents by shifting some of the blame from them and their children to an environment that they might be able to manage in some way?

Absolutely. Because parents…they blame themselves oftentimes. You know, how did I let this happen? What did I do to sort of cause it happen and it's not. So, we do try to shift that of looking at ourselves as the reason blame. But you can kind of look at the - and I'm just going to focus on nutrition as the focus - the broader food environment and how that impacts. We tend to get a lot of buy-in or understanding when you talk about how they are trying to market to kids. And so, for any parent, all you have to do is bring up the checkout line at a grocery store, you know? And all the things that are at the kids' level that is just made to make your life as a parent hard when you're trying to feed your kids well-balanced regular meals but you're just kind of constantly walking through this landmine. It's the same thing with electronics and social media. There are so many things that they have a lot more money than you do to market to you than you do to protect yourself against it. And it absolutely influences it. And the way I talk about this is really when it comes down to snack foods, and using the parenting language that snacks get you between long periods of time between meals, but that got co-opted by companies marketing snack foods. And when you see food, smell food or hear about food, you kind of want that food. And that's what parents have every day to now the point is. Snacks always have to be crunchy, salty, and sweet, and we're supposed to give kids snacks when they ask for it, because that's what these companies tell us about hunger. You know, hunger hits us every time and you have got to have this bar to sort of get through that. Parenting is hard enough and then trying to parent through this when they're directly marketing kids... you know, in most European countries, they're not allowed to market to kids. In some countries it's age eight. Some countries it's age 12 because they don't quite recognize this is marketing, they're want you to buy this. It makes it a lot harder for parents.

You know, when I was on the faculty at Yale, I got to know a political scientist. A very impressive person named Jacob Hacker. And he'd written a book called The Great Risk Shift. What he talked about was how government and American businesses have systematically shifted the responsibility for overcoming harm from products from themselves onto the consumer. And that's really true in a way here, isn't it? Because the problem is created by corporations who are marketing unhealthy foods in such high levels. It's not the only cause, but it's certainly an important one. But the responsibility for solving the problem then falls to the parents and the children who have it. And one party has way more resources than the other. As you said, it's really not a fair fight and parents have a very tough battle dealing with these things.

Yes. There was a marketing study called The Nag Factor, and I'm an old Simpsons fan, you know. You imagine the people behind the one-way mirror watching things and trying to manipulate. And that's what the nag factor was. How can we get kids to nag their parents more effectively? And what they found is parents that were immune to nagging tended to be the more educated, higher-income parents. And so, they literally had this plan of we need to change how we're getting these kids to nag. We need to give them reasons to nag. And that's when you started seeing vitamin C, high in protein. So, you think the checkout at the grocery store is bad, but then the signage in the commercials each and every day are giving kids reasons they can go to their parents to tell them get me this. Because nagging is not going to be enough for the high-income parents. They have to have some purpose behind it.

You know, when I was growing up, the only way I saw advertisements for food was on Saturday morning cartoon television. And there were three channels showing it. Well, it shows how old I am, but now it's just an avalanche of messages on social media, built into gaming, and it's just everywhere. And it's probably pretty hard for parents to control that. Wouldn't you say?

Well, now that you've said that, that's what my phone's going to start doing. The next time I open up my Facebook, there's going to be an ad for some sort of food camp because it's listening to us. Absolutely. Oh yeah. There's just no comparison. And I think that's also something very hard for parents, regardless of the topic, is what worked for me that my parents used is different than for my kids. And even between your kids. You know, my 24-year-old and my 20-year-old are completely different kids. You wouldn't even know they're related and different personalities. And so, what worked for one, you can't necessarily apply to the other. And whereas we love the idea of multi-generation households and, you know, being involved and being there to give advice. And you should take the advice of your parents, but it doesn't always apply. It's just a different world. I feel like I need to give credit to my East Tennessee farming roots. There are two stories I always remember my dad talking about when they would go to a car hop. Maybe some of your listeners know what a car hop is maybe they don't. It's like a Sonic, you know, it's the old school drive up. Or for you Atlanta folks, like the varsity drive up. My grandparents would make my dad put on his Sunday clothes. You know, that was how rare they went out is they would actually get dressed up driving into town to go try these hamburgers and these French fries. Versus now you can you DoorDash that 24/7. I mean just what a different world and concept. And I still have to share this other story for my grandfather, who my oldest son is named after, he was a tobacco and sustenance his farmer in East Tennessee. And every time I have a med student that's a vegetarian in my cooking class, I always tell the story of he came home one day, and he was talking to my aunt. He says, you know what? The county agent said one day people are going to be eating soybeans. That's so funny. Soybeans were fed to cattle back then. It's really just how drastically we change and now it's changing even faster. I mean, my grandchildren will be light years different than what my children are.

Let's dive back into your book. Tell me about the collaboration with the American Academy of Pediatrics and how did the book come about?

They have had two books in the past that were sort of geared towards parents, you know, how to address weight in your kids if your child has a problem with their weight, what can you do about it? Well-written books. They had done well. But they were looking to try to do something different. It was kind of time to sort of update that. And the last book was great by Natalie Muth. It was a fantastic book. So, a lot of my friends were on the 2023 clinical practice guidelines. And when that came out, there was a huge blowback from the eating disorder community. And, again, it's sort of the polarization of our country right now. And, they had asked me to speak at a conference saying, hey, can you try to do something in the middle? They knew that we included elements of the body positivity movement in what we do. We're big adherents and teachers of authoritative parenting. And they said could you try to give a talk that kind of goes in between what we're trying to do with the treatment of obesity that's affecting children's health as well as the body positivity movement. It's kind of, again, speaking of the Saturday morning cartoons, it was kind of those things that everyone stepped back, and Bugs Bunny was still in the front and got volunteered. It was sort of one of those situations. And so, I gave this presentation and they said, hey, well, what do you think about turning this into a book? Would you be interested in writing a book? And I said, absolutely not. I don't have time. And never in a million years would I do it. But this needed to be out there. So, first of all, the AAP asks, as a pediatrician, you do it. And second of all, I feel like this book needs to be out there. Both for who I talked about earlier, those parents that don't want to hurt the kids' feelings, make them hate their bodies, feel like something's wrong with them, which is what a lot of kids say. But it's also for those parents that are wanting to do something. These are the parents that, you know, they want to put their kid on a diet or make a comment to them of you sure you need to have seconds on that? You know, which we know can do damage. And of course, parents, you know, they don't want to hurt their kids and get in the way. And so, it was kind of geared toward those parents that were starting down an avenue that may not have been safe. You know, they don't have access to a good evidence-based program. And so, it's also for those parents that says, hey, your kids aren't little adults. Don't take these weight loss approaches to kids. It's just a different beast.

We'll come back in a minute and talk about specific parenting strategy, but you alluded to this blowback from the eating disorders fields and the clinical guidelines. Tell us a little bit more about that, because it's one of the key features that would drive the need for a book like yours.

I'm not an eating disorder specialist, but there was a big concern that one of the big recommendations that was new was that you can't have watchful waiting anymore. It used to be, you know, if younger children were starting to gain weight, before you intervene or start into treatment or start to change a lot that maybe just wait to see if, you know kind of the old-fashioned thing, are they going to outgrow it? Are they going to go through a growth spurt? So that was a part of the recommendations. The evidence says that watchful waiting in today's world, you're unlikely to see a kid outgrow it anymore, including bariatric surgery, use of medications and things like that. And so, they felt like this increased focus that this was going to cause pediatricians and parents to focus even more on weight and therefore lead to eating disorders. And then that was coinciding over the previous five years, a lot of studies were coming out and then it got put into a couple of systematic reviews of meta-analyses that showed that kids in bigger bodies, kids with overweight and obesity, had a two to three times higher prevalence of eating disorders. Because typically eating disorders are always thought to occur in underweight or thinner children. But it actually is much higher risk of these in children in bigger bodies. And so, we use that term threading the needle, how do you help families who want to do something about their child's weight for health reasons but not worsening disorders. And so that blowback was really saying, hey, by increasing focus on this, you're going to make things worse with that. And it was kind of surprising. A lot of my good friends were on that practice guidelines and they're kind of taken aback because these are experts in the field. Well-meaning people that for 10, 15, 20 years had dedicated their careers to helping these kids looking for help. And I think any care provider to be accused of causing harm is always, always jarring.

Tell us how you navigate that and what sort of advice do you give parents in this book?

Yeah, so one is that I call weight literacy. It's sort of understanding this is a complex issue. It's not something you did. This is something that happens. We can't always explain it. There are still things, this is where you read too much of this science, it gets you really paranoid about microplastics and things like that. There are some legitimate arguments to me be made there in endocrine disrupting chemicals and stuff like that. We can't always explain why kids are growing bigger than other kids or at a heavier weight. So, the weight literacy, sort of, understanding this is a complex issue, this is not a lifestyle issue. And the second thing is it's worthwhile to focus on healthy eating and physical activity for health. Sometimes that will see improvements in weight, sometimes it won't. But it's still important to do. That's the idea of getting away from that weight being the primary outcome. We feel like this is a great adjunct for someone who might be pursuing bariatric surgery or medications, because it does give us the opportunity to not keep pushing kids harder on nutrition and physical activity, which could lead to that disorder eating. And I think the final thing is sometimes parents and kids are aligned. You know, give me a 15-year-old girl that wants to lose weight. A 15-year-old girl that wants to lose weight, that is unfortunately a child that's very high risk of developing disordered eating. And maybe the parents really wanted to help. But what oftentimes we see a lot is tension brewing between the parent and child. The parent making efforts to help the child with their health and their weight, and the child interpreting those efforts as you think I'm fat, you think I'm ugly, you think something's wrong with me. And it's causing that tension: you know, you can't eat too much of that. Taking Food away. That movie Spanglish with Adam Sandler, several scenes in that sort of reflect that of just small comments that parents can make. You know, actually wanting to help and how that can hurt children. And what we would hope for a lot of parents is to say how can you do this in a way that can be helpful. And one of our chapters is called how to not talk to your children about their weight. You know, the idea that parents don't need to feel that pressure to bring that up. Now, if their child wants to talk about it, absolutely they need to be there, and we give a lot of tips for that. But, you know, your job as the parent, you don't really have control of your child's weight, but there's lots that you can control and lots that you can do to promote the healthy development of your child.

You know there's a heavy dose of compassion in your book. That was one thing that appealed to me about it and impressed me. Because if one thinks about a book for parents on dealing with their overweight children, you sort of default to, oh, this book is probably a diet or an exercise program, or things like that about how the child can change their weight. And you're talking much more here about understanding the psychological world of the child. Being sensitive to possible risks of talking to them in ways that are unhelpful or lead to eating disorders and things like that. It's wonderful that you pay so much attention to those issues. And it's very affirming because you're saying that there are some things parents can do about this in ways that affirm their children, accept them as individuals. It's built into the title of your book that your child is not their weight. And that just means so much, I think.

Oh, thank you. That is what we had hoped. I mean, you know, parents love their children and in endless, endless ways. And the parents are the key to their children and their children's health. And I feel like sometimes we push too hard. Now we're doing it for good reasons. We want this child to be healthy. We want to help make some improvements. And we put a lot on the parents' back. And I think sometimes then that pressure then is extended to the children. And a lot of this is trying to get parents some insights of, we know you love your children. Here's how to make sure that your child is being loved. You know, the old parenting typology, and I kind of go through some of that history in there, really kind of gets at that. But sometimes we do or say things that doesn't make their children feel loved by accident of course. And it sort of highlights that, not to make parents feel bad, just so they're aware. I've been guilty of it. None of us are perfect parents. And you know, making sure that our kids are feeling, loved by us. Family-based treatment is obviously the key. And I always think of one of your, one of your hypertension studies, I think from 1983. I still quote it to this day. You know, the idea that even though we talk about family-based treatment, we're usually dealing with a parent and a child. The dyad. Now they're representative of the family and I've always felt like something was, sort of, missing there. And two things really influenced me. One of that is one of my co-authors, Dara Gardner-Edwards, who is a licensed clinical social worker. And they are all about the family. They know how to do family assessments. And so, recognizing there's more than just those parents and the child in the clinic with you. In addition to that, working the whole field, I didn't know about human development and family studies. Didn't know that was a field and actually came from the University of Minnesota. I was one of the early. Strong program. So, UNC-Greensboro, our neighbor over there. I started working with a professor over there, Cheryl Buehler, and we would go meet over sushi and she essentially taught me a four-hour freshman-focused family studies course. And just this whole other world, social science world of family dynamics and recognizing when you're working with that child and parent. You may or may not be affecting the family dynamics in the household, of that family system. And so being able to extend differently and having some more appreciation of the complexity of families and the relationships with families. Hopefully we're helping people understand making changes in health habits, relationships matter. We have a project going right now, led by one of my medical students. She was always impressed, in shadowing with us, of how many siblings were picky eaters. And I brought this up to my team, like, oh yeah, this is a huge stress. You know, this parent is obviously wants to change the habits of the entire family but is obviously focused on this child we have in clinic. But the struggle of having this other kid that's a picky eater really throws off those dynamics. And being able to account for that and that stress that that puts on families, and what can we do around that?

Oh, that's so interesting. You know, the more aggressive, dramatic treatments that are being used for adults like bariatric surgery and the GLP one drugs, how do they fit into this picture?

Yeah, so we feel like it's a perfect adjunct if someone is pursuing with this with their child, because it still is talking about that parenting approach. And it's not really going to change anything with how you're parenting around these things. You know, bariatric surgery for many years has been done safely and effectively in children. Not that it's always perfect, but again, because of the cost, the idea that it's not reversible and typically you want that done in a center that's very experienced with working with kids. So, access issues tend to be really big with that. It can be very effective for some kids but is not available to everyone. We're in the same situation with the medicines with GLP1s. There's one that has been approved for use down to age 12, and overall, they tend to work very well with kids. But we're in the real world now. We're learning a lot about that. It can be miraculous for some children because it gives them success with their weight. It takes pressure off themselves. We're always trying to prevent that restriction, both in hearing that from another adult or the child doing it themselves, trying to tell themselves to eat less. It's always going to backfire. It's going to increase your hunger and things like that. And having that GLP1 is going to help with that. It's actually going to lower that pressure. And oftentimes they can get in that healthy routine much quicker. In others, it's causing some problems. We are seeing some kids that it is absolutely wiping out their appetite. And we're figuring out now the kids are sort of at risk for that. And you can't do that. The kids gotta eat. But for some kids, they just lose all appetite whatsoever. And they can't not eat. And so, we're still figuring out through the real world. But I think, what we're also finding is the job that we do in these multidisciplinary teams, it's just as important if not more important when you're using medications than when you're not.

Let me ask you a big picture question and let me see how optimistic you might feel about how, where things are going. So, think of a physician who is treating people with lung cancer. So, the lung cancer is caused by this terrible environmental influence: cigarettes. And the physician then is in the position of having to treat the people who have that really unfortunate problem. And thank God there are physicians who do that, and there's research showing how to treat it effectively. But of course, it would be better if the environmental insult that's causing the problem in the first place didn't exist. That would make everybody happier, except for the companies that sell the product. So, do you think you and colleagues who are doing similar work are faced with a similar kind of a problem? There are all these environmental things that are helping push this problem in the first place. Thankfully, there's kindness, compassion and effective care available and your book helps push that forward even further. But are you hopeful at all that the environmental situation, you know, all the bad foods and stuff out there is changing in a positive way so that there might be less of the problem, or it might be easier on the children now who deal with the problem? Some people think it's getting worse. Others think we might see some progress. But what do you think about that?

My brother is an HR guy and he kind of talks about these different typologies with that. And, I forget, I'm called something like the mad scientist, which is you're very pessimistic in complaining, but you have enthusiasm. I don't really know how to take that. But I think, you know, I'm enthusiastic obviously about this topic and what we can do to help parents. But I'm a little pessimistic when it comes to the broader world. I think there's enough, and not saying that every for-profit company's bad, but I think a lot of history is on my side with that. I don't get paid more the more kids I see and the better success I have. I don't get paid more. My job is to be here to help. But, you know, companies, every time I see a for-profit company that comes out and says safety is our number one priority. Or, you know, your satisfaction is number priority, I'm like, no, it's not. Your number priority are your shareholders. And I think that's a very, you know, jaded way to say, I don't quite trust companies right now because of that. Are there some positives that you see, and do you see some changes being made in some menus? Do you see some different products out there that are really trying to get it healthy? But it's hard. I think I have some trust issues and I think that's well founded. Maybe that's my Appalachian background. I tend to be very distrustful of the large mining companies coming in. That, speaking of your lung analogy, that I think I have some healthy distrust that is well founded. So, I think trying to help, and that's obviously a big movement that we have, of trying to help people be more discerning parents, more discerning consumers. But it's hard because they, like you said earlier, they have a whole lot more marketing dollars to convince you to buy their product than we have trying to convince them to make smarter choices about it.

BIO

Joseph A. "Joey" Skelton, MD, MS, FAAP, FTOS, DABOM is a Professor of Pediatrics, and of Epidemiology and Prevention, at Wake Forest University School of Medicine. He is the Founder and Director of Brenner FIT® (Families In Training), an interdisciplinary pediatric obesity treatment, prevention, research, and educational program. He serves as the Director of the Center for Prevention Science in Child and Family Health, Vice Chair of Research for the Department of Pediatrics, Associate Leader of Community and Stakeholder Engagement at Wake Forest University School of Medicine. He is the Editor-in-Chief of the journal Childhood Obesity. He is board certified in Pediatrics and Obesity Medicine. His research and clinical work has focused on the treatment of children with obesity. He has secured nearly $10 million in funding over the past 15 years, has given over 50 national and international presentations, and has over 130 peer-reviewed publications. He enjoys teaching cooking classes that are both fun and informative to anyone who will listen.

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It's the story of a guy on a road trip across the country, checking out America's classic greasy spoons. And the adventure is all about finding the restaurant owners and creative cooks serving up the very best of down-home style food. That's the premise of the hit series Diners, Drive-Ins, and Dives starring everyman chef Guy Fieri. Today we're going to talk with the show's creator, two-time Emmy Award winning food journalist and executive producer David Page.

Interview Transcript

David, I can't wait to talk to you about the show. But before we dive in and talk about the specifics, how long did the show run and how many episodes were done? My impression it's still on and it's always been there.

Yes. I created it in 2006, 2007. I did the first 11 seasons and moved on. And funny story, in the first month of the show we had a couple of strong initial outings. And everyone was all excited thinking maybe this will be a hit. A food network executive called me up to tamp down my expectations and said, look, this is all fine and dandy, but this thing isn't gonna go more than a season or two. There's just not that many restaurants. And you know, to quote the great screenwriter William Goldman whose rule of Hollywood is 'no one knows anything.' I did 11 seasons. It's now in season 40 or something, I think.

Holy cow. I could just think of enough restaurants around me to do a couple of seasons worth. So, tell us the origin story. How did Diners, Drive-Ins and Dives come about?

Well, I had left a career in network news and moved to the Twin Cities because I thought I wanted to be in business for a public corporation. And I took a job as the Senior Vice president at a home shopping channel, and I was all excited, and I hated it. It was just horrible. I did not want to sell second rate gold jewelry to shut ins. So, I quit, and I opened a production company and began to starve because I wasn't selling anything. Then I called Al Roker, who has a production company and who had technically worked for me, although stars don't work for executive producers in the real world. When I was the co-producer of the Weekend Editions of the Today Show. Al was on the weekend show at the time. He hadn't yet moved up to the big show. And I said, hey, Al, I'm starving. You got any work you could throw me? And he said, yeah, I'm doing a lot of stuff for the Food Network. I'll subcontract some of it to you. Which was good for both of us. I got to work, and Al got to take a cut without doing anything. So, that hooked me up with the Food Network. I started working for them and Al and I both knew I wasn't gonna get rich doing a pass-through deal, so I started pitching them directly. And I was getting nowhere. There was this very nice development exec who would talk to me on the phone. And everything I proposed she would shoot down. And one day I'm on the phone with her and we're going through a pitch call and I'm proposing this and proposing that, and she's saying, no, no, no. Finally, the Food Network had asked Al to do a documentary on diners and the history of diners and such. And Al had subcontracted it to me. So, this development exec had a frustration and I think pity for me and finally said to me on this call, don't you have another thing on diners? And I immediately, I said, oh, absolutely. I'm developing a show called Diners, Drive-Ins and Dives. And I told her all about it. And this was like late on a Thursday or Friday afternoon. And she said, 'you know, that sounds good. We have a development meeting Tuesday. Get me a writeup on Monday.' And I got off the phone elated because it was the first time she'd expressed interest in anything. But also, I'd kind of put myself in a jam because I was not developing a show called that. I had literally pulled the title out of thin air. Or a body part, depending upon how scatological you want to get. And that gave me the weekend to try to put a pitch together. So, this was in the old days when you didn't email people, you called them. I did as much research as I could, and I started calling restaurants around the country. And on Monday I sent her a pitch for a one-hour special with, I think, it had seven restaurants in it. And, they had their meeting on Tuesday and here here's, you know, you get lucky. Guy Fieri had just won their second Food Network Star competition. Back then they naively believed that that contest was gonna generate them a new star every year. Someone who would be a big deal for it. In fact, Guy is the only one who ever made it and, when I'm drunk and immodest, I take a lot of credit for having taught him how to make it. But he has immense natural talent. Anyway, they wanted to make Guy a star. And they were trying to get a primetime show for him. And big deal, major league production companies had been asked to come up with proposals, which had not come back yet. They figured, what the hell, let's do a special with Guy just to keep on the air so people wouldn't forget about him. So, they picked up this special from me. It was gonna be a one-shot deal. We did it. I think they were kind of stunned by how well it did. And then something really great happened for me. They looked at the proposals from the big boys and didn't like them. And they were kind of stuck. They were desperate to get Guy on the air in prime time. So, they figured, well, you know, let's pick up a very short season of this thing. And they bought, I don't know if it was eight or 10 episodes, but they committed to that. And very quickly, we became a hit and off we went.

It's an amazing story. So many people have seen so many episodes of that show. But nobody would have any idea that's how it got started. It's wonderful to hear about that. Once you got going and got your feet on the ground with this, what were you hoping to accomplish through this show?

Well, look, TV's about storytelling. I've been a storyteller, hell, for 50 some odd years now as a mostly broadcast journalist. You learn, if you're any good, that the best stories come from and are about people. I conceive this not as a food show, but as an opportunity for the viewer to meet really cool, passionate people doing something they cared about. You know, independent restaurant owners make a buck 3.80 at best. They're passionate about making good food. If they're any good. They're often trying to keep family legacies alive. And more than anything else to succeed in the food biz you gotta wanna serve people. You gotta wanna make people happy. So, I went out to document the stories of some of the coolest people in America. Now, it was in the food world, which is a world of shared experience. We all eat. Most of us have favorite foods. Most of our favorite foods are the kinds of foods that I featured on Diners. TV is about one thing: hanging out with someone you want to hang out with. That's why Tom Selleck remains a star; whatever crappy TV show you put him in. That's why for your older audience, Tyne Daly kept getting series after series, or James Garner. There are just people you want to hang out with and that's all television is. Guy is someone people want to hang out with. His personality comes through the screen in a particular way. And you know, I said earlier, frankly or implied, that I taught him a lot about how to make TV. I did, but that's because at heart, he is the most naturally talented performer I've ever worked with in 50 years in the business. And was brilliantly able to soak up anything he learned along the way. I mean, it's like a chef. If you're a good chef, a better chef can make you better. But if you're not a good chef, you'll never be a good chef. To be good on TV, you have to have it. I can't define IT, but to quote the Supreme Court justice about pornography, I know it when I see it. And Guy has IT. So basically, this show put together people you wanted to hang out with and brought them into your living room or your bedroom or whatever room you watch in.

The show is very compelling and you're right, you get to know the chefs, the restaurant owners in these little places, and there's something wonderfully wholesome about it. It's so good that you came up with this idea. You know, I was reminded as you were talking about a conversation you and I had when we first got to know each other by Zoom a few weeks ago. And I was mentioning I was going to do a self-guided drive called the Blues Triangle Tour. Starting in Memphis going down to Tupelo, over to Mussell Shoals, ending up in Nashville. And immediately you started telling me about places I needed to go. You said, oh, there's this wonderful place in Memphis. It's down an alley and down these stairs.

Yeah, the rendezvous.

Yes. They have the best Memphis dry rub ribs. I thought, oh my God, I'm, I can't tell you how grateful I am for that recommendation.

Well, did you go?

I'm going plan my trip around that. And then as I was reading your book, Food Americana, which we've discussed in a separate podcast, you mentioned the hot wings in Nashville. You mentioned former Mayor of Nashville, Bill Purcell, who was an inspiration for the hot wing festival they have there. Well, I happen to know him. And because our professional paths intersected around some health and wellness things, and he's a wonderful guy. So, you inspire me to get back in touch with him. You know, I wrote to him, I said, I'm going to be in Nashville. Let's go out for some hot wings. You know, at the place where they were invented. How wonderful is all this?

Well, the story behind them is phenomenal. Apparently, the guy, Prince I guess was his last name... he was not a real faithful husband or boyfriend. I'm not sure if he was married to the woman. But he came in one night after gallivanting around and told his partner, told apparently, didn't ask, to make him some wings. And she was so teed off at him that she made them hotter than hell and he liked them. And you know, an industry is born. Or so the story goes.

That's so interesting. Tell us some of your most memorable experiences doing the show. And some of the places you were, the people you met. There must be so many that stand out and you did so many. But give us a few examples.

Well, I understand I kind of lost out on part of this after the first season. I, I was back at home base putting the show together. So, okay, my in-person experiences were somewhat limited. Although I made some phenomenal friends in the course of it. Louie Miller's Barbecue in Taylor, Texas. Which, I visited. It's a legacy joint. Opened 80 some odd years at this point in a converted, they always include the word girls, a converted girls basketball gym in this small town in Texas. And when we went to shoot there, Louis Miller had passed away. His son Bobby was running the place. Bobby has now passed away and his son Wayne has the place. But I just fell in love with Bobby, who was, mm-hmm, dry as a bone and hilarious. I mean, Guy says to him, well, what are you gonna cook these over? You know, expecting post oak or mesquite. Bobby looked at 'em and said, wood. I said, oh, so that's how it's gonna go. And, and that's how it went. Now we started at three in the morning. That's when they start the fire. And, you know, we're in the middle of an interview in front of one of the pits, which was at that point, I don't know, maybe 60 years old. And without looking, without checking, Bobby turns around and starts moving briskets from one part of the pit to the other. And either I or Guy said, why are you doing that? How do you know to do that? He said they needed it. It's that kind of innate understanding of his food, his technique, the pit - which had a personality of its own - and he understood it. It was just extraordinary. It's the best barbecue I've ever had. The brisket there is extraordinary. It's unbelievable.

They make their own sausage, out of bull meat. You know, again, food of the poor. Barbecue started as a way to salvage tough cuts and meat that was going bad in Czech and German owned butcher shops in central Texas. It was all about making do and the argument has allegedly been that bull meat has a better chew. BS. Once the old Bull was done siren, you had to do something with 'em. Grinding them up into sausage was efficient. And I, I mean, it's fascinating what you learn along the way. Bulls are kinda lean. So, when you make sausage outta bull meat, you actually add fat. That you've taken from other animals to get the right mix. Their sausage is amazing. It's the finest barbecue I've ever had. There's a place in West Lafayette, Indiana, called the Triple XXX Family Restaurant. They added family restaurant to it 'cause when it was just the Triple XXX Drive-In, they used to get phone calls, yeah, from people asking what time the next show was. And the married couple that owns it, they started going there when they were in high school dating. His father owned it at one point. It's basically a burger joint, but much more than that where they make the burgers out of steak. They name the burgers after star athletes from Purdue University right down the street. And they just, their, their love for the business, their love for the community, it's just something really, really special. And, you know, Wayne Miller's become a friend. They've become friends. It, it, it's a delight to see. there's a barbecue joint in Lexington, Kentucky. And I know Lexington because when my daughter was in high school, she was a competitive equestrian. And, Lexington has a pretty big deal horse show every year. And we would go there, and she actually ribboned there. She was damn good at it. But there was a barbecue joint that I found there. I didn't find it on a trip there. I mean, my research department found it. And their specialty was, as is the case in that part of Kentucky, mutton. And we sent a crew down there and Guy and did a segment with them. Like the next year when we were in Lexington, I took the family there and we had dinner. And it turned out I couldn't go there very often because they wouldn't let me pay. And they would just fill the table with all this food because as it turned out, they told me that being on Diners saved them from going bankrupt and shutting down. And I found out that we actually saved a bunch of restaurants, which was not our intent. But I'm damn glad it happened. And by the way, if you've never had mutton barbecue, you gotta go for it. It's fabulous.

You know, when you were talking about Texas barbecue, I don't think I've ever come across barbecue I don't like. And, you know, North Carolina has its own distinctive barbecue, and Kansas City and Memphis, you know, all that. But by far my favorite, and I shouldn't say this because I live in North Carolina, but it's Texas barbecue, just like you said.

Well, I think we're talking central Texas barbecue because...

Yes.

In Southern Texas, there's a Mexican style of barbecue, in Southeastern Texas there's the kind of barbecue you're used to because there was an African American migration from the Southeast into that area, so they're making pork. But yes, central Texas barbecue is second to caviar and hallava. Probably the third best substance on earth.

Oh my God, I totally agree. I have a good friend in Austin, so I've been down there and I've gone to Lockhart and, you know, Austin and places, and you're right, that Central Texas barbecue is just unbelievable. It, it hijacks every atom in my body.

And, and what's incredible about it is in most cases. There's no sauce.

No, I was just gonna say...

that it's only with salt and pepper.

You don't... the meat is so good. Yeah. You don't want to besmirch it with sauce.

No, no.

At other places you need sauce because the meat's not that good to begin with. Oh, it's just absolute heaven.

And again, it was born of a need to do something with bad meat. And, and by the way, interestingly enough, you know, unlike North Carolina barbecue, which was born of whole animals, this kind of barbecue was impossible until the meat cutting industry was born. And pieces of beef were being shipped that were not whole carcasses or half carcasses. This old form of food is actually also a modern form of food that couldn't exist until the industrial age began treating beef differently.

You know, I'm dying to make a trip down to Austin, use that as a base and do nothing but barbecue for about three or four days. I don't know if the body can tolerate that, but, oh...

Oh sure it can!

But I'm going to find out perhaps.

Well, you know, there's three Michelin star barbecue joints in Austin now. I interviewed the owner of La Barbecue, which has a Michelin star who was actually married to a woman who is a descendant of Louis Miller's family. And she unfortunately passed away. Her widow runs the place alone now. But they're doing some remarkable stuff. And of course, there's Franklin's, which is famous, which I've never been to. But oh, Obama was the only one allowed to cut the line there.

Yeah, I wasn't, I had to stand in line a long time.

How good was it?

Unbelievably good. I mean, you go up and, you know, Aaron Franklin was there at the counter chopping up the brisket and asked which part you'd like. And you just don't... sauce belongs nowhere near it. The meat is just so tender, so beautiful.

But it does raise a definitional issue. He was one of the first to use prime beef. Is that cheating? Barbecue's goal is to make the most out of the least.

I don't know. If it's good. It's good.

Okay.

Cheating or not? It's really good.

Okay. Just checking.

So, let's get back to food television. Social media has come into the picture, since you began doing the Diners show. How has that changed things? And is TV still the predominant place people are learning about food or is it social? How do the two interact? Where does that work?

I think it's mostly social media these days.I mean, look, TV evolved. Food TV evolved into two things. Truly beautiful paeans to food and chefs done generally on streaming channels. And they're fine. They're good. A bit, too dreamy for my taste. They take you out of the real world of your shared experience, but that's okay. I, I like going to museums and looking at pretty pictures. What troubles me is that so much of food TV turned into competition shows and BS reality shows. They glorify, you know, Gordon Ramsey's a great chef. I doubt he runs his real kitchens the way he screams and yells on that show. And given the toxicity in the restaurant kitchen culture, that got a spotlight a few years ago and is still, you know, it hasn't been eradicated. I'm not in love with the glorification of screaming and yelling. But the Bear has the same problem. I mean, this 'yes chef' mentality but it's still the French brigade system and an awful lot of the chefs I enjoy talking to these days will tell you, you don't have to do that.

But I think the impetus in food as an audio-visual medium. Or food presented as an audio-visual medium is very much social media [these days. And you know, on the one hand, that's fine. The more interest there is in food. Hopefully the more people may sample my podcast Culinary Characters Unlocked. Look for it wherever you get your podcasts. But look, I confused the folks at the Food Network by insisting that my show be completely factual. You know, if they would ask me to stretch a point or something, I would say no. I held it to the same standards that I held all the reporting to when I was the senior investigative producer at 2020. I believe you should tell the truth. Well, social media doesn't give a damn. Most food shows, frankly, don't give a damn. But you've got influencers who have their own agendas. Who are wheedling free meals out of restaurants. I mean, why the hell glorify to buy chocolate? It's a goddamn chocolate bar, but it's 20 bucks. That's ridiculous. Food has been turned into a designer, accoutrement. It's, you know, it's a YSL designer bag. That doesn't make me happy. But then again as a society it's harder and harder to get people to be interested in actually learning stuff. They wanna be titillated, they wanna be shocked, they wanna be amazed. And look, teaching people stuff or imparting information doesn't have to be broccoli. I believe, frankly, one of the things I'm proudest of is that Diners, while entirely factual, was entertaining as hell. You can do both. But there's no code of honor or honesty or obligation among anybody picking up a camera and going on social media and saying, look at this.

Where could it go? How could it be better?

Well, don't take money or free meals to go pump places up. Have some expertise in what you're analyzing. I mean, criticism's fine, but if you don't know what you're talking about, the criticism is not valid. And I look to food critics to guide me toward where I want to go and eat and what I should like and help me broaden my palate and my understanding. Is it entertaining? Yeah, fine. It's okay. But again, I'm a grumpy old man telling kids to get off the shed.

So David, you know, I'm really grateful you joined us today because the Diners, Drive-Ins and Dives is such an important part of American food television history. And it's amazing to hear how it got started and where it went and your vision of how things could be better. But boy, it's just fun to talk to you about food in general and places to eat and the people. And it is just this wonderful world of connection, isn't it?

It, it is. And for example, this conversation, Kelly, I didn't know you till we started talking about doing this podcast, and now you're a new buddy. I love talking food with you.

BIO

David Page is the President and Executive of Page Productions. He is a two-time Emmy award winning Executive Producer with a focus on culinary projects and a special expertise in creating entertaining and engaging programming that combines the highest production values with the richest storytelling. Page is best known for creating the Food Network hit Diners, Drive-Ins and Dives and executive producing the program for eleven seasons. He is also an author, having written the book Food Americana about the evolution of American cuisine. And he is now producing and hosting the podcast Culinary Characters Unlocked, featuring entertaining but substantive interviews with important people in the world of food.

View Details

If someone asked you about French, Korean, or Thai food, you could probably name some signature flavors and dishes. I certainly can. Well, what about American food? What stands out for you there and what IS it, really? Today we're going to dig into the roots of American cuisine with food journalist David Page, who initially was an investigative journalist but turned his attention to food. And he's author of a book called Food Americana: The Remarkable People and Incredible Stories Behind America's Favorite Dishes. But you might also know David's work from television. He was executive producer on the hit series Diners, Drive-Ins, and Dives for 11 years. He has two Emmy awards and has his own podcast series, which is excellent, called Culinary Characters Unlocked.

Interview Transcript

So, here's the book: Food Americana. It's really a wonderful read and, you know, every case study you go through in the book, like pizza, Chinese food, Mexican food, every one is completely fascinating. I'd love to dive in and hear more about your thoughts about how all this unfolded. So, is there such a thing as American cuisine and how did you come to write this book, Food Americana?

Well, the short answer is yes, there's American Cuisine. I came to write it out of personal experience. I became really deeply interested in food when I was posted overseas for NBC News as a producer and traveling from country to country, pre-Internet. And not ever having expected to leave America. I mean, they called me up one day and said, Hey, you wanna move to England? And from there I moved to Germany and then Budapest, Hungary. I was remarkably unprepared for all of the places I was being sent. And I kind of had a study pretty quickly. And I found that one of the best ways to understand a country or culture was through its food. You know, why do they eat so much wild boar in Tuscany? Well, because it was historically a poor region. And if you wanted to eat, you had to kill something. And what you were most likely to find that you could kill was a wild boar. When you go to Strasburg in France, why are you eating Germanic choucroute, which is, you know, pork on top of sauerkraut. Well, that reveals to you that that area went back and forth in terms of which country owned it forever. And that really awakened in me a deep interest in food.

When I got back to the States, I eventually ended up creating Diners, Drive-Ins and Dives. And that got me deep into American food, if you will. And, more and more over time, I stockpiled stories and interests and decided as all TV producers do eventually, whether they actually act on it or not. Everyone thinks it's easy to write TV and it's hard to write a book. Those of us who are TV producers carry a chip on our shoulder because frankly, it's harder to write for television. You can't just sit down and type out whatever you want to type out. You've got to figure out the words that integrate with the pictures and that can move the pictures forward. But, you know, we all think we have a book in us, and I said, what interests me? And it was this. And I dived in; thoroughly enjoyed the process.

To answer the other half of the question, I came to the conclusion looking at everything that I had put on Diners, looking at every place that I liked eating in various towns, there was a cuisine. It was something we constructed, much like we constructed American democracy out of other countries and cultures. And you know, when you go to a Chinese restaurant in America, all of us have gone with that real bore who looks up and says, this isn't authentic Chinese food. Well, no, it's not authentic Chinese food. It is authentic Chinese American food. Just as, with the exception of something called polpette, which are very small round meatballs, there are no meatballs as we know them in Italy. When the poorest of the poor left Southern Italy to come to the United States in the 1800s, to their shock when they got here, they found out that being poor here was different than being poor there, where even pasta was considered a luxury item and only enjoyed on a Sunday, if ever. Here, poor people could afford meat. And that is what created Italian American cuisine, which is to a great extent based on abbondanza, you know, a whole lot of everything. I live in New Jersey where red sauce cooking means open your belt and, you know, strap in for a few hours of absolute gluttony. And we've done that with bagels from Poland. In Poland, they weren't quite what they are here. But they were similar, and they were sold by Jewish peddlers in the streets on long sticks. Because they had holes in the middle, you could, you could stack 'em on the sticks and young kids would walk around the town square shouting in polish. I don't know the actual words but shouting something that translated as bagels and lemonade. When Jewish immigrants arrived in the United States, packed into the Lower East side into tenements, they did what they knew how to do. And bakers started making bagels which then became far more than a Jewish food. They became a New York food. And then in horribly awful incarnations, they became an American food. I would argue it's still hard to get a decent bagel outside of New York for any number of reasons, but bagels are American cuisine now. They're not the bagels per se that were eaten in Poland. But there's something from another country that we took and made into our own. And by the way, the cuisine continues to evolve. It now includes Vietnamese banh mi. As more and more cuisines are sampled here, they're modified by the lack of availability of original ingredients for the immigrants who are here who have to look for alternatives. And they're modified to suit broader tastes. You know, the original spices of much of Mexican cuisine... and when I say Mexican cuisine, it was basically the food of the Nortenos, Northern Mexico, because as with all countries, Mexico is a combination of cuisines based on regionality. But, when Americans started sampling, quote, Mexican cuisine, unquote, much of it was too hot for us. For the most part, those people who had lived in what was Mexico who were now living in America after the Mexican American war, when America seized half of Mexico. Those who opened restaurants realize that, you know, if you want a broader clientele, you better tone things down. That's the Americanization of another culture's food, and that is American cuisine.

I'm hoping you wouldn't mind taking a little detour and talk about how magical it is to connect with a culture through food and through the people you meet in that context. You and I were talking before we started recording and you mentioned a trip you made to Spain and how wonderful this particular connection was. And I was thinking about some things I've done recently that have connected me with people and their history through their food. And there's something very magical about that. But tell us about your trip to Spain because I thought it was very interesting.

My wife and I went to Spain a few years ago, and I had worked in Spain a fair amount when I was overseas as a journalist. But I'd never really had the opportunity to do much vacation in Spain. And I can't remember if it was Madrid or Valencia, it may have been Valencia. But we signed up for a half day cooking course. And we showed up and it was taught by somebody's grandmother. I made the mistake of trying to be polite and use my leftover high school Spanish, and I was the only one who in the class who did. So, she decided I was fluent, which I'm not. But she and I had a lengthy conversation during the class, which consisted of her saying things I did not understand in me nodding my head and saying, si. But it was just a remarkably wonderful experience to have my hands on and in and be learning about another culture. You know, one of the things I realized when I first started traveling much of the world for NBC and again, I had never expected to be sent overseas, was that there are a million ways to do things. You know, this is going to sound kind of gross, but until you go overseas and you realize there are different shapes to toilets, you know, people look at the same problem and figure it out in slightly different ways. You learn that there are multiple ways to approach things, to address things, to do things. And first of all, the cooking in Spain is extraordinary. And it's an underappreciated cuisine here in the United States. But, you know, we're in cooking class making a Spanish tortilla, which is not a Mexican tortilla. Mexican tortilla obviously is a disc of dough, either corn or wheat, depending upon the region. A tortilla in Spain is an omelet, but more than an omelet, it's kinda like a frittata. It's a very thick, almost spongy, egg-based product with potatoes in it. And making that and learning how to make that and the way that this teacher had clearly been making it, that she had learned from her mother, who had learned from her mother. You know, you turn it upside down to get it out of the dish. It was just a wonderful experience. And look, I've been fortunate enough to have that experience in any number of countries. This one, wasn't terribly culinary, but I was in Moscow in a bar frequented by locals. And this was under the Soviet Union; it was a long time ago. But they had the bars for Westerners where they took dollars and served the good vodka, which Russians could not get by the way. I mean, there was no Stoli for Russians. But we were in this real low rent bar and a guy sat down next to me with Asian features. And through, kind of, hand signals and some assistance from I guess one of the NBC translators or something, we exchanged life stories. It turned out he was visiting from Siberia to do some kind of business. Had never been to the big city. And he had... everything in the Soviet Union was crappy. I mean, it was made of plastic. He had a plastic briefcase. But he was here on business apparently. And as we got drunker and friendlier and you know, arms around each other and hail fellow well met, he opened his briefcase to reveal that it was filled with salted fish. He had brought his own delicacy from home because you never know what you're going to find in the big, bad city. And sitting at that bar, I had me some Siberian salted fish and it was damn fine.

What a neat experience.

Oh, it was fantastic. Just fantastic.

You've reminded me, and I was mentioning this to you as well, but I love barbecue of all kinds from all places. And the North Carolina form of barbecue is typically pulled pork. And the Eastern part of the state is famous for cooking whole hogs, the Western part for cooking just the pork shoulder. But in the Eastern part they say they talk about cooking everything but the squeal. And there's a local restaurant in Raleigh, which is about a half hour for me and where I live in Durham. And there's a well-known barbecue icon in North Carolina named Sam Jones, who's the third generation of his family to run a restaurant in a little town called Aiden, North Carolina, which is frequently considered the best barbecue place in the state. Sam, at his restaurant in Raleigh, was running a half a day intensive workshop for those of us out there in the world who want to learn more about it. I took that workshop and it was a wonderful experience just like you're talking about. Because not only did I learn about the techniques of cooking the food and I was in their smokehouse, and it was just a great experience. But this fellow, Sam himself, was a really interesting character. And to hear about his family history and what the food means to them and how they learned the traditions and stuff was just absolutely fascinating. And I'm reaching for, I got a copy of a book he wrote on whole hog barbecue. There's Sam himself and with...

Daniel Vaughn the writer.

Yes, that's exactly right. What a great experience. I feel as you do that connecting with cultures through their food and meeting the people is just an incredible experience. Let's get back to your book now, Food Americana. So, you gave us the example of bagels, you talked a little bit about Chinese food, but give us some more richness to how these foods might have begun and what kind of forms they took in America. And I know you talked about pizza as one example. I thought the pizza one was especially interesting. Part of it is because I spent many years of my career at Yale University and was surrounded by New Haven Pizza, which was unbelievable.

Which is called what? Apizza?

Apizza. Yes.

Well, that's coal-fired thin crust, right?

Coal-fired. You know, I could go in one of those restaurants and just order crust and be happy. It was that good.

What I found interesting in researching one of the New Haven pizzas that's legendary is clam pizza. And what I learned was that the clams weren't from Connecticut. That they were brought in from someplace else. I just assumed, because, you know, you got the water there that that was a local thing. And apparently it was not, which surprised the hell outta me. I mean, I live on the coast of New Jersey and there's a place down here that does its version of clam pizza and it is local clams.

Oh, that's interesting.

Pizza was the food of the poor in the South of Italy. Pizza was basically dough with a little bit of tomato. And if you had a couple of bucks that day, that week, maybe you put a piece of lard on top. I mean that, that was it. And when the immigrants began arriving in the United States and found that good food was easier to obtain, that's when pizza started to morph into what we know it as today. Now the wheat in Italy was different than the wheat here. The form of a fire being used was different. I'm trying to remember, I guess it was coal in New York at the time, and wood in Italy. So, you ended up with a different kind of crust in terms of airiness and crispness. But what you also ended up with is a perfect example of the development of American cuisine. Which is every place that pizza went, it was different. It evolved based on what was available in a particular region. You've got pizza in, I think it's St. Louis, maybe Kansas City, where they use kind of a processed provel cheese. I guess it's St. Louis. Because that's what they had. That's nothing. It's not mozzarella. It's not Parmesan. It's the local cheese. Or you have pizza in Old Forge, Pennsylvania, that was created for the miners by a bar owner using what is rumored to have been government cheese. These were poor people. So that's how that developed. You've got Detroit Pizza, which is having a renaissance moment now, but it has its square shape because it was initially baked in these blue steel automotive pans. They may have been oil pans that were liberated either from an auto factory or a parts supplier. You know, Chicago Pizza certainly developed in a unique way, although there are two kinds of Chicago pizza. There's the deep dish that, it's really a frigging casserole. And then there's cracker thin pizza that, that's delightful. But you see pizza developing according to what's around it. I mean, it's the perfect example of local, regional, seasonal. And then as pizza became a self-perpetuating thing, it then became a kind of a palette for creative American chefs to go nuts. The iconic decision being Wolfgang Puck at Spago in Beverly Hills. Putting what would be politely called smoked salmon, what else? New York Jews would call lox on a pizza with creme fresh and, you know, reinventing the world. In fact, the real reinvention of pizza in that way occurred at California Pizza Kitchen in California, where barbecue chicken pizza became a big deal. And pizza continues to evolve. I mean, I had a debate the other day with the owner and chef at an Italian restaurant about whether or not pineapple goes on pizza. And I obviously, I think that Hawaiian pizza with pineapple and ham is a war crime. He argues that doing what he does, which is a not canned pineapple but fresh pineapple that is macerated, chopped, and served with, I think, pork cheek as opposed to ham. Some more subtle, substantial use of pork that is in fact a terrific combination of flavors. And I'm not going to argue with him because that actually sounded pretty damn good.

It does sound good.

You know, pizza continues to evolve. What's interesting with pizza is, and I have this complaint with so much of how Americans consume food, is that given the choice between a great local pizzeria and BS factory like Dominoes, so much of America picks Dominoes. I mean, at the time I wrote the book a few years ago, 60% of pizza was sold at chains; 40% was sold at independents. But why, why would you possibly pick this cookie cutter piece of crap when somebody down the street from you is doing it right?

You just remind me of so much, and when you mentioned Old Forge, Pennsylvania, when I read that in your book, I have a good friend who lives in Philadelphia. And I got in touch with him. I said, oh, I need to come up to Philadelphia, and we need to make a road trip to the Martin Guitar Factory in Nazareth, Pennsylvania. And then go down to Old Forge and try this pizza David Page was writing about and stuff. And it's just fun to do this. And I did this recently. I told you earlier, I'd made a road trip and driven part of Route 66 through Oklahoma. And stopped in this little town El Reno and had the famous Oklahoma onion burger at Johnny's and sat at the counter and talked to the cook. And I enjoyed that as much as any four-star, high end, hundreds of dollars meal. It just, it's fun.

Well, but there is a misunderstanding of what good food is. I liked, well, many things about what Pete Wells did when he was a New York Times food critic. But one of the things I really liked was the fact that he evaluated restaurants based on their intent. You could be a three-star taco stand. If the promise you are making to someone is, I'm gonna make you the best goddamn taco you ever had. You have to evaluate that based on that. Not, is it La Verna dining? And frankly, our hangup with and fascination on high end haute cuisine, $350 a plate, little, tiny morsels of shit. I much prefer real food. And, you know, the foodie culture goes nuts for stuff that is fru fru, and they did this, and they did that. Making the perfect hamburger in El Reno, Oklahoma, and you know, I talked about how in Tuscany boar was the food of poverty. Onion burgers, which are considered by some purest to be the finest form of hamburger came out of, I think it was the Depression. It was certainly a time of poverty. Where you stretched a burger by adding onions to the meat. And that's a wonderful, wonderful thing. Now, I don't think it was... is El Reno outside Oklahoma City?

Yes. It's within an hour drive.

Yeah. It's near Tinker Airbase. El Reno is where, I included this in the book, there is a fabulous sushi restaurant in a gas station. Now the local clientele heavily Air Force people who have been in Asia, but apparently, it's phenomenal sushi. And interestingly enough, I just interviewed the chef owner of three restaurants in Oklahoma. He has a restaurant called Gray Sweater, which is highly upscale, and he has a couple of others. He was telling me that the food scene in Oklahoma has been really, really booming under the radar. And I went to school in Oklahoma. I was thrown out of both major state universities. And you know, back when I went, it was great chicken fried steak. There was some barbecue that was basically Texas barbecue that had migrated North. But I didn't see Oklahoma as culinary heaven. And apparently, it's quite the place to eat these days.

I would agree with that. I went to some really fine restaurants when I was there. Plus the people are just lovely.

Oh, yeah. And by the way, you talk about American cuisine. And I'm not sure if there was a direct evolution, but clearly it's an Americanized form of schnitzel. It's hard to, if you live in the East coast and you haven't had a chicken fried steak...you have no idea what you're missing. But again, food of poverty. You take a bad cut of meat, you tenderize it by beating the hell out of it with a mallet, then you dip it in egg and flour and you deep fry it. I mean that's...

Oh, and the right gravy on that.

Oh yeah. The cream gravy.

Yeah.

And, you know, don't mention it to your cardiologist, but I fell in love with that and as a college student with pure grain alcohol when I was in Oklahoma. So, it did have a couple of things I liked.

I might have recorded 300 podcasts or something like that, but none has made me as hungry.

This is good, right?

Oh, it's great. So, let me end with a final question. And I think I can guess how you're going to answer this, but if you look at American cuisine compared to the things that it descended from, like foods from Italy and Mexico, and China and things. Is it just different? Is it authentic in its own right? Is it better worse? How do you think about that?

It is wonderfully different. It has an antecedent. It's like looking at a German Shepherd and also being aware it was once a wolf. They're two completely different species. And some of the traits of one are reflected in the other, but they're different cuisines. I mean, I've spent a lot of time in Italy, thank God. And second to Spanish food, it's probably my number two all-time favorite. But, when you look at American cuisine, red sauce Italian is among my favorites. They're totally different cuisines. Chinese food, the same. You know, there's a great book and documentary In Search Of General Tso, in which the writer, Jennifer A. Lee. went looking for the guy who invented General Tso's chicken in Taiwan. And she found him and showed him what his invention had become in America. They bear no resemblance to each other. He was shocked. But I love general. Now, I can't eat it much because had a diabetes scare and had to lose a bunch of weight. But it's a wonderful dish. It is about as Chinese as Matzo. You know, it's an American invention, but remember, American Chinese food began in California after the Gold Rush when a whole bunch of Cantonese people came over to search for gold and they set up restaurants. Some came to set up restaurants for them, and they realized that Americans didn't eat offal, and much of Chinese cuisine is, you know, a nose to tail. So, they either invented or reinvented chopped suey with Americanized proteins and that's what kicked off the Chinese food boom. And there's this mall in Flushing New York that serves the food the way it's served in China. This stuff, it'll blow your mind. It's extraordinary. But that doesn't make the food that you get at a good Chinese American restaurant invalid. It's just wonderfully different.

BIO

David Page is the President and Executive of Page Productions. He is a two-time Emmy award winning Executive Producer with a focus on culinary projects and a special expertise in creating entertaining and engaging programming that combines the highest production values with the richest storytelling. Page is best known for creating the Food Network hit Diners, Drive-Ins and Dives and executive producing the program for eleven seasons. He is also an author, having written the book Food Americana about the evolution of American cuisine. And he is now producing and hosting the podcast Culinary Characters Unlocked, featuring entertaining but substantive interviews with important people in the world of food.

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Paper: Gearhardt AN, Brownell KD, Brandt AM. From Tobacco to Ultraprocessed Food: How Industry Engineering Fuels the Epidemic of Preventable Disease. Milbank Q. 2026;104(1):0202.https://doi.org/10.1111/1468-0009.70066

https://www.milbank.org/quarterly/articles/from-tobacco-to-ultraprocessed-food-how-industry-engineering-fuels-the-epidemic-of-preventable-disease/

Ashley, let's talk a little bit about, just set the stage for what this paper was all about, and since it was your brainchild, you approached Allan and me about being involved. Tell us what you set out to do and why you thought these issues were worth digging into.

Ashley - You know, I've just been so struck that when we think of cigarettes, they were something that's so common, so normal that we kind of think, oh, they've always just sort of been there. But truly, they're just taking a natural plant from the ground and through advancements and corporate engineering and technology and knowhow, they took a poisonous plant and made it into the most deadly and addictive drug in human history. And yet that was, you know, just accompanied by tons of debate. It didn't look like other addictive substances. And I just really felt like, man, we're reliving this history right now when it comes to how we've altered our food supply. I wanted to really bring you all together and see if we could really lay that story out of the, the parallels of these two public health crises.

We'll get in a minute into the issue of what you discovered, but tell us what you covered, what the paper was meant to do.

Ashley - The paper really goes back from how you take the tobacco plant in the field, or the corn in the field, and walks essentially through all the kind of levers that are being pulled to transform it in very specific ways. And through specific technologies and corporate practices that are being shared by modern cigarettes and ultra processed foods. These products maybe look harmless on their face initially, or don't look like they're just maybe pleasurable or craveable. But truly, I would argue that they've crossed thresholds into things that are addictive and clearly damaging many people's lives.

Okay, so several decades ago, I don't know who came up with a term, but there was a lot of discussion about similarities between tobacco industry behavior and food industry behavior. And the press started publishing cover pieces that would say food is the next tobacco. And it was a term that the food industry really didn't like, and they don't want that comparison at all. It'll be interesting to see whether they deserve it. You clearly made that connection in this paper.

Allan, let's turn to you. Oh my God. I mean, we could do a 15-hour podcast and not cover the history of the tobacco industry. There's so much to say, enough that you wrote a massive book about it. But give an overall sense, if you will, of the kind of tactics and morality of that industry.

Allan - Well, as Ashley already mentioned, early in the 20th Century we wouldn't really be thinking much of cigarettes, and they were just a very peripheral sales consumer item. And over the course of the 20th Century, we came to a point in the middle of the century of the 1970s, and '80s where about half of all American adults were smoking cigarettes regularly. I wanted to understand that. How do you take something that's at the very margin of the economy and culture and make it a dominant consumer force? And I think in that way, we have certain parallels to ultra processed foods. But then there were the questions, how do you make it so popular? Is it dangerous to use? Is it addictive? Does it cause disease? And how do you resist regulation and other public health approaches to try to keep people smoking? And I found a lot of evidence in each of those areas, both of how the industry acted. And when you say, you know, it's ultra processed food like cigarettes, we're learning a lot about ultra processed foods. But we know a ton about what the industry did to make the 20th Century what I call the Cigarette Century. And we have seen really important declines in smoking in the last 30-40 years. It's a remarkable public health effort. But at the same time, the industry worked incredibly hard and, in some ways brilliantly, to maintain the popularity of their product. And underlying all this is the idea that nicotine is highly addictive. And the industry came to understand that certainly before consumers did. And as a result, they could engineer, manage, manipulate the addictive character of a product that kills. I think looking for parallels, both in terms of how the industry did it and how perhaps public health law regulation can undo it, is the critical aspect of what we've been working on together.

Okay. So, the tobacco industry did more than just take a plant, dry it out, chop it up, and roll it up in some paper. Then people might be driving whatever natural pleasure there would be from that product. But they did more, didn't they?

Allan - Yes.

And you talked about nicotine in particular. So how manipulated was this industrial process and was it designed to create such high levels of addiction?

Allan - Well, for a long time we couldn't be sure about that. And we have learned that the industry had learned sophisticated techniques of industrial production of cigarettes. So, it wasn't like just chopping up tobacco and putting it in paper. You know, they added many additives. They added liquids. They dried it out, they put it in long strips of tobacco for cutting and packaging. And they had innovated the technologies, instead of human beings rolling cigarettes, they were able through machinery and technology to produce hundreds of thousands of cigarettes a day. And then they had to figure out how do we sell this tremendous volume of cigarettes in order to make our industry truly lucrative. So, there were those aspects. And certainly by the middle of the 20th Century, many people realize that - I smoke regularly and I crave my next cigarette and I'm smoking a pack a day, sometimes two packs a day. And people would ask, well, is it a habit? Is it habituating? Is it addictive? And as the science of addiction really grew in the middle of the 20th Century, we began to realize it had all the characteristics of addiction. But we really didn't know exactly what the companies were doing. And what we did learn in the '80s and '90s is that the companies had a precise ability to manage the nicotine in their product. And they did, so that even as they put filters on and they claimed they had safer cigarettes, they were also producing increasingly addictive cigarettes where we have craving, we have withdrawal, we have tolerance. The basic categories, that structure, how we understand addiction.

Okay. We'll dive into some of those in a little more detail, but thanks for that background. Ashley, people kind of get it that drugs can be addictive and they know that alcohol can be addictive. They know that cigarettes can. But what about food?

Ashley - Yes, so I think one of the things that when I take a step back, is that the reward and motivation system that alcoholic beverages, cigarettes can start to hijack and drive towards compulsive problematic use, that was laid down in the brain to make sure we were getting enough food. It's really sensitive to food reward, energy density. But the thing is you actually consume nicotine probably most days. Nicotine is actually in a lot of plants like tomato and eggplant, but nobody's getting addicted to the chemical in that delivery vehicle. I would argue the same thing's happening. When we look at our research nobody's getting addicted to minimally processed foods like bananas and broccoli, and salmon filets. It's when you're able to process and titrate and hedonically engineer food reward in a way that mimics the intensity and the sensory appeal and the spikes and crashes and the craveability of something like cigarettes, that you start to see people losing control. And when I read Allan's book, my husband was watching over my shoulder. And he's like, you know, if you highlight every single sentence, it's not gonna help you because you've highlighted the whole book. And reading what Allan laid out about how each wave of cigarette addiction, it wasn't because we suddenly discovered what nicotine was, it's because the industry got better at manipulating engineering, designing, flooding the market with it. And then health washing it, so people didn't really understand what they were getting into. And to me, that is what we've done to our food supply. And the result of that has been the astronomical increases in diet related disease and health concerns.

Tell us about the concept of ultra processed food and how that fits in.

Ashley - Yes. Yeah, that's a great question. So, ultra processed food is a concept that actually came out at about the same time as the Yale Food Addiction Scale, that Kelly and I published together, about how to operationalize who might be showing signs of addiction and certain foods. Carlos Monteiro from Brazil was noticing that his grocery store was starting to be flooded by foods that you could not make in your home kitchen. I have exactly no idea how to make a double stuffed Oreo or a flaming hot Cheeto, or a Cherry Coca-Cola. And as these products that were industrially created with additives and flavor enhancers that are kind of biologically novel, that's when the disease risk started to go up. And so, these foods are so fundamentally changed in they're kind of most archetypal forms of things, like sodas and, you know, your sweet, savory sort of snacks, that a whole new category had to be created for them. To really distinguish them from, you know, grandma's homemade cookies or, you know, an apple or an orange.

Ashley, you're brilliant at framing things. And one of the things that I learned from you a long time ago, and I've used a thousand times in discussions with people, is thinking about food, like turning the coca plant into cocaine and into crack cocaine. That if you take the coca plant into its natural form, people can live in harmony with it. You don't really have addiction. But when you process it and it becomes cocaine, then things change dramatically. And when you hyper process it, like the hyper palatable foods and the ultra processed foods, then the crack cocaine becomes incredibly addictive. So that same sort of phenomenon I think applies here. And it's a very compelling way to think about this.

Allan, let's get back to the addiction thing and tobacco. One of the most stunning things I remember about the tobacco history. Is the videotape of the seven tobacco company executives testifying before Congress that nicotine wasn't addictive. Swearing, you know, sworn statements about nicotine. Tell us about that and what that kind of meant in history.

Allan - It's a great story and it has a kind of visual linkage to many of us who actually saw those congressional hearings. And it was a brilliant sort of performative politics, if you will. And there had been more and more knowledge that the industry was manipulating nicotine to make cigarettes that they were claiming were safer and not addictive, even more highly addictive. And David Kessler, the head of the FDA under Clinton, had really been a major player in this. And one thing I should say is we were learning more and more about the industry because people were suing them. And they would typically lose the suits, but they would get hundreds, hundreds of thousands of documents. And the industry also had whistleblowers who were coming forward and saying, of course we know it's addictive. So, Henry Waxman, a really fantastic congressman who represented consumers invited all seven of the major tobacco CEOs to a hearing on nicotine. And he went one by one - do you believe nicotine is addictive? And they would say, Congressman, I do not believe that nicotine is addictive. And it's like any great prosecutor, he had figured out how to get them essentially to perjure themselves in front of a congressional, and video news audience. And in fact, the Department of Justice considered for some time whether they should be put on trial and indicted for perjury before Congress. But it was so in congress, with what we had come to know, especially experts, but even, you know, parents and the public and citizens had come to know that it was incredibly difficult to get off of nicotine. It just didn't comport with our existing knowledge. And we're not quite to that point with ultra processed foods yet, but I think we have a good chance to get there because as we understand what they're doing better and we have a sophisticated understanding of the characteristics of addiction, that same question will be put ultimately to CEOs of the food industry. Especially those who are producing these highly addictive products. And there are many people who are involved in this. So, they will tell a story of how we understood we could make our product sell better and be used at a much higher level if we could make it addictive. And regrettably, as we learn more about addictive addiction, we not only learn perhaps how to help people who are addicted. But we often learn how to make certain products even more highly addictive.

Ashley, let's take what Allan said and apply it into the food arena. So, if you think about the criteria for addiction, like Allan had mentioned: cravings, withdrawal, and tolerance, and, tolerance being the need to have more of the substance over time in, in order to produce the same pharmacologic effect. How do those things apply to foods?

Ashley - Yes. There there's very strong parallels there. And I actually have a paper I wrote with Dr. Alex DiFeliceantonio, where we took the 1988 Surgeon General's report on the addictiveness of tobacco and nicotine in particular. And we took what they identified as the necessary and sufficient criteria to prove that it was addictive. It was a watershed moment for tobacco. And the major one is that people consume it compulsively. Meaning, you know, they want to cut down and they can't. They know it's harming them and they can't. Clearly we see that with ultra processed food. That it shifts mood. It increases pleasure. It reduces negative affect through its mechanism on the brain. And I think if you look at any marketing, you know, they're always saying you're craving meet your maker, get your bliss point. You're not you unless you're eating a Snickers. They show that it was highly reinforced. And that is, you know, animals and humans will work really hard to get access to it. With nicotine one of the major points of that is that animals, about 20% of the time, would work to get nicotine over cocaine. And that was quite striking because cocaine is so powerfully addictive. Well in those same models, animals will work for processed sweet taste and choose it 80% of the time over cocaine. It just shows that when we start altering, processing food reward into these unnaturally intensely stimulating packages, our brains were not evolved to protect itself against that. And then the final pieces that's been kind of added over time has been the cravings. I mean, if you think about what is the core of addiction, it's the craveability of it. That they maximize that. So, you can't stop thinking about anything else. And when I read, and we even quote in our paper, spots where, you know, industries, the big food is having webinars and how to turn cravings into corporate wins. And how to take snackers who are consuming, because their cravings feel unmanageable, but here's how you can keep them snacking even though they want to quit. And so, the craving really seems to me, based on my read of what I've seen from the industry, is the core engine of driving and selling ultra processed food.

So, these foods, and I've heard you say this, Ashley, you know, they have less to do with the farm and, you know, these sort of romantic ideas of the farmer growing crops and the crops being harvested and coming to a farmer's market. These are really industrial lab-based, you know, heavy duty factory related products. And there's a real question, isn't there, about what you even should call them food.

Ashley - Yes, absolutely. I actually grew up on a farm and I never ate anything that we grew on the farm because it was all due to Ag policy. Just, corn to go into high fructose corn syrup, soy to go into soybean oil. And I was surrounded by what looked like lots of food, but in reality, it was not. And some of the things that I learned in writing this paper with you all is just to what degree ultra processing allows them to even control the molecular structure and size of the different starch chemicals. That carby kind of access point in food. Allan talks in his book about how you can treat tobacco. So, you break it down and make it molecularly more bioavailable so nicotine gets more rapidly into the body. That's a huge driver of addictive potential. I found in ours that they were actually using enzymes that mimic what's in the saliva in your mouth. And hitting starches with it. Essentially you were predigesting, pre salivating, essentially the starch creating what's called a starch slurry. And that's a base of so many common ultra processed foods like cereals and savory snacks. Many of these products really have far more in common with that cigarette and have almost nothing in common, you know, with the apple or the can of beans anymore.

You know, that image that you said about pre salivating food. I mean, it's in some ways as if the industry is spitting in your food to bypass your own biological mechanisms that occur when the food gets in the mouth and. People get a kind of a yuck response to that, but it deserves that kind of a response. Let's dive into the paper and talk about what you reported, Ashley. You talk a lot about the kind of processes. You just mentioned one of them, but there are a lot more. What are some of the specific techniques to food processing that surprised you when you started digging in. How did you get this information?

Ashley - Yes, so one of the functions that actually didn't surprise me, but it made me look at it in new light, is the work on how we really changed the way we saw cigarettes when we realized they weren't just taking a plant and drying it and rolling it up. But that they were actually curating and titrating these just right doses of nicotine. So, you get stimulated, but not too satisfied and you don't feel overwhelmed by the amount of nicotine. When we realized that was very intentional and designed and titrated, that really changed this from a natural kind of product, it's just a plant to, oh, this is an in industry engineered product. They're controlling so much of this. We all know that they are altering the amount of sweetened refined carbohydrates and fats in our food. I mean, that's just plain knowledge. And at levels that go way beyond what exists in nature. But I think I've become very obsessed with extrusion technology. Extrusion is something where they take really high pressure, high shear mechanical impact, high pH, high temperature. And they can break the corn or the potatoes and things into this slurry that is broken down again into this kind of predigested molecular base that on its own is nasty. No one is like, oh, starch, slurry, yes! They need all the sensory and flavor additives to blitz that and texturize it so it can trick your brain into thinking it's appealing. I realized that actually has such a strong parallel to modern cigarette where, as Allan talks about in his book, one of the major technological advances was creating reconstituted tobacco where they take the tobacco scraps and they do the same sort of process to create what they call a tobacco slurry. That was then very easy to manipulate by putting flavor and preservative additives in it, and that's what makes up a large component of modern cigarette. And so, when we look at these processes and those sensory additives, the flavors, that are put in it, cigarettes have more sugar and flavor additives in them by weight than they do nicotine. And so many of those flavor additives are actually in our ultra processed food supply. Why? Because the flavor and sensory profiles are what you start to become really emotionally attached to. And that starts to drive brand loyalty from a very young age. I could go on and on and on. Oh man, we could be here for a day, so I'm really inhibiting myself. I'll be exhausted. I'll have to go get an ultra processed food from this. But it was stunning to me to see how the goals of the engineering were so shared. And I guess it shouldn't surprise us because, you know, we know that the tobacco companies like Philip Morris and RJ Reynolds actually created, manufactured and sold many of our favorite ultra processed foods that are now in our modern food supply, like Fig Newton's and you know, Hawaiian Punch and things. It really came from the same industrial practices.

So Allan, I want to bring this back to the tobacco industry in a minute, but Ashley, I wanted to ask you first. I'm going to make a characterization. Tell me if I'm off on this. The industry is kind of manipulating every possible characteristic of a product. Its fragrance, its color, its texture, everything in the ways you mentioned. It becomes this industrialized product much more than a food. People consume it. They get immense reward from it because it's delivering a drug, basically, to the brain very quickly in a very efficient way. People then, of course, want more of that sensation. If tolerance exists, then it means they need more of the food over time in order to get the same reward. And then you've got a public health nightmare on your hand because people aren't just eating a little bit of these foods, they're eating a lot of these foods. And they're designed in order to produce that very impact. Does that seem fair?

Ashley - Absolutely. That sums it up quite nicely.

Okay, Allan, back to the tobacco experience. This kind of information that Ashley is talking about in the context of food, and you talked about in the context of tobacco. Manipulation of the product. As this kind of damning information became public knowledge, how did that happen in the tobacco arena? And then what was the consequence? Was it, you mentioned whistleblowers; was it investigative journalism? The hearings you mentioned were important. Scientific research, discovery. It sounds like a whole lot of things happened that made this information available to the public, which in turn changed public opinion against the industry.

Allan - Yes, I think that's exactly right. It changed public opinion and it changed public policy and it took a long time. So, these are aspects that I think we have to, you know, acknowledge in thinking about public health and especially these powerful commercial interests that spend a lot of money on lobbying. They spend a lot of money on advertising. They know how to get to kids. These are very challenging. I do think, you know, early in the anti-tobacco campaigns, there were a few lawyers who said, well, we're going to sue them because they have misled, deceived, and in some instances probably acted criminally to build their addictive and extremely harmful life-threatening product. And people said, well, you know, it's everybody's decision whether they want to smoke and people quit all the time, so you're not going to do very well. And I think as a young academic type, I was very skeptical of the suits against the companies. But one thing that happened that I think was unanticipated, the lawyers asked for the company's records and their research reports and what people were doing. And they took depositions and the lawyers often lost the case, but they won an incredible archive that was incredibly self-incriminating of what the industry knew. When they knew it and how they continued to act to sell a harmful product. And I think that began to change things. So once you have documents, you know you're going to be more successful in court. Once you have some documents, you can call the CEOs in and say is it addictive? When they say no, you have documentation to challenge them about their own industry. Obviously, education is important. Investigative journalism. A lot of the documents not only came from the court suits, but from whistleblowers who snuck them out of law firms. Some of the whistleblowers came directly from the industry where they said, here's what my bosses told me. They need to know can you make this cigarette even more addictive? And they knew, for example, that taking nicotine out of cigarettes, which is not that difficult to do given the extent of manipulation, had to be something that was resisted. We could end the tobacco pandemic by just removing nicotine. Even if we did, you know, 10% a year. Many people would be able to stop smoking who cannot. But we had to array a kind of knowledge and practice and advocacy that really hadn't existed till the second half of the 20th Century.

Ashley, when Allan mentioned these archives that exist on tobacco industry behavior, there's some food things in there, aren't there? Tell us about that connection between tobacco and food companies.

Ashley - Yes, so you know, actually, Dr. Laura Schmidt at University of California - San Francisco, has done this just stunning work by using those same tobacco archives. Because they owned alcoholic beverage and ultra processed food and beverage companies she's been able to show really how much these industries kind of spoke back and forth. The different sectors of Philip Morris and RJ Reynolds, you know, they're big conglomerates. They were pulling scientists working on the cigarettes, or the marketers working on marketing cigarettes to kids, and putting them on and intentionally using that playbook to sell their ultra processed foods and beverages. That's very clear and very intentional. They might not say as blatantly. I feel like they learned their lesson a little bit. Oh, we're going to make this more addictive. They use synonyms even out in the public. Some of it that we report in this paper is not hidden. It's industry trade newsletters. It's interviews on 60 minutes with labor scientists where they're saying, yeah, we design these products, so you get a big flavor burst. And then it fades really rapidly because that makes you want to keep coming back for more and more and more. And yeah, addictive is a good word for that. And so there is this moment where it just becomes so implausible that they don't know that they have crossed the Rubicon into something that is hooking people. That plausible deniability that we're just, you know, giving consumers what they want, not actually engineering their desires to override what they know they should have to nourish themselves. It just feels beyond the pale to me to believe that's the case.

Allan, look, you mentioned delay. And I'd like to talk about that a little bit more. There's a point in time when the science on something becomes robust. And you're very certain say that tobacco is causing lung cancer and heart disease. And then you can't change things the next day or the next week. So, a little bit of delay is probably acceptable and to be understood. But the delay in this case between that knowledge and significant public health action policy action wasn't measured in days, weeks, months, or even years. It was decades. And you can count the number of attributable deaths to that delay in the millions. What did the industry do to make that delay as long as possible in terms of planting doubt, conflicts of interest with science and things like that?

Allan - This is highly relevant to our moment because I make a few claims in the book. One is that the industry invented disinformation and misinformation. And there's always this way that says, well, I know that study appeared, but we need more information. And this was very clever on the part of the tobacco companies because they said, well, you know, that science shows this, but that science is unreliable. And we need to use different methods. And lung cancer is not a result of cigarette smoking, it's actually genetic. And maybe there are a few people that shouldn't be smoking cigarettes. We should be able to identify what's different about them. They kept finding strategies of delay, manipulation, building uncertainty. There's one of the tobacco documents in this phase that says, from now on, our product is doubt. And what they really needed to do to sell the product was to create doubt about a science that was highly robust and really important to consumers. On the other hand, I think consumers are sensitive to being manipulated. They don't like that. They don't like being tricked. They know these industries, especially tobacco industry, you know, is disreputable. And as that became the case, what did they know and what are they selling. We began to see some slow shifts in public awareness. And, you know, it's so interesting presenting the cigarette problem to a jury in 1970 became radically different than presenting the case against the tobacco companies in the 1990s. And a lot had changed, A lot had been documented and, you know, we never even thought of the idea that a company would scientifically mislead us probably until in any consequential way till the middle of the 20th Century. And now we're incredibly skeptical and I think taking advantage of the public skepticism, both politically and culturally is going to be one of the important issues of pushing back against what I've called rogue industries. They're operating unethically; in many cases, unlawfully. They're misrepresenting what they produce. And they have the idea that having addicted customers is the best customer. And Warren Buffet once said, you know the tobacco industry, that's crazy. It cost a dime to make it. You sell it for a dollar and its addictive. He said, what industry could be more, you know, lucrative than tobacco?

Ashley, how do those things apply into the food area now?

Ashley - Oh, my brain is just exploding with all the things I want to say. But I think I have an answer to Warren Buffett, which is if you've pulled all those same levers and pretend to people that it's food, and it's because we all have to eat, you know? And I walk around a grocery store and I, in my head, I'm like, if I waved a magic wand, and all the products in here that are masquerading as food but are actually ultra processed, chemically adulterated starch, slurries essentially disappeared. There is so little food in my grocery store. Real food. And it's also expensive. We would be rioting in the streets if we really saw the degree that we're not being adequately nourished or supported in our current environment. And it's the mirage of abundance that is totally hooking us. You know, taking us hook, line, and sinker. And so, you know, I'll have people often say to me, you know, it's food. Like can't really be addictive. We all need to eat. And to me that is absolutely true. Just like we all need pain management. And there used to be a belief, a myth, that if you were in pain, you couldn't get addicted to painkillers like opiates which we now know is incredibly wrong. That just because we need calories to survive doesn't mean that if you manipulate and hedonically engineer those products, that it won't impact the brain in a way that can drive it in compulsive problematic ways. It's so essential for us to carve out, yes, you need real nourishing food. This is real nourishing food and these other things. I'd love it if the grocery store, it's like you're walking around this spot, you know you're getting real food. Sure, you want to go get those Cheetos, go for it. But it's in a very clear designated area that you're not being tricked into thinking that you're eating something that's nourishing you when it's really addicting you.

So, people have very strong affective attachments to foods. Particular foods that they like. Some of it is kind of what you grew up with, what your parents gave you, but a lot of it's marketing as well. And you mentioned a Cheeto or Coca-Cola, or a Dorito or a Twinkie or whatever it is. People don't want that taken away from them. Tell me if this is correct, the problem isn't so much that people eat Cheetos. It's that they overeat Cheetos, and then you add to that all the other thing, not just that food. But then you've got a real problem. Could it be a matter of just removing some of the especially troublesome ingredients from that. If you look at the list of ingredients on these foods, there could be 25 or 30 different ingredients. Well, what if, what if 12 of them got taken out or 13 or 15 of them got taken out? You'd still have the food; it would still have its taste. People could enjoy it, but it's not hijacking your biology.

Ashley - Yes, I'm very skeptical of that as the response, because as Allan lays out in his book, we were like, okay, if we just get the tar out of the cigarette. You know, it's all fine, Vapes, right? Oh, you're vaping. It's fine. It will be harmless because our reward system is so porous to different levers that signal food reward. We see it with the non-sugar sweeteners. Look, we took all the sugar out, we gave you Diet Coke, we gave you non-sugar sweeteners. It's a get out of jail free card. And now we're realizing how much that messes up our gut microbiome, could potentially lead to earlier brain aging and so, you know, abstinence, clearly making this stuff illegal, that's never the goal. But I think that sense of saying, oh, we can just engineer our way out of this is unlikely. And we have the alternative. You know, for what should be the majority of what we're eating. I love a Reese's Cup, right? I will have an ultra processed food, but it shouldn't be 60% of the food supply, or 70% of what my kids are getting for their calories. And so again, that clear understanding that this is something that's fundamentally different from the food that nourishes us. We have the answer which is real food. If we poured even a tiny amount of the investment, even closing the tax loopholes on things like ultra processed food marketing to kids that they get tax breaks on and invested that into technology to make real food in its original food matrix affordable, accessible, convenient. That stuff is tasty. Have a fresh apple. It's just everything's been wired for that to be the minority of our food supply. That's often unaffordable and we all feel really time poor. These are solvable problems. We've just been shoving all our money towards how we make new flavor additives to sell high fructose corn syrup, starch, slurries. So, we just need to have the right in incentives in mind.

Your point is very well taken that government trying to say, okay, let take out this ingredient or that ingredient is stepping into a trap. It makes all the sense to me in the world that that is a trap because. Using that philosophy requires a trust in the industry that if you ask them to take out these 12 things, they're not going to put in 12 new things that might even make things worse. And both of these industries, tobacco and the food industry have done everything but earn our trust so that's a very good cautionary note that you raised.

I would say in the tobacco area, the idea of that we think that, you know, vaping will be harm reduction. And there's been a strong political notion that we should be, you know, doing harm reduction. And of course, in many instances, harm reduction can be helpful. But I found in tobacco, that I can't trust the industry to make a harm reduction product that's not going to get kids addicted. That's going to, you know, make sure that we're not using both tobacco and nicotine in the form of vape or other products. And so while many people who I admire in the public health world have said, yes, harm reduction is the way to go. I don't think that's true with tobacco. We have a lot of children and adolescents today who are profoundly addicted to nicotine.

So, this discussion has led to lots of, oh my God, kind of observations from both of you. Paints a pretty scary picture of the food supply. How much manipulation there is. And how much harm gets caused by it. I'm hoping we might end on a bit of a positive note if there is one here. I'd like to ask each of you, is there a reason to be hopeful about the future? Allan, let me start with you. You're looking in on this with a unique perspective because of your years and years of working on tobacco. As you look in on the food space and see what's happening, what do you think?

Allan - Well, I tend to be an optimist. I believe public policies can make a difference. I believe the courts can be used to serve consumers who have been harmed in the market. So, I have seen those things work to a really significant degree around the cigarette. Especially in countries where we have resources for education, where we can make policies that sometimes work or mostly work. I don't think I ever would've thought when I started this work in like the 1980s that we would've gotten so far. I once said to my son when he was seven, he was taking a flight with me. And I said, you know, people used to smoke on airplanes. And he said, no, that's impossible. And he just couldn't believe the idea that we had let people smoke on airplanes. And I've been collecting cigarette packages that were given out by the big airlines. Of course, you and I, Kelly, remember probably, when they start to put smokers in the back of the plane. But the smoke was wafting throughout it. And a lot of things that seem almost impossible now, were actually reduced through regulation and politics and public health. I'm very hopeful that we can use what we've learned about how to get smoking from 50% of the population down to 15 or 12, as bad as that is. And apply it to other gigantic risks like ultra processed foods.

All right, thanks for that positive note. Ashley, what do you think are there grounds for being positive?

Ashley - Yes, I'm also a huge optimist. I feel wildly optimistic. I just, from listening to consumer sentiment right now, the degree to which corporations are able to hack our limbic systems, I mean, you see it right now with social media and sports betting. I think in our bones as a society, we're starting to just get fed up. And to me there is nothing that is more clear cut of how industries can manipulate us than taking food, the thing we most evolved to care about and to find rewarding and nourishing, and somehow jacking it up into an addictive, harmful substance. And I have two little kids. I have a five and 7-year-old and I am just as a mom full of rage every time I go grocery shopping because they've just shoved protein in a Pop-Tart, now they're trying to tell me it's a health food. I think we're catching onto them, and I think that there is no way to go but up. And again, we already have the solution. In opiates, we are still struggling to find non-addictive pain management. We have non-addictive food and it's called, you know, minimally processed real foods. So, it's just about putting the incentives in the right place.

BIOS

Ashley Gearhardt, Ph.D., is a Professor of Psychology in the Clinical Science area at the University of Michigan. She also earned her B.A. in psychology from The University of Michigan as an undergraduate. While working on her doctorate in clinical psychology at Yale University, Dr. Gearhardt became interested in the possibility that certain foods may be capable of triggering an addictive process. To explore this further, she developed the Yale Food Addiction Scale (YFAS) to operationalize addictive eating behaviors, which has been linked with more frequent binge eating episodes, an increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. It has been cited over 800 times and translated into over ten foreign languages. Her areas of research also include investigating how food advertising activates reward systems to drive eating behavior and the development of food preferences and eating patterns in infants. She has published over 100 academic publications and her research has been featured on media outlets, such as ABC News, Good Morning America, the Today Show, the Wall Street Journal, and NPR.

Allan M. Brandt is the Amalie Moses Kass Professor of the History of Medicine and Professor of the History of Science at Harvard University, where he holds a joint appointment between the Faculty of Arts and Sciences and Harvard Medical School. Brandt served as Dean of the Graduate School of Arts and Sciences from 2008 to 2012. He earned his undergraduate degree at Brandeis University and a Ph.D. in American History from Columbia University. His work focuses on social and ethical aspects of health, disease, medical practices, and global health in the twentieth century. Brandt is the author of No Magic Bullet: A Social History of Venereal Disease in the United States since 1880 (paperback, 1987; 35th Anniversary Edition, 2020); and co-editor of Morality and Health (1997). He has written on the social history of epidemic disease, the history of public health and health policy, and the history of human experimentation, among other topics. His book on the social and cultural history of cigarette smoking in the U.S., The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America, was published by Basic Books in 2007 (paperback, 2009). It received the Bancroft Prize from Columbia University in 2008 and the Welch Medal from the American Association for the History of Medicine in 2011, among other awards. Brandt has been elected to the National Academy of Medicine and the American Academy of Arts and Sciences. In 2015, he was awarded the Everett Mendelsohn Excellence in Mentoring Award by the Harvard Graduate School of Arts and Sciences. In 2019-20, Brandt was a recipient of fellowships from the American Council of Learned Societies and the Radcliffe Institute for Advanced Study. He recently served as the interim chair of the Department of Global Health and Social Medicine at Harvard Medical School. Brandt is currently writing about the history and ethics of stigma and its impact on patients and health outcomes.

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In 1881, African American educator and political leader Booker T. Washington founded Tuskegee Institute in Tuskegee, Alabama. The school's mission was to provide practical education and vocational training in fields such as agriculture and mechanics to African Americans in the post-Reconstruction South. Tuskegee ultimately became a world-renowned agricultural and industrial school for African Americans – and actually for all people. Today, we're speaking with Duke University's Jarvis McInnis about his award-winning book Afterlives of the Plantation: Plotting Agrarian Futures in the Global Black South.

Interview Transcript

Jarvis, I cannot tell you how much I appreciate this book. And hopefully we'll make a link to the Franklin Humanities gathering (https://youtu.be/rfSy1lWWOwA?si=dVcWH3xDBuBStEEc) that we had for your book launch. As I said at that time, and I'll say it right now, this book resonated with me so deeply because of my rural upbringing. My experience as a son, a grandson of farmers and agricultural workers. And someone who grew up in the 4-H Club down South. Hopefully we will get to some of those topics as we go through. So, let's start off with a real basic idea. Could you give our readers an overview of what the book is? And also, about what you mean by the Afterlives of the Plantation.

Yes, absolutely. Thank you so much for that question, Norbert. The book is an effort to think about the cultural and intellectual and political ties between Southern African Americans and Afro-Caribbean people in the late 19th to early 20th Century as they were responding to the legacies of slavery, right? This is the period after emancipation, and across the hemisphere. And so, I'm really interested in the way that they are sharing ideas as they are confronting the new modes of racial oppression that emerged in slavery's aftermath. In the United States, you have Jim Crow, right? Segregation, and other forms of violence and dispossession like lynching and land dispossession and so forth and so on. And then in the Caribbean, in Latin America, you have institutions like the European colonialism, and US imperialism, right? And so that is the afterlife of slavery. They're emancipated, but it's not a period of full citizenship, right? Of full access to the rights and privileges of citizenship. And so in telling that story, I center Booker T. Washington's school, the Tuskegee Institute, which was founded on the site of an abandoned and burned cotton plantation in Alabama in 1881.

And this is getting at the second part of your question. I became really fascinated by what it meant to establish a school, to establish a future-oriented institution, that's committed to uplifting Black people. To establish that on the site, on the ruins of a burned plantation. And, in some ways, I became curious about that as an undergraduate student because I'm a graduate of Tougaloo College, in Tougaloo, Mississippi, which is a historically black college much like Tuskegee. And much like Tuskegee, Tougaloo was also founded on the site of a former cotton plantation.

And I saw that this idea, or this practice, this logic of transforming these sites of violence into something that is more liberatory and more emancipatory was really a strategy that Black people used throughout the US South and throughout the Caribbean. Throughout much of the Americas where slavery and the plantation had existed. I placed Tuskegee, and particularly its approach to agriculture, at the center of that story to demonstrate how an institution rooted in the US South is not backward. It's not pre-modern. That's firmly rural, but that rurality... they're taking the knowledge that's cultivated there and disseminating it to other Black people in other parts of the world to aid in their struggles toward freedom and citizenship.

I think this is an important point to make. And I know we've had conversations about this as you were developing the book. And I'll just say again, out of my rural Southern agricultural background, I often found a sense that people thought, oh, well you must be backward. Oh, you must come from this... and that's not a good thing. I can only imagine that people of this time must have thought, well, shouldn't people want to move away from agriculture? Why would you want to be invested in this thing that was a part of former enslavement? How do you think about this in light of this notion of agrarian futures? You would think people would want to move away from that. What is your understanding of sort of this move towards agriculture and seeing this as something for the future and even modern.

That's such a great question. And I, you know, I have to say that I came to agriculture relatively late in the project. I was initially most interested in what Tuskegee was doing with Black aesthetics: with photography and with music and with literature. I'm a literary scholar after all. But as I sat with Tuskegee's aesthetic output, I realized the significance of agriculture within that. And as I began to explore the ways that Tuskegee was being disseminated to other parts of the Black world, to places like Haiti, to places like Puerto Rico. And as they were admitting students from those particular colonies at that time. Now some of them are countries; Puerto Rico is still a territory. But I realized that what other Black people, both in the US South and abroad, were interested in was its agrarian vision. Was the work, the research that someone like George Washington Carver was doing at Tuskegee and as a mode of self-help. And so I really had to wrestle with that because it was outside of how I had conceived of agriculture. And in many ways, writing this book transformed my own understanding of what the modern was. And, you know, forced me to, or perhaps invited me, to think about agriculture to understand it as intellectual. To understand it certainly as a skill, in all of these ways that I had not really given much thought to it previously. But as I sat with George Washington Carver's bulletins. As I sat with Tuskegee's extension initiatives. As I sat with the knowledge that they were producing, the various print cultural artifacts, the newspapers. And again, the agricultural bulletins and so forth and so on. I realized, wait a minute. This is a site of knowledge production, and its modern up-to-date knowledge production that actually still has a lot of sound basis that can be used in contemporary agriculture to this very day. And so, it radically transformed my understanding of Tuskegee, of a figure like Booker T. Washington. who as we know, is a much-maligned figure in Black studies and American studies because of his conservative politics. But agriculture gave me another way into that institution and to think about, again, the significance of the cultural and intellectual contributions of the US South at this particular period.

Thank you for that. I want to talk about a particular section of the text that has to do with both the agricultural philosophy, but also this idea of sharing information, and you've made some reference to it. So, I grew up, as I mentioned, going and being a part of the 4-H program, which was a part of the Cooperative Extension System. And Tuskegee, in many ways, helped form and helped inform what extension would look like. Which ultimately became a thing, federally, in 1914. But I want to read this one passage from your text, and you say:

"In 1897, the state of Alabama passed legislation allocating $1,500 to establish an agricultural experiment station on campus. The station also known as the Experiment Plot."

And plot is something you come back to. And I would love to hear your thoughts about this garden plot and the Experiment Plot and just the metaphor of plot throughout your text.

"But the station also known as the Experiment Plot, was managed by George Washington Carver. Washington insisted that the experiment station ' should not be used for scientific experiments of interest only to experts. Should deal with the fundamental problems with which the Negro Farmers of Alabama were daily confronted.' The results of Carver's experiments were thus published in bulletins that were then distributed among farmers throughout Alabama and the broader US South."

And then you go on and talking about the different courses that were made available. But I wanna get this one quote from the Tuskegee student. And you said the Tuskegee student observed: 'Tuskegee Institute is primarily a school for the masses of our people. Both old and young and in all degrees of development.'

I mean, Tuskegee was doing something that other land grant institutions would eventually take on, is this idea of sharing knowledge and using this. As a means of uplift and I would say even citizen building. What are your thoughts about that sort of perspective?

Yeah. Yeah. I'm going to try to wrap all of those questions up into one response. We'll see how successful I am.

I know I gave you a lot.

Well, one of the things that I wanted to say, that I did not get a chance to say in my response to your previous question is that, you know, the majority of African Americans lived in the South in this particular period. And many of them viewed agriculture as a viable future. And that was one of the aspects of, you know, doing research on this book that was transformative for me. Was understanding that they did not hold this same necessarily, sort of, denigrating attitudes toward agriculture. In part because the United States was largely agricultural writ large, right? [00:11:00] And so it was across the country, across the color line, was regarded as a viable pathway. But it is the case that Booker T. Washington was attempting to rebrand agriculture, to re-signify it. Because there were a number of African Americans who did not want to have anything to do with it because it reminded them of the degradation of slavery. And so, what Washington said was he said, hey, you know, that there's a distinction between working and being worked, right? Being worked means degradation. Working for oneself, right? Being independent is a mode of civilization, is what he argued. And so what I argue in the book is that Washington is attempting to resignify labor, to make it something that is regarded as self-proprietorial, right? And that is a necessary tool in not just labor but agricultural labor in particular. But we can add, I would say, industrial labor also as something that is self-proprietorial and that is a part of that citizenship making project. So, I wanted to be sure to home in on that aspect of your previous question. And then I think the way into this next question is to talk a little bit about the plot. The slave garden plot. So, this idea in the book, right? The subtitle is Plotting Agrarian Futures. And there are multiple residences of the plot throughout the book. But the easiest way to, sort of, describe it is that it is an elaboration on the slave garden plot. The patches of land that enslaved people could cultivate throughout the Americas to grow foods to nourish themselves, because the rations that were provided from the plantation owners, those rations were too meager, right? A number of scholars and theorists across disciplines have theorized that the slave garden plot was a site of resistance to the plantation system. In part because it is enabling them to survive, to live, to nourish their bodies, right? But also because of what they did on the plot, right? Not only growing food, but also perhaps growing flowers. There's one scholar who regards it as the botanical gardens of the dispossessed, right? And so this idea that on these garden plots where they could cultivate food for themselves, their time was their own. They weren't growing food for sale on the global market, necessarily, or other cash crops for sale in the global market. They were growing foods that perhaps have been a part of their diets in Africa. And in addition to that, they were engaging in communal practices, singing, dancing, and sometimes perhaps even plotting revolutions, right? Another valence of the plot.

And so, a scholar like Sylvia Winter establishes a kind of dichotomy between the plot and the plantation under enslavement. And when I realized that Tuskegeeans were also trying to encourage Black folks to grow food, and in doing so helping them to circumvent the predatory practices of sharecropping, of tenant farming, that would have those sharecroppers and tenant farmers to buy their foods from the local commissary and to remain in cycles of debt. And that of course, that they had an experiment station that they called an Experiment Plot. I thought, okay, this is the post emancipation iteration of the slave garden plot. It stands as a counterpoint to the plantation system, and it is imbued with these logics and ethics of care. And one of those logics and ethics of care is the dissemination of knowledge, right? Ensuring that rural Black farmers who were perhaps too old to attend Tuskegee, or could not afford to do so, that they could come to campus and learn the most up-to-date agricultural knowledge, right? And for those who couldn't come to campus, to attend the Tuskegee Farmers Conference, they would take the Jessup Agricultural Wagon into the countryside and teach them about crop rotation. Teach them about how to grow certain food crops, right? Teach them about how to grow certain plants to beautify their homes and so forth and so on. And so I think about that dissemination of knowledge, right? Whether it's those farmers coming to campus or Tuskegee taking those ideas into the countryside, as an ethic of care that is connected to the way that the plot exists as a counter to the plantation.

Yeah. Wow, this is really wonderful. I love how you're able to weave in this agricultural philosophy that had deep resonance with people of the rural American South. But you also saw this as something that moved beyond the borders of the American South, and thus in your subtitle, the Global Black South. How did Tuskegee get involved in this transnational sharing of knowledge, and working in the Caribbean, and particularly, Puerto Rico, Haiti? Tell us a little bit more about that experience.

Absolutely. Absolutely. Tuskegee really began to recruit students from the broader diaspora in the latter part of the 19th Century. So, around 1897. Certainly, the Caribbean, certainly Cuba and Puerto Rico, following the Spanish American War. And Booker T. Washington sent a Tuskegee student who was actually fluent in Spanish into Florida, and then later on to Havana, to recruit students to Tuskegee. He understood, he believed, that because they were experiencing conditions that were very similar to African Americans, they too were responding to the afterlife of slavery in the plantation. Given that emancipation in Cuba and Puerto Rico, in particular had just occurred in the late 1880s, he believed that their conditions were very similar to those of African Americans and that they could benefit from agricultural and industrial education as well.

And there was a reformer by the name of Grace Mins. She was based in Boston. And she ensured that Booker T. Washington's autobiography, Up From Slavery, was translated into Cuban Spanish. And then that autobiography was then disseminated. A thousand copies were disseminated throughout the island of Cuba. And so as a result of that, he inspired, or the model of self-help that Washington depicted in Up From Slavery, inspired a host of Afro-Cuban readers. Students and parents and government officials and educational officials then begin to write to Tuskegee, write to Washington, wanting entry into the school.

It's also translated into French, right? And so, you have French readers, particularly in a place like Haiti coming to Tuskegee. Someone by the name of the Jean Price Mars, who was the foremost Haitian intellectual of the 20th Century, actually met Washington in France when Washington was traveling there on vacation and became inspired by that model. A year later, he comes to the United States to attend the 1904 World's Fair and then spends two weeks at Tuskegee, learning those ideas and wanting to take them back to Haiti. So, through translation, right? Into different languages, those ideas then circulate throughout the Black world, but also through efforts to actively recruit students from those other places that Washington understood as experiencing a similar condition as African Americans. People whom he understood could benefit, he believed, could benefit from agricultural and industrial education.

Great. And one of the things I loved in the way you talked about this in the text is you talked about not only translation but transplantation. And I thought that was an interesting turn of phrase because of what you were trying to communicate through that term. I want to, sort of, bring us up to some things that are currently happening. We just had a conference and you were a participant on a panel on humanistic issues around addressing food waste. And I've got to say, this was one of the panels that people really leaned into, that were really caught up by it. And you made some really insightful interventions based on some of the work that you've done in your book. So, you spoke about the anti-waste ethos at Tuskegee and I really found that interesting. Could you speak to that for a moment?

Absolutely. Well, first I want to say thank you again for the opportunity to participate in that symposium. I really enjoyed it, and it really gave me an opportunity to think about various dimensions of a kind of anti-waste ethos at Tuskegee. And I think that there are a couple of different ways in which it manifested at the institution. So first there's a kind of metaphorical dimension to waste at Tuskegee. When Booker T. Washington writes to George Washington Carver to hire him, to recruit him to the institution. He said, I can't pay you a lot of money, but we have been tasked with helping to transform formerly enslaved people from conditions of waste to full manhood. Right? And so there is that sort of metaphorical, or what I would argue in the book is a kind of ontological understanding of waste, given the degraded status of the enslaved. And then there's a kind of philosophical dimension to waste as well. One, so Washington, Tuskegee, they are informed by the progressive era, right? It's a progressive era institution that's guided by a commitment to thrift and economy. And so, they're very much interested in a kind of practical attitude toward not being wasteful, right? To being thrifty with money, but also with resources. And what we see is, you know, complaints about food waste in the dining hall at Tuskegee, right? A very practical issue for a poor rural institution wherein the students are growing the food, right? Wherein the students are making the bricks, right? Are helping to transform this plantation into a school. We can't afford to waste food, right? But they're also teaching students and Black folks in the countryside how to preserve fruits and vegetables. There are these photographs of them teaching folks how to can and preserve fruits and veggies, right? To ensure that they have food throughout the winter months, so that they are not stricken by hunger and poverty and starvation. So that they aren't forced to borrow additional money from the plantation owners if they are indeed in sharecropping and tenant farming arrangements. And so, the last aspect I suppose of waste at Tuskegee that I want to highlight here is a kind of ecological one. Where in George Washington Carver is calling on farmers to take advantage of the quote unquote waste that is on their farms, right? The cow manure, right? To regenerate the soil. The swamp muck, right? The dead leaves, the night soil; to use that waste to regenerate the soil, to replenish it, right? In addition to practices of crop rotation and so forth and so on. And so that ecological dimension of waste is really important for understanding Tuskegee's ecological vision.

I think this is so important because conversations around regenerative agriculture, and going back to, sort of, broader notions of traditional farming practices, minimizing the use of chemicals, people were talking about this. Folks like Carver were trying to find ways of using very little resources to help support the growers that he worked with. And we're hearing these echoes again and again. I'm so grateful that you illuminated that throughout your text. Thank you.

I am not the only one who seems to have appreciated that because you won the 2026 Association for the study of African American Life and History Book Prize and the 2025 On the Brink book Award from the University of New Mexico School of Architecture and Planning. Why do you think this narrative of agricultural liberation is resonating with people so strongly?

You know, first of all, Norbert, I just have to say how honored I am that the book has received these recognitions. And that it's finding its audiences. Audiences that I couldn't have imagined. Imagine my seeing my face when I opened the email to see that it had been acknowledged by both of these institutions. But especially the architecture and planning. I thought, oh my goodness. I, could not have, I could not have imagined this. So, I just want to say that I'm grateful first and foremost.

You know, as I've been talking to people, you know, and as I've been moving around and talking to readers at my book tour, or people have been writing to me via email, what I've found is that the historians really appreciate the archival richness, and robustness of the text, right? So, the historians, the literary scholars, they really appreciate that aspect of the book. Many people, I think, also really appreciate the fact that it is giving us a new way to think about Tuskegee and Booker T. Washington. A place and a person who we thought we knew, right? And not in a flat way; a way that holds the complexity of that institution in place. And throughout the text, I really try to wrestle with the critiques, the valid and legitimate critiques that are coming from people like Ida B. Wells Barnett, and WEB Du Bois, about the limits of Booker T. Washington's political philosophy. But at the same time, I say, but if we don't acknowledge what they were doing through agriculture and by extension through aesthetics, then we're missing a really important part of this story, right? And I think that the book is giving us a model for thinking about how to engage in criticism that is both generative and productive, I suppose, right? Like how do we hold them to a particular standard where we say, you know, here are the limits of your political vision, but at the same time, this is what you enabled, right? And that's what the text is trying to do. And I think, you know, others have shared that they appreciate that it honors the intelligence and sophistication and dignity of Black rural people, of Black Southerners, who in my opinion, are often written out of Black studies in a way that is substantive. In a way that honors their contributions, especially in this period. The South is a space that people are simply fleeing from because of Jim Crow. And I'm saying, wait, what about the people who remain rooted in the land, on the land, either in the US South or in other sort of rural places throughout the diaspora.

And then finally, I think that the book seems to be connecting to people who really care about our world. Who really care about the state of environmental degradation that we have found ourselves in as a result of institutions like the plantation, of monocrop agriculture, of industrialization in the way that it abuses, and misuses the earth. And so, because the book is invested in thinking about regeneration and repair, and about more sustainable methods from the past that can be useful for our present. I think that it seems to be connecting with readers who are interested in issues like climate change and environmental catastrophe. So that's what I suspect, based on some of the feedback that I have received. But I just want to reiterate just how grateful I am that it is finding its audience.

BIO

Jarvis C. McInnis holds a BA in English from Tougaloo College in Jackson, Mississippi, and a Ph.D. in English & Comparative Literature from Columbia University in the City of New York. Jarvis is an interdisciplinary scholar of African American & African Diaspora literature and culture, with teaching and research interests in the global south (primarily the US South and the Caribbean), sound studies, performance studies, and visual culture. Jarvis's research has been supported by numerous grants and fellowships, including the Mellon Mays Undergraduate Fellowship, the Ford Foundation Pre-doctoral and Dissertation Fellowships, and Princeton University's Department of African American Studies postdoctoral fellowship. His work appears or is forthcoming in journals and venues such as Callaloo, MELUS, Mississippi Quarterly, Public Books, and The Global South.

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Over the last several years, I have been thinking about food waste and food loss a lot. It's been a topic that we've seen in many spaces in the US and around the world. And it's interesting to compare how the US handles food waste with other countries. To that end, we will learn more about how Belgium addresses food waste in a conversation with an anthropologist and journalist, Dr. Kelly Alexander from the University of North Carolina at Chapel Hill. Her book, Truffles and Trash: Recirculating Food in a Social Welfare State, explores community driven solutions and policy around food waste. And Belgium's capital city of Brussells.

Interview Transcript

Let's start with your research in Brussels at a high end truffle restaurant... but you ended up in food banks and social restaurants and community kitchens. Tell us a little bit about the evolution. How did this project evolve to finding yourself in these new places?

Yeah, it's a, a strange trajectory. I did not start out to be a food waste researcher. But how it started and how it's going, you know, that meme from 2018? This is like what I love to talk about when I talk to my food study students, because I started out, as a researcher, very interested in the development of haut cuisine. I had worked in a lot of restaurants. I had worked as a journalist for several food magazines. And the question that really animated me was how a truffle, this little spore on a fungus, has become one of the world's most expensive ingredients. And so I was doing ethnographic research in the kitchen of a Michelin starred truffle restaurant. And there is not that many of those, and one of them happens to be in Brussels, Belgium. And I'm in the kitchen there and I'm working on the line. And I usually have to specify to my students like it wasn't a stunt. Like you can't write to a Michelin star restaurant and say, 'Hey, can I come on in and work in your kitchen?' I had a lot of credentials as a journalist and as a chef first. What I did have going for me is that I was in a funded doctoral dissertation program, actually the anthropology program at Duke. So, I had funding to go and do that research in this kitchen. And there's probably no restaurant in the world, no matter how high end, that is not willing to accept some free labor.

So, I'm working in that kitchen. I'm working with fantastic chefs. And what happens when you work at a super high-end restaurant is that is aesthetics are valued above all else. The food has to be really, really beautiful. And this restaurant charges extraordinarily. It's called La Truffe Noire. It's still in Brussels now. It's a truffle restaurant. The black truffle. Super high prices for very, very refined food. And in order to do that, a large part of my job was brushing priceless truffles, throwing away an unbelievable amount of very beautiful produce that would otherwise have been exceptionally valued in other contexts.

And I come from a background - my grandmother was a Russian Jewish woman. She grew up in Brooklyn. She moved to Atlanta, Georgia after World War II. She taught me to cook, and she never threw anything away. And when I say that to people, I think they're like, oh yeah, I have a grandmother like that. But she really never threw anything away, like can of grease under the sink. The whole thing. Every little butt of a vegetable was saved for stock for later. And I was throwing away so much good food working in La Truffe Noire just making beautiful garnishes and vegetable carvings and things like that, that I started following the food waste around the city. I was wondering where all of this went. And I actually asked the chef in the restaurant, you know, we throw away so much food, would it be possible to give some of it to people who could really use it? And his response really interested me and changed the whole course of my research because he said, I am really willing to do that. However, I pay chefs to cook food and not to give it away. So, if somebody was willing to come here and pick it up, I'd happily give it to him. But I'm not going to pay people to go and do that. And I thought, well, I wonder what else is going on in this city in terms of this. Like where does all this food go? And I discovered I was doing this research at a fortuitous moment in the EU when the EU had just made this compulsory policy aimed at supermarkets. So, all large scale supermarkets across the EU were suddenly required to donate all edible but unsellable food. And the EU didn't give a lot of direction about how they could do that, and also didn't give the supermarkets any money.

So, what happened as a result of that? Well, there were lots of local grassroots efforts communicating directly with supermarkets who were like, 'Hey, we're over here. We'll come pick up the food that you don't want to sell that's still good to eat. And we'll use it in our food banks and in our zero food waste popup restaurants.' And all the supermarkets had to do was get the food waste off their books. So, while I was there working in this truffle restaurant, all this other food waste activity was going on. And I discovered that's really what I wanted to be doing. I loved working as a chef, but I wanted to see what the possibilities were for recuperating food around the city. So, I changed. I changed everything I was doing pretty quickly.

Oh, this is really fascinating. Thank you for sharing that. I know that the field of anthropology and other fields, you can start off on one project and discover that there's this whole new world that you didn't even realize until you started down the path. This is fascinating and I'm sure your advisor was thrilled to know that you wanted to change topic midstream. But it worked out. It worked out beautifully, it seems.

It is true. I couldn't look away from the food waste to the point where I was taking pictures of the garbage can in the restaurant every day. And this big industrial garbage can filled with like priceless wild mushrooms. And a big part of my job is the restaurant made this dish. This is what changed my life. There's like a series of food journalists who talk about the dish that changed my life and what they're talking about is when you eat something super delicious and you have some kind of awakening, this is like the opposite of what happened to me. I am making this dish called Salad Stephanie. It's like a 40-euro salad that has a lobster tail in it and all these beautiful wild mushrooms, and it has eight spinach leaves. So, a big part of my job when I worked at La Truffe Noire was to hold up individual spinach leaves up to the light, and if they had any blemish or like a broken vein in them to throw it away. So, this is beautiful, this is like the best spinach that you could get. The best produce in all of Europe was coming to this restaurant and I was throwing it away. And I started taking photographs just to document all the food I was throwing away. And I couldn't look away. And actually my advisor, Dr. Anne Allison, in cultural anthropology at Duke, was really excited because I had been doing a project on aesthetics and now I was proposing a total change to do this much more political project about where food waste goes. So, she was like, yes, let us follow the food waste. This is so much more interesting. So that was kind of a nice nod that I was thinking in the right anthropological direction about food and value.

Thank you. This is such an important uncovering that, you know, research isn't static. It's not linear. It takes deviations and it's in those deviations that you find the real truths. The real exciting things. Let's continue the conversation because I think there's so much more to uncover. In your book, Truffles and Trash, you describe a particular day of field work at a Brussels food pantry. It was a really powerful moment. And I will say, having worked at food pantries in different parts of the US, I recognize this story in a serious way. You mentioned that this moment turned into a tense moment around fish and pork. Can you describe this to our listeners and why did this experience stick with you? What did it teach you about the hidden social politics of food waste and redistribution?

Yeah. I often frame, you know, I did this work back and forth to Brussels for about six years and certain moments just absolutely have stayed with me and haunted me in a lot of ways. And one of them was working at this food bank in a former hospital. So, there's a former hospital that had shut down. It was still like a hospital with rooms for sick people in a giant sick bay. And it had been turned into a kind of community residential center where people could rent rooms, they could use the kitchen to prepare their food. That had been the hospital's kitchen. And the bottom floor of it, which had been the whole emergency triage center, was turned into a thrice weekly food bank. So, I'm volunteering at this food bank and there's tons of food coming in from grocery stores. And this is Brussels in the summer. It's pretty hot outside. A lot of people go on vacation. There's a lot of expensive food coming in, including fish and pork, fresh fish and fresh pork. I am assigned to work on this station. The person who usually runs the station, who is my boss, is an older Vietnamese woman who's an immigrant herself to Brussels. And she is kind of giving me the ropes. And she has figured something out where she says, you know, we have to give equal things to equal people, right? And she's telling me this before anybody comes in the food bank. Yes, sure. We will give one to one to each person as the people are coming through the food bank. Brussels has a very high population of Moroccan immigrants, and this is due to historical factors. The Nation of Belgium invited Moroccan immigrants to help them build their subways in the '50s and '60s with the promise of citizenship, including they have an amazing educational system. It's a whole social welfare state, healthcare, everything. So, this is guaranteed to those Moroccan immigrants. What the Belgian government didn't do, and has been pretty clear on admitting, is create any social programming around those assimilation efforts. So, the generations of those people who came to build the subways are now a lot of them living on social assistance. That is who is coming through. A lot of Moroccan people who are Muslim, into this food bank. Muslim people typically have prohibitions against eating pork. So, we have fresh fish and fresh pork. There are women coming through, they're in hijabs, they're obviously presenting as Muslim and they are asking, could I have the fish please? And we were told to give the pork first and then the fish, because the fish is considered more valuable. And I am thinking, in my own head, oh, I'll just be an amazing social innovator here. Yes, of course. If you don't eat pork, please let me give you this fish. It is not occurring to me that other people coming through the line are considering this preferential treatment. So, I am giving fish to these Muslim women. One of them sees me in line and says, my friend is back there. Can you put aside a piece of fish for her? Yes, sure, no problem. I set it aside. A woman who is Flemish is coming through and she's speaking to me in Dutch and I'm handing her pork. Pork is super popular amongst Flemish diners. No problem. And she's pointing down and she had seen me put the fish away and said, can I have that fish? Well that fish is for someone else and she absolutely threw a fit. No, you can't do that. It's not fair. It's not just, you must give me a fish. Long story short, there's a whole tug of war between this package of fish. There's a security person at the food bank, which I had not considered why there would need to be a security person at the food bank who has to come in, break up this fight. It was, it was so humbling. I had not considered these factors. It's really on me. It's like you as a social scientist who's thinking it's not on me to innovate this food bank's pantry. I didn't follow directions. I thought I was doing a good thing. You know, the whole war over this fish. And when you see what it means to someone's culture to eat the foods that are appropriate to your culture, I would fight if someone was like, you can't have that matzo ball soup again. I'm going to take it away from you. There's no telling what I would do to get my hands on it.

And I just felt in that moment, like I had done it all wrong. Like I had really misunderstood food waste distribution. But more than that, of course, I'm not the star of this story. If you are at the mercy of what is available and without choice... anthropologists spend a lot of time talking about the good life and what constitutes the good life and studying the good life. I would define the good life as being able to eat the food that you wish when you wish for it. If you don't have that and you are at the mercy of the state to decide what is appropriate for you, then you find yourself in these kinds of conflicts. And you see them, you said you could relate, you see them in food banks playing out all over the world.

Yeah. First, Kelly, thank you for sharing that because I know that wasn't a fun story. I mean, I can only imagine the, the, the pain of you watching this scene unfold. I mean, that must have been difficult. Especially when the security guard is called in. Okay, that's tough. And realizing that there were differences in cultures that were clashing. All of that happening at the same time. And one of the things I pick up out of this story is that which is considered food that could be wasted, that could be redistributed, is not acceptable for all people. And like, how do we then make sense of that? Because you're in a culture where something is considered a good product...pork, but it's not considered a good product for other people. And so, you know, our food system, and I always say this about food banking in general, people complain about the foods that show up in food banks, in sort of a traditional sense. But it's just a reflection of the food system of that country, right? It just looks like what we have. And we may think that's not good, but it's, it's what you see in the grocery store often. And for all those reasons, I think there's such a richness to this story. So, thank you for sharing and also the humility it takes for telling that story too.

I wanted to not be intrusive like any social scientist. I was there to share my time to do some participant observation research. Suddenly I had ignited this culture war amongst these two women, which is the least population I would want to affect. And you know, the security guard turned to me at the end of it, which is in the book and said, you get what you get. That is the policy. Yeah. If they want to trade when they get outside, you do not decide. You get what you get. That's how we do it. And I saw the wisdom of it in that moment. But at the same time, to your point, you see, sort of, like there have been much bigger tensions in Europe, especially around halal meat. You see it in France all the time, should McDonald's serve halal meat. And there's a certain very conservative contingent of Flemish people who are like, you can't tell us what we can eat. You can't tell us how we have to butcher our meat. And that's what I had seen firsthand happening in a food bank, which you think of as a place of lack where politics don't come, and politics are there.

Yes, very much so. And the idea of equitable distribution; it can feel restrictive in some ways, but it serves a purpose. And like I said, I really appreciate you sharing that, and I think it's an important thing for all of us to understand the complexity of those environments. I want to move on and ask about sort of regulatory and legislative realities in Europe. So, Europe, as you mentioned, has this compulsory legislation requiring supermarkets to donate edible but unsellable food. While in the US food redistribution is often framed as charity. How does this policy difference shape what's possible?

Yeah. This is the question. So, you know, one of the things I learned, even in that example. I always highlight like my worst, hardest, saddest day of participant observation in six years, which was that one. Which shows a kind of flaw in a food bank model. And sometimes I have students who say, oh, you hate food banks. I don't hate food banks. I think food banks have a lot of flaws. And what they do is continue to reproduce this structure of givers and receivers, right? Like there's, on one hand, one side of the equation are people who are giving food and on the other side who are people who were receiving food. And one thing this policy did this, like compulsory policy of forcing supermarkets... and you can't really force them, you can only levy huge fines with them. Which is... I am a big fan of policy with teeth, not just policy, but policy with teeth. You will have to pay a huge fine as a supermarket if you don't want to do this. And very few supermarkets have had to pay that fine as a result of this. There was massive compliance.

But one thing I discovered was really better ways than food bank models, or that I think are better ways. In part because they're more equitable. And one of them is this concept of a social restaurant, which is very European, although you're seeing them spring up in the US more and more. So, a social restaurant, according to this model, is a government institution. It's funded by the government. And it has internship programs that people who are job seekers can apply to. They can learn skills on the job to work in restaurants, to work in the service industry. This is really important in a place like Belgium where there are two official languages, French and Dutch, but most immigrants come with only one, if any. And to be bilingual in a job market makes you far more competitive. So, you can learn this in these restaurants. You have language lessons. And then you also learn how to run a restaurant. The restaurant is entirely powered by this surplus distributed food from supermarkets, which gives you an idea of the scale. In my thinking, I was like, how can a couple of supermarkets possibly be giving an institution so much food that it could run a restaurant? The restaurant where I worked called Bel Mundo had four gigantic rooms of freezers, all of which had been donated, and they were turning away supermarkets. So that's how much food was coming in every day, just to say that. And so my greatest day of field work was called Steak Night. You wouldn't believe that you could find steak that was coming from a supermarket into a zero-food waste restaurant. And by the way, the restaurant sells meals at a lower cost. A lot of the meals were for pensioners. And also sliding scale. So, you know, one day I walked into the kitchen and there were 25 steaks, and they were fresh and they were going to expire in the next couple of days. And we needed to make them. The chefs were so excited. The chef trainees were so excited that diners were so excited about Steak Night. It was easily the happiest day of field work I'd ever had. People were dancing in the kitchen, we're playing music. It felt like we were doing something that was really luxurious and that's what that kind of policy can enable, right? There was a freezer full of unsold Christmas gooses from December that were then served for spring for Easter. That was like amazing. It's just another model. It's another way of doing things, right? That that policy made possible.

Yes, and that's a great set of examples of how we can think about new ways of meeting these needs, using the surplus of our food system in creative and innovative spaces. And there's this possibility of training and development. I think there's something valuable there. You report that people in the US who talk with you about food waste, including your students, often ask, why don't we do this here? After everything you've seen, what's one realistic lesson or one small shift that communities in the US could adopt, right here, right now to rethink food waste?

This the best question, and it is the number one question I get. Why don't we have this here? And we have seeds of some of it here already. I always point that out. One of the best programs I've ever seen is a program that is associated with the city's abattoir, which is a huge outdoor market that runs only on the weekends. And this grassroots group got together and said, you know, nobody's ever hanging out in this market during the week, we want to revitalize it. And one of the ways that they did it, just to get people to use the space more, was to take all the unsold produce. So instead of having vendors at the end of a market, and I think of my Carborro, NC farmer's market like this, at the end of the market, which is a pretty bougie farmer's market lots of chefs go there and get local produce. But at the end of the market instead of having farmers and produce vendors take home what they couldn't sell, they have an aftermarket. And the aftermarket turns that produce into edible meals. Everybody pays $5. There are people who come and cook the meal. If you cook the meal, you get to work for free, and it's a whole community workforce. It has had a tremendous effect. So, 60% of that market's food waste is now consumed. That's a big shift and it's happening at a local level.

So, one thing, I think Michael Pollan's an amazing food journalist, but one of his great conclusions is that people need to grow their own food. And I'm critical of this. I don't think that's appropriate. I don't think that's a sustainable solution for a lot of people. But what I do think is sustainable in a market like that where there's food that doesn't sell, instead of throwing it away or taking it back or letting it rot, we could do something with it on the spot. And that's a little thing that makes a big difference. So, I am a fan of that. Food waste is one of the problems that is actually, in my view, best solved by local efforts because it's there, it's just sitting there. If you can move it around before it spoils you have won. If the ultimate goal is to just not throw away food.

Now I do have students, I will say who are brilliant, who say stuff to me like isn't that neoliberalism? Look, yes. The answer's, the answer's yes. The answer's yes. If what your goal is, is to make sure that more edible food is not buried in landfills, which is bad for the environment and is not helping hungry people, it can be really effective. It can be really effective to say we don't actually have to overthrow the whole system while we're looking for better solutions. We can work within it. And that's probably my biggest takeaway is that even within a global industrial food system, there are lots of ways of moving food around from people who choose, who opt, who have the luxury of opting against it to people who would really like to have it. And it actually creates more equity instead of a culture of lack.

I love your enthusiasm, and I love your vision of how we can work within the system to make it better for all people. Kelly, thank you so much for this engaging conversation.

BIO

Dr. Kelly Alexander is an assistant professor and George B. Tindall Fellow of American Studies in the University of North Carolina's College of Arts and Sciences, where she also co-directs the minor in Food Studies. She holds a bachelor's degree in journalism from Northwestern University's Medill School of Journalism and a doctorate in cultural anthropology from Duke University. She is a James Beard Award-winning writer and former editor at Saveur and Food & Wine magazines. Dr. Alexander's work has appeared in The New York Times, Newsweek, and O: The Oprah Magazine. She is also co-author of The New York Times best-selling barbecue cookbook Smokin' with Myron Mixon. Her research has been supported by the Mellon Foundation, the New York Botanical Gardens, Duke University, and the University of North Carolina at Chapel Hill.

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It seems like the frequency of weather-related disasters is increasing. Across the US we're seeing wildfires, tropical storms and hurricanes, extreme heat, extreme cold with snow or ice. And torrential rain leading to a loss of property, life, and livelihoods. What's more, similar extreme events are happening across the globe. These disasters all can have an impact on our food supply and the ability of people to access food. Today, we're speaking with environmental sustainability management expert, Betsy Albright, who is an associate professor of the practice at Duke University's Nicholas School of the Environment. Betsy's research centers on how policies and decisions are made in response to weather related disasters.

Interview Summary

Betsy, I've been wanting to have you on the podcast for a while, so I'm excited to get you now. So, let's begin with the first broad question. I'd be really interested to learn a little bit more about your research to make sure that our listeners are up to date on it. And I know you really study disasters, but could you explain or expand on what that really means for our listeners?

I'm an environmental social scientist who studies the human and social side of disasters. And I ask questions about how climate related disasters or climate driven disasters, or weather disasters affect communities and households. And how individuals perceive risks from disasters, how they're affected by disasters, how they learn from make changes and adapt after disasters. My work started with my dissertation in central Europe. I had a Fulbright in Hungary. But from then I've expanded and moved most of my work to the US context. And our research team and I have done work on flooding and wildfires in Colorado, hurricanes in North Carolina. And I'm also working on a study of the flows of disaster assistance funds from FEMA to communities. And all of this is with or through a lens of equity or inequities and thinking about that across the disaster cycle.

This is really important, and I remember being at a conference with you and learning about your work. And I was struck by what happens after the disaster. And in particular what happens to availability of food. And I work with the food bank here in North Carolina. And one of the things I know is when there is a disaster, like when Helene hit Asheville, there are real challenges in getting food out to people. Does your work touch on those topics as well?

Yes. I would not say that our work centers on food, but food definitely intersects across all phases of the disaster cycle from preparing for disaster, experiencing disaster, the immediate response- that food bank getting food out- to long term recovery and thinking about risk mitigation. And we can think about that, you know, through a number of different lenses. Both on the food access side, but also on the food systems agriculture side as well. As I mentioned earlier, I take an equity lens on much of the work that we do. It's really important to recognize that disasters hit unevenly across society, across the landscape. Disproportionately they magnify social and environmental stressors that are already there. Communities with limited access to wealth, limited access to food, who are underserved, rural communities, racialized communities, often experience greater impacts from disasters. Disasters occur on top of histories of disenfranchisement. For example, centuries of marginalization of the minoritized Romani peoples of Central Europe they've seen great impacts from flooding. And in North Carolina, Black and African American communities whose ancestors were enslaved and suffered land loss through racist systems of who gets access to loans, access to land ownership. And because of these systems and processes, communities, families, individuals may live on marginal lands, may not own their lands. Their lands may be more prone to flood risk. May be underserved. Their housing may be more at risk. They may rent and not own. May have less agency and resources to repair their homes. And may have less trust in government and government systems. So really thinking about all of that, and then piling on disasters over these centuries of marginalization, disenfranchisement, underinvestment is really critical when trying to disentangle all these processes and develop policy solutions.

This is really fascinating work and so thank you for laying out the sort of reality of the experience of disasters where people who have been marginalized may have difficulty accessing resources or there may be some concerns about trust. Broadly, we're interested also in the food system, and I'd be interested to understand how, when disasters strike, do you see effects upon the food system or the food system responding to these disasters?

Recognizing that some individuals have higher food stress, even without a disaster, they may have higher pollutant burden because they live next to a concentrated animal feed lot operation. They may have weaker infrastructure systems: electricity, transportation, because of disinvestment. And so, when a disaster strikes, pollution loads may increase, access to food becomes even more of a challenge. Food stress increases. For example, in North Carolina, across the Southeast and further in the United States, Latino migrant farm workers face higher risks during hurricanes and floodings because of barriers, like limited access to emergency information and Spanish language barriers, fears about government intervention, fears tied to immigration status, housing conditions, lack of transportation. And these factors can delay access to food, evacuation, reduce preparedness, slow recovery. And yes, it's a challenge to really think then hard about what policy solutions make sense.

That does make me also appreciate when we think about some of the folks involved in the food system, that the disruption that a disaster can bring will also mean a loss of employment or opportunities to continue earning income. And that seems to be a sort of a knock-on effect of these disasters. It's not just the immediate weather event. It's all of the other things that follow afterwards.

Yes. And so when thinking about policy solutions, I really think it's critical to address these inequities even outside of the disaster cycle, or outside of the framing of disasters. And can we think about and develop ways, for example, to do reduce the risks of concentrated animal feedlot operations in North Carolina. Other ways for more resilient and sustainable and local ways of farming that minimize environmental risks, increase wealth, increase jobs, access to jobs. That then, when disaster strikes, are going to be more resilient because they're more resilient even before disasters. You know, I'd like to see greater investment in areas of food access, strengthening support for farm workers, encouraging development of local food hubs. Also thinking about making food access hubs more resilient to extreme weather events. Maybe elevating them, getting them all generators or solar microgrids. So that when disaster does happen, they're more resilient and then they can serve as community hubs with less reliance on supply chains at the national level. Really, coming back local, mutual aid, supporting each other, community supporting communities, non-governmental organizations, government, faith-based organizations strengthening local food systems. Also, everything that I just said for food I also think for health. You know, access to healthcare goes along with access to food in terms of critical infrastructure for community to flourish. And so, making sure there are local hospitals, not just in time of disaster, but in time of not disaster. So, expedite funding for small businesses, for neighborhood organizations, neighbors getting to know neighbors in disasters. Neighbors relying on neighbors. And that's critical. Anything we can do to build up networks. And that doesn't necessarily have to be government intervention. That could be faith-based organizations, churches, working with communities. It could be Little Leagues. There's lots of different ways to help build that social infrastructure that's so critical during disasters.

Betsy, thank you for that. And as I hear you talk about these issues, what I am grateful for is we normally talk about food and the food system, but it's a parallel reality of what happens with the healthcare system when the disaster strikes. I can only imagine if someone is in need of a certain medicine when the disaster hits access to that medicine may be called into question as happens with food. But one of the big things I get out of what you're saying is we need to build resilient communities. Not when the disaster happens but do that work now. How do we create mutual aid? How do we create actual neighborhoods that know what's going on and to care for one another. Because it's that THAT helps us through these difficult times. Is that a fair assessment?

Yes. That's more well said than I said it. So yes. Thank you.

I am so grateful for this. Betsy, is there anything else we should think about when it comes to disasters and the food system or how we should prepare for disasters in the future?

One thing that I didn't emphasize that my early work really looked at is how we grow food. And in Central Europe and Hungary in the area that I studied, this large-scale infrastructure on land that had previously, centuries ago, been wetlands. And then was drained for large scale agricultural systems, not unlike what we see in much of the Midwest of the United States. But as climate change worsens, we're seeing more extreme rain events. It's becoming harder and harder to basically fight against these floods in our agricultural system. And so really rethinking. What a resilient kind of agroecological system could look like on the food growing side. And that could be issues of what is grown, that could be issues of scale, thinking about maybe we need to put more land aside and not farm. But really thinking hard about how we incentivize, how do we set up insurance to help mitigate some of the risks. But I think that's going to be one of the major challenges moving forward.

Bio

Elizabeth (Betsy) Albright is the Dan and Bunny Gabel Associate Professor of the Practice of Environmental Ethics and Sustainable Environmental Management at Duke University's Nicholas School for the Environment. Her current research centers on how policies and decisions are made in response to extreme climatic events. She is interested in collaborative decision-making processes, particularly in the realm of water resource management. The Midwest Political Science Associated recently awarded Elizabeth the 'Best Paper by an Emerging Scholar' award at their national conference. Her geographic regions of interest include the southeast US and Central and Eastern Europe. Prior to completing her Ph.D. Elizabeth worked for the State of North Carolina in water resource management.

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As global demand for meat grows, this episode of Duke University's Leading Voices in Food podcast examines cell-cultivated protein—real meat grown from animal cells—and the evolving U.S. policy landscape shaping its future. Host Norbert Wilson (Duke World Food Policy Center) speaks with postdoctoral researchers Kate Consavage Stanley (Duke/Bezos Center for Sustainable Proteins) and Katariina Koivusaari (NC State/Bezos Center) about their article in Trends in Food Science and Technology on U.S. regulatory and legislative activity. The conversation explains the joint FDA–USDA regulatory approach for cell-cultivated meat (FDA oversight through cell cultivation; USDA oversight from harvest through processing, packaging, and labeling) and FDA oversight for cell-cultivated seafood (except catfish). They discuss timelines companies report for approval (often two to three years), the lack of federal public guidance on naming and labeling so far, and how USDA label approvals are currently handled case by case (e.g., "cell-cultivated chicken" and "cell-cultivated pork"). The episode also covers state-level labeling laws and the likelihood of federal preemption if state requirements conflict with federal statutes, as well as a growing wave of state restrictions and bans—Florida and Alabama in 2024, followed by Indiana, Mississippi, Montana, Nebraska, and Texas in 2025—plus funding restrictions in South Dakota and Iowa. The guests explore implications for consumers, interstate commerce, innovation, investment, and U.S. leadership, noting ongoing lawsuits in Florida and Texas and continued legislative activity such as a proposed ban in Georgia.

Interview Transcript

Kate, let's begin with you. In the paper, you write about the regulatory frameworks that have been developed for cell-cultivated meat and seafood products in the US. To start, let's talk about what's unique about cell-cultivated products from a regulatory standpoint and how the US Department of Agriculture and US Food and Drug Administration have decided to handle cell-cultivated protein products.

Kate - Yes, so as you mentioned in the introduction, Norbert, cell-cultivation is a new technology for use of the food supply. So, the US government had to adapt its existing legal frameworks for food safety regulation. As your listeners may already know seafood is regulated by the FDA, so it was within their scope to also regulate cell-cultivated seafood. The FDA therefore regulates all cell-cultivated seafood products with the exception of catfish.

When it came to determining the regulatory approach for cell-cultivated products from livestock, poultry, and catfish, it was a bit more nuanced as the processes and components evolved fell under both USDA and FDA purview. In 2019, the FDA and USDA therefore agreed on a joint regulatory approach where the FDA regulates the early stages of the cell cultivation process, including when those cells are taken from the animal, grown in the bioreactor, and matured into specific cell types such as muscle or fat cells. At the point where those cells are ready to be harvested from the bioreactor to use in a food product, oversight transfers to USDA who oversees that harvesting process as well as food processing, packaging, and labeling.

I know this joint regulatory approach may sound complicated, but it's important to note that USDA and FDA already coordinate oversight over other foods in the food supply. I'll give you an example that we all love pizza. A frozen cheese pizza is regulated by the FDA, whereas a frozen pizza with meat toppings like pepperoni is regulated by the USDA. It is therefore not unprecedented that FDA and USDA would agree to jointly regulate cell-cultivated products. And while the process is new, the products go through the same safety checks as other foods in the food supply.

In the past few years, we've seen four cell-cultivated meat products go through the joint USDA-FDA regulatory process, meaning they can be sold in the US food supply. And one cell-cultivated seafood product has gone through the FDA regulatory process.

Kate, thank you for sharing this. And I've used a pizza example in my class, and it is super complex this regulatory maze that we're talking about. It seems like there has been a lot of collaboration between these two agencies, and so that's important to hear. But it is also the case that it seems challenging for cell-cultivated protein companies to get through this process. Is this a fair assessment and would you elaborate?

Kate - Yes, absolutely. We've heard from cell-cultivated companies that it can take two to three years to get through this process. And there certainly is a lot of back and forth between the companies and FDA and USDA.

Great, thank you. Katariina, now let's turn to you. How do these regulations extend to labeling and what do we know about the federal government's approach to labeling the sale of cultivated products thus far?

Katariina – So, labeling regulations are the most consumer facing part of regulations, really. And they are used to ensure that the product label has information that's truthful, that's not misleading. And that the package has sufficient information and consistent information also across products so that the consumer can make an educated decision on what product they want to purchase. And you'd think that how you label the product or just how you call the product on the label would be simple. But there are certain regulations in place that define how food items can or cannot be called. Now, when it comes to cell-cultivated products, as you and Kate mentioned, they are novel in the food supply. So, there is not a long-established term or nomenclature on how we should call these products. The federal regulators, FDA and USDA, to date have not released any public guidance either on how these products should be called on the label. The USDA did release an advanced notice of proposed rulemaking back in 2021, requesting comments from stakeholders on how these products should be labeled. And the FDA has also requested comments when it comes to labeling cell-cultivated fish and seafood. But to date, no guidance has been published yet.

Kate gave an overview of the regulatory process between FDA and UFDA when it comes to labeling this product products. The USDA oversees labeling cell-cultivated meat, and the FDA oversees labeling cell-cultivated fish and seafood. The USDA has a pre-market approval process for labels, similarly to conventional meat industry. So, whenever a company wants to bring to market a new product, they first submit their label to the USDA. And the USDA reviews it and make sure that they agree with the language used in the label. The FDA does not have a similar pre-market approval process for labeling fish or seafood or cell-cultivated fish or seafood. So, currently cell-cultivated meat labels are approved on a case-by-case basis. And we can see from the products that have gone through the regulatory review so far that the USDA seem to approve the use of 'cell-cultivated' as a qualifying term, together with a meaty term such as chicken or pork. So, the products that we've seen approved to date or brought to market to date are called cell-cultivated chicken or cell-cultivated pork.

This is really helpful to know what's happened at the federal level. We also know that there are several actions happening at the state level, so several states have proposed their own laws outlining how and what to label these products. Katariina, can you talk us through what this study regarding state labeling?

Katariina - To date, about half of the US states have enacted or proposed their own labeling legislation on cell-cultivated products. Missouri became the first state in 2018, so well before any of these products was available on the market. And they specifically prohibited the use of word meat unless the food was from harvested production livestock or poultry. Restricting, therefore, the use of meat not only on cell-cultivated, but also on other alternative protein products such as plant-based meat analogs or fermentation derived proteins. And this is true for many state level labeling laws. That they are applicable not only to cell-cultivated meat, but also other alternative proteins aiming to mimic meat.

In addition to Missouri, there are six other states that prohibit the use of meat or meat related terms, such as chicken or pork. Now, the other group of states that have restrictions on cell-cultivated meat labeling do not concentrate on prohibiting the use of word meat, but they require the use of qualifying terms or other additional language that clearly states that the product does not come from livestock or poultry. And this group of states, there are 18 states, have quite a bit of variation in what kind of qualifying terms they require to be used. And I thought I'd give a couple of examples here. For example, Indiana requires the package to include the phrase this is an imitation meat product. Iowa requires the product to be labeled with qualifying terms such as cell-cultivated, cell-cultured, fake, grown in a lab, imitation, lab grown, lab created, meat free, or meatless. What's interesting though is that the federal statutes that regulate the US food supply have actual language that prevents states from establishing laws or regulations that conflict with or are additional to the federal labeling regulations. So, this means that the state level labeling laws are actually likely to be preempted if they conflict with the federal regulations.

So, we've only talked about labeling so far. Kate, I want to go back to you. More recently, we've seen a number of states propose greater restrictions on these products. Can you describe these attempts to restrict cell-cultivated meat and their immediate implications? And how have cell-cultivated companies and other stakeholders responded?

Kate - In the past few years we've seen quite a few attempts by states to ban or restrict cell-cultivated meats. And these attempts fall into two buckets: bans that aim to restrict the manufacturer sale or distribution of cell-cultivated products and bans that aim to limit the use of state funding to support these products.

In 2024, Florida was the first state to pass a ban on the manufacture, sale, and distribution of cell-cultivated meats. Alabama followed shortly thereafter. In 2025, five more states passed similar bans on cell-cultivated products, including Indiana, Mississippi, Montana, Nebraska, and Texas. And many other states proposed bans that ultimately didn't pass. The language on what is banned differs some between states. For instance, Texas only bans the sale of cell-cultivated products. Whereas Florida and others also ban cell-cultivated manufacturing and distribution. But the core message in all these bans is similar. Cell-cultivated meats are not welcome in those states.

The time span for the bans differs too. So, Indiana and Texas have two-year bans while Florida and other states passed indefinite bans. And we've seen two states, South Dakota and Iowa pass legislation to restrict the use of state funding to support cell-cultivated products.

What's frustrating about these bands and confusing for those in the alternative protein sector is that cell-cultivated technology is largely still in the early stages. Yes, as I mentioned earlier, five products have passed through the regulatory process. But these products have mainly been made available in small tasting events. And only one has actually made it to retail. Most Americans have never had a chance to actually try these products. So, it begs the question, why is there such resistance?

State bans on these products mean that Americans will not have the chance to decide for themselves if they like these products, or if and how they want to incorporate them into what they eat. Another big concern is that these bans create a fragmented policy landscape that's challenging for cell-cultivated startups, especially, to navigate. And it raises a lot of concerns about cross state sales. Concerns like these are the basis for two lawsuits against cell-cultivated bans in Florida and Texas. Those lawsuits are still playing out in court, so we don't yet know how those may

Kate, this is really fascinating. And as both you and Katariina described, there's a patchwork of policies and a complex landscape for these companies to navigate. It has the potential of keeping consumers from even trying the products, as you've already suggested, when they're made available. And what I'm hearing from both of you is that this is an ongoing project. So even though there's a paper that's published now, it seems like there will be opportunities to keep going back as new laws and new regulations and new lawsuits are decided. So, this is a policy space that we need to keep an eye on. That's something I want to pick up on this last question. In closing, what does this legislation mean for consumers and the future of cell-cultivated products in the US and even globally? Katariina, let's begin with you.

Katariina - Yes. In addition to impeding interstate and international commerce of cell-cultivated products, these bans could negatively impact the US investment climate on these products and technologies. For example, China has included developing cell-cultivated meat in their five-year plan. Within Europe, there's some variation. Some countries are being rather supportive of these technologies and products, whereas others have tried to ban them similarly to some US states. But I think it's important to note that even with some states in the US banning these products, the US will still likely remain a significant market area for cell-cultivated products. And it still takes significant investment and infrastructure to produce the products on a large scale enough to even reach the whole country.

Another really important thing to mention here is that the global demand for meat is growing. If we look at global population forecasts, global meat or protein consumption forecasts, we need these alternative proteins. Not only cell-cultivated meat, but also for example, plant-based meat alternatives to help meet the increasing demand for protein and complement conventional meat supply.

Kate, what about you?

Kate – I agree with everything that Katariina said. To add on to her points, I note that the US has been a leader in the cell-cultivated research development and innovation spaces to date. We are one of only a few countries that have both developed a framework for regulating these products and had products successfully pass through that process.

The bans tell a different story, and they may restrict US innovation in the cell-cultivated space because companies will be limited to only the states where they can produce and sell these products. What this means for US leadership in the space remains to be seen. However, one could ask will cell-cultivated companies choose to set up shop in the US versus another country that isn't facing such legal challenges? We don't yet know the answer to that.

You also mentioned consumers. We don't yet know about how these bans and the media surrounding them may influence consumer perceptions of cell-cultivated foods. Products, as you said, they've never even really had the chance to try. But these bans will certainly restrict consumer access to these products in certain states, and the varying state approaches to labeling that Katariina described are likely to confuse consumers.

Going back to something you mentioned earlier, Norbert, we're excited to have this paper out in the world. But this work is certainly continuing to evolve. Just recently, a senator in Georgia proposed a new ban on cell-cultivated meat in the state, and other countries have faced similar legislative challenges against these products. So, we'll be watching and learning as these challenges continue to play out.

Bios

Katariina Koivusaari, Ph.D. is a postdoctoral researcher at the Bezos Center for Sustainable Protein at North Carolina State University. Her work focuses on stakeholder engagement and the regulatory and policy landscape of alternative proteins, including cell-cultivated products, fermentation-derived proteins, and plant-based proteins. She received her Ph.D. in Public Health Nutrition and M.Sc. in Food Sciences from the University of Helsinki. Prior to her current role, she worked in the biotechnology industry as a Senior Regulatory Scientist, where she focused on scientific strategy and regulatory affairs related to cell-cultured human milk ingredients.

Katherine (Kate) Consavage Stanley, Ph.D., serves as a postdoctoral associate within the World Food Policy Center at the Sanford School. In this role, Kate supports Duke's research for the Bezos Center for Sustainable Protein housed at NC State. Her research seeks to detail the complexities of the consumer, market, and policy landscapes for alternative protein products. Kate holds a Ph.D. from Virginia Polytechnic Institute and State University where her research focused on how diverse U.S. food and health systems actors can support sustainable diet transitions through promoting plant-rich dietary patterns and reducing red and processed meat intake. She has also published scholarly work on digital food and nutrition literacy, sugary beverage media campaigns, and incorporating sustainability considerations into dietary guidelines, among others. Prior to starting her doctoral studies, Kate worked for the U.S. Agency for International Development (USAID) where she developed technical, communications, and advocacy-focused materials on key nutrition and maternal and child health issues. Kate holds a Master of Science in global health from Georgetown University and a Bachelor of Science in biology from Emmanuel College.

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Do you ever wonder whether your grocery store cares about whether you have a healthy diet? Every time we shop or read advertisement flyers, food retailers influence our diets through product offerings, pricings, promotions, and of course store design. Think of the candy at the checkout counters. When I walk into my Costco, over on the right there's this wall of all these things they would like me to buy and I'm sure it's all done very intentionally. And so, if we're so influenced by these things, is it in our interest? Today we're going to discuss a report card of sorts for food retailers and the big ones - Walmart, Kroger, Ahold Delhaize USA, which is a very large holding company that has a variety of supermarket chains. And this is all about an index produced by the Access to Nutrition Initiative (ATNi), a global foundation challenging the food industry investors and policy makers to shape a healthier food system. The US Retail Assessment 2025 Report evaluates how these three businesses influence your access to nutritious and affordable foods through their policies, commitments, and actual performance. The Access to Nutrition Initiatives' director of Policy and Communications, Katherine Pittore is here with us to discuss the report's findings. We'll also speak with Eva Greenthal, who oversees the Center for Science in the Public Interest's Federal Food Labeling work.

Interview Transcript

Access ATNi's 2025 Assessment Report for the US and other countries here: Retail https://accesstonutrition.org/index/retail-assessment-2025/

Let's start with an introduction to your organizations. This will help ground our listeners in the work that you've done, some of which we've spoken about on our podcast. Kat, let's begin with you and the Access to Nutrition Initiative. Can you tell us a bit about the organization and what work it does?

Kat Pittore - Thank you. So, the Access to Nutrition Initiative is a global foundation actively challenging the food industry, investors, and policymakers to shape healthier food systems. We try to collect data and then use it to rank companies. For the most part, we've done companies, the largest food and beverage companies, think about PepsiCo, Coca-Cola, and looking are they committed to proving the healthiness of their product portfolios. Do the companies themselves have policies? For example, maternity leave. And these are the policies that are relevant for their entire workforce. So, from people working in their factories all the way up through their corporate areas. And looking at the largest companies, can these companies increase access to healthier, more nutritious foods. One of the critical questions that we get asked, and I think Kelly, you've had some really interesting guests also talking about can corporations actually do something. Are corporations really the problem? At ATNi, we try to take a nuanced stance on this saying that these corporations produce a huge amount of the food we eat, so they can also be part of the solution. Yes, they are currently part of the problem. And we also really believe that we need more policies. And that's what brings us too into contact with organizations such as Eva's, looking at how can we also improve policies to support these companies to produce healthier foods.

The thought was coming to my mind as you were speaking, I was involved in one of the initial meetings as the Access to Nutrition Initiative was being planned. And at that point, I and other people involved in this were thinking, how in the world are these people going to pull this off? Because the idea of monitoring these global behemoth companies where in some cases you need information from the companies that may not reflect favorably on their practices. And not to mention that, but constructing these indices and things like that required a great deal of thought. That initial skepticism about whether this could be done gave way, at least in me, to this admiration for what's been accomplished. So boy, hats off to you and your colleagues for what you've been able to do. And it'll be fun to dive in a little bit deeper as we go further into this podcast.

Eva, tell us about your work at CSPI, Center for Science in the Public Interest. Well known organization around the world, especially here in the US and I've long admired its work as well. Tell us about what you're up to.

Eva Greenthal - Thank you so much, Kelly, and again, thank you for having me here on the pod. CSPI is a US nonprofit that advocates for evidence-based and community informed policies on nutrition, food safety and health. And we're well known for holding government agencies and corporations to account and empowering consumers with independent, unbiased information to live healthier lives. And our core strategies to achieve this mission include, of course, advocacy where we do things like legislative and regulatory lobbying, litigation and corporate accountability initiatives. We also do policy and research analysis. We have strategic communications such as engagement with the public and news media, and we publish a magazine called Nutrition Action. And we also work in deep partnership with other organizations and in coalitions with other national organizations as well as smaller grassroots organizations across the country. Across all of this, we have a deep commitment to health equity and environmental sustainability that informs all we do. And our ultimate goal is improved health and wellbeing for people in all communities regardless of race, income, education, or social factors.

Thanks Eva. I have great admiration for CSPI too. Its work goes back many decades. It's the leading organization advocating on behalf of consumers for a better nutrition system and better health overall. And I greatly admire its work. So, it's really a pleasure to have you here.

Kat, let's talk about the US retail assessment. What is it and how did you select Walmart, Kroger, and Ahold Dehaize for the evaluation, and why are retailers so important?

Kat - Great, thanks. We have, like I said before, been evaluating the largest food and beverage manufacturers for many years. So, for 13 years we have our global index, that's our bread and butter. And about two years ago we started thinking actually retailers also play a critical role. And that's where everyone interfaces with the food environment. As a consumer, when you go out to actually purchase your food, you end up most of the time in a supermarket, also online presence, et cetera. In the US 70% or more of people buy their food through some type of formal food retail environment. So, we thought we need to look at the retailers. And in this assessment we look at the owned label products, so the store brand, so anything that's branded from the store as its own. We think that's also becoming a much more important role in people's diets. In Europe it's a really critical role. A huge majority of products are owned brand and I think in the US that's increasing. Obviously, they tend to be more affordable, so people are drawn to them. So, we were interested how healthy are these products? And the US retail assessment is part of a larger retail assessment where we look at six different countries trying to look across different income levels. In high income countries, we looked at the US and France, then we looked at South Africa and Indonesia for higher middle income. And then finally we looked at Kenya and the Philippines. So, we tried to get a perspective across the world. And in the US, we picked the three companies aiming to get the largest market share. Walmart itself is 25 to 27% of the market share. I've read an amazing statistic that something like 90% of the US population lives within 25 kilometers of a Walmart. Really, I did not realize it was that large. I grew up in the US but never shopped at Walmart. So, it really does influence the diet of a huge number of Americans. And I think with the Ahold Delhaize, that's also a global conglomerate. They have a lot of supermarkets in the Netherlands where we're based, I think also in Belgium and across many countries. Although one interesting thing we did find with this retail assessment is that a big international chain, they have very different operations and basically are different companies. Because we had thought let's start with the Carrefours like those huge international companies that you find everywhere. But Carrefour France and Carrefour Kenya are basically very different. It was very hard to look at it at that level. And so that's sort of what brought us to retailers. And we're hoping through this assessment that we can reach a very large number of consumers. We estimate between 340 to 370 million consumers who shop at these different modern retail outlets.

It's so ambitious what you've accomplished here. What questions did you try to answer and what were the key findings?

Kat - We were interested to know how healthy are the products that are being sold at these different retailers. That was one of our critical questions. We look at the number of different products, so the owned brand products, and looked at the healthiness. And actually, this is one of the challenges we faced in the US. One is that there isn't one unified use of one type of nutrient profile model. In other countries in the Netherlands, although it's not mandatory, we have the Nutri Score and most retailers use Nutri Score. And then at least there's one thing that we can use. The US does not have one unified agreement on what type of nutrient profile model to use. So, then we're looking at different ones. Each company has their own proprietary model. That was one challenge we faced. And the other one is that in other countries you have the mandatory that you report everything per hundred grams. So, product X, Y, and Z can all be compared by some comparable thing. Okay? A hundred grams of product X and a hundred grams of product Y. In the US you have serving sizes, which are different for different products and different companies. And then you also have different units, which all of my European colleagues who are trying to do this, they're like, what is this ounces? What are these pounds? In addition to having non-comparable units, it's also non-standardized. These were two key challenges we face in the US.

Before you proceed, just let me ask a little bit more about the nutrient profiling. For people that aren't familiar with that term, basically it's a way to score different foods for how good they are for you. As you said, there are different profiling systems used around the world. Some of the food companies have their own. Some of the supermarket companies have their own. And they can be sort of unbiased, evidence-based, derived by scientists who study this kind of thing a lot like the index developed by researchers at Oxford University. Or they can be self-serving, but basically, they're an index that might take away points from a food if it's high in saturated fat, let's say but give it extra points if it has fiber. And that would be an example. And when you add up all the different things that a food might contain, you might come away with a single score. And that might then provide the basis for whether it's given a green light, red light, et cetera, with some sort of a labeling system. But would you like to add anything to that?

Kat - I think that's quite accurate in terms of the nutrient profile model. And maybe one other thing to say here. In our retail index, it's the first time we did this, we assess companies in terms of share of their products meeting the Health Star rating and we've used that across all of our indexes. This is the one that's used most commonly in Australia and New Zealand. A Health Star rating goes zero to five stars, and 3.5 or above is considered a healthier product. And we found the average healthiness, the mean Health Star rating, of Walmart products was 2.6. So quite low. Kroger was 2.7 and Food Lion Ahold Delhaize was 2.8. So the average is not meeting the Health Star rating of 3.5 or above. We're hoping that by 2030 we could see 50% of products still, half would be less than that. But we're not there yet.

And another thing that we looked at with the retail index that was quite interesting was using markers of UPFs. And this has been a hotly debated discussion within our organization as well. Sort of, how do you define UPF? Can we use NOVA classification? NOVA Classification has obviously people who are very pro NOVA classification, people who also don't like the classification. So, we use one a sort of ranking Popkins et al. developed. A sort of system and where we looked at high salt, fat sugar and then certain non-nutritive sweeteners and additives that have no benefit. So, these aren't things like adding micronutrients to make a product fortified, but these are things like red number seven and colors that have no benefit. And looked at what share of the products that are produced by owned label products are considered ultra processed using this definition. And there we found that 88% of products at Walmart are considered ultra processed.

Wow. That's quite shocking. Eighty eight percent.

Yeah, 88% of all of their own brand products.

Oh, my goodness.

Twelve percent are not. And we did find a very high alignment, because that was also a question that we had, of sort of the high salt, fat, sugar and ultra processed. And it's not a direct alignment, because that's always a question too. Can you have a very healthy, ultra processed food? Or are or ultra processed foods by definition unhealthy beyond the high fat, salt, sugar content. And I know you've explored that with others.

Don't the retailers just say that they're responding to demand, and so putting pressure on us to change what we sell isn't the real problem here, the real issue. It's to change the demand by the consumers. What do you think of that?

Kat - But I mean, people buy what there is. If you went into a grocery store and you couldn't buy these products, you wouldn't buy them. I spent many years working in public health nutrition, and I find this individual narrative very challenging. It's about anything where you start to see the entire population curve shifting towards overweight or obesity, for example. Or same when I used to work more in development context where you had a whole population being stunted. And you would get the same argument - oh no, but these children are just short. They're genetically short. Oh, okay. Yes, some children are genetically short. But when you see 40 or 50% of the population shifting away from the norm, that represents that they're not growing well. So I think it is the retailer's responsibility to make their products healthier and then people will buy them.

The other two questions we tried to look at were around promotions. Are our retailers actively promoting unhealthy products in their weekly circulars and flyers? Yes, very much so. We found most of the products that were being promoted are unhealthy. The highest amount that we found promoting healthy was in Food Lion. Walmart only promoted 5% healthy products. The other 95% of the products that they're actively promoting in their own circulars and advertising products are unhealthy products. So, then I would say, well, retailers definitely have a role there. They're choosing to promote these products.

And then the other one is cost. And we looked across all six countries and we found that in every country, healthier food baskets are more expensive than less healthier food baskets. So you take these altogether, they're being promoted more, they're cheaper, and they're a huge percentage of what's available. Yes. Then people are going to eat less healthy diets.

Right, and promoted not only by the store selling these products, but promoted by the companies that make them. A vast amount of food marketing is going on out there. The vast majority of that is for foods that wouldn't score high on any index. And then you combine that with the fact that the foods are engineered to be so palatable and to drive over consumption. Boy, there are a whole lot of factors that are conspiring in the wrong direction, aren't there.

Yeah, it is challenging. And when you look at all the factors, what is your entry point?

Yes. Eva, let's talk about CSPI and the work that you and your colleagues are doing in the space. When you come up with an interesting topic in the food area and somebody says, oh, that's pretty important. It's a good likelihood that CSPI has been on it for about 15 years, and that's true here as well. You and your colleagues have been working on these issues and so many others for so many years. But you're very active in advocating for healthier retail environments. Can you highlight what you think are a few key opportunities for making progress?

Eva - Absolutely. To start off, I could not agree more with Kat in saying that it really is food companies that have a responsibility for the availability and affordability of healthy options. It's absolutely essential. And the excessive promotion of unhealthy options is what's really undermining people's ability to make healthy choices. Some of the policies that CSPI supports for improving the US retail environment include mandatory front of package nutrition labeling. These are labels that would make it quick and easy for busy shoppers to know which foods are high in added sugar, sodium, or saturated fat, and should therefore be limited in their diets. We also advocate for federal sodium and added sugar reduction targets. These would facilitate overall lower amounts of salt and sugar in the food supply, really putting the onus on companies to offer healthier foods instead of solely relying on shoppers to navigate the toxic food environments and make individual behavior changes.

Another one is taxes on sweetened beverages. These would simultaneously nudge people to drink water or buy healthier beverages like flavored seltzers and unsweetened teas, while also raising revenue that can be directed towards important public health initiatives.

Another one is healthy checkout policies. These would require retailers to offer only healthier foods and beverages in areas where shoppers stand in line to purchase their groceries. And therefore, reduce exposure to unhealthy food marketing and prevent unhealthy impulse purchases.

And then another one is we advocate for online labeling requirements that would ensure consumers have easy access to nutrition, facts, ingredients, and allergen information when they grocery shop online, which unbelievably is currently not always the case.

And I can also speak to our advocacy around the creating a uniform definition of healthy, because I know Kat spoke to the challenges in the US context of having different retailers using different systems for identifying healthier products. So the current food labeling landscape in the US is very confusing for the consumer. We have unregulated claims like all natural, competing with carefully regulated claims like organic. We have a very high standard of evidence for making a claim like prevents cold and flu. And then almost no standard of evidence for making a very similar claim like supports immunity. So, when it comes to claims about healthiness, it's really important to have a uniform definition of healthy so that if a product is labeled healthy, consumers can actually trust that it's truly healthy based on evidence backed nutrition standards. And also, so they can understand what that label means. An evidence-based definition of healthy will prevent misleading marketing claims. So, for example, until very recently, there was no limit on the amount of added sugar or refined grain in a product labeled healthy. But recent updates to FDA's official definition of healthy mean that now consumers can trust that any food labeled healthy provides servings from an essential food group like fruit, vegetable, whole grain, dairy, or protein. And doesn't exceed maximum limits on added sugar, sodium, and saturated fat. This new healthy definition is going to be very useful for preventing misleading marketing claims. However, we do think its reach will be limited for helping consumers find and select healthy items mainly because it's a voluntary label. And we know that even among products that are eligible for the healthy claim, very few are using it on their labels. We also know that the diet related chronic disease epidemic in the US is fueled by excess consumption of junk foods, not by insufficient marketing of healthy foods. So, what we really need, as I mentioned before, are mandatory labels that call out high levels of unhealthy nutrients like sodium, added sugar, and saturated fat.

Thanks for that overview. What an impressive portfolio of things you and your colleagues are working on. And we could do 10 podcasts on each of the 10 things you mentioned. But let's take one in particular: the front of the package labeling issue. At a time where it seems like there's very little in our country that the Democrats and Republicans can't agree on, the Food and Drug Administration, both previously under the Biden Harris Administration, now under the Trump Vance Administration have identified for a package of labeling as a priority. In fact, the FDA is currently working on a mandatory front of package nutrition label and is creating a final rule around that issue. Kat, from Access to Nutrition Initiative's perspective, why is mandatory front of package labeling important? What's the current situation kind of around the world and what are the retailers and manufacturers doing?

Kat - So yes, we definitely stand by the need for mandatory front of package labeling. I think 16 countries globally have front of package labeling mandated, but the rest have voluntary systems. Including in the Netherlands where I live and where Access to Nutrition is based. We use the voluntary Nutri Score and what we've seen across our research is that markets where it's voluntary, it tends to not be applied in all markets. And it tends to be applied disproportionately on healthy products. So if you can choose to put it, you put it all on the ones that are the A or the Nutri Score with the green, and then you don't put it on the really unhealthy products. So, then it also skews consumers. Because like Eva was saying, people are not eating often. Well, they, they're displacing from their diet healthy products with unhealthy products. So that that is a critical challenge. Until you make it mandatory, companies aren't going to do that. And we've seen that with our different global indexes. Companies are not universally using these voluntary regulations across the board. I think that's one critical challenge that we need to address.

If you scan the world, there are a variety of different systems being used to provide consumers information on the front of packages. If you could pick one system, tell us what we would actually see on the package.

Kat - This is one we've been debating internally, and I saw what CSPI is pushing for, and I think there's growing evidence pushing for warning style labels. These are the ones that say the product is high in like really with a warning, high in fat, high in salt, high in sugar. And there is evidence from countries like Chile where they have introduced this to show that that does drive change. It drives product reformulation. Companies change their products, so they don't have to carry one of the labels. Consumers are aware of it. And they actively try to change their purchasing behaviors to avoid those. And there's less evidence I think interpretive is important. A Nutri Score one where you can see it and it's green. Okay, that's quick. It's easy. There are some challenges that people face with Nutri Score, for example. That Nutri Score compares products among the same category, which people don't realize outside of our niche. Actually, a colleague of mine was telling me - my boyfriend was in the grocery store last week. And he's like picked up some white flour tortillas and they had a Nutri Score D, and then the chips had a Nutri Score B. And he's like, well, surely the tortillas are healthier than the chips. But obviously the chips, the tortilla chips were compared against other salty snacks and the other one was being compared to bread. So, it's like a relatively unhealthy bread compared to a relatively healthy chip. You see this happening even among educated people. I think these labels while well intentioned, they need a good education behind them because they are challenging, and people don't realize that. I think people just see A or green and they think healthy; E is bad, and people don't realize that it's not comparing the same products from these categories.

One could take the warning system approach, which tells people how many bad things there are in the foods and flip it over and say, why not just give people information on what's good in a food? Like if a food has vitamins and minerals or protein or fiber, whatever it happens. But you could label it that way and forget labeling the bad things. But of course, the industry would game that system in about two seconds and just throw in some good things to otherwise pretty crappy foods and make the scores look good. So, yeah, it shows why it's so important to be labeling the things that you'd like to see less of.

I think that's already happening. You see a lot of foods with micronutrient additions, very sugary breakfast cereals. You see in Asia, a lot of biscuits and cookies that they add micronutrients to. I mean, there's still biscuits and cookies.

So Eva, I'd like to get your thoughts on this. So tell us more about the proposed label in the US, what it might look like, and the history about how this got developed. And do you think there's anything else needed to make the label more useful or user-friendly for consumers?

Eva - Absolutely. It is a very exciting time to work on food policy in the US, especially with this momentum around front of package labeling. CSPI actually first petitioned calling for front of pack labeling in 2006. And after more than a decade of inaction, industry lobbying, all these countries around the world adopting front of pack labeling systems, but not the US. In 2022 CSPI filed a new petition that specifically called for mandatory interpretive nutrient specific front of package labeling, similar to the nutrient warning labels already required in Mexico, Canada, and as Kat said, around 16 other countries. And in early 2025, FDA finally responded to our petition by issuing a proposal that if finalized would require a nutrition info box on packaged foods. And what the nutrition info box includes is the percent daily value per serving of sodium, added sugar and saturated fat, accompanied by the words high, medium, or low, assessing the amount of each nutrient.

This proposal was a very important step forward, but the label could be improved in several ways. First off, instead of a label that is placed on all foods, regardless of their nutrient levels, we strongly recommend that FDA instead adopt labels that would only appear on products that are high in nutrients of concern. A key reason for this is it would better incentivize companies to reduce the amount of salt, sugar, or saturated fat in their product because companies will want to avoid wasting this precious marketing real estate on mandatory nutrition labels. So, for example, they could reduce the amount of sodium in a soup to avoid having a high sodium label on that soup. And also, as you were saying before around the lack of a need to require the positive nutrients on the label, fortunately the FDA proposal didn't, but just to chime in on that, these products are already plastered with claims around their high fiber content, high protein content, vitamin C, this and that. What we really need is a mandatory label that will require companies to tell you what they would otherwise prefer not to. Not the information that they already highlight for marketing purposes. So, in addition to these warning style labels, we also really want FDA to adopt front of package disclosures for foods containing low and no calorie sweeteners. Because this would discourage the industry from reducing sugar just by reformulating with additives that are not recommended for children. So that's a key recommendation that CSPI has made for when FDA finalizes the rule. FDA received thousands and thousands of comments on their labeling proposal and is now tasked with reviewing those comments and issuing a final rule. And although these deadlines are very often missed, so don't necessarily hold your breath, but the government's current agenda says it plans to issue a final rule in May 2026. At CSPI, we are working tirelessly to hold FDA to its commitment of issuing a final regulation. And to ensure that the US front of pack labeling system is number one mandatory and number two, also number one, really, mandatory, and evidence-based so that it really has the best possible chance of improving our diets and our food supply.

Well, thank you for the tireless work because it's so important that we get this right. I mean, it's important that we get a system to begin with, even if it's rudimentary. But the better it can be, of course, the more helpful it'll be. And CSPI has been such an important voice in that.

Kat, let's talk about some of the things that are happening in developing countries and other parts of the world. So you're part of a multi-country study looking at five additional countries, France, South Africa, Indonesia, the Philippines, and Kenya. And as I understand, the goal is to understand how retail food environments differ across countries at various income levels. Tell us about this, if you would, and what sort of things you're finding.

Kat – Yes. So one of our questions was as companies reach market saturation in places like France and the US and the Netherlands, they can't get that many more customers. They already have everyone. So now they're expanding rapidly. And you're seeing a really rapid increase in modern retail purchasing in countries like Indonesia and Kenya. Not to say that in these countries traditional markets are still where most people buy most of their food. But if you look at the graphs at the rate of increase of these modern different retailers also out of home, it's rapidly increasing. And we're really interested to see, okay, given that, are these products also exposing people to less healthy products? Is it displacing traditional diets? And overall, we are seeing that a lot of similar to what you see in other context. In high income countries. Overall healthier products are again, more expensive, and actually the differential is greater in lower income countries. Often because I think also poor people are buying foods not in modern retail environments. This is targeting currently the upper, middle, and higher income consumer groups. But that will change. And we're seeing the same thing around really high percentages of high fat, salt, sugar products. So, looking at how is this really transforming retail environments?

At the same time, we have seen some really interesting examples of countries really taking initiative. In Kenya, they've introduced the first Kenyan nutrient profile model. First in Africa. They just introduced that at the end of 2025, and they're trying to introduce also a mandatory front of package warning label similar to what Eva has proposed. This would be these warnings high in fat, salt, and sugar. And that's part of this package that they've suggested. This would also include things around regulations to marketing to children, and that's all being pushed ahead. So, Kenya's doing a lot of work around that.

In South Africa, there's been a lot of work on banning marketing to children as well as front of package labeling. I think one of the challenges we've seen there, and this is something... this is a story that I've heard again and again working in the policy space in different countries, is that you have a lot of momentum and initiative by civil society organizations, by concerned consumer groups. And you get all the way to the point where it's about to be passed in legislation and then it just gets kicked into the long grass. Nothing ever happens. It just sits there. I was writing a blog, we looked at Indonesia, so we worked with this organization that is working on doing taxation of sugar sweetened beverages. And that's been on the card since 2016. It actually even reminded me a lot of your story. They've been working on trying to get the sugar sweetened beverage tax in Indonesia passed since 2016. And it gets almost there, but it never gets in the budget. It just never passes. Same with the banning marketing to children in South Africa. This has been being discussed for many years, but it never actually gets passed. And what I've heard from colleagues working in this space is that then industry comes in right before it's about to get passed and says, oh no, but we're going to lose jobs. If you introduce that, then all of the companies that employ people, people will lose their jobs. And modeling studies have shown this isn't true. That overall, the economy will recover, jobs will be found elsewhere. Also, if you factor in the cost to society of treating diabetes from high consumption or sugar sweetened beverages. But it's interesting to see that this repeats again and again of countries get almost over the line. They have this really nice draft initiative and then it just doesn't quite happen. So, I think that that will be really interesting. And I think a bit like what Eva was saying in many of these countries, like with Kenya, are we going to see, start seeing the warning labels. With South Africa, is this regulation banning marketing to children actually going to happen? Are we going to see sugar sweetened beverage taxes written into the 2026 budget in Indonesia? I think very interesting space globally in many of these questions. But I think also a key time to keep the momentum up.

It's interesting to hear about the industry script, talking about loss of jobs. Other familiar parts of that script are that consumers will lose choices and their prices will go up. And those things don't seem to happen either in places where these policies take effect. But boy, they're effective at getting these things stomped out. It feels to me like some turning point might be reached where some tipping point where a lot of things will start to happen all at once. But let's hope we're moving in that direction.

Kat - The UK as of five days ago, just implemented bans on marketing of unhealthy products to children, changes in retail environment banning promotions of unhealthy products. I do think we are seeing in countries and especially countries with national healthcare systems where the taxpayer has to take on the cost of ill health. We are starting to see these changes coming into effect. I think that's an interesting example and very current.

Groundbreaking, absolutely groundbreaking that those things are happening. Let me end by asking you each sort of a big picture question. Kat, you talked about specific goals that you've established about what percentage of products in these retail environments will meet a healthy food standard by a given year. But we're pretty far from that now. So I'd like to ask each of you, are you hopeful we'll get anywhere near those kind of goals. And if you're hopeful, what leads you to feel that way? And Kat, let's start with you and then I'll ask Eva the same thing.

Kat - I am hopeful because like you said, there's so much critical momentum happening in so many different countries. And I do find that really interesting. And these are the six countries that we looked at, but also, I know Ghana has recently introduced a or working to introduce a nutrient profile model. You're seeing discussions happening in Asia as well. And a lot of different discussions happening in a lot of different places. All with the same ambition. And I do think with this critical momentum, you will start to break through some of the challenges that we're facing now too. Where you see, for example, like I know this came up with Chile. Like, oh, if you mandate it in this context, then it disadvantages. So like the World Trade Organization came out against it saying it disadvantaged trade, you can't make it mandatory. But if all countries mandate it, then you remove some of those barriers. It's a key challenge in the EU as well. That the Netherlands, for example, can't decide to introduce Nutri Score as a mandatory front of package label because that would disadvantage trade within the European Union. But I think if we hit a critical point, then a lot of the kind of key challenges that we're facing will no longer be there. If the European Union decides to adopt it, then also then you have 27 countries overnight that have to adopt a mandatory front of package label. And as companies have to do this for more and more markets, I think it will become more standardized. You will start seeing it more. I'm hopeful in the amount of momentum that's happening in different places globally.

Good. It's nice to hear your optimism on that. So, Eva, what do you think?

Eva - So thinking about front of package labeling and the fact that this proposed regulation was put out under the previous presidential administration, the Biden Harris Administration and is now intended to be finalized under the Trump Vance Administration, I think that's a signal of what's really this growing public awareness and bipartisan support for food and nutrition policies in the US. Obviously, the US food industry is incredibly powerful, but with growing public awareness of how multinational food companies are manipulating our diets and making us sick for their own profit, I think there's plenty of opportunity to leverage the power of consumers to fight back against this corporate greed and really take back our health.

I'm really happy that you mentioned the bipartisan nature of things that starting to exist now. And it wasn't that long ago where you wouldn't think of people of the political right standing up against the food companies. But now they are, and it's a huge help. And this fact that you have more people from a variety of places on the political spectrum supporting a similar aim to kinda rein in behavior of the food industry and create a healthier food environment. Especially to protect children, leads me to be more optimistic, just like the two of you. I'm glad we can end on that note.

Bios

Katherine Pittore is the director of Policy and Communications at the Action to Nutrition Initiative. She is responsible for developing a strategy to ensure ATNi's research is translated into better policies. Working collaboratively with alliances and other stakeholders, she aims to identify ways for ATNi's research to support improved policies, for companies, investors and governments, with the aim of creating a more effective playing field enabling markets to deliver more nutritious foods, especially for vulnerable groups in society. Katherine has been working in the field of global nutrition and food systems since 2010. Most recently at Wageningen Centre for Development Innovation (WCDI), where she worked as a nutrition and food security advisor on range projects, mostly in Africa. She also has also worked as a facilitator and trainer, and a specific interest in how to healthfully feed our increasingly urbanizing world. She has also worked for several NGOs including RESULTS UK, as a nutrition advocacy officer, setting up their nutrition advocacy portfolio focusing aimed at increasing aid spending on nutrition with the UK parliament, and Save the Children UK and Save the Children India, working with the humanitarian nutrition team. She has an MSc in Global Public Health from the London School of Hygiene and Tropical Medicine and a BA in Science and Society from Wesleyan University.

Eva Greenthal oversees Center for Science in the Public Interest's federal food labeling work, leveraging the food label as a powerful public health tool to influence consumer and industry behavior. Eva also conducts research and supports CSPI's science-centered approach to advocacy as a member of the Science Department. Prior to joining CSPI, Eva led a pilot evaluation of the nation's first hospital-based food pantry and worked on research initiatives related to alcohol literacy and healthy habits for young children. Before that, Eva served as a Program Coordinator for Let's Go! at Maine Medical Center and as an AmeriCorps VISTA Member at HealthReach Community Health Centers in Waterville, Maine. Eva holds a dual MS/MPH degree in Food Policy and Applied Nutrition from Tufts University and a BA in Environmental Studies from University of Michigan.

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In this episode of the Leading Voices in Food podcast, Norbert Wilson of Duke University's Sanford School of Public Policy speaks with researchers Jean Adams from the University of Cambridge and Mike Essman from Duke's World Food Policy Center. They discuss the mandatory calorie labeling policy introduced in England in April 2022 for large food-away-from-home outlets. The conversation covers the study recently published in the British Medical Journal, exploring its results, strengths, limitations, and implications within the broader context of food labeling and public health policies. Key findings include a slight overall reduction in calorie content offered by food outlets, driven by the removal of higher-calorie items rather than reformulation. The discussion also touches on the potential impacts on different consumer groups, the challenges of policy enforcement, and how such policies could be improved to more effectively support public health goals.

Interview Summary

Now everyone knows eating out is just part of life. For many, it's a place to make connections, can be a guilty pleasure, and sometimes it's just an outright necessity for busy folks. But it is also linked to poor dietary quality, weight gain, and even obesity. For policymakers, the challenge is identifying what policy changes can help improve population health. Jean, let's begin with you. Can you tell our listeners about the UK's menu labeling intervention and what change did you hope to see?

Jean - Yes, so this was a policy that was actually a really long time in coming and came in and out of favor with a number of different governments. So maybe over the last 10 years we've had various different suggestions to have voluntary and/or mandatory calorie labeling in the out-of-home sector. Eventually in April, 2022, we did have new mandatory regulations that came into a force that required large businesses just in England - so not across the whole of the UK, just in England - if they sold food and non-alcoholic drinks and they had to display the calories per portion of every item that they were selling. And then have alongside that somewhere on their menu, a statement that said that adults need around 2000 calories per day. The policy applied just to large businesses, and the definition of that was that those businesses have 250 or more employees, but the employees didn't all have to be involved in serving food and drinks. This might apply also to a large hotel chain who just have some bars or something in their hotels. And the food and drinks covered were things that were available for immediate consumption. Not prepackaged. And then there was also this proviso to allow high-end restaurants to be changing their menus regularly. So, it was only for things that were on the menu for at least 30 days.

You mentioned that this policy or a menu labeling might have at least two potential modes of impacts. There's first this idea that providing calories or any sort of labeling on food can somehow provide information for consumers to make what we might hope would be better choices. Might help them choose lower calorie options or healthier options. And then the second potential impact is that businesses might also use the information to change what sort of foods they're serving. It might be that they didn't realize how many calories were in the foods and they're suddenly embarrassed about it. Or as soon as their customers realize, they start to put a little bit of pressure on, you know, we want something a little bit lower calorie. So, there's this potential mechanism that operates at the demand side of how consumers might make choices. And another one at the supply side of what might be available to consumers. And we knew from previous evaluations of these sorts of interventions that there was some evidence that both could occur. Generally, it seems to be that findings from other places and countries are maybe null to small. So, we were thinking that maybe we might see something similar in England.

Thank you for sharing that background. I do have a question about the length of time it took to get this menu labeling law in place. Before we get into the results, do you have a sense of why did it take so long? Was it industry pushback? Was it just change of governments? Do you have a sense of that?

Jean - Yes, so I think it's probably a bit of both. To begin with, it was first proposed as a voluntary measure actually by industry. So, we had this kind of big public-private partnership. What can industry do to support health? And that was one of the things they proposed. And then they didn't really do it very well. So, there was this idea that everybody would do it. And in fact, we found maybe only about 20% of outlets did it. And then definitely we have had government churn in the UK over the last five years or so. So, every new prime minister really came in and wanted to have their own obesity policy threw out the last one started over. And every policy needs consulted on with the public and then with industry. And that whole process just kind of got derailed over and over again.

Thank you. That is really helpful to understand that development of the policy and why it took time. Industry regulated policy can be a tricky one to actually see the results that we would hope. You've already given us a sort of insight into what you thought the results may be from previous studies - null to relatively small. So, Mike, I want to turn to you. Can you tell us what came out of the data?

Mike - Thank you, yes. So, we found a small overall drop in average calories offered per item. That amounts to a total of nine calories per item reduction in our post policy period relative to pre policy. And this is about a 2% reduction. It was statistically significant and we do in public health talk about how small effects can still have big impacts. So, I do want to sort of put that out there, but also recognize that it was a small overall drop in calories. And then what we did is we looked at how different food groups changed, and also how calories changed at different types of restaurants, whether it was fast food, restaurants, sit downs that we call pubs, bars, and inns. And then also other different types of takeaways like cafes and things like that where you might get a coffee or a cappuccino or something like that.

What we found was driving the overall reduction in calories was a reduction in higher calorie items. So, as Jean mentioned at the outset, one of the things we were trying to identify in this analysis was whether we saw any evidence of reformulation. And we defined reformulation as whether specific products were reduced in their calories so that the same products were lower calories in the post period. We define that as reformulation. And that would be different from, say, a change in menu offering where you might identify a high calorie item and take it off the menu so that then the overall calories offered goes down on average. We found more evidence for the latter. Higher calorie items were removed. We separated into categories of removed items, items that were present in both periods, and new items added in the post period. There were higher calorie items in the removed group. The items that were present in both periods did not change. The new items were lower calorie items. What this says overall is this average reduction is driven by taking off high calorie items, adding some slightly lower calorie items. But we did not find evidence for reformulation, which is a crucial finding as well.

We saw that the largest reductions occurred in burgers, beverages and a rather large mixed group called Mains. So, burgers reduced by 103 calories per item. That's pretty substantial. One of the reasons that's so large is that burgers, particularly if they're offered at a pub and might even come with fries or chips, as they say in the UK. And because they have such a high baseline calorie level, there's more opportunity to reduce. So, whether it's making it slightly smaller patty or reducing the cheese or something like that, that's where we saw larger reductions among the burgers. With beverages, typically, this involved the addition of lower calorie options, which is important if it gives an opportunity for lower calorie selections. And that was the main driver of reduction there. And then also we saw in Mains a reduction of 30 calories per item.

A couple of the other things we wanted to identify is whether there was a change in the number of items that were considered over England's recommended calories per meal. The recommended calories per meal is 600 calories or less for lunch and dinner. And we saw no statistical change in that group.

So overall, we do see a slight reduction in average calories. But this study did not examine changes in consumer behavior. I do want to just briefly touch on that because this was part of a larger evaluation. Another study that was published using customer surveys that was published in Nature Human Behavior found no change in the average calories purchased or consumed after the policy. This evaluation was looking at both the supply and the demand side changes as a result of this policy.

Thanks, Mike and I've got lots of questions to follow up, but I'll try to control myself. The first one I'm interested to understand is you talk about the importance of the really calorie-heavy items being removed and the introduction of newer, lower calorie items. And you said that this is not a study of the demand, but I'm interested to know, do you have a sense that the higher calorie items may not have been high or top sellers. It could be easy for a restaurant to get rid of those. Do you have any sense of, you know, the types of items that were removed and of the consumer demand for those items?

Mike - Yes. So, as I mentioned, given that the largest changes were occurring among burgers, we're sort of doing this triangulation attempt to examine all of the different potential impacts we can with the study tools we have. We did not see those changes reflected in consumer purchases. So, I think sticking with the evidence, the best thing we could say is that the most frequently purchased items were not the ones that were being pulled off of menus. I think that would be the closest to the evidence. Now, no study is perfect and we did in that customer survey examine the purchases and consumption of about 3000 individuals before and after the policy. It's relatively large, but certainly not fully comprehensive. But based on what we were able to find, it would seem that those reductions in large calorie items, it's probably fair to say, were sort of marginal choices. So, we see some reduction in calories at the margins. That's why the overall is down, but we don't see at the most commonly sold. I should also mention in response to that, a lot of times when we think about eating out of home, we often think about fast food. We did not see reductions in fast food chains at all, essentially. And so really the largest reductions we found were in what would be considered more sit-down dining establishment. For example, sit-down restaurants or even pubs, bars and ends was one of our other categories. We did see average reductions in those chains. The areas you kind of think about for people grabbing food quickly on the go, we did not see reductions there. And we think some of this is a function of the data itself, which is pubs, bars and inns, because they offer larger plates, there's a little bit more space for them to reduce. And so those are where we saw the reductions. But in what we might typically think is sort of the grab and go type of food, we did not see reductions in those items. And so when we did our customer surveys, we saw that those did not lead to reductions in calories consumed.

Ahh, I see this and thank you for this. It sounds like the portfolio adjusted: getting rid of those heavy calorie items, adding more of the lower calorie items that may not have actually changed what consumers actually eat. Because the ones that they typically eat didn't change at all. And I would imagine from what you've said that large global brands may not have made many changes, but more local brands have more flexibility is my assumption of that. So that, that's really helpful to see.

As you all looked at the literature, you had the knowledge that previous studies have found relatively small changes. Could you tell us about what this work looks like globally? There are other countries that have tried policy similar to this. What did you learn from those other countries about menu labeling?

Jean - Well, I mean, I'm tempted to say that we maybe should have learned that this wasn't the sort of policy that we could expect to make a big change. To me one of the really attractive features of a labeling policy is it kind of reflects back those two mechanisms we've talked about - information and reformulation or changing menus. Because we can talk about it in those two different ways of changing the environment and also helping consumers make better choices, then it can be very attractive across the political landscape. And I suspect that that is one of the things that the UK or England learned. And that's reflected in the fact that it took a little while to get it over the line, but that lots of different governments came back to it. That it's attractive to people thinking about food and thinking about how we can support people to eat better in kind of a range of different ways. I think what we learned, like putting the literature all together, is this sort of policy might have some small effects. It's not going to be the thing that kind of changes the dial on diet related diseases. But that it might well be part of an integrated strategy of many different tools together. I think we can also learn from the literature on labeling in the grocery sector where there's been much more exploration of different types of labeling. Whether colors work, whether black stop signs are more effective. And that leads us to conclusions that these more interpretive labels can lead to bigger impacts and consumer choices than just a number, right? A number is quite difficult to make some sense of. And I think that there are some ways that we could think about optimizing the policy in England before kind of writing it off as not effective.

Thank you. I think what you're saying is it worked, but it works maybe in the context of other policies, is that a fair assessment?

Jean - Well, I mean, the summary of our findings, Mike's touched on quite a lot of it. We found that there was an increase in outlets adhering to the policy. That went from about 20% offered any labeling to about 80%. So, there were still some places that were not doing what they were expected to do. But there was big changes in actual labeling practice. People also told us that they noticed the labels more and they said that they used them much more than they were previously. Like there was some labeling before. We had some big increases in noticing and using. But it's... we found this no change in calories purchased or calories consumed. Which leads to kind of interesting questions. Okay, so what were they doing with it when they were using it? And maybe some people were using it to help them make lower calorie choices, but other people were trying to optimize calories for money spent? We saw these very small changes in the mean calorie of items available that Mike's described in lots of detail. And then we also did some work kind of exploring with restaurants, people who worked in the restaurant chains and also people responsible for enforcement, kind of exploring their experiences with the policy. And one of the big conclusions from that was that local government were tasked with enforcement, but they weren't provided with any additional resources to make that happen. And for various reasons, it essentially didn't happen. And we've seen that with a number of different policies in the food space in the UK. That there's this kind of presumption of compliance. Most people are doing it all right. We're not doing it a hundred percent and that's probably because it's not being checked and there's no sanction for not following the letter of the law. One of the reasons that local authorities are not doing enforcement, apart from that they don't have resources or additional resources for it, is that they have lots of other things to do in the food space, and they see those things as like higher risk. And so more important to do. One of those things is inspecting for hygiene, making sure that the going out is not poisonous or adulterated or anything like that. And you can absolutely understand that. These things that might cause acute sickness, or even death in the case of allergies, are much more important for them to be keeping an eye on than labeling.

One of the other things that emerged through the process of implementation, and during our evaluation, was a big concern from communities with experience of eating disorders around kind of a greater focus on calorie counting. And lots of people recounting their experience that they just find that very difficult to be facing in a space where they're maybe not trying to think about their eating disorder or health. And then they're suddenly confronted with it. And when we've gone back and looked at the literature, there's just not very much literature on the impact of calorie labeling on people with eating disorders. And so we're a little bit uncertain still about whether that is a problem, but it's certainly perceived to be a problem. And lots of people find the policy difficult for that reason because they know someone in their family or one of their friends with an eating disorder. And they're very alert to that potential harm.

I think this is a really important point to raise that the law, the menu labeling, could have differential effects on different consumers. I'm not versed in this literature on the triggering effects of seeing menu labeling for people with disordered eating. But then I'm also thinking about a different group of consumers. Consumers who are already struggling with obesity, and whether or not this policy is more effective for those individuals versus folks who are not. In the work that you all did, did you have any sense of are there heterogeneous effects of the labeling? Did different consumers respond differentially to seeing the menu label? Not just, for example, individuals maybe with disordered eating?

Mike - In this work, we mostly focused on compliance, customer responses in terms of consumption and purchases, changes in menus, and customers reporting whether or not they increase noticing and using. When we looked at the heterogeneous effects, some of these questions are what led us to propose a new project where we interviewed people and tried to understand their responses to calorie labeling. And there we get a lot of heterogenous groups. In those studies, and this work has not actually been published, but should be in the new year, we found that there's a wide range of different types of responses to the policy. For example, there may be some people who recently started going to the gym and maybe they're trying to actually bulk up. And so, they'll actually choose higher calorie items. Conversely, there may be people who have a fitness routine or a dieting lifestyle that involves calorie tracking. And they might be using an app in order to enter the calories into that. And those people who are interested in calorie counting, they really loved the policy. They really wanted the policy. And it gave them a sense of control over their diet. And they felt comfortable and were really worried that if there was evidence that it wouldn't work, that would be taken away. Then you have a whole different group of people who are living with eating disorders who don't want to interact with those numbers when they are eating out of home. They would rather eat socially and not have to think about those challenges. There's really vast diversity in terms of the responses to the policy. And that does present a challenge.

And I think what it also does is cause us just to question what is the intended mechanism of action of this policy? Because when the policy was implemented, there's an idea of a relatively narrow set of effects. If customers don't understand the number of calories that are in their items, you just provide them with the calories that are in those items, they will then make better choices as rational actors. But we know that eating out of home is far more complex. It's social. There are issues related to value for money. So maybe people want to make sure they're purchasing food that hasn't been so reduced in portions that now they don't get the value for money when they eat out. There are all sorts of body image related challenges when people may eat out. We didn't find a lot of evidence of this in our particular sample, but also in some of our consultation with the public in developing the interview, there's concern about judgment from peers when eating out. So, it's a very sensitive topic. Some of the implications of that are we do probably need more communication strategies that can come alongside these policies and sort of explain the intended mechanism impact to the public. We can't expect to simply add numbers to items and then expect that people are going to make the exact choices that are sort of in the best interest of public health. And that sort of brings us on to some potential alternative mechanisms of impact and other modes of labeling, and those sorts of things.

Mike, this has been really helpful because you've also hinted at some of the ways that this policy as implemented, could have been improved. And I wonder, do you have any other thoughts to add to how to make a policy like this have a bigger impact.

Mike - Absolutely. One of the things that was really helpful when Jean laid out her framing of the policy was there's multiple potential mechanisms of action. One of those is the potential reformulation in menu change. We talked about those results. Another intended mechanism of action is through consumer choice. So, if items have fewer calories on average, then that could reduce ultimately calories consumed. Or if people make choices of lower calorie items, that could also be a way to reduce the overall calories consumed. And I would say this calorie labeling policy, it is a step because the calories were not previously available. People did not know what they were eating. And if you provide that, that fulfills the duty of transparency by businesses. When we spoke to people who worked in enforcement, they did support the policy simply on the basis of transparency because it's important for people to understand what they're consuming. And so that's sort of a generally acceptable principle. However, if we want to actually have stronger population health impact, then we do need to have stronger mechanisms of action.

One of the ways that can reduce calories consumed by the consumers, so the sort of demand side, would be some of the interpretive labels. Jean mentioned them earlier. There's now a growing body of evidence of across, particularly in Latin America. I would say some of the strongest evidence began in Chile, but also in Mexico and in other Latin American countries where they've put warning labels on items in order to reduce their consumption. These are typically related to packaged foods is where most of the work has been done. But in order to reduce consumer demand, what it does is rather than expecting people to be sort of doing math problems on the fly, as they go around and make their choices, you're actually just letting them know, well, by the way, this is an item that's very high in calories or saturated fat, or sodium or sugars. Or some combination of those. What that does is you've already helped make that decision for the consumers. You've at least let them know this item has a high level of nutrients of concern. And you can take that away. Conversely, if you have an item that's 487 calories, do you really know what you're going to do with that information? So that's one way to have stronger impact.

The other way that that type of policy can have stronger impact is it sets clear thresholds for those warnings. And so, when you have clear thresholds for warnings, you can have a stronger mechanism for reformulation. And what companies may want to do is they may not want to display those warning labels, maybe because it's embarrassing. It makes their candy or whatever the unhealthy food look bad. Sort of an eyesore, which is the point. And what they'll do is they can reformulate those nutrients to lower levels so that they no longer qualify for that regulation. And so there are ways to essentially strengthen both of those mechanisms of action. Whereas when it's simply on the basis of transparency, then what that does is leave all of the decision making and work on the consumer.

Mike, this is great because I've worked with colleagues like Gabby Fretes and Sean Cash and others on some menu labeling out of Chile. And we're currently doing some work within the center on food nutrition labels to see how different consumers are responding. There's a lot more work to be done in this space. And, of course, our colleagues at UNC (University of North Carolina-Chapel Hill) have also been doing this work. So, this work is really important because it tells us how it can help consumers make different choices, and how it can affect how companies behave. My final question to the two of you is simply, what would you like policymakers to learn from this study? Or maybe not just this study alone, but this body of work. What should they take away?

Jean - Well, I think there's lots of information out there on how to do food labeling well, and we can certainly learn from that. And Mike talks about the work from South America particularly where they're helping people identify the least healthy products. And they're also providing messaging around what you should do with that - like choose a product with fewer of these black symbols. But I think even if labeling is optimized, it's not really going to solve our problem of dietary related diseases. And I think I always want policymakers to know, and I think many of them do understand this, that there is no one magic solution and we need to be thinking about labeling as part of a strategy that addresses marketing in its entirety, right? Companies are using all sorts of strategies to encourage us to buy products. We need to be thinking of all sorts of strategies to support people to buy different products and to eat better. And I think that focuses on things like rebalancing price, supporting people to afford healthier food, focusing advertising and price promotions on healthier products. And I also think we need to be looking even further upstream though, right? That we need to be thinking about the incentives that are driving companies to make and sell less healthy products. Because I don't think that they particularly want to be selling less healthy products or causing lots of illness. It's those products are helping them achieve their aims of creating profit and growth for their shareholders. And I think we need to find creative ways to support companies to experiment with healthier products that either help them simultaneously achieve those demands of profit or growth. Or somehow allow them to step away from those demands either for a short period or for a longer period. I think that that requires us to kind of relook at how we do business in economics in our countries.

Mike?

Yes, I think that was a really thorough answer by Jean. So, I'll just add a couple points. I think most fundamentally what we need to think about when we're doing policy making to improve diet is we need to always think about are we helping to make the healthier choice the easier choice? And what that means is we're not implementing policies that merely provide information that then require individuals to do the rest of the work. We need to have a food environment that includes healthier options that are easily accessible, but also affordable. That's one thing that's come through in quite a lot of the work we've done. There are a lot of concerns about the high cost of food. If people feel like the healthier choices are also affordable choices, that's one of many ways to support the easier choice. And I really just want to reiterate what Jean said in terms of the economics of unhealthy food. In many ways, these large multinational corporations are from their perspective, doing right by their shareholders by producing a profitable product.

Now there are debates on whether or not that's a good thing, of course. There's quite a lot of evidence for the negative health impacts of ultra-processed (UPF) products, and those are getting a lot more attention these days and that's a good thing. What we do need to think about is why is it that UPFs are so widely consumed. In many ways they are optimized to be over consumed. They're optimized to be highly profitable. Because the ingredients that are involved in their production means that they can add a lot of salt, sugar, and fat. And what that does is lead to overconsumption. We need to think about that there's something fundamentally broken about this incentive structure. That is incentivizing businesses to sell unhealthy food products with these food additives that lead to over consumption, obesity, and the associated comorbidities. And if we can start to make a little progress and think creatively about how could we incentivize a different incentive structure. One where actually it would be in a food business's best interest to be much more innovative and bolder and produce healthier products for everyone. That's something that I think we will have to contend with because if we are thinking that we are only going to be able to restrict our way out of this, then that's very difficult. Because people still need to have healthy alternatives, and so we can't merely think about restricting. We also have to think about how do we promote access to healthier foods.

This is great insight. I appreciate the phrasing of making the healthy choice the easy choice, and I also heard a version of this making the healthy choice the affordable choice. But it also seems like we need to find ways to make the healthy choice the profitable choice as well.

Bios:

Jean Adams is a Professor of Dietary Public Health and leads the Population Health Interventions Programme at the University of Cambridge MRC Epidemiology Unit. Adams trained in medicine before completing a PhD on socio-economic inequalities in health. This was followed by an MRC Health of the Population fellowship and an NIHR Career Development Fellowship both exploring influences on health behaviours and socio-economic inequalities in these. During these fellowships Jean was appointed Lecturer, then Senior Lecturer, in Public Health at Newcastle University. Jean moved to Cambridge University to join the MRC Epidemiology Unit and CEDAR in 2014 where she helped establish the Dietary Public Health group. She became Programme Leader in the newly formed Population Health Interventions programme in 2020, and was appointed Professor of Dietary Public Health in 2022.

Mike Essman is a Research Scientist at Duke University's World Food Policy Center. His background is in evaluating nutrition and food policies aimed at improving diets and preventing cardiometabolic diseases. His work employs both quantitative and qualitative methods to explore drivers of dietary behavior, particularly ultra-processed food consumption, across diverse environments and countries. Mike earned his PhD in Nutrition Epidemiology from the University of North Carolina at Chapel Hill, where his research focused on evaluating the impacts of a sugary beverage tax in South Africa. He completed MSc degrees in Medical Anthropology and Global Health Science at the University of Oxford through a fellowship. Prior to joining Duke, he conducted research at the MRC Epidemiology Unit at the University of Cambridge, where he evaluated the impacts of calorie labeling policies in England and led a study examining public perceptions of ultra-processed foods.

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Today we're speaking with Aidan Reilly, co-founder and chief of External Affairs at the Farmlink Project, a national nonprofit connecting farmers with surplus produce to communities facing insecurity. What's especially interesting about Farmlink (https://www.farmlinkproject.org/) is that it was started by college students in 2020 as a response to the food supply challenges our nation experienced during the COVID-19 pandemic. The project is now a nationwide movement of college students who provide a key logistical link in a food system that currently sees up to a third of all food produced go to waste. The program delivers fresh produce to food banks as opposed to packaged or processed foods at zero cost, as opposed to charging delivery fees.

Interview Summary

So, you were a student when you decided to take on this issue of food waste. Was there sort of a moment where you realized that there was an opportunity in this area of food recovery? And how were you able to move from an idea to action so quickly, especially just being a college student?

Yeah, I would say the moment where we realized the opportunity was actually well after we started. So maybe a couple weeks after we started. Initially, we figured that we might have been the first people to ever have this idea. We basically went to our local food bank. It was April of 2020 and classes had been canceled. We weren't doing anything, wanted to be helpful in our community. And the food bank told us we don't need any more volunteers. But we do need food and we especially need fresh food. That's what we're really short on right now. And we have a lot more people coming to our food bank compared to usual. And so, they were naming things like eggs, milk, produce. And then I happened to read a New York Times article that was talking about farmers who were dumping those very items due to supply chain breakdown. They were smashing eggs into the ground, dumping into farms because they couldn't store it anymore. And that's where the idea was initially born. And we just figured, why don't we call these farmers and reach out and ask if we can have this excess instead of them dumping it, so we can get it to our food bank. And those initial deliveries that we did, it was basically us driving the trucks ourselves. Driving it on the freeway, getting it to the food bank. But within three weeks, we'd moved a million pounds of food. And we realized, wow, there's potentially not a lever or an existing organization that is suited to solve this issue at scale. And this issue of food waste and fresh food going to waste while people need it, that's definitely not unique to the pandemic. One out of every three pounds of food we grow in this country is getting thrown out on a year-to-year basis. And there's tens of millions of people in the country who could use that. That's when the opportunity struck us that we could do something much, much larger than just a grassroots pandemic project.

Pretty remarkable. So where were you in school at the time? Where did this take place?

I was at Brown University, but I was sent home so I was in Los Angeles at the time.

Okay. So, tell us what Farmlink does and how it works.

It's a pretty basic concept. When I say farm, I'm basically referring to every point along the supply chain before it gets to the supermarket, let's say. So that means all the distribution centers, the packing houses, everything from field to packing house to distribution center, to that food being on a truck on its way to a grocery store. And then the grocery store might reject it due to it arriving late, for example. So when that happens, at the moment there really is no solution for that kind of large scale surplus, that kind of large scale waste. There are a few things you might be able to do. Like at the farm, they might be able to till it back in, use it for fertilizer. They may be able to send it to animal feed. In some cases, they can compost it. In some cases, you can send it to a bio digester to create methane - usable natural gas. That being said, there's so much of this. And oftentimes producers don't have the time. And when we're dealing with 24-to-48-hour window or less, if the food's already on that truck, it's much easier to just send it to a landfill. That's where we make ourselves available. All you have to do is give Farmlink a call. Doesn't matter where you are in the country. Often doesn't matter where you are in North America. We're going to be able to book the truck, find out a location that can receive it in the capacity and the packaging that it's in. And then we coordinate the delivery, and we cover the cost of that delivery so that it's ultimately at no cost to the food banker community.

So how do you support the expenses?

We're 501C3. We're a nonprofit. And we're about five and a half years in. And to this date, we've moved just under 500 million pounds of food. I don't even want to put a ballpark number out there, but it's a fraction of a very small fraction of the cost it usually costs us around, let's say four and a half cents per pound of food that we move and. We do that all through philanthropic dollars. So, grants, corporate partnerships, private family foundations.

That's really nice. And you mentioned that this has grown beyond its original location and you mentioned around the country. So how widely available is this and how big is Farmlink?

We've moved food in every single state in the US. We've also moved food in Mexico and in Canada and are capable of doing so. And, you know, we don't own any assets for two reasons. The first being that there is enough available infrastructure at the moment that we don't think is being taken full, complete advantage of that can take in more excess food than is currently being taken in. The second reason is that if we don't have infrastructure, then we're not beholden to one particular region of the US. In the future, it might make sense for us to maybe get something like a packing house. We think there's enough available infrastructure that just needs to be maximized through connection and that's what we provide.

Tell me how it works. Does the process in a given location get initiated by a call from a farmer saying, I have extra eggs, or extra lettuce, or whatever it is? Or is it a call from a food bank saying, we need these things, and who owns the truck? Who drives the truck? How does all that work?

There are a couple different instances. One very common one actually is from food bank to food bank. So, that process is not a hundred percent efficient. Sometimes it's a lot less than a hundred percent efficient. One food bank receives, let's say they get a relationship with a company that has decided to do some good and donate a huge amount of their product to that food bank. There's kind of a misconception that food banks can take and want to take everything in. So, they might have excess that they're not sure what to do with. Farmlink will actually be able to coordinate. We'll get a call from that food bank. We will just connect them with another partner in our network who might need whatever they have access of, and then we'll facilitate that delivery. We don't count that towards our pounds of food move. That's just one way that we're easily able to make sure food's not going to waste at the end.

The more understandable thing that we do is can really just be a call direct from a farmer. We've received calls from farmers who might tell us that a contract has been cut. We worked with a group of farmers in West Virginia who had a contract cut. They were apple farmers, and they were left with tens of millions of apples that they were basically having to burn them because storing them was so expensive and there was nowhere else they could meaningfully send them. And what we do is we have to basically find the demand. Let's say all the local food banks, institutions are full of all the apples that they could ever possibly need or want. But several states over, organizations, especially rural ones, might have no access to anything like that. We're going to work then with the third-party logistics company. It's kind of like Uber, but for a big semi-truck. Figure out how those apples are going to get packaged. If we're sending it to a local organization that has only volunteers and they don't have a forklift, if you just send them 800-pound bins of apples, it's going to hurt them more than it's going to help them. We've got to figure out how to get it packaged into smaller cartons. We could figure out if they need to be washed, if they need to be processed at all. Most of the time we don't have to do that. But if it's coming direct from a field, you never know. And then we pay for the truck and basically see the delivery all the way through until it gets to that food bank. And then from there, it's important to mention that the food bank itself is not necessarily always the end recipient. It goes from there to churches, schools, it goes in in smaller receivable loads to tens of thousands of different nodes across the country.

Pretty remarkable. As you were building this, what were some of the biggest logistic challenges that you faced, and how did you overcome them?

You know, it's relatively basic supply chain matching. And I don't say that to underplay what my team does because they are working literally around the clock. I mean, you have to work on the farmer's schedule. That's one big thing is that if you wanted to set this up out of the good of your heart and because you believe food shouldn't go to waste, great. But you've got to be ready to work on the farmer schedule. You know, I really don't know a busier working person and it's a Wednesday night and they've got a truck stuck on a road somewhere. Or whoever they might be working with, wherever they're sending it, they've got a truck stuck on the road and you don't pick up their call and you're not ready and capable to figure out how it's going to get sent, then they're never going to call you again. And even though there's all that available food out there, you're not going to have access to it. [00:10:00] And that was a huge distinguishing factor. We're not going to operate on the schedule of the charitable food system, which due to constrained resources having to depend on volunteers, might only be a couple days a week for a lot of these food banks. We're going to basically be available 24-7 and make this possible. The other thing is just the scale. I'll go back to this West Virginia example with the apples, because as far as we can tell, that was the largest food recovery ever done in the United States. We moved 50 million apples across 27 states. It took us about five weeks to do so. And, you can't have even one of those truckloads go wrong. You can't have one of them show up at a place where nobody's ready to receive it. You can't have one of them not be temperature controlled and have something spoil or get stuck. It basically has to be perfect. And that's round the clock extreme attention to detail. Working on the farmer schedule, but working based on the food bank and the community preferences. To be a middleman is a sense of responsibility. We are middleman to make things easier. The second we make it harder, then the importance of something like Farmlink existing is not, you know?

Does all the middlemen activity occur in a one central location or is it somehow distributed all around the country?

Yes, so on any given day, we could be moving food in California, Arizona, Texas, Michigan, Florida, and Ontario. On a given week it could be more than that. We have over 400 different recipient locations that we're pretty regularly sending food to and that we have done.

But is all this work done in one central hub?

No, it's not. It's really decentralized. First of all, our team is decentralized. I'm in New York City. The head of our farmer advocacy is in the middle of Texas. The head of our agency relations is in Los Angeles. We're decentralized. But we're booking these trucks and coordinating. If we're not there in person at the farm, it's happening over the phone, and you can book it from anywhere in the country.

What metrics do you use to make priorities about what to deliver to the food banks and how do you collect data on the impact you're having? And one of the reasons I asked that is that food banks often use pounds of food distributed as the metric for how successful they are. But of course, a pound of broccoli is different nutritionally than a pound of sugar beverage. But it sounds like in your case, that's not such a worry because it's fresh, healthy food. And you're not worried about the kind of packaged processed food.

There's a lot of metrics that get thrown around. We've spent years going over verbiage and that has to do with pounds of. It's not verbiage, it's real impact. I mean, it's pounds of food that we deliver. There's a kind of an industry standard that 1.2 pounds of food you're, you can call a meal. And so, we will kind sometimes refer to it as meals, but we feel like that's a little misleading because 1.2 pounds of onions is not a meal for anyone. There are emissions that's avoided. We basically did years of work to figure out and get a model that is third party verified that shows exactly the methane avoidance for every type of food and where it's coming from, that we avoid going to the landfill.

That being said, I don't think metrics necessarily are going to be what's going to grow this industry into its potential. I think behavior change really could. I think when you look at what, you know, let's call it the food crisis in the United States, and what we see, it's often not that there isn't enough food, it's that Americans aren't getting the right kinds of food. We see refrigerators full that are supposed to be for fresh food that are just full of energy drinks. And people honestly not wanting or not knowing what to cook if they're given a bunch of organic produce. And what we'd like to track is if you can take excess food, surplus produce, get that into a community and do it in a way that is trustworthy such that you can see people start to familiarize with it and you can see diets change and the level of nutrition change over the period of a year or two consistently in that community. How are education levels changing? How are like graduation rates changing? How is the ability to meet your mortgage changing? I mean, there's so many different things that are tied into once you meet your basic level of nutrition that it kind of demands a level deeper of metrics that we're excited to explore but have not been able to yet.

My guess is that this work is especially important at the moment because of cuts to the SNAP program, uncertainty about its future, problems with economies and the cost of food and things. Is that right? Is this an especially difficult time?

Grocery prices are at all-time highs. There's economic uncertainty that comes and goes, but really there's a massive, short term blow that has come with federal funding since the start of 2025. So many, so many food banks that relied on federal cuts or on federal funding had billions of dollars cut from their budget, which means fewer employees, less ability to purchase food to give more round out meal, which means they're going to cheaper, more processed meals. And then to cap that off has been the uncertainty with SNAP that we saw at the beginning of this month where it looked like there was going to be no SNAP benefits given at all. And what ultimately was agreed on is a significantly reduced SNAP benefits going towards Americans.

And you can't forget that SNAP provides more meals to people in the country than the rest of the charitable food system. Every food bank combined by a pretty significant multiplier. All is to say this is becoming a lot more visible for people. The fragility and the line between what it means to be food secure and to not know how you're going to afford your next meal. And that's something that you don't feel like is an issue that you live with day to day in the United States if you have a roof over your head or even if you have a job. But there's over 40 million Americans who are living like that, right at or under the poverty line. It's very relevant. It's the most extreme I've seen it ever, and that include the pandemic.

It's pretty remarkable statement. My guess is that the answer to this question is going to be all of the above. But when you talk to a farmer who donates food to this process, is the farmer doing it because it just helps offload things he or she would have to deal with otherwise? Does it feel good to the farmer to know that all the things that he or she puts so much work into producing is actually getting used? They're helping people? I mean, how does that sort out? Why is it in their interest to do this?

From what we heard from farmers, yes, they work a lot. That's a massive understatement. They work extremely hard and invest an incredible amount into growing this food first and foremost. They definitely don't want to see it just go to waste. And, if they have any ability whatsoever to get it to a secondary market, to be able to turn a dollar on that we don't want to take it. There's no other option for the farmer. We did not approach and do not approach this from the perspective of asking farmers to do this out of the good of their hearts. As much as they might like to, they don't have the time and they do not have the budget to do things out of the good of their heart. One of the things we did right initially and then have always continued to do is approaches from how is this going to save a farmer a headache and maybe save the farmer some money. If you've got a massive pile of something that you can't sell in your backyard it, I don't know if you've ever tried to just donate 50 pounds of something to a food bank. It's not as easy as you might think. Let alone 500,000 pounds. How are they going to call 30 different food banks or compost centers or whatever. It's just that much easier to go to a landfill. And then once they're going to the landfill that, especially depending which state they're in, it costs them money to dump it. There are tipping fees. And if it's already in packaging those can be significant. It can be $3,000 up to we've seen $15,000 for them just to dump fresh food.

So, the concept is we're going to make it just one phone call away, no matter how big your pile of food is, we can take it. If it's 50 million apples or if it's a couple thousand pounds. And then we're going to save you the cost of that tipping fee. And so if we're working with you consistently, because you might grow extra so that if the weather changes, you're not going to under meet your demand. If we're working with you consistently, that's $3,000 on every truckload we're taking from you. That adds up. And then we'll get you a tax write off for a bit of the value of that food. And we are pushing for something that we see here in New York, which is the Farm-to-Food-Tank tax credit, where it's an actual credit that means cash actually back in the farmer's pocket. We'd like to see that instituted on a federal level because ultimately a write off is not enough. And often not taken advantage of for pretty clear reasons. So, that's a long answer, but we're farmers first. We need to figure out what helps them, what's easy for them, and that can put some money back in their pocket. And that's how we're going to be able to get available food to people who need it.

So, let's end with a crystal ball type question. What do you hope the future of Farmlink will be and what will it look like in generations to come?

You know, we put up billboards a couple years back, which said help put Farmlink out of business. And the mindset around that is the future you want to see really one where something like Farmlink is moving billions of pounds of food? Because that means there's still billions of pounds going to waste. It means there's still millions of people who could use that. But my mindset has actually shifted on that. I think what our role is, and organizations that are similar to us, is to show what's possible to drive the political will to institute incentive to have this be an existing lever. I think we've seen other countries do this effectively. The United States is just such a large and extremely productive country that it's a big undertaking. But when you get a big group of students who are able to move half a billion pounds of food on a pretty minimal budget, and continuing to climb that number year after year, then we start seeing people turn their heads and pay attention. Oh, this might actually be possible. And there's a lot of creative things that you could do with this food. You see other companies pop up. Some for-profit some non-profit and basically you develop an industry around this. Food recovery, I think has been an edge case industry where it's been something that's either done locally or it's been done in an incredibly scrappy, grassroots way. The future needs to be that this is an industry and that has the same level of attention as any other industry in the United States. So that we have a built-in solution for billions of pounds of food going to waste. And we can deal with that abundance by re-routing it back to the people in the country who need it. I think that's the kind of country that the United States should be and the one that I think we're working towards. But I think we live in a society where it's got to be done to get people to follow. You can't just say it, you got to go do it. And that's what we're here for.

Well, thank you for your inspired work. It's really pretty remarkable what you've accomplished in such a short period of time, and it shows how much difference one or two, or three people can make if they have vision and passion and creativity in trying to implement new solutions to existing problems. I hope your crystal ball works out and that what you're hoping to come true really will and it would be so good for the planet, for people who don't have enough food, for the farmer, just for everybody in the whole chain. So again, congratulations for such great work and thanks so much for joining us.

BIO

Aidan Reilly is Co-Founder and Chief of External Affairs at The Farmlink Project, a national nonprofit connecting farmers with surplus produce to communities facing food insecurity. Within its first five years, the organization has rescued and distributed nearly 500 million pounds of food that would have otherwise gone to waste.

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In this episode, Kelly Brownell speaks with Jerold Mande, CEO of Nourish Science, adjunct professor at the Harvard School of Public Health, and former Deputy Undersecretary for Food Safety at the USDA. They discuss the alarming state of children's health in America, the challenges of combating poor nutrition, and the influence of the food industry on public policy. The conversation explores the parallels between the tobacco and food industries and proposes new strategies for ensuring children reach adulthood in good health. Mande emphasizes the need for radical changes in food policy and the role of public health in making these changes.

Transcript

So, you co-founded this organization along with Jerome Adams, Bill Frist and Thomas Grumbly, as we said, to ensure every child breaches age 18 at a healthy weight and in good metabolic health. That's a pretty tall order given the state of the health of youth today in America. But let's start by you telling us what inspired this mission and what does it look like to achieve this in today's food environment?

I was trained in public health and also in nutrition and in my career, which has been largely in service of the public and government, I've been trying to advance those issues. And unfortunately over the arc of my career from when I started to now, particularly in nutrition and public health, it's just gotten so much worse. Indeed today Americans have the shortest lifespans by far. We're not just last among the wealthy countries, but we're a standard deviation last. But probably most alarming of all is how sick our children are. Children should not have a chronic disease. Yet in America maybe a third do.

I did some work on tobacco at one point, at FDA. That was an enormous success. It was the leading cause of death. Children smoked at a higher rate, much like child chronic disease today. About a third of kids smoked. And we took that issue on, and today it's less than 2%. And so that shows that government can solve these problems. And since we did our tobacco work in the early '90s, I've changed my focus to nutrition and public health and trying to fix that. But we've still made so little progress.

Give us a sense of how far from that goal we are. So, if the goal is to make every child reaching 18 at a healthy weight and in good metabolic health, what percentage of children reaching age 18 today might look like that?

It's probably around a half or more, but we're not quite sure. We don't have good statistics. One of the challenges we face in nutrition is, unfortunately, the food industry or other industries lobby against funding research and data collection. And so, we're handicapped in that way. But we do know from the studies that CDC and others have done that about 20% of our children have obesity about a similar number have Type 2 diabetes or the precursors, pre-diabetes. You and I started off calling it adult-onset diabetes and they had to change that name to a Type 2 because it's becoming so common in kids. And then another disease, fatty liver disease, really unthinkable in kids. Something that the typical pediatrician would just never see. And yet in the last decade, children are the fastest growing group. I think we don't know an exact number, but today, at least a third, maybe as many as half of our children have a chronic disease. Particularly a food cause chronic disease, or the precursors that show they're on the way.

I remember probably going back about 20 years, people started saying that we were seeing the first generation of American children that would lead shorter lives than our parents did. And what a terrible legacy to leave our children.

Absolutely. And that's why we set that overarching goal of ensuring every child reaches age 18 in good metabolic health. And the reason we set that is in my experience in government, there's a phrase we all use - what gets measured gets done. And when I worked at FDA, when I worked at USDA, what caught my attention is that there is a mission statement. There's a goal of what we're trying to achieve. And it's ensuring access to healthy options and information, like a food label. Now the problem with that, first of all, it's failed. But the problem with that is the bureaucrats that I oversaw would go into a supermarket, see a produce section, a protein section, the food labels, which I worked on, and say we've done our job. They would check those boxes and say, we've done it. And yet we haven't. And if we ensured that every child reaches age 18 at a healthy weight and good metabolic health, if the bureaucrats say how are we doing on that? They would have to conclude we're failing, and they'd have to try something else. And that's what we need to do. We need to try radically different, new strategies because what we've been doing for decades has failed.

You mentioned the food industry a moment ago. Let's talk about that in a little more detail. You made the argument that food companies have substituted profits for health in how they design their products. Explain that a little bit more, if you will. And tell us how the shift has occurred and what do you think the public health cost has been?

Yes, so the way I like to think of it, and your listeners should think of it, is there's a North star for food design. And from a consumer standpoint, I think there are four points on the star: taste, cost, convenience, and health. That's what they expect and want from their food. Now the challenge is the marketplace. Because that consumer, you and I, when we go to the grocery store and get home on taste, cost, and convenience, if we want within an hour, we can know whether the food we purchased met our standard there. Or what our expectations were. Not always for health. There's just no way to know in a day, a week, a month, even in a year or more. We don't know if the food we're eating is improving and maintaining our health, right? There should be a definition of food. Food should be what we eat to thrive. That really should be the goal. I borrowed that from NASA, the space agency. When I would meet with them, they said, ' Jerry, it's important. Right? It's not enough that people just survive on the food they eat in space. They really need to thrive.' And that's what WE need to do. And that's really what food does, right? And yet we have food, not only don't we thrive, but we get sick. And the reason for that is, as I was saying, the marketplace works on taste, cost and convenience. So, companies make sure their products meet consumer expectation for those three. But the problem is on the fourth point on the star: on health. Because we can't tell in even years whether it's meeting our expectation. That sort of cries out. You're at a policy school. Those are the places where government needs to step in and act and make sure that the marketplace is providing. That feedback through government. But the industry is politically strong and has prevented that. And so that has left the fourth point of the star open for their interpretation. And my belief is that they've put in place a prop. So, they're making decisions in the design of the product. They're taste, they gotta get taste right. They gotta get cost and convenience right. But rather than worrying what does it do to your health? They just, say let's do a profit. And that's resulted in this whole category of food called ultra-processed food (UPF). I actually believe in the future, whether it's a hundred years or a thousand years. If humanity's gonna thrive we need manmade food we can thrive on. But we don't have that. And we don't invest in the science. We need to. But today, ultra-processed food is manmade food designed on taste, cost, convenience, and then how do we make the most money possible.

Now, let me give you one other analogy, if I could. If we were CEOs of an automobile company, the mission is to provide vehicles where people can get safely from A to point B. It's the same as food we can thrive on. That is the mission. The problem is that when the food companies design food today, they've presented to the CEO, and everyone gets excited. They're seeing the numbers, the charts, the data that shows that this food is going to meet, taste, cost, convenience. It's going to make us all this money. But the CEO should be asking this following question: if people eat this as we intend, will they thrive? At the very least they won't get sick, right? Because the law requires they can't get sick. And if the Midmanagers were honest, they'd say here's the good news boss. We have such political power we've been able to influence the Congress and the regulatory agencies. That they're not going to do anything about it. Taste, cost, convenience, and profits will work just fine.

Couldn't you make the argument that for a CEO to embrace that kind of attitude you talked about would be corporate malpractice almost? That, if they want to maximize profits then they want people to like the food as much as possible. That means engineering it in ways that make people overeat it, hijacking the reward pathways in the brain, and all that kind of thing. Why in the world would a CEO care about whether people thrive?

Because it's the law. The law requires we have these safety features in cars and the companies have to design it that way. And there's more immediate feedback with the car too, in terms of if you crashed right away. Because it didn't work, you'd see that. But here's the thing. Harvey Wiley.He's the founder of the food safety programs that I led at FDA and USDA. He was a chemist from academia. Came to USDA in the late 1800s. It was a time of great change in food in America. At that point, almost all of families grew their own food on a farm. And someone had to decide who's going to grow our food. It's a family conversation that needed to take place. Increasingly, Americans were moving into the cities at that time, and a brand-new industry had sprung up to feed people in cities. It was a processed food industry. And in order to provide shelf stable foods that can offer taste, cost, convenience, this new processed food industry turned to another new industry, a chemical industry. Now, it's hard to believe this, but there was a point in time that just wasn't an industry. So these two big new industries had sprung up- processed food and chemicals. And Harvey Wiley had a hypothesis that the chemicals they were using to make these processed foods were making us sick. Indeed, food poisoning back then was one of the 10 leading causes of death. And so, Harvey Wiley went to Teddy Roosevelt. He'd been trying for years within the bureaucracy and not making progress. But when Teddy Roosevelt came in, he finally had the person who listened to him. Back then, USDA was right across from the Washington Monument to the White House. He'd walk right over there into the White House and met with Teddy Roosevelt and said, ' this food industry is making us sick. We should do something about it.' And Teddy Roosevelt agreed. And they wrote the laws. And so I think what your listeners need to understand is that when you look at the job that FDA and USDA is doing, their food safety programs were created to make sure our food doesn't make us sick.

Acutely sick. Not heart disease or cancer, 30, 40 years down the road, but acutely sick.

No. I think that's absolutely the point. That's what Wiley was most concerned about at the time. But that's not the law they wrote. The law doesn't say acutely ill. And I'll give you this example. Your listeners may be familiar with something called GRAS - Generally Recognized as Safe. It's a big problem today. Industry co-opted the system and no longer gets approval for their food additives. And so, you have this Generally Recognized as Safe system, and you have these chemicals and people are worried about them. In the history of GRAS. Only one chemical has FDA decided we need to get that off the market because it's unsafe. That's partially hydrogenated oils or trans-fat. Does trans-fat cause acute illness? It doesn't. It causes a chronic disease. And the evidence is clear. The agency has known that it has the responsibility for both acute and chronic illness. But you're right, the industry has taken advantage of this sort of chronic illness space to say that that really isn't what you should be doing. But having worked at those agencies, I don't think they see it that way. They just feel like here's the bottom line on it. The industry uses its political power in Congress. And it shapes the agency's budget. So, let's take FDA. FDA has a billion dollars with a 'b' for food safety. For the acute food safety, you're talking about. It has less than 25 million for the chronic disease. There are about 1400 deaths a year in America due to the acute illnesses caused by our food that FDA and USDA are trying to prevent. The chronic illnesses that we know are caused by our food cause 1600 maybe a day. More than that of the acute every day. Now the agency should be spending at least half its time, if not more, worrying about those chronic illness. Why doesn't it? Because the industry used their political power in Congress to put the billion dollars for the acute illness. That's because if you get acutely ill, that's a liability concern for them.

Jerry let's talk about the political influence in just a little more detail, because you're in a unique position to tell us about this because you've seen it from the inside. One mechanism through which industry might influence the political process is lobbyists. They hire lobbyists. Lobbyists get to the Congress. People make decisions based on contributions and things like that. Are there other ways the food industry affects the political process in addition to that. For example, what about the revolving door issue people talk about where industry people come into the administrative branch of government, not legislative branch, and then return to industry. And are there other ways that the political influence of the industry has made itself felt?

I think first and foremost it is the lobbyists, those who work with Congress, in effect. Particularly the funding levels, and the authority that the agencies have to do that job. I think it's overwhelmingly that. I think second, is the influence the industry has. So let me back up to that a sec. As a result of that, we spend very little on nutrition research, for example. It's 4% of the NIH budget even though we have these large institutes, cancer, heart, diabetes, everyone knows about. They're trying to come up with the cures who spend the other almost 50 billion at NIH. And so, what happens? You and I have both been at universities where there are nutrition programs and what we see is it's very hard to not accept any industry money to do the research because there isn't the federal money. Now, the key thing, it's not an accident. It's part of the plan. And so, I think that the research that we rely on to do regulation is heavily influenced by industry. And it's broad. I've served, you have, others, on the national academies and the programs. When I've been on the inside of those committees, there are always industry retired scientists on those committees. And they have undue influence. I've seen it. Their political power is so vast.

The revolving door, that is a little of both ways. I think the government learns from the revolving door as well. But you're right, some people leave government and try to undo that. Now, I've chosen to work in academia when I'm not in government. But I think that does play a role, but I don't think it plays the largest role. I think the thing that people should be worried about is how much influence it has in Congress and how that affects the agency's budgets. And that way I feel that agencies are corrupted it, but it's not because they're corrupted directly by the industry. I think it's indirectly through congress.

I'd like to get your opinion on something that's always relevant but is time sensitive now. And it's dietary guidelines for America. And the reason I'm saying it's time sensitive is because the current administration will be releasing dietary guidelines for America pretty soon. And there's lots of discussion about what those might look like. How can they help guide food policy and industry practices to support healthier children and families?

It's one of the bigger levers the government has. The biggest is a program SNAP or food stamps. But beyond that, the dietary guidelines set the rules for government spending and food. So, I think often the way the dietary guidelines are portrayed isn't quite accurate. People think of it in terms of the once (food) Pyramid now the My Plate that's there. That's the public facing icon for the dietary guidelines. But really a very small part. The dietary guidelines are meant to help shape federal policy, not so much public perception. It's there. It's used in education in our schools - the (My) Plate, previously the (Food) Pyramid. But the main thing is it should shape what's served in government feeding programs. So principally that should be SNAP. It's not. But it does affect the WIC program- Women, Infants and Children, the school meals program, all of the military spending on food. Indeed, all spending by the government on food are set, governed by, or directed by the dietary guidelines. Now some of them are self-executing. Once the dietary guidelines change the government changes its behavior. But the biggest ones are not. They require rulemaking and in particular, today, one of the most impactful is our kids' meals in schools. So, whatever it says in these dietary guidelines, and there's reason to be alarmed in some of the press reports, it doesn't automatically change what's in school meals. The Department of Agriculture would have to write a rule and say that the dietary guidelines have changed and now we want to update. That usually takes an administration later. It's very rare one administration could both change the dietary guidelines and get through the rulemaking process. So, people can feel a little reassured by that.

So, how do you feel about the way things seem to be taking shape right now?

This whole MAHA movement Make America Healthy Again. What is it? To me what it is we've reached this tipping point we talked about earlier. The how sick we are, and people are saying, 'enough. Our food shouldn't make us sick at middle age. I shouldn't have to be spending so much time with my doctor. But particularly, it shouldn't be hard to raise my kids to 18 without getting sick. We really need to fix that and try to deal with that.' But I think that the MAHA movement is mostly that. But RFK and some of the people around them have increasingly claimed that it means some very specific things that are anti-science. That's been led by the policies around vaccine that are clearly anti-science. Nutrition is more and more interesting. Initially they started out in the exact right place. I think you and I could agree the things they were saying they need to focus on: kids, the need to get ultra-processed food out of our diets, were all the right things. In fact, you look at the first report that RFK and his team put out back in May this year after the President put out an Executive Order. Mostly the right things on this. They again, focus on kids, ultra-processed food was mentioned 40 times in the report as the root cause for the very first time. And this can't be undone. You had the White House saying that the root cause of our food-caused chronic disease crisis is the food industry. That's in a report that won't change. But a lot has changed since then. They came out with a second report where the word ultra-processed food showed up only once.

What do you think happened?

I know what happened because I've worked in that setting. The industry quietly went to the White House, the top political staff in the White House, and they said, you need to change the report when you come out with the recommendations. And so, the first report, I think, was written by MAHA, RFK Jr. and his lieutenants. The second report was written by the White House staff with the lobbyists of the food industry. That's what happened. What you end up with is their version of it. So, what does the industry want? We have a good picture from the first Trump administration. They did the last dietary guidelines and the Secretary of Agriculture, then Sonny Perdue, his mantra to his staff, people reported to me, was the industries- you know, keep the status quo. That is what the industry wants is they really don't want the dietary guidelines to change because then they have to reformulate their products. And they're used to living with what we have and they're just comfortable with that. For a big company to reformulate a product is a multi-year effort and cost billions of dollars and it's just not what they want to have to do. Particularly if it's going to change from administration to administration. And that is not a world they want to live in. From the first and second MAHA report where they wanted to go back to the status quo away from all the radical ideas. It'll be interesting to see what happens with dietary guidelines because we've seen reports that RFK Jr. and his people want to make shifts in policies. Saying that they want to go back to the Pyramid somehow.

There's a cartoon on TV, South Park, I thought it was produced to be funny. But they talked about what we need to do is we need to flip the Pyramid upside down and we need to go back to the old Pyramid and make saturated fat the sort of the core of the diet. I thought it meant to be a joke but apparently that's become a belief of some people in the MAHA movement. RFK. And so, they want to add saturated fat back to our diets. They want to get rid of plant oils from our diets. There is a lot of areas of nutrition where the science isn't settled. But that's one where it is, indeed. Again, you go back only 1950s, 1960s, you look today, heart disease, heart attacks, they're down 90%. Most of that had to do with the drugs and getting rid of smoking. But a substantial contribution was made by nutrition. Lowering saturated fat in our diets and replacing it with plant oils that they're now called seed oils. If they take that step and the dietary guidelines come out next month and say that saturated fat is now good for us it is going to be just enormously disruptive. I don't think companies are going to change that much. They'll wait it out because they'll ask themselves the question, what's it going to be in two years? Because that's how long it takes them to get a product to market.

Jerry, let me ask you this. You painted this picture where every once in a while, there'll be a glimmer of hope. Along comes MAHA. They're critical of the food industry and say that the diet's making us sick and therefore we should focus on different things like ultra-processed foods. In report number one, it's mentioned 40 times. Report number two comes out and it's mentioned only once for the political reasons you said. Are there any signs that lead you to be hopeful that this sort of history doesn't just keep repeating itself? Where people have good ideas, there's science that suggests you go down one road, but the food industry says, no, we're going to go down another and government obeys. Are there any signs out there that lead you to be more hopeful for the future?

There are signs to be hopeful for the future. And number one, we talked earlier, is the success we had regulating tobacco. And I know you've done an outstanding job over the years drawing the parallels between what happened in tobacco and food. And there are good reasons to do that. Not the least of which is that in the 1980s, the tobacco companies bought all the big food companies and imparted on them a lot of their lessons, expertise, and playbook about how to do these things. And so that there is a tight link there. And we did succeed. We took youth smoking, which was around a 30 percent, a third, when we began work on this in the early 1990s when I was at FDA. And today it's less than 2%. It's one area with the United States leads the world in terms of what we've achieved in public health. And there's a great benefit that's going to come to that over the next generation as all of those deaths are prevented that we're not quite seeing yet. But we will. And that's regardless of what happens with vaping, which is a whole different story about nicotine. But this idea success and tobacco. The food industry has a tobacco playbook about how to addict so many people and make so much money and use their political power. We have a playbook of how to win the public health fight.

So, tell us about that. What you're saying is music to my ears and I'm a big believer in exactly what you're saying. So, what is it? What does that playbook look like and what did we learn from the tobacco experience that you think could apply into the food area?

There are a couple of areas. One is going to be leadership and we'll have to come back to that. Because the reason we succeeded in tobacco was the good fortune of having a David Kessler at FDA and Al Gore as Vice President. Nothing was, became more important to them than winning this fight against a big tobacco. Al Gore because his sister died at a young age of smoking. And David Kessler became convinced that this was the most important thing for public health that he could do. And keep in mind, when he came to FDA, it was the furthest thing from his mind. So, one of it is getting these kinds of leaders. Did does RFK Jr. and Marty McCarey match up to Al Gore? And we'll see. But the early signs aren't that great. But we'll see. There's still plenty of time for them to do this and get it right.

The other thing is having a good strategy and policy about how to do it. And here, with tobacco, it was a complete stretch, right? There was no where did the FDA get authority over tobacco? And indeed, we eventually needed the Congress to reaffirm that authority to have the success we did. As we talked earlier, there's no question FDA was created to make sure processed food and the additives and processed food don't make us sick. So, it is the core reason the agency exists is to make sure that if there's a thing called ultra-processed food, man-made food, that is fine, but we have to thrive when we eat it. We certainly can't be made sick when we eat it. Now, David Kessler, I mentioned, he's put forward a petition, a citizens' petition to FDA. Careful work by him, he put months of effort into this, and he wrote basically a detailed roadmap for RFK and his team to use if they want to regulate ultra-processed stuff food. And I think we've gotten some, initially good feedback from the MAHA RFK people that they're interested in this petition and may take action on it.

So, the basic thrust of the Kessler petition from my understanding is that we need to reconsider what's considered Generally Recognized as Safe. And that these ultra-processed foods may not be considered safe any longer because they produce all this disease down the road. And if MAHA responds positively initially to the concept, that's great. And maybe that'll have legs, and something will actually happen. But is there any reason to believe the industry won't just come in and quash this like they have other things?

This idea of starting with a petition in the agency, beginning an investigation and using its authority is the blueprint we used with tobacco. There was a petition we responded, we said, gee, you raised some good points. There are other things we put forward. And so, what we hope to see here with the Kessler petition is that the FDA would put out what's called an advanced notice of a proposed rulemaking with the petition. This moves it from just being a petition to something the agency is saying, we're taking this seriously. We're putting it on the record ourselves and we want industry and others now to start weighing in. Now here's the thing, you have this category of ultra-processed food that because of the North Star I talked about before, because the industry, the marketplace has failed and gives them no incentive to make sure that we thrive, that keeps us from getting sick. They've just forgotten about that and put in place profits instead. The question is how do you get at ultra-processed food? What's the way to do it? How do you start holding the industry accountable?

Now what RFK and the MAHA people started with was synthetic color additives. That wasn't what I would pick but, it wasn't a terrible choice. Because if you talk to Carlos Monteiro who coined the phrase ultra-processed food, and you ask him, what is an ultra-processed food, many people say it's this industrial creation. You can't find the ingredients in your kitchen. He agrees with all that, but he thinks the thing that really sets ultra-processed food, the harmful food, is the cosmetics that make them edible when they otherwise won't I've seen inside the plants where they make the old fashioned minimally processed food versus today's ultra-processed. In the minimally processed plants, I recognize the ingredients as food. In today's plants, you don't recognize anything. There are powders, there's sludges, there's nothing that you would really recognize as food going into it. And to make that edible, they use the cosmetics and colors as a key piece of that. But here's the problem. It doesn't matter if the color is synthetic or natural. And a fruit loop made with natural colors is just as bad for you as one made with synthetics. And indeed, it's been alarming that the agency has fast tracked these natural colors and as replacements because, cyanide is natural. We don't want to use that. And the whole approach has been off and it like how is this going to get us there? How is this focus on color additives going to get us there. And it won't.

Yeah, I agree. I agree with your interpretation of that.

But the thing with Kessler you got part of it right but the main thing he did is say you don't have to really define ultra-processed food, which is another industry ploy to delay action. Let's focus on the thing that's making us sick today. And that's the refined carbohydrates. The refined grains in food. That's what's most closely linked to the obesity, the diabetes we're seeing today. Now in the 1980s, the FDA granted, let's set aside sugar and white flour, for example, but they approved a whole slew of additives that the companies came forward with to see what we can add to the white flour and sugar to make it shelf stable, to meet all the taste, cost, and convenience considerations we have. And profit-making considerations we have. Back then, heart disease was the driving health problem. And so, it was easy to overlook why you didn't think that the these additives were really harmful. That then you could conclude whether Generally Recognized as Safe, which is what the agency did back then.

What Kessler is saying is that what he's laid out in his petition is self-executing. It's not something that the agency grants that this is GRAS or not GRAS. They were just saying things that have historical safe use that scientists generally recognize it as safe. It's not something the agency decides. It's the universe of all of us scientists generally accept. And it's true in the '80s when we didn't face the obesity and diabetes epidemic, people didn't really focus on the refined carbohydrates. But if you look at today's food environment. And I hope you agree with this, that what is the leading driver in the food environment about what is it about ultra-processed food that's making us so sick? It's these refined grains and the way they're used in our food. And so, if the agency takes up the Kessler petition and starts acting on it, they don't have to change the designation. Maybe at some point they have to say some of these additives are no longer GRAS. But what Kessler's saying is by default, they're no longer GRAS because if you ask the scientists today, can we have this level of refined grains? And they'd say, no, that's just not Generally Recognized as Safe. So, he's pointing out that status, they no longer hold that status. And if the agency would recognize that publicly and the burden shifts where Wiley really always meant it to be, on the industry to prove that there are foods or things that we would thrive on, but that wouldn't make us sick.

And so that's the key point that you go back to when you said, and you're exactly right that if you let the industry use their political power to just ignore health altogether and substitute profits, then you're right. Their sort of fiduciary responsibility is just to maximize profits and they can ignore health. If you say you can maximize profits, of course you're a capitalist business, but one of the tests you have to clear is you have to prove to us that people can thrive when they eat that. Thrive as the standard, might require some congressional amplification because it's not in the statute. But what is in the statute is the food can't make you sick. If scientists would generally recognize, would say, if you eat this diet as they intend, if you eat this snack food, there's these ready to heat meals as they intend, you're going to get diabetes and obesity. If scientists generally believe that, then you can't sell that. That's just against the law and the agency needs them to enforce the law.

Bio:

Jerold Mande is CEO of Nourish Science; Adjunct Professor of Nutrition, Harvard T.H. Chan School of Public Health; and a Non-Resident Senior Fellow, Tisch College of Civic Life, Tufts University. Professor Mande has a wealth of expertise and experience in national public health and food policy. He served in senior policymaking positions for three presidents at USDA, FDA, and OSHA helping lead landmark public health initiatives. In 2009, he was appointed by President Obama as USDA Deputy Under Secretary for Food Safety. In 2011, he moved to USDA's Food, Nutrition, and Consumer Services, where he spent six years working to improve the health outcomes of the nation's $100 billion investment in 15 nutrition programs. During President Clinton's administration, Mr. Mande was Senior Advisor to the FDA commissioner where he helped shape national policy on nutrition, food safety, and tobacco. He also served on the White House staff as a health policy advisor and was Deputy Assistant Secretary for Occupational Health at the Department of Labor. During the George H.W. Bush administration he led the graphic design of the iconic Nutrition Facts label at FDA, for which he received the Presidential Design Award. Mr. Mande began his career as a legislative assistant for Al Gore in the U.S. House and Senate, managing Gore's health and environment agenda, and helping Gore write the nation's organ donation and transplantation laws. Mande earned a Master of Public Health from the University of North Carolina at Chapel Hill and a Bachelor of Science in nutritional science from the University of Connecticut. Prior to his current academic appointments, he served on the faculty at the Tufts, Friedman School of Nutrition Science and Policy, and Yale School of Medicine.

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In this episode of the Leading Voices in Food podcast, host Norbert Wilson is joined by food and nutrition policy economists Will Masters and Parke Wilde from Tufts University's Friedman School of Nutrition, Science and Policy. The discussion centers around the concept of the least cost diet, a tool used to determine the minimum cost required to maintain a nutritionally adequate diet. The conversation delves into the global computational methods and policies related to least cost diets, the challenges of making these diets culturally relevant, and the implications for food policy in both the US and internationally. You will also hear about the lived experiences of people affected by these diets and the need for more comprehensive research to better reflect reality.

Interview Summary

I know you both have been working in this space around least cost diets for a while. So, let's really start off by just asking a question about what brought you into this work as researchers. Why study least cost diets? Will, let's start with you.

I'm a very curious person and this was a puzzle. So, you know, people want health. They want healthy food. Of course, we spend a lot on healthcare and health services, but do seek health in our food. As a child growing up, you know, companies were marketing food as a source of health. And people who had more money would spend more for premium items that were seen as healthy. And in the 2010s for the first time, we had these quantified definitions of what a healthy diet was as we went from 'nutrients' to 'food groups,' from the original dietary guidelines pyramid to the MyPlate. And then internationally, the very first quantified definitions of healthful diets that would work anywhere in the world. And I was like, oh, wow. Is it actually expensive to eat a healthy diet? And how much does it cost? How does it differ by place location? How does it differ over time, seasons, and years? And I just thought it was a fascinating question.

Great, thank you for that. Parke?

There's a lot of policy importance on this, but part of the fun also of this particular topic is more than almost any that we work on, it's connected to things that we have to think about in our daily lives. So, as you're preparing and purchasing food for your family and you want it to be a healthy. And you want it to still be, you know, tasty enough to satisfy the kids. And it can't take too long because it has to fit into a busy life. So, this one does feel like it's got a personal connection.

Thank you both for that. One of the things I heard is there was an availability of data. There was an opportunity that seems like it didn't exist before. Can you speak a little bit about that? Especially Will because you mentioned that point.

Will: Yes. So, we have had food composition data identifying for typical items. A can of beans, or even a pizza. You know, what is the expected, on average quantity of each nutrient. But only recently have we had those on a very large scale for global items. Hundreds and hundreds of thousands of distinct items. And we had nutrient requirements, but only nutrient by nutrient, and the definition of a food group where you would want not only the nutrients, but also the phytochemicals, the attributes of food from its food matrix that make a vegetable different from just in a vitamin pill. And those came about in, as I mentioned, in the 2010s. And then there's the computational tools and the price observations that get captured. They've been written down on pads of paper, literally, and brought to a headquarters to compute inflation since the 1930s. But access to those in digitized form, only really in the 2000s and only really in the 2010s were we able to have program routines that would download millions and millions of price observations, match them to food composition data, match that food composition information to a healthy diet criterion, and then compute these least cost diets. Now we've computed millions and millions of these thanks to modern computing and all of that data.

Great, Will. And you've already started on this, so let's continue on this point. You were talking about some of the computational methods and data that were available globally. Can you give us a good sense of what does a lease cost diet look like from this global perspective because we're going to talk to Parke about whether it is in the US. But let's talk about it in the broad sense globally.

In my case the funding opportunity to pay for the graduate students and collaborators internationally came from the Gates Foundation and the UK International Development Agency, initially for a pilot study in Ghana and Tanzania. And then we were able to get more money to scale that up to Africa and South Asia, and then globally through a project called Food Prices for Nutrition. And what we found, first of all, is that to get agreement on what a healthy diet means, we needed to go to something like the least common denominator. The most basic, basic definition from the commonalities among national governments' dietary guidelines. So, in the US, that's MyPlate, or in the UK it's the Eat Well Guide. And each country's dietary guidelines look a little different, but they have these commonalities. So, we distilled that down to six food groups. There's fruits and vegetables, separately. And then there's animal source foods altogether. And in some countries they would separate out milk, like the United States does. And then all starchy staples together. And in some countries, you would separate out whole grains like the US does. And then all edible oils. And those six food groups, in the quantities needed to provide all the nutrients you would need, plus these attributes of food groups beyond just what's in a vitamin pill, turns out to cost about $4 a day. And if you adjust for inflation and differences in the cost of living, the price of housing and so forth around the world, it's very similar. And if you think about seasonal variation in a very remote area, it might rise by 50% in a really bad situation. And if you think about a very remote location where it's difficult to get food to, it might go up to $5.50, but it stays in that range between roughly speaking $2.50 and $5.00.

Meanwhile, incomes are varying from around $1.00 a day, and people who cannot possibly afford those more expensive food groups, to $200 a day in which these least expensive items are trivially small in cost compared to the issues that Parke mentioned. We can also talk about what we actually find as the items, and those vary a lot from place to place for some food groups and are very similar to each other in other food groups. So, for example, the least expensive item in an animal source food category is very often dairy in a rich country. But in a really dry, poor country it's dried fish because refrigeration and transport are very expensive. And then to see where there's commonalities in the vegetable category, boy. Onions, tomatoes, carrots are so inexpensive around the world. We've just gotten those supply chains to make the basic ingredients for a vegetable stew really low cost. But then there's all these other different vegetables that are usually more expensive. So, it's very interesting to look at which are the items that would deliver the healthfulness you need and how much they cost. It's surprisingly little from a rich country perspective, and yet still out of reach for so many in low-income countries.

Will, thank you for that. And I want to turn now to looking in the US case because I think there's some important commonalities. Parke, can you describe the least cost diet, how it's used here in the US, and its implications for policy?

Absolutely. And full disclosure to your audience, this is work on which we've benefited from Norbert's input and wisdom in a way that's been very valuable as a co-author and as an advisor for the quantitative part of what we were doing. For an article in the journal Food Policy, we use the same type of mathematical model that USDA uses when it sets the Thrifty Food Plan, the TFP. A hypothetical diet that's used as the benchmark for the maximum benefit in the Supplemental Nutrition Assistance Program, which is the nation's most important anti-hunger program. And what USDA does with this model diet is it tries to find a hypothetical bundle of foods and beverages that's not too different from what people ordinarily consume. The idea is it should be a familiar diet, it should be one that's reasonably tasty, that people clearly already accept enough. But it can't be exactly that diet. It has to be different enough at least to meet a cost target and to meet a whole long list of nutrition criteria. Including getting enough of the particular nutrients, things like enough calcium or enough protein, and also, matching food group goals reasonably well. Things like having enough fruits, enough vegetables, enough dairy. When, USDA does that, it finds that it's fairly difficult. It's fairly difficult to meet all those goals at once, at a cost and a cost goal all at the same time. And so, it ends up choosing this hypothetical diet that's almost maybe more different than would feel most comfortable from people's typical average consumption.

Thank you, Parke. I'm interested to understand the policy implications of this least cost diet. You suggested something about the Thrifty Food Plan and the maximum benefit levels. Can you tell us a little bit more about the policies that are relevant?

Yes, so the Thrifty Food Plan update that USDA does every five years has a much bigger policy importance now than it did a few years ago. I used to tell my students that you shouldn't overstate how much policy importance this update has. It might matter a little bit less than you would think. And the reason was because every time they update the Thrifty Food Plan, they use the cost target that is the inflation adjusted or the real cost of the previous edition. It's a little bit as if nobody wanted to open up the whole can of worms about what should the SNAP benefit be in the first place.

But everything changed with the update in 2021. In 2021, researchers at the US Department of Agriculture found that it was not possible at the old cost target to find a diet that met all of the nutrition criteria - at all. Even if you were willing to have a diet that was quite different from people's typical consumption. And so, they ended up increasing the cost of the Thrifty Food Plan in small increments until they found a solution to this mathematical model using data on real world prices and on the nutrition characteristics of these foods. And this led to a 21% increase in the permanent value of the maximum SNAP benefit. Many people didn't notice that increase all that much because the increase came into effect at just about the same time that a temporary boost during the COVID era to SNAP benefits was being taken away. So there had been a temporary boost to how much benefits people got as that was taken away at the end of the start of the COVID pandemic then this permanent increase came in and it kind of softened the blow from that change in benefits at that time. But it now ends up meaning that the SNAP benefit is substantially higher than it would've been without this 2021 increase. And there's a lot of policy attention on this in the current Congress and in the current administration. There's perhaps a skeptical eye on whether this increase was good policy. And so, there are proposals to essentially take away the ability to update the Thrifty Food Plan change the maximum SNAP benefit automatically, as it used to. As you know, Norbert, this is part of all sorts of things going on currently. Like we heard in the news, just last week, about plans to end collecting household food security measurement using a major national survey. And so there will be sort of possibly less information about how these programs are doing and whether a certain SNAP benefit is needed in order to protect people from food insecurity and hunger.

Parke, this is really important and I'm grateful that we're able to talk about this today in that SNAP benefit levels are still determined by this mathematical program that's supposed to represent a nutritionally adequate diet that also reflects food preferences. And I don't know how many people really understand or appreciate that. I can say I didn't understand or appreciate it until working more in this project. I think it's critical for our listeners to understand just how important this particular mathematical model is, and what it says about what a nutritionally adequate diet looks like in this country. I know the US is one of the countries that uses a model diet like this to help set policy. Will, I'd like to turn to you to see what ways other nations are using this sort of model diet. How have you seen policy receive information from these model diets?

It's been a remarkable thing where those initial computational papers that we were able to publish in first in 2018, '19, '20, and governments asking how could we use this in practice. Parke has laid out how it's used in the US with regard to the benefit level of SNAP. The US Thrifty Food Plan has many constraints in addition to the basic ones for the Healthy Diet Basket that I described. Because clearly that Healthy Diet Basket minimum is not something anyone in America would think is acceptable. Just to have milk and frozen vegetables and low-cost bread, that jar peanut butter and that's it. Like that would be clearly not okay. So, internationally what's happened is that first starting in 2020, and then using the current formula in 2022, the United Nations agencies together with the World Bank have done global monitoring of food and nutrition security using this method. So, the least cost items to meet the Healthy Diet Basket in each country provide this global estimate that about a third of the global population have income available for food after taking account of their non-food needs. That is insufficient to buy this healthy diet. What they're actually eating is just starchy staples, oil, some calories from low-cost sugar and that's it. And very small quantities of the fruits and vegetables. And animal source foods are the expensive ones. So, countries have the opportunity to begin calculating this themselves alongside their normal monitoring of inflation with a consumer price index. The first country to do that was Nigeria. And Nigeria began publishing this in January 2024. And it so happened that the country's national minimum wage for civil servants was up for debate at that time. And this was a newly published statistic that turned out to be enormously important for the civil society advocates and the labor unions who were trying to explain why a higher civil service minimum wage was needed. This is for the people who are serving tea or the drivers and the low wage people in these government service agencies. And able to measure how many household members could you feed a healthy diet with a day's worth of the monthly wage. So social protection in the sense of minimum wage and then used in other countries regarding something like our US SNAP program or something like our US WIC program. And trying to define how big should those benefit levels be. That's been the first use.

A second use that's emerging is targeting the supply chains for the low-cost vegetables and animal source foods and asking what from experience elsewhere could be an inexpensive animal source food. What could be the most inexpensive fruits. What could be the most inexpensive vegetables? And that is the type of work that we're doing now with governments with continued funding from the Gates Foundation and the UK International Development Agency.

Will, it's fascinating to hear this example from Nigeria where all of the work that you all have been doing sort of shows up in this kind of debate. And it really speaks to the power of the research that we all are trying to do as we try to inform policy. Now, as we discussed the least cost diet, there was something that I heard from both of you. Are these diets that people really want? I'm interested to understand a little bit more about that because this is a really critical space.Will, what do we know about the lived experiences of those affected by least cost diet policy implementation. How are real people affected?

It's such an important and interesting question, just out of curiosity, but also for just our human understanding of what life is like for people. And then of course the policy actions that could improve. So, to be clear, we've only had these millions of least cost diets, these benchmark 'access to' at a market near you. These are open markets that might be happening twice a week or sometimes all seven days of the week in a small town, in an African country or a urban bodega type market or a supermarket across Asia, Africa. We've only begun to have these benchmarks against which to compare actual food choice, as I mentioned, since 2022. And then really only since 2024 have been able to investigate this question. We're only beginning to match up these benchmark diets to what people actually choose. But the pattern we're seeing is that in low and lower middle-income countries, people definitely spend their money to go towards that healthy diet basket goal. They don't spend all of their additional money on that. But if you improve affordability throughout the range of country incomes - from the lowest income countries in Africa, Mali, Senegal, Burkina Faso, to middle income countries in Africa, like Ghana, Indonesia, an upper middle-income country - people do spend their money to get more animal source foods, more fruits and vegetables, and to reduce the amount of the low cost starchy staples. They do increase the amount of discretionary, sugary meals. And a lot of what they're eating exits the healthy diet basket because there's too much added sodium, too much added sugar. And so, things that would've been healthy become unhealthy because of processing or in a restaurant setting. So, people do spend their money on that. But they are moving towards a healthy diet. That breaks down somewhere in the upper income and high-income countries where additional spending becomes very little correlated with the Healthy Diet Basket. What happens is people way overshoot the Healthy Diet Basket targets for animal source foods and for edible oils because I don't know if you've ever tried it, but one really delicious thing is fried meat. People love it. And even low middle income people overshoot on that. And that displaces the other elements of a healthy diet. And then there's a lot of upgrading, if you will, within the food group. So, people are spending additional money on nicer vegetables. Nicer fruits. Nicer animal source foods without increasing the total amount of them in addition to having overshot the healthy diet levels of many of those food groups. Which of course takes away from the food you would need from the fruits, the vegetables, and the pulses, nuts and seeds, that almost no one gets as much as is considered healthy, of that pulses, nuts and seeds category.

Thank you. And I want to shift this to the US example. So, Parke, can you tell us a bit more about the lived experience of those affected by least cost diet policy? How are real people affected?

One of the things I've enjoyed about this project that you and I got to work on, Norbert, in cooperation with other colleagues, is that it had both a quantitative and a qualitative part to it. Now, our colleague Sarah Folta led some of the qualitative interviews, sort of real interviews with people in food pantries in four states around the country. And this was published recently in the Journal of Health Education and Behavior. And we asked people about their goals and about what are the different difficulties or constraints that keep them from achieving those goals. And what came out of that was that people often talk about whether their budget constraints and whether their financial difficulties take away their autonomy to sort of be in charge of their own food choices. And this was something that Sarah emphasized as she sort of helped lead us through a process of digesting what was the key findings from these interviews with people. One of the things I liked about doing this study is that because the quantitative and the qualitative part, each had this characteristic of being about what do people want to achieve. This showed up mathematically in the constrained optimization model, but it also showed up in the conversations with people in the food pantry. And what are the constraints that keep people from achieving it. You know, the mathematical model, these are things like all the nutrition constraints and the cost constraints. And then in the real conversations, it's something that people raise in very plain language about what are all the difficulties they have. Either in satisfying their own nutrition aspirations or satisfying some of the requirements for one person or another in the family. Like if people have special diets that are needed or if they have to be gluten free or any number of things. Having the diets be culturally appropriate. And so, I feel like this is one of those classic things where different disciplines have wisdom to bring to bear on what's really very much a shared topic.

What I hear from both of you is that these diets, while they are computationally interesting and they reveal some critical realities of how people eat, they can't cover everything. People want to eat certain types of foods. Certain types of foods are more culturally relevant. And that's really clear talking to you, Will, about just sort of the range of foods that end up showing up in these least cost diets and how you were having to make some adjustments there. Parke, as you talked about the work with Sarah Folta thinking through autonomy and sort of a sense of self. This kind of leads us to a question that I want to open up to both of you. What's missing when we talk about these least cost diet modeling exercises and what are the policy implications of that? What are the gaps in our understanding of these model diets and what needs to happen to make them reflect reality better? Parke?

Well, you know, there's many things that people in our research community are working on. And it goes quite, quite far afield. But I'm just thinking of two related to our quantitative research using the Thrifty Food Plan type models. We've been working with Yiwen Zhao and Linlin Fan at Penn State University on how these models would work if you relaxed some of the constraints. If people's back in a financial sense weren't back up against the wall, but instead they had just a little more space. We were considering what if they had incentives that gave them a discount on fruits and vegetables, for example, through the SNAP program? Or what if they had a healthy bundle of foods provided through the emergency food system, through food banks or food pantries. What is the effect directly in terms of those foods? But also, what is the effect in terms of just relaxing their budget constraints. They get to have a little more of the foods that they find more preferred or that they had been going without. But then also, in terms of sort of your question about the more personal. You know, what is people's personal relationships with food? How does this play out on the ground? We're working with the graduate student Angelica Valdez Valderrama here at the Friedman School, thinking about what some of the cultural assumptions and of the food group constraints in some of these models are. If you sort of came from a different immigrant tradition or if you came from another community, what things would be different in, for example, decisions about what's called the Mediterranean diet or what's called the healthy US style dietary pattern. How much difference do this sort of breadth, cultural breadth of dietary patterns you could consider, how much difference does that make in terms of what's the outcome of this type of hypothetical diet?

Will: And I think, you know, from the global perspective, one really interesting thing is when we do combine data sets and look across these very different cultural settings, dry land, Sahelian Africa versus countries that are coastal versus sort of forest inland countries versus all across Asia, south Asia to East Asia, all across Latin America. We do see the role of these cultural factors. And we see them playing out in very systematic ways that people come to their cultural norms for very good reasons. And then pivot and switch away to new cultural norms. You know, American fast food, for example, switching from beef primarily to chicken primarily. That sort of thing becomes very visible in a matter of years. So, in terms of things that are frontiers for us, remember this is early days. Getting many more nutritionists, people in other fields, looking at first of all, it's just what is really needed for health. Getting those health requirements improved and understood better is a key priority. Our Healthy Diet Basket comes from the work of a nutritionist named Anna Herforth, who has gone around the world studying these dietary guidelines internationally. We're about to get the Eat Lancet dietary recommendations announced, and it'll be very interesting to see how those evolve.

Second thing is much better data on prices and computing these diets for more different settings at different times, different locations. Settings that are inner city United States versus very rural. And then this question of comparing to actual diets. And just trying to understand what people are seeking when they choose foods that are clearly not these benchmark least cost items. The purpose is to ask how far away and why and how are they far away? And particularly to understand to what degree are these attributes of the foods themselves: the convenience of the packaging, the preparation of the item, the taste, the flavor, the cultural significance of it. To what degree are we looking at the result of aspirations that are really shaped by marketing. Are really shaped by the fire hose of persuasion that companies are investing in every day. And very strategically and constantly iterating to the best possible spokesperson, the best possible ad campaign. Combining billboards and radio and television such that you're surrounded by this. And when you drive down the street and when you walk into the supermarket, there is no greater effort on the planet than the effort to sell us a particular brand of food. Food companies are basically marketing companies attached to a manufacturing facility, and they are spending much more than the entire combined budget of the NIH and CDC, et cetera, to persuade us to eat what we ultimately choose. And we really don't know to what degree it's the actual factors in the food itself versus the marketing campaigns and the way they've evolved. You know, if you had a choice between taking the food system and regulating it the way we regulate, say housing or vehicles. If we were to say your supermarket should be like an auto dealership, right? So, anything in the auto dealership is very heavily regulated. Everything from the paint to where the gear shift is to how the windows work. Everything is heavily regulated because the auto industry has worked with National Transportation Safety Board and every single crash investigation, et cetera, has led to the standards that we have now. We didn't get taxes on cars without airbags to make us choose cars with airbags. They're just required. And same is true for housing, right? You can't just build, you know, an extension deck behind your house any way you want. A city inspector will force you to tear it out if you haven't built it to code. So, you know, we could regulate the grocery store like we do that. It's not going to happen politically but compare that option to treating groceries the way we used to treat the legal services or pharmaceuticals. Which is you couldn't advertise them. You could sell them, and people would choose based on the actual merit of the lawyer or the pharmaceutical, right? Which would have the bigger impact. Right? If there was zero food advertising, you just walked into the grocery store and chose what you liked. Or you regulate the grocery store the same way we regulate automotive or building trades. Obviously, they both matter. There's, you know, this problem that you can't see, taste or smell the healthiness of food. You're always acting on belief and not a fact when you choose something that you're seeking health. We don't know to what extent choice is distorted away from a low-cost healthy diet by things people genuinely want and need. Such as taste, convenience, culture, and so forth. Versus things that they've been persuaded to want. And there's obviously some of both. All of these things matter. But I'm hopeful that through these least cost diets, we can identify that low-cost options are there. And you could feed your family a very healthy diet at the Thrifty Food Plan level in the United States, or even lower. It would take time, it would take attention, it would be hard. You can take some shortcuts to make that within your time budget, right? And the planning budget. And we can identify what those look like thanks to these model diets.

It's a very exciting area of work, but we still have a lot to do to define carefully what are the constraints. What are the real objectives here. And how to go about helping people, acquire these foods that we now know are there within a short commuting distance. You may need to take the bus, you may need carpool. But that's what people actually do to go grocery shopping. And when they get there, we can help people to choose items that would genuinely meet their needs at lower cost.

Bios

Will Masters is a Professor in the Friedman School of Nutrition, with a secondary appointment in Tufts University's Department of Economics. He is coauthor of the new textbook on Food Economics: Agriculture, Nutrition and Health (Palgrave Macmillan, 2024). Before coming to Tufts in 2010 he was a faculty member in Agricultural Economics at Purdue University (1991-2010), and also at the University of Zimbabwe (1989-90), Harvard's Kennedy School of Government (2000) and Columbia University (2003-04). He is former editor-in-chief of the journal Agricultural Economics (2006-2011), and an elected Fellow of the American Society for Nutrition (FASN) as well as a Fellow of the Agricultural and Applied Economics Association (AAEA). At Tufts his courses on economics of agriculture, food and nutrition were recognized with student-nominated, University-wide teaching awards in 2019 and 2022, and he leads over a million dollars annually in externally funded research including work on the Agriculture, Nutrition and Health Academy (https://www.anh-academy.org), as well as projects supporting government efforts to calculate the cost and affordability of healthy diets worldwide and work with private enterprises on data analytics for food markets in Africa.

Parke Wilde (PhD, Cornell) is a food economist and professor at the Friedman School of Nutrition Science and Policy at Tufts University. Previously, he worked for USDA's Economic Research Service. At Tufts, Parke teaches graduate-level courses in statistics, U.S. food policy, and climate change. His research addresses the economics of U.S. food and nutrition policy, including federal nutrition assistance programs. He was Director of Design for the SNAP Healthy Incentives Pilot (HIP) evaluation. He has been a member of the National Academy of Medicine's Food Forum and is on the scientific and technical advisory committee for Menus of Change, an initiative to advance the health and sustainability of the restaurant industry. He directs the USDA-funded Research Innovation and Development Grants in Economics (RIDGE) Partnership. He received the AAEA Distinguished Quality of Communication Award for his textbook, Food Policy in the United States: An Introduction (Routledge/Earthscan), whose third edition was released in April 2025.

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The gut is in the news. It's really in the news. Catapulted there from exciting developments coming from laboratories all around the world. Links of gut health with overall health are now quite clear and surprising connections are being discovered between gut health and things like dementia and Alzheimer's. But how does the gut communicate with other parts of the body in ways that make it this important, and where does the brain figure into all this? Well, there's some interesting science going on in this topic, and a leading person in this area is Dr. Diego Bohorquez. Dr. Bohorquez is the associate professor of medicine, of molecular genetics and microbiology and of cell biology at the Duke University School of Medicine.

Interview Transcript

Diego, your bio shows that you blend work in nutritional biochemistry, gastrointestinal physiology, and sensory neurobiology. It took me a little time to figure out just what these things are, but what this represents, to be a little more serious, is a unique ability to understand that the different parts of the body, the gut and the brain in particular, interact a lot. And you're in a very good position to understand how that happens. Let's dive in with the kind of a basic question. What got you interested in this interaction of the gut with the brain and why care about it?

Yes. Kelly, I think that that's all technicalese for saying that we are at the interface of food, the gut, and the brain. Apart from the fact that we are what we eat and if we truly believe that then food will be shaping us. Not only our body, but also like our belief systems, our societal systems, and so on and so forth. I don't think that that is anything new. However, what is new is the ability of the gut to guide our decision making. And it was interesting to hear in your introduction that now the gut is all in the news. In 2005 when I came to the United States, and I was at North Carolina State University, and I joined a graduate school. I remember taking a graduate course in physiology in 2007. And when the professor opened the session on gastrointestinal physiology, he said the gut is one of the most misunderstood and mysterious organs. It has almost as many neurons as the spinal cord, or more. But honestly, we don't give a lot of respect to the gut. We only think that it does some digestion and absorption, and we judge it more for the value of its products of digestion than what it does for the entire body.

And fast forward almost 20 years later now, partly my laboratory and other laboratories that have entered this field since some of our discoveries started to emerge, it's very clearly showing that the gut not only has its own sensory system that is behind what we call gut feelings. The gut feelings are actually real. But it actually can influence our decision making. Like specifically, we have shown that our ability to choose sugars and consume sugars and feel sugars and choose them over sweeteners, it can be pinpointed to a specific set of cells in the intestine called neuropod cells and specific receptors in those cells. And the intestine is right after the stomach. And this is where these cells are exposed to the surface of the gut and detect the chemical composition of food to guide our decision making.

Let's talk about that a little bit more. So, you've got this axis, or this means of communication between the gut and the brain going on. And let's talk about how it affects what we eat. You just alluded to the fact that it's pretty important. What does it tell us? What to eat, how much to eat? What we like to eat? When we're hungry, when we've had enough? How does this affect our eating?

We are beginning to understand how much it affects this eating. And obviously we are departing from understanding, right? And an understanding is cognitive. In the 1500s is when the idea of 'we think therefore we are,' came online. And we needed to think things before we actually will understand them. But well before thinking them, we actually feel them. And you probably have noticed that. If anybody offers you maybe a cup of water at 5:00 AM, 6:00 AM, it will be very welcome. Especially with it's a little bit warm. If they offer you a steak at 5:00 AM you will run away from that. But in fact, you'll create distress I think unless you are like severely jet lagged. And a lot of those feelings not only come from the experience, but even if you blind are blindfolded, your gut will be able to evaluate what you just ingested.

And it is because the intestine, it is the point where those molecules in the meal or in the drink, will be either absorbed to become part of who we are, or will be excreting and expelled. And that absorption of who we are is dependent on the context. Like for instance, the part of the month, morning versus afternoon, health status, age, will influence specifically like at the molecular level, what it is that we need to continue to thrive.

It sounds like there's lots of potential for the gut and its interaction with the brain working in concert with the rest of the body. Things are in balance and working like they should be. But there are lots of things going on out there that disrupt that. Tell us more about that and how it affects eating. For example, the levels of obesity have risen so much in the past decades. How does the gut figure into that, for example. Could there be environmental things like the microplastics or exposure to toxins like pesticides and things that might be affecting the gut that throws the system off?

I think that that is a very timely question for the days. Over the last 10 years, we have documented that the gut has its own sensory system. And in fact, it's one of the most ancient sensory systems. At the very beginning, 600 million years ago, when cells started to coalesce into animals, multicellular organisms, they needed to eat. And they needed to not only find the food but create a sensory representation of the food. What do I mean by that? Eating algae is very different than eating bacteria, for instance. And the gut needed to have these sensors to be able to rapidly create first a representation, this is bacteria. And then put out the molecules to digest that bacterium or those bacteria. And then ultimately absorb them, turn them into metabolites and continue to thrive, right? Perhaps reproduce, coalesce and so on and so forth. This is a very important concept because our reality, the reality that you and I are having right now, it is guided by our senses. And we have multiple senses. Like for instance, we are able to communicate partly because of the sound that is going through our ears. And then there are inner hair cells that are picking up those waves. Passing that information to the brain, decoding it, and then the brain coalesces with everything else and saying like, 'okay, Diego, you're in a podcast. Make sure that you say something hopefully reasonable, right?' What the gut is doing, as a true sensory system, is also detecting the food that we have ingested, creating a rapid representation. It's not the reality itself. It is a representation of the reality. Because when we eat an apple, ultimately the gut, what it's doing is creating a representation that was an apple and not an orange. And then telling the brain, look, you're going to get some glucose, some fiber, a little bit of a skin. And you may need to adjust it with water, right? And then that will trigger the desire to, 'oh, maybe I should have also a cup of water.' Why does that have to do with, the societal issues that we are facing? Since the 1970s, we learned to disentangle the sensory experience of food, not only as humans or scientists, but also that was extrapolated to the society. So, if you go and look, and it is not a secret, it has been very well documented. For instance, the ability to put artificial sweeteners out there. It has really changed the health landscape. And it was just a normal progression of how it is that we humans think. We thought well, people consume sugars because they're sweet. If we take out the calorie and we just leave the sweetness, it will be totally fine because it's benign. You're not consuming anything else. However, the gut, you have promised the gut something sweet. That it has always, or almost always, invariably, been associated with a nutritional value. Then the gut is fed this information that is skewed. Then it has to go and adjust. And we actually have demonstrated that in the laboratory that when the neuro pods detect a non-caloric sweetener, they actually release a different neurotransmitter that communicates to the brain that artificial sweeteners have arrived at the gut, as opposed to glucose, which triggers the release of glutamate. And that glutamate is essential for the organism to know that we have consumed sugar.

Is it safe to say then that the body has evolved to be able to have effective signaling and feedback systems with things that are found out there in nature, like sugar or an apple or an orange. But when you start introducing things that don't exist in nature, like the artificial sweeteners, then bad things can happen.

Yes. Because imagine right now your brain will swap the reality and you will transport yourself or the beach. You may not even have the clothing ready to confront the breeze of the beach, right? Or the salt. You would have not been prepared, right? We evolved around nature because nature was there before us. Therefore, we had gradually adjusted to what nature had to offer. Eventually we introduced fire, and we were able to transform simple or complex carbohydrates into something digestible. And then the body had the ability to adjust to it. And not only the body, but also the microbiota in the gut. Now we are talking about like the transformation of foods. And especially I think in the last 30 years we have been able to transform those foods. Beverages have sweeteners now. We have energy drinks that have a composition of vitamins and other things. And while those things individually perhaps are not innocuous, we haven't explored what is the conglomerate effect on long-term health.

When we talk about these things being added to foods, I mean, there are whole classes of things like colorings and dyes and artificial sweeteners and things. And then there are processing things that go on, like extrusion and different things that take something like wheat or corn and turn it into something that the body is not accustomed to dealing with. Is the body incapable of perceiving what these things are? Does it get send out wrong signals? Why should we be worried about these things?

I don't think that we should be worried necessarily because that's alarming, right? But we should be aware, certainly, that the body keeps tabs on it. Something very simple. If you rub water on your skin versus if you rub oil on your skin, your brain already starts to perceive that substance as different. Now, imagine the gut is going to know exactly the same thing. It knows what water is. It knows what oil is. It knows what carbs are. It knows what protein is. And depending on what it has been fed for, thousands of years, it will be able to create that representation as I alluded to. And therefore, if there is a foreign composition, it's going to have to adjust to the situation. And that is how you can end up altering the composition of a regular body. Because like, for instance, in nature if you go and look at native populations that live very close to nature, you know, the body composition is in a certain form. But in cities where you're exposed to foods that have been transformed, the body composition is very different. And I'm not talking only about body weight, but also height, shape, you know.

That certainly makes sense. You know, something that's been in the news a lot lately are the GLP1 drugs like Ozempic and Zepbound and they have very powerful effects on appetite, satiety, and weight regulation. How is the gut brain axis involved in this?

I would like to make a couple of points in there.The first one is that glucagon-like peptide is obviously is very similar to glucagon. Glucagon is produced in the pancreas. Glucagon-like peptide is actually produced in the gut. And it is produced by these neuro pod cells that also produce some neurotransmitters. And it is produced in response to specific nutrients like glucose. And it is a signal glucagon like peptide 1. It is a signal for not only adjusting insulin release, but it is also a signal for coordinating what has arrived in the gut. It does affect motility. Eventually it is thought that goes into the bloodstream and affects the nervous system. However, and I said it is thought because the brain also produces glucagon-like peptide. There are cells in the skin. There are cells in the urethra. There are cells in the bladder. There are cell cells in the spinal cord in the choroid plexus that is exposed to the cerebral spinal fluid that also produces some of these peptides as signaling molecules. And I have to make that clarification because traditionally it has been thought to be a signal from the gut, per se. But these are just signaling molecules. The second part is that the arrival of Ozempic, I thought that it was obviously a very important step not only scientifically, but also societally. Why? Because up until 1980s and I have thought with many colleagues especially in medicine. And they will say like, when an obese patient will arrive in the office, first of all, there was not a lot of options. One of the recommendations is - are you doing enough dieting or exercise? And if the patient was like, you know, I'm not eating even a lot, but I'm gaining weight. Or it was perhaps psychosomatic because we didn't have the molecular language to be able to explain what was going on. I think that Ozempic clearly has shown that when we are affecting a set of receptors in the body, perhaps in the gut, it's changing many different things. Not only like food intake, but also alcohol intake and how people feel. I think that is definitely a breakthrough. Where are we going from here? I think that this is the beginning of a long conversation in which we are going to be looking for options not only to reduce the amount of food, but actually to steer food choices from the gut. Because the gut is still as an external surface. And that's what I've mentioned that the discovery that these neuro pot cells can guide our food choices, I think that is very attractive for future options on how we are going to steer decision making.

So, let me ask a final question. You partly just answered it, but where do you see this field going? What are you excited about and what do you think the next frontiers will be?

I think that I'm a little bit more close to nature. I think that on moving forward, there's all obviously a lot of technologies and molecules that are going to be developed to perhaps treat some disorders. Not only related to the body, but also to the mind. Chronic depression and so on and so forth. But I think a lot of these elements have already been explored in nature. And if we look back anthropologically, people were solving the issue of medicine with their environment. In fact, what we call metropolitan medicine evolved largely from natural medicine. And in fact, today, 80% of the world, they still rely directly on plants and other compounds that are directly from plants for healthcare. I think that there is a lot to learn in there and a lot to merge, especially with the new technologies on diagnostics. And I think that that's a very exciting area to keep nature in mind. And when I said nature is like our relationship with environment, right?

Bio

Diego V. Bohorquez is an associate professor of medicine, associate professor in molecular genetics and microbiology, associate professor of cell biology, associate research professor in neurobiology, and an associate professor in pathology at Duke University's Department of Medicine. Bohorquez is a gut-brain neuroscientist and holds a Ph.D. from North Carolina State University. His research focus is to unveil how the brain perceives what the gut feels, how food in the intestine is sensed by our body, and how a sensory signal from a nutrient is transformed into an electrical signal that alters behavior.

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An avalanche of information besets us on what to eat. It comes from the news, from influencers of every ilk, from scientists, from government, and of course from the food companies. Super foods? Ultra-processed foods? How does one find a source of trust and make intelligent choices for both us as individuals and for the society as a whole. A new book helps in this quest, a book entitled Food Intelligence: the Science of How Food Both Nourishes and Harms Us. It is written by two highly credible and thoughtful people who join us today.Julia Belluz is a journalist and a contributing opinion writer for the New York Times. She reports on medicine, nutrition, and public health. She's been a Knight Science Journalism Fellow at MIT and holds a master's in science degree from the London School of Economics and Political Science. Dr. Kevin Hall trained as a physicist as best known for pioneering work on nutrition, including research he did as senior investigator and section chief at the National Institutes of Health. His work is highly regarded. He's won awards from the NIH, from the American Society of Nutrition, the Obesity Society and the American Physiological Society.

Interview Transcript

Thank you both very much for being with us. And not only for being with us, but writing such an interesting book. I was really eager to read it and there's a lot in there that people don't usually come across in their normal journeys through the nutrition world. So, Julia, start off if you wouldn't mind telling us what the impetus was for you and Kevin to do this book with everything else that's out there.

Yes, so there's just, I think, an absolute avalanche of information as you say about nutrition and people making claims about how to optimize diet and how best to lose or manage weight. And I think what we both felt was missing from that conversation was a real examination of how do we know what we know and kind of foundational ideas in this space. You hear a lot about how to boost or speed up your metabolism, but people don't know what metabolism is anyway. You hear a lot about how you need to maximize your protein, but what is protein doing in the body and where did that idea come from? And so, we were trying to really pair back. And I think this is where Kevin's physics training was so wonderful. We were trying to look at like what are these fundamental laws and truths. Things that we know about food and nutrition and how it works in us, and what can we tell people about them. And as we kind of went through that journey it very quickly ended up in an argument about the food environment, which I know we're going to get to.

We will. It's really interesting. This idea of how do we know what we know is really fascinating because when you go out there, people kind of tell us what we know. Or at least what they think what we know. But very few people go through that journey of how did we get there. And so people can decide on their own is this a credible form of knowledge that I'm being told to pursue. So Kevin, what do you mean by food intelligence?

Coming from a completely different background in physics where even as we learn about the fundamental laws of physics, it's always in this historical context about how we know what we know and what were the kind of key experiments along the way. And even with that sort of background, I had almost no idea about what happened to food once we ate it inside our bodies. I only got into this field by a happenstance series of events, which is probably too long to talk about this podcast. But to get people to have an appreciation from the basic science about what is going on inside our bodies when we eat. What is food made out of? As best as we can understand at this current time, how does our body deal with. Our food and with that sort of basic knowledge about how we know what we know. How to not be fooled by these various sound bites that we'll hear from social media influencers telling you that everything that you knew about nutrition is wrong. And they've been hiding this one secret from you that's been keeping you sick for so long to basically be able to see through those kinds of claims and have a bedrock of knowledge upon which to kind of evaluate those things. That's what we mean by food intelligence.

It makes sense. Now, I'm assuming that food intelligence is sort of psychological and biological at the same time, isn't it? Because that there's what you're being told and how do you process that information and make wise choices. But there's also an intelligence the body has and how to deal with the food that it's receiving. And that can get fooled too by different things that are coming at it from different types of foods and stuff. We'll get to that in a minute, but it's a very interesting concept you have, and wouldn't it be great if we could all make intelligent choices? Julia, you mentioned the food environment. How would you describe the modern food environment and how does it shape the choices we make?

It's almost embarrassing to have this question coming from you because so much of our understanding and thinking about this idea came from you. So, thank you for your work. I feel like you should be answering this question. But I think one of the big aha moments I had in the book research was talking to a neuroscientist, who said the problem in and of itself isn't like the brownies and the pizza and the chips. It's the ubiquity of them. It's that they're most of what's available, along with other less nutritious ultra-processed foods. They're the most accessible. They're the cheapest. They're kind of heavily marketed. They're in our face and the stuff that we really ought to be eating more of, we all know we ought to be eating more of, the fruits and vegetables, fresh or frozen. The legumes, whole grains. They're the least available. They're the hardest to come by. They're the least accessible. They're the most expensive. And so that I think kind of sums up what it means to live in the modern food environment. The deck is stacked against most of us. The least healthy options are the ones that we're inundated by. And to kind of navigate that, you need a lot of resources, wherewithal, a lot of thought, a lot of time. And I think that's kind of where we came out thinking about it. But if anyone is interested in knowing more, they need to read your book Food Fight, because I think that's a great encapsulation of where we still are basically.

Well, Julie, it's nice of you to say that. You know what you reminded me one time I was on a panel and a speaker asks the audience, how many minutes do you live from a Dunkin Donuts? And people sort of thought about it and nobody was more than about five minutes from a Dunkin Donuts. And if I think about where I live in North Carolina, a typical place to live, I'm assuming in America. And boy, within about five minutes, 10 minutes from my house, there's so many fast-food places. And then if you add to that the gas stations that have foods and the drug store that has foods. Not to mention the supermarkets. It's just a remarkable environment out there. And boy, you have to have kind of iron willpower to not stop and want that food. And then once it hits your body, then all heck breaks loose. It's a crazy, crazy environment, isn't it? Kevin, talk to us, if you will, about when this food environment collides with human biology. And what happens to normal biological processes that tell us how much we should eat, when we should stop, what we should eat, and things like that.

I think that that is one of the newer pieces that we're really just getting a handle on some of the science. It's been observed for long periods of time that if you change a rat's food environment like Tony Sclafani did many, many years ago. That rats aren't trying to maintain their weight. They're not trying to do anything other than eat whatever they feel like. And, he was having a hard time getting rats to fatten up on a high fat diet. And he gave them this so-called supermarket diet or cafeteria diet composed of mainly human foods. And they gained a ton of weight. And I think that pointed to the fact that it's not that these rats lacked willpower or something like that. That they weren't making these conscious choices in the same way that we often think humans are entirely under their conscious control about what we're doing when we make our food choices. And therefore, we criticize people as having weak willpower when they're not able to choose a healthier diet in the face of the food environment. I think the newer piece that we're sort of only beginning to understand is how is it that that food environment and the foods that we eat might be changing this internal symphony of signals that's coming from our guts, from the hormones in our blood, to our brains and the understanding that of food intake. While you might have control over an individual meal and how much you eat in that individual meal is under biological control. And what are the neural systems and how do they work inside our brains in communicating with our bodies and our environment as a whole to shift the sort of balance point where body weight is being regulated. To try to better understand this really intricate interconnection or interaction between our genes, which are very different between people. And thousands of different genes contributing to determining heritability of body size in a given environment and how those genes are making us more or less susceptible to these differences in the food environment. And what's the underlying biology? I'd be lying to say if that we have that worked out. I think we're really beginning to understand that, but I hope what the book can give people is an appreciation for the complexity of those internal signals and that they exist. And that food intake isn't entirely under our control. And that we're beginning to unpack the science of how those interactions work.

It's incredibly interesting. I agree with you on that. I have a slide that I bet I've shown a thousand times in talks that I think Tony Sclafani gave me decades ago that shows laboratory rats standing in front of a pile of these supermarket foods. And people would say, well, of course you're going to get overweight if that's all you eat. But animals would eat a healthy diet if access to it. But what they did was they had the pellets of the healthy rat chow sitting right in that pile.

Exactly.

And the animals ignore that and overeat the unhealthy food. And then you have this metabolic havoc occur. So, it seems like the biology we've all inherited works pretty well if you have foods that we've inherited from the natural environment. But when things become pretty unnatural and we have all these concoctions and chemicals that comprise the modern food environment the system really breaks down, doesn't it?

Yeah. And I think that a lot of people are often swayed by the idea as well. Those foods just taste better and that might be part of it. But I think that what we've come to realize, even in our human experiments where we change people's food environments... not to the same extent that Tony Sclafani did with his rats, but for a month at a time where we ask people to not be trying to gain or lose weight. And we match certain food environments for various nutrients of concern. You know, they overeat diets that are higher in these so-called ultra-processed foods and they'd spontaneously lose weight when we remove those from the diet. And they're not saying that the foods are any more or less pleasant to eat. There's this underlying sort of the liking of foods is somewhat separate from the wanting of foods as neuroscientists are beginning to understand the different neural pathways that are involved in motivation and reward as opposed to the sort of just the hedonic liking of foods. Even the simple explanation of 'oh yeah, the rats just like the food more' that doesn't seem to be fully explaining why we have these behaviors. Why it's more complicated than a lot of people make out.

Let's talk about ultra-processed foods and boy, I've got two wonderful people to talk to about that topic. Julia, let's start with your opinion on this. So tell us about ultra-processed foods and how much of the modern diet do they occupy?

So ultra-processed foods. Obviously there's an academic definition and there's a lot of debate about defining this category of foods, including in the US by the Health and Human Services. But the way I think about it is like, these are foods that contain ingredients that you don't use in your home kitchen. They're typically cooked. Concocted in factories. And they now make up, I think it's like 60% of the calories that are consumed in America and in other similar high-income countries. And a lot of these foods are what researchers would also call hyper palatable. They're crossing these pairs of nutrient thresholds like carbohydrate, salt, sugar, fat. These pairs that don't typically exist in nature. So, for the reasons you were just discussing they seem to be particularly alluring to people. They're again just like absolutely ubiquitous and in these more developed contexts, like in the US and in the UK in particular. They've displaced a lot of what we would think of as more traditional food ways or ways that people were eating. So that's sort of how I think about them.

You know, if you go to a supermarket these days, it's pretty hard to find a part of the supermarket that doesn't have these foods. You know, whole entire aisles of processed cereals and candies and chips and soft drinks and yogurts, frozen foods, yogurts. I mean, it's just, it's all over the place. And you know, given that if the average is 60% of calories, and there are plenty of people out there who aren't eating any of that stuff at all. For the other people who are, the number is way higher. And that, of course, is of great concern. So there have been hundreds of studies now on ultra-processed foods. It was a concept born not that long ago. And there's been an explosion of science and that's all for the good, I think, on these ultra-processed foods. And perhaps of all those studies, the one discussed most is one that you did, Kevin. And because it was exquisitely controlled and it also produced pretty striking findings. Would you describe that original study you did and what you found?

Sure. So, the basic idea was one of the challenges that we have in nutrition science is accurately measuring how many calories people eat. And the best way to do that is to basically bring people into a laboratory and measure. Give them a test meal and measure how many calories they eat. Most studies of that sort last for maybe a day or two. But I always suspected that people could game the system if for a day or two, it's probably not that hard to behave the way that the researcher wants, or the subject wants to deceive the researcher. We decided that what we wanted to do was bring people into the NIH Clinical Center. Live with us for a month. And in two two-week blocks, we decided that we would present them with two different food environments essentially that both provided double the number of calories that they would require to maintain their body weight. Give them very simple instructions. Eat as much or as little as you'd like. Don't be trying to change your weight. We're not going to tell you necessarily what the study's about. We're going to measure lots of different things. And they're blinded to their weight measurements and they're wearing loose fitting scrubs and things like that, so they can't tell if their clothes are getting tighter or looser. And so, what we did is in for one two-week block, we presented people with the same number of calories, the same amount of sugar and fat and carbs and fiber. And we gave them a diet that was composed of 80% of calories coming from these ultra-processed foods. And the other case, we gave them a diet that was composed of 0% of calories from ultra-processed food and 80% of the so-called minimally processed food group. And what we then did was just measured people's leftovers essentially. And I say we, it was really the chefs and the dieticians at the clinical center who are doing all the legwork on this. But what we found was pretty striking, which was that when people were exposed to this highly ultra-processed food environment, despite being matched for these various nutrients of concern, they overate calories. Eating about 500 calories per day on average, more than the same people in the minimally processed diet condition. And they gained weight and gained body fat. And, when they were in the minimally processed diet condition, they spontaneously lost weight and lost body fat without trying in either case, right? They're just eating to the same level of hunger and fullness and overall appetite. And not reporting liking the meals any more or less in one diet versus the other. Something kind of more fundamental seemed to have been going on that we didn't fully understand at the time. What was it about these ultra-processed foods? And we were clearly getting rid of many of the things that promote their intake in the real world, which is that they're convenient, they're cheap, they're easy to obtain, they're heavily marketed. None of that was at work here. It was something really about the meals themselves that we were providing to people. And our subsequent research has been trying to figure out, okay, well what were the properties of those meals that we were giving to these folks that were composed primarily of ultra-processed foods that were driving people to consume excess calories?

You know, I've presented your study a lot when I give talks. It's nice hearing it coming from you rather than me. But a couple of things that interest me here. You use people as their own controls. Each person had two weeks of one diet and two weeks of another. That's a pretty powerful way of providing experimental control. Could you say just a little bit more about that?

Yeah, sure. So, when you design a study, you're trying to maximize the efficiency of the study to get the answers that you want with the least number of participants while still having good control and being able to design the study that's robust enough to detect a meaningful effect if it exists. One of the things that you do when you analyze studies like that or design studies like that, you could just randomize people to two different groups. But given how noisy and how different between people the measurement of food intake is we would've required hundreds of people in each group to detect an effect like the one that we discovered using the same person acting as their own control. We would still be doing the study 10 years later as opposed to what we were able to do in this particular case, which is completed in a year or so for that first study. And so, yeah, when you kind of design a study that way it's not always the case that you get that kind of improvement in statistical power. But for a measurement like food intake, it really is necessary to kind of do these sorts of crossover type studies where each person acts as their own control.

So put the 500 calorie increment in context. Using the old fashioned numbers, 3,500 calories equals a pound. That'd be about a pound a week or a lot of pounds over a year. But of course, you don't know what would happen if people were followed chronically and all that. But still 500 calories is a whopping increase, it seems to me.

It sure is. And there's no way that we would expect it to stay at that constant level for many, many weeks on end. And I think that's one of the key questions going forward is how persistent is that change. And how does something that we've known about and we discuss in our books the basic physiology of how both energy expenditure changes as people gain and lose weight, as well as how does appetite change in a given environment when they gain and lose weight? And how do those two processes eventually equate at a new sort of stable body weight in this case. Either higher or lower than when people started the program of this diet manipulation. And so, it's really hard to make those kinds of extrapolations. And that's of course, the need for further research where you have longer periods of time and you, probably have an even better control over their food environment as a result.

I was surprised when I first read your study that you were able to detect a difference in percent body fat in such a short study. Did that surprise you as well?

Certainly the study was not powered to detect body fat changes. In other words, we didn't know even if there were real body fat changes whether or not we would have the statistical capabilities to do that. We did use a method, DXA, which is probably one of the most precise and therefore, if we had a chance to measure it, we had the ability to detect it as opposed to other methods. There are other methods that are even more precise, but much more expensive. So, we thought that we had a chance to detect differences there. Other things that we use that we also didn't think that we necessarily would have a chance to detect were things like liver fat or something like that. Those have a much less of an ability. It's something that we're exploring now with our current study. But, again, it's all exploratory at that point.

So what can you tell us about your current study?

We just wrapped it up, thankfully. What we were doing was basically re-engineering two new ultra-processed diets along parameters that we think are most likely the mechanisms by which ultra-processed meals drove increased energy intake in that study. One was the non-beverage energy density. In other words, how many calories per gram of food on the plate, not counting the beverages. Something that we noticed in the first study was that ultra-processed foods, because they're essentially dried out in the processing for reasons of food safety to prevent bacterial growth and increased shelf life, they end up concentrating the foods. They're disrupting the natural food matrix. They last a lot longer, but as a result, they're a more concentrated form of calories. Despite being, by design, we chose the overall macronutrients to be the same. They weren't necessarily higher fat as we often think of as higher energy density. What we did was we designed an ultra-processed diet that was low in energy density to kind of match the minimally processed diet. And then we also varied the number of individual foods that were deemed hyper palatable according to kind of what Julia said that crossed these pairs of thresholds for fat and sugar or fat and salt or carbs and salt. What we noticed in the first study was that we presented people with more individual foods on the plate that had these hyper palatable combinations. And I wrestle with the term terminology a little bit because I don't necessarily think that they're working through the normal palatability that they necessarily like these foods anymore because again, we asked people to rate the meals and they didn't report differences. But something about those combinations, regardless of what you call them, seemed to be driving that in our exploratory analysis of the first study. We designed a diet that was high in energy density, but low in hyper palatable foods, similar to the minimally processed. And then their fourth diet is with basically low in energy density and hyper palatable foods. And so, we presented some preliminary results last year and what we were able to show is that when we reduced both energy density and the number of hyper palatable foods, but still had 80% of calories from ultra-processed foods, that people more or less ate the same number of calories now as they did when they were the same people were exposed to the minimally processed diet. In fact they lost weight, to a similar extent as the minimally processed diet. And that suggests to me that we can really understand mechanisms at least when it comes to calorie intake in these foods. And that might give regulators, policy makers, the sort of information that they need in order to target which ultra-processed foods and what context are they really problematic. It might give manufacturers if they have the desire to kind of reformulate these foods to understand which ones are more or less likely to cause over consumption. So, who knows? We'll see how people respond to that and we'll see what the final results are with the entire study group that, like I said, just finished, weeks ago.

I respond very positively to the idea of the study. The fact that if people assume ultra-processed foods are bad actors, then trying to find out what it is about them that's making the bad actors becomes really important. And you're exactly right, there's a lot of pressure on the food companies now. Some coming from public opinion, some coming from parts of the political world. Some from the scientific world. And my guess is that litigation is going to become a real actor here too. And the question is, what do you want the food industry to do differently? And your study can really help inform that question. So incredibly valuable research. I can't wait to see the final study, and I'm really delighted that you did that. Let's turn our attention for a minute to food marketing. Julia, where does food marketing fit in all this?

Julia - What I was very surprised to find while we were researching the book was this deep, long history of calls against marketing junk food in particular to kids. I think from like the 1950s, you have pediatrician groups and other public health professionals saying, stop this. And anyone who has spent any time around small children knows that it works. We covered just like a little, it was from an advocacy group in the UK that exposed aid adolescents to something called Triple Dip Chicken. And then asked them later, pick off of this menu, I think it was like 50 items, which food you want to order. And they all chose Triple Dip chicken, which is, as the name suggests, wasn't the healthiest thing to choose on the menu. I think we know obviously that it works. Companies invest a huge amount of money in marketing. It works even in ways like these subliminal ways that you can't fully appreciate to guide our food choices. Kevin raised something really interesting was that in his studies it was the foods. So, it's a tricky one because it's the food environment, but it's also the properties of the foods themselves beyond just the marketing. Kevin, how do you think about that piece? I'm curious like.

Kevin - I think that even if our first study and our second study had turned out there's no real difference between these artificial environments that we've put together where highly ultra-processed diets lead to excess calorie intake. If that doesn't happen, if it was just the same, it wouldn't rule out the fact that because these foods are so heavily marketed, because they're so ubiquitous. They're cheap and convenient. And you know, they're engineered for many people to incorporate into their day-to-day life that could still promote over consumption of calories. We just remove those aspects in our very artificial food environment. But of course, the real food environment, we're bombarded by these advertisements and the ubiquity of the food in every place that you sort of turn. And how they've displaced healthy alternatives, which is another mechanism by which they could cause harm, right? It doesn't even have to be the foods themselves that are harmful. What do they displace? Right? We only have a certain amount the marketers called stomach share, right? And so, your harm might not be necessarily the foods that you're eating, but the foods that they displaced. So even if our experimental studies about the ultra-processed meals themselves didn't show excess calorie intake, which they clearly did, there's still all these other mechanisms to explore about how they might play a part in the real world.

You know, the food industry will say that they're agnostic about what foods they sell. They just respond to demand. That seems utter nonsense to me because people don't overconsume healthy foods, but they do overconsume the unhealthy ones. And you've shown that to be the case. So, it seems to me that idea that they can just switch from this portfolio of highly processed foods to more healthy foods just doesn't work out for them financially. Do you think that's right?

I honestly don't have that same sort of knee jerk reaction. Or at least I perceive it as a knee jerk reaction, kind of attributing malice in some sense to the food industry. I think that they'd be equally happy if they could get you to buy a lot and have the same sort of profit margins, a lot of a group of foods that was just as just as cheap to produce and they could market. I think that you could kind of turn the levers in a way that that would be beneficial. I mean, setting aside for example, that diet soda beverages are probably from every randomized control trial that we've seen, they don't lead to the same amount of weight gain as the sugar sweetened alternatives. They're just as profitable to the beverage manufacturers. They sell just as many of them. Now they might have other deleterious consequences, but I don't think that it's necessarily the case that food manufacturers have to have these deleterious or unhealthy foods as their sole means of attaining profit.

Thanks for that. So, Julia, back to you. You and Kevin point out in your book some of the biggest myths about nutrition. What would you say some of them are?

I think one big, fundamental, overarching myth is this idea that the problem is in us. That this rise of diet related diseases, this explosion that we've seen is either because of a lack of willpower. Which you have some very elegant research on this that we cite in the book showing willpower did not collapse in the last 30, 40 years of this epidemic of diet related disease. But it's even broader than that. It's a slow metabolism. It's our genes. Like we put the problem on ourselves, and we don't look at the way that the environment has changed enough. And I think as individuals we don't do that. And so much of the messaging is about what you Kevin, or you Kelly, or you Julia, could be doing better. you know, do resistance training. Like that's the big thing, like if you open any social media feed, it's like, do more resistance training, eat more protein, cut out the ultra-processed foods. What about the food environment? What about the leaders that should be held accountable for helping to perpetuate these toxic food environments? I think that that's this kind of overarching, this pegging it and also the rise of personalized nutrition. This like pegging it to individual biology instead of for whatever the claim is, instead of thinking about how did environments and don't want to have as part of our lives. So that's kind of a big overarching thing that I think about.

It makes sense. So, let's end on a positive note. There's a lot of reason to be concerned about the modern food environment. Do you see a helpful way forward and what might be done about this? Julia, let's stay with you. What do you think?

I think so. We spent a lot of time researching history for this book. And a lot of things that seem impossible are suddenly possible when you have enough public demand and enough political will and pressure. There are so many instances and even in the history of food. We spend time with this character Harvey Wiley, who around the turn of the century, his research was one of the reasons we have something like the FDA protecting the food supply. That gives me a lot of hope. And we are in this moment where a lot of awareness is being raised about the toxic food environment and all these negative attributes of food that people are surrounded by. I think with enough organization and enough pressure, we can see change. And we can see this kind of flip in the food environment that I think we all want to see where healthier foods become more accessible, available, affordable, and the rest of it.

Sounds good. Kevin, what are your thoughts?

Yes, I just extend that to saying that for the first time in history, we sort of know what the population of the planet is going to be that we have to feed in the future. We're not under this sort of Malthusian threat of not being able to know where the population growth is going to go. We know it's going to be roughly 10 billion people within the next century. And we know we've got to change the way that we produce and grow food for the planet as well as for the health of people. We know we've got to make changes anyway. And we're starting from a position where per capita, we're producing more protein and calories than any other time in human history, and we're wasting more food. We actually know we're in a position of strength. We don't have to worry so acutely that we won't be able to provide enough food for everybody. It's what kind of food are we going to produce? How are we going to produce it in the way that's sustainable for both people and the planet? We have to tackle that anyway. And for the folks who had experienced the obesity epidemic or finally have drugs to help them and other kinds of interventions to help them. That absolve them from this idea that it's just a matter of weak willpower if we finally have some pharmaceutical interventions that are useful. So, I do see a path forward. Whether or not we take that is another question.

Bios

Dr. Kevin Hall is the section chief of Integrative Physiology Section in the Laboratory of Biological Modeling at the NIH National Institute of Diabetes and Digestive and Kidney Diseases. Kevin's laboratory investigates the integrative physiology of macronutrient metabolism, body composition, energy expenditure, and control of food intake. His main goal is to better understand how the food environment affects what we eat and how what we eat affects our physiology. He performs clinical research studies as well as developing mathematical models and computer simulations to better understand physiology, integrate data, and make predictions. In recent years, he has conducted randomized clinical trials to study how diets high in ultra-processed food may cause obesity and other chronic diseases. He holds a Ph.D. from McGill University.

Julia Belluz is a Paris-based journalist and a contributing opinion writer to the New York Times, she has reported extensively on medicine, nutrition, and global public health from Canada, the US, and Europe. Previously, Julia was Vox's senior health correspondent in Washington, DC, a Knight Science Journalism fellow at the Massachusetts Institute of Technology in Cambridge, and she worked as a reporter in Toronto and London. Her writing has appeared in a range of international publications, including the BMJ, the Chicago Tribune, the Economist, the Globe and Mail, Maclean's, the New York Times, ProPublica, and the Times of London. Her work has also had an impact, helping improve policies on maternal health and mental healthcare for first responders at the hospital- and state-level, as well as inspiring everything from scientific studies to an opera. Julia has been honored with numerous journalism awards, including the 2016 Balles Prize in Critical Thinking, the 2017 American Society of Nutrition Journalism Award, and three Canadian National Magazine Awards (in 2007 and 2013). In 2019, she was a National Academies of Sciences, Engineering, and Medicine Communications Award finalist. She contributed chapters on public health journalism in the Tactical Guide to Science Journalism, To Save Humanity: What Matters Most for a Healthy Future, and was a commissioner for the Global Commission on Evidence to Address Societal Challenges.

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Interview Summary

You know I really like the innovative nature of Food On The Move, and I'm eager for you to tell us more about what it involves. But before we do that, how does a young, highly successful musician turn to battling food insecurity? What led you to create Food On The Move?

It took me years to say I even created it. I didn't even use the term founder because I really had this sense of partnership that was a part of how it came to be. But I did found or 'start' Food On The Move because I have just a deep sense of gratitude in my life experience and also maybe a calling? I call it the tap on the shoulder that said there's more for you to do. There's more for me to do. And I didn't really know what that meant. I wanted to invest in Oklahoma and where we're from because as a musician, first you travel, you leave, you go out, you connect with people all over the world. But there's something about building and doing well for your community from the town you're from. And I was inspired by a former US ambassador. A man named Edward Perkins, who was an incredible representative of our country. He worked in some of the most difficult parts of the world representing the US and working with other nations. And his story struck me so deeply because he found ways to partner and transform communities as an ambassador. And I got to know him after his time as an ambassador because he was teaching as a professor at OU (Oklahoma University), in Oklahoma. And I asked him, I said - I want to honor your life. I want to learn from you. If I was to begin to really impact my community, Oklahoma where I'm from and maybe beyond, where would you begin? And he said, I would start with food.

That's so interesting. You know, your concept of partnership is so interesting. I'd like to dive into that a little bit deeper in a little bit. But first, tell us about your organization and what it does, how it works, what it tries to accomplish.

Yes. So, inspired by Ambassador Perkins' example, we set out to ask the right questions more than have the answers. And in 2014, I just basically cold called everyone in the community that worked in food - from the food bank to the food pantries and said ‘help me understand the gaps.’ Help me understand where it's hard to accomplish change. And the term food desert began coming up more and more. And food deserts are communities without grocery stores. So, think of it as the canary in the mine. Sort of when a grocery store goes, the neighborhood is declining. Because they're small margin organizations they have a hard time staying afloat and when they go it's hard to bring them back because you need either a company like a big chain or a small business that doesn't have a lot of resources. And oftentimes that decline continues, and it impacts the community. So, with Food On The Move I basically brought together partners to create an access point in food deserts where it's was all in kind. From food trucks that could bring great, tasty food and give people dignity and excitement and energy, to partners that are doing food safety training and teaching people to cook. And places like Oklahoma State University extension where they train people about how to prepare food because they may not know. And so, all these partners came together, and we basically spent five years just learning and serving people in those communities. And focusing on an environment that was not about raising a bunch of money; it was really about who is already in this space that we can garner relationships with and get to know the communities. And now those events continue to be flagships. We call them food and resource festivals. They are a pay-as-you-can. You show up, you get access to fresh produce, you have food trucks, you have wraparound services. You have people that are in the community, in different nonprofits, for-profits, and government organizations that we all collaborate with. And we reach people where they are while serving and getting to know them and learning from them. And through those relationships, through those events - which we still do - what it's brought us to is the innovation and education side, and ultimately transformation. We realized in order to change food deserts, end food deserts, bring grocery stores back, that we had to get to the heart of the food system. Which is we had to be teaching people to grow things again, rebuild the local foundation of farmers being trained, use new, innovative systems like indoor growing and aquaponics, hydroponics. And basically, we had to kind of build the foundation back that's been lost since post World War II in our community, like many places. And that means a food hub to bridge farmers to distributors. That means training those farmers for the future. And it ultimately means building a new model for a grocery store. So, we are at the heart of that now with a project we call Food Home, where we are building a campus that is like a microcosm of the food system. Hopefully could be the end of this year, we'll see. Construction is always tricky. But, for sure by the start of first quarter next year, we'll be opening a 10,000 square foot urban farm, which is a training facility, and producing hundreds of thousands of pounds of food every year, and this is really the launchpad for future farmers.

My God, I mean, and one of those things you mentioned would be wonderful to dive into and talk about a lot. Because I mean, each is impressive in its own right. But you bring them together, you're probably doing some of the most extensive, impressive things I know of around the country. Let me ask how you address the fundamental issue that we've actually faced ourselves. So communities often feel set upon by outsiders coming in to help. You know, it could be a philanthropy, it could be universities, it could be somebody, you know, who's just coming in well-meaning, wanting to help. But nonetheless may not know the communities or understand the realities of day-to-day life and things like that. And people from communities have often told us that 'we're in the best position to come up with solutions that will work for the members of our own community.' How did you work through those things?

Well, this is always why my story elevator pitch tends to be too long. Because I want to actually talk about that element. It's not super elevator pitchy because what it involves is building relationships and trust and what I first learned from Ambassador Perkins. I'll tell you a small story of his example and it really rocked me. I asked him where would you start if you wanted to change community? Because I'd learned from his story that he had actually done it. He was sent to South Africa at the heart of the Apartheid Movement to with a mission from at the time President Ronald Reagan, to free Nelson Mandela from prison and help dismantle the Apartheid system. This is about as high a mark as anybody could have. And he had no policy. They said you're going to make policy. And what he did was so extraordinary, and I think is the mark of his success. And that's, to answer your question, he said, I recognized that every ambassador had held court. You are one step away from the president of the United States, which means you're always the most powerful person in the room. And other ambassadors, he'd ask them to come to him. But you had this deep divide between Black and white, deep divide between economics. And so, what he did was he told his team when he went to South Africa, he said, put the American flags on the front of the car, roll the windows down and take me to the townships. Take me to the neighborhoods. They need to know I'm here. And he took the time to build real relationships and build trust with communities. Black, white, rich, and poor, you know, old and young. He really did the time. And so that model, though obviously South Africa is a deeply entrenched community that, you know, especially that time.

And this is kind of world politics, but I listened to that. And I thought, wow, we have a divide in our own community. And it's true of so many American cities. And where people, they see an area and they say that's not my community. They're going to come to me. And so, Food On The Move is built on we will build a partnership-based foundation which is like a block party where you walk up, and I'm a musician, I'm a DJ. So, we have a DJ playing music, we have food trucks. It smells great. You have smiling faces. You have a feeling that when you go there, you're not there, like, I need help and I'm in a soup kitchen. It's like there's a community party and you get invited and everyone's available to go there because if you want to give, you can go. If you don't have a dollar in your pocket, you go. And everybody leaves with the same treatment. And that foundation, the way we go about building those relationships, that is the heart and soul of how we are getting to the question and then trying to answer: we need more grocery stores, and we need more farmers. Because we heard it from the neighborhood. And I'll wrap up the answer a little bit which is to say we have multiple community farms as well as our own training farms. And we've worked in middle schools to teach young people to grow things with high-end aquaponics. You know, statistically the worse school in the city. But we've seen it just rocket people to engagement and better education and being fired up to come to school. But the community grow beds are the real test because you can't just drop a community grow bed and say, ‘Hey, isn't this awesome? Here's your grow bed.’ You have to stay engaged with community, but you also have to invite them to be participants. And so, we work with our neighbors. We treat one another as neighbors, and you are right, it is wrought with pick your cliche. You know, the complex of the outsider coming in with money. The contrast between racial issues and economic issues. It's so wrought with problems potentially. But I believe that real solutions are possible when you build relationships.

It sounds like one of the, you didn't say this directly, but one of the most important things you did was listen. Tell me about that a little more.

Well, yes. I mean, I said it. I kind of coined this phrase now because I realize it's so true. We really started with I think good questions, not good answers. And so, the listening... first of all, the listening started with people that were doing work. So, if you went to the food bank, the question wasn't, ‘hey, we're here to help.’ This is what we want to do. It was what's going on? You're the food bank, you guys have been here since the '80s. And hey, you're the health department. Hey, you're a food truck, like, what do you see? And I determined early that we needed to always have three pillars. We need to always have representation of for-profit, non-profit, and government agencies at some level. And so, a food truck is a business, right? They understand how hard it is to get people to show up and make a living, right? And you know, a nonprofit or an agency they know about service, they know about the stats. And frankly, however you are on the political spectrum, the government agencies, whatever they happen to be, they have a role to play. They have, whether big or small. Again, people of different walks of life have different views on that. But they should be a part of the conversation no matter what. And so, that was the first step. And then I like to say, an example Kelly, of kind of the dynamic shift is - if you walk up to somebody you barely know, you're not going to tell them like, ‘hey man, I'm not sure about that shirt. Or you got something in your tooth,’ you know? Or, ‘have you really considered redecorating your house? Like, it's kind of dated.’ Those are things you get to say to friends. You know, you tell a friend, ‘hey man, you know, suck it in. You're taking a picture.’ You know? And so at the foundation, the questions we were asking were also why do you think this has happened? Why is a neighborhood that was a thriving new neighborhood in 1965 now dangerous and in decline. And talking with elders. And they became and have become some of our greatest advocates. And you know what? It's not flashy. You show up and you just keep showing up. And you show up when it's rainy and you show up when it's cold. And at some point people go. Wow. Like they're actually going to do this. So, you know, we're still doing it. We're not there. There's no finish line on this.

So consistent with what we found in our own work about the importance of showing up. I'm happy that you raised that particular term. Speaking of terms, when I introduced you there, I used this term that I pulled right from your website about the legacy issues created by food insecurity. What do you mean by that?

Yes. So legacy issues. You know, people develop heart disease, diabetes, frankly anxiety, ADHD/ADD things. A lot of stuff that's diet and a lot of things that's habit. So, if you grow up in a house that nobody ever cooked really. Because the neighborhood lost its store. Mom and dad were busy. Maybe a single parent home. You know, look, my wife and I have blessed, we have seven children. Wow. And we have a full house. And even with, you know, plenty of resources and plenty of support, it's still hard to do right. It's still hard to eat well. You know, you're running and you're gunning. And so legacy issues are habits. Eating habits. Consumption habits. By the way, poverty does not discriminate on race. Poverty hits whoever it hits, right? And so, Black and white, different backgrounds you'd be speaking with somebody that, 'like I've never seen a red bell pepper. I didn't know that existed. I've never seen What is That's a kiwi. What's a kiwi? I don't want to eat that.' You know? And so, the legacy issues are health, habits, education. Also, if you've never had access to resources, if you've never had an uncle that became an attorney or somebody that knew how to manage money because your neighborhood was a history of decline. You just don't know anybody. Or even worse, you have communities because of poverty that everybody in your family knows somebody that was in jail or was headed to jail because of their climate, their environment. And things that occur because of limited, you know, resources. And things that happen among, you know, communities with less available to them. And you have to take judgment and just throw it across the room. Just completely eject any sense of judgment. And recognize that somebody that's grown up with those different parameters, they're carrying those around. So, you're trying to restart. You're trying to begin again. And say, you know, let's get us back to having as little baggage behind us. Let's get diabetes out of the way. Let's get heart disease (out of the way) and we're going to do it by eating good food. Or getting educated. And it's not going to happen quick. It's going to happen through probably an entire generation if we're lucky.

Now, let me ask a related question about dignity because this comes up in the way you've spoken about this. And in the way our country has addressed hunger. I mean, going back to when the War on Hunger began really in the 1960s, it was a nation's compassionate response to a very real issue that so many people faced. But the solution wasn't to try to give people more financial means so they could buy their own food and not have to face this. It was to give them food. But to do so in ways that really did destroy dignity in many ways. How are you addressing that and how does that term figure into the work you're doing?

Well, I love the way you couch that. And unfortunately, among these discussions, people glom onto certain aspects if they have their own sort of paradigm that's ingrained. And one, you have to throw out ideology and focus on, I think, common sense. And the short answer is we believe in teach a man to fish as the philosophy. There is no way to ultimately change things if your goal is not aligned with creating opportunity, creating, transitioning folks that have not been able to support their families, to finding ways to transform that. And that comes by getting to know one another. That comes with creating education. And that comes with looking at the whole system. And so, when I brought sort of to my team this answer or this proposal of why we need to build Food Home. The Food Home campus. It wasn't just that I had some epiphany that I walked into the desert and came back with an idea. It was built around the work we were doing. And we already had somebody that wanted to build a grocery store. We already had somebody that was farm focused, thinking about food hub to bridge the gap with farmers. We had a study that was done by a local foundation that said we don't have enough farmers right now to get all the local food. And we need local because it's more affordable. We shouldn't be paying for our lettuce to travel from California to Oklahoma. We don't need to do that. And so, dignity and building the transition, the future, is about looking at the whole and being willing to do, I think, the hard work. Which is to realize our food, our food economy has to change. And recognizing that opportunity is not a bad word, you know? Economic investment in communities. These are good things. And at the same time, you meet people where they are. You meet them right where they are.

And when COVID happened, our pitch about building Food Home and building the food systems and training people to grow things, it pivoted a little bit. Because people saw for the first time in a generation what it's like when the food's not there. Like you're in Oklahoma and we were the distribution partner for the USDA doing Farm to Family boxes. Food On The Move was. We had trucks that were designated for us from farmers that had been supported by government purchasing to bring food to food banks, and to resources, to communities. And we had a truck that was a state away and we were supposed to go get that truck and give it to people that needed it in our neighborhood in Oklahoma. And we were going guys, if we had a food home, a food hub, a bridge between local farmers, every community would know where their food is coming from. And so there is a food security side of this discussion as well which is that we need to have sovereignty. We need to have structure that gives us access and that builds long-term economic sustainability. And Oklahoma is a great example of this. We used to have a very thriving local farm community system. All my grandparents, my parents, they went to farmer's markets. They bought great food. And many of those folks working in that land because there's not a food hub that bridges this medium farmer to the distributors - they've lost economic ability to scale. And they do better to sell their land to a developer and grow sod or put a bunch of houses on it. And that has got to change.

You know, you reinforce the idea that there's a lot of ingenuity in communities. And lots of good ideas about how to solve the problems. And many times, the people that are wanting to help communities can be helped best by just supporting the ideas that are already there. Because, as I said, we've encountered so much ingenuity from people in the communities who've been thinking about these issues for a long time. Let me ask something. You kind of began this by talking about food deserts and grocery stores leaving areas. And you've come up with a lot of creative ways of compensating for the loss of grocery stores. But what about correcting that problem. What about getting more grocery stores back into these areas? Is that something that you guys deal with?

That's ultimately our mission. I mean, I say the mission is the solution so that I don't want to put it into one square box called a store. But the store departing is at the heart of the key question we're asking. Why? And so, the Food Home campus is a four phased vision. And the first two phases are underway, or about to be open with the food hub and the urban farm. The second two are a community hub, which is teaching and training people to prepare and cook food better, getting urban and rural together. And the last phase, which started as the first, by the way. It began as the first thinking we're just going to get a store. We realized you had to get the food chain right before you could build a better store. And so the model for a store, we believe, is going to be probably a hybrid between a fresh delivery and a physical place that is there living right at the heart of a neighborhood. Let's do an update on this here as we get to opening that door, because I believe what we've seen is the umbrella that allows the small store is still needed. That's, kind of, we're stepping in with a food hub. We're stepping in with a bigger footprint, buying power, larger volume, purchasing local. But really entrepreneurs where single operators are invested in owning and operating that store. They're also committed more to that store. It's not just a corporate line item. I'm interested in studying, frankly, some of the really smart food franchisees that have understood the power of creating economic models that are sustainable. But you have to connect them to a bigger umbrella to help support that medium grocer. It's going to be a combination of those things. But yeah, we have to get stores where you can actually buy your food and it is affordable and it is quality.

Quality becomes an interesting issue here. And I haven't looked at the research literature on this for a little while. When I did, there was some research looking at what happened to the quality of nutrition in neighborhoods where grocery stores had left or had come back in. And it didn't seem to make a lot of difference in terms of overall nutrition profile of the people there. It provided some real benefits. Access. People didn't have to go a long way to get their groceries. Costs tended to come down, so there were some real benefits aside from nutrition. But just focusing on nutrition, of course a big supermarket brings more fresh fruits and vegetables. But it also brings aisle after aisle of highly processed, highly calorie dense foods that aren't necessarily helpful. So, the fact that you're working on the healthy food part of the equation and finding ways to get foods from farms to people, not necessarily from a big food processing plant. From farms to people, is really an important part of the overall picture, isn't it?

Fresh produce is the sort of heart and soul of the food dilemma. And so yes, it is very, very tricky. You know, a little bit like how do you raise a child to have good habits? We're all trying to have good habits and we still eat hamburgers and fries because they're delicious. So, going back to dignity, I do not believe, and this is my perspective mixed with the data and the experience. I don't believe, the opinion side, in deciding whether or not people deserve certain things. And early on when we started the food pop-up events, I suggested, 'hey, call the food trucks. Have the pizza truck come have because they're awesome and they're mobile and they can show up.' And we had some folks that were partners that kind of went well, but that's greasy food and that's, you know, it's X, Y, and Z. And this is what I said to that: it's like, look, our job is first to meet people and treat them like we would want to be treated. And then we work on the produce. And so, with a grocery store, you're absolutely right. You can't just drop good food somewhere and think everybody's going to get healthy. Most people are going to eat what they like. But mostly the barrier to entry on healthy food is economics. People do not have the dollars to buy the kale or to buy the fresh tomatoes. Most people actually do, find that they will, you know, consume that food. But you have to get the generational conversation happening where families have grown up seeing fresh produce. Cooking with fresh produce. And they can actually buy it. And that's not going to happen unless we get food closer. Because the closer food allows us to cut down the margin that's going to transportation and make quality food more affordable.

Makes good sense. So you've been at this a while. What have you learned? How do you look at things differently now than when you started?

I learned that creating change is not for the faint of heart. First of all, you better really sort of revel in a challenge. And also, we've touched on several of the elements of what I've learned. You have to build trust. You can't expect people to just change just because you say so. You also have to be really interested in learning. Like, not just learning because you have to, but you have to be interested in understanding. And I think that's at the heart of getting to solutions. It's not even just asking the right question. It's actually being interested in the answer to that question. Like it's wanting to genuinely know. And so, these are all things I put in and I'll say the last, which is not the sexy one. It's difficult to build a good organization that's sustainable. And we've spent the second half of the Food On The Move journey building a strong team, hiring the right CEO, building a great board, having governance, having sustainability in your culture. I mean, these are business things and you know, I'm the founder. I'm a board member. I'm at the heart of who we are, but we've had to build a team. And so, anybody that wants to make things sustainable or create sustainable change, and this would be my last takeaway to your question, is you have to grow past yourself. You have to be anticipating giving that away. Growing much, much further than the bottleneck of the big idea person. But you also have to stay in stewardship mode. So, that's kind of where I am now is how do we make this continue to grow towards the solutions we're hoping for? And how do I stay engaged, fired up, focused, inspired to get the team involved, but also trust people on the team to do what they have been asked to do.

I'd like to pick up on something that you mentioned along the way, which is work that you're doing on urban farming, and you mentioned things like hydroponics and aquaponics. Tell us a little bit more about that.

Wo we came across hydroponics and aquaponics because when you look at growing methodologies, one of the challenges we have is our eating habits have changed. People don't just eat seasonally. We've become accustomed to getting strawberries year-round and getting all these different flavors. And you can't expect that that's just going to happen. We're not just going to change that and make everybody eat the harvest of Ohio or the harvest of Tulsa. Like we all expect good food when we do go to the store. The economics of food means people are ready to buy certain things. And for a sustainable grocery store, you need to have the things that people will buy. So, aquaponics and hydroponics are new technologies that were pioneered to create high production and high volume in areas that might have different climates. You can grow year round. The things that grow best are leafy greens, but you can grow all kinds of things. Tomatoes, you know, vining plants. Cucumbers. You can grow incredible amounts of food. A large portion of your food can be grown through these indoor systems, and they cost more to start than a traditional dirt farm. But once established they produce year round, they are more resilient with obviously pests and weather and things like that. With aquaponics and hydroponics you have systems that naturally are organic. They need to be organic because that's how they function, you know? Fish tanks, you know, that are naturally fertilizing. The fish are giving the plants what they need. This is cool stuff. So, we were led to those systems because sustainability and better food and more of it for small communities in a place like Oklahoma where you have hot and cold, and if you can grow year round, then you could have a cash crop that somebody could build a business with and provide better for that store. And not be buying it from Mexico or California. I mean, God bless Mexico and California, but we're putting too much food on a truck. And it's older than it should be, and it's sprayed with stuff because it needs to look good when it shows up, and that's hurting everybody. So, we need new methodologies.

Well, and not only are you producing food, but it's a community driven solution because it's right there. People in the community can own it, can run it, can work at it, and things like that. And just it's mere presence probably signals something very positive that is good economically good nutritionally, but also good psychologically, I think. So, let me ask one parting question. Hunger has been an issue in the United States for a long, long time. And it continues to be. And now there have been even more cutbacks than before and the SNAP program and things like that. Are you optimistic that we can address this problem and do you think a local very creative and innovative local solution that you're talking about in Oklahoma, can that be exported and replicated and are you optimistic? Let me just ask you that.

Are you optimistic is an interesting question because I don't think we can afford not to be optimistic. If you ask a parent, are you optimistic your child will eat, there's no choice there. Your child will eat. Or you will die trying to feed them. And I've spoken to, you know, leadership groups and rotary clubs and nonprofits about different aspects of my journey. And I think the heart of this issue is to not make it an option that we don't solve this. We cannot talk about feeding our community. And by the way, I don't mean feeding them just like I said, through nonprofit, but changing the culture and eliminating hunger in this country. And really, it's facing hunger. We can't make it an option that we don't. My perspective is, I think it's going to take, solutions like what Food On the Move is doing, which is at the heart of understanding our food systems. And we are definitely building. Everything we're doing is to try and have a model hoping that what we're doing in Oklahoma, which has a lot of parallels to, you know, whether you're talking about North Carolina or Ohio or Missouri, or Houston. All these communities have a lot of similarities. We believe that if we can show that you build trust, you then develop models, you then train future farmers. You build an infrastructure to launch and bridge the gap between small and medium farmers. And then here's a model for a better store that's sustainable. We believe that we're going to be able to show that that is a long road, but the road that is maybe less traveled but needed. And that could be the difference that's needed. So, it's fingers are crossed.

BIO

Tulsa native Taylor Hanson grew up in a home where artistic expression was encouraged and celebrated. At the age of nine he, along with brothers Isaac and Zac, formed the band HANSON. Just five years later their debut album was released and the lead single, “MMMBop”, hit number one in 27 countries, and earned the group 3 GRAMMY nominations. At the age of 20, he co-founded 3CG Records, allowing the band to produce music on their own terms, and is recognized as a longtime advocate for independent music globally. The group continues to produce meaningful music for its ever-growing fanbase. Hanson possesses a deep commitment to social change. In 2007 he inspired others to make an impact through simple actions, co-founding non-profit Take The Walk, combating extreme poverty in Sub-Saharan Africa. In 2014, he founded Food On The Move, which provides access, education, and innovative solutions, to transform food deserts and the legacy issues created by food insecurity. Since its founding, Food On The Move has distributed millions of pounds of fresh produce to members of the Oklahoma community, and is a leader in the movement to reshape sustainable local food systems. He has been instrumental in a number of community-oriented music initiatives, including contributing to “The Sounds of Black Wall Street”, to commemorate the centennial of the Tulsa Race Massacre, spearheading “For Women Life Freedom” highlighting the human-rights atrocities taking place in Iran, and currently serves as is a National Trustee of the Recording Academy. Hanson, his wife Natalie, and their seven children, make their home in Tulsa, where he was recently named Tulsan of the Year.

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In today's episode, we're discussing the complex and urgent topic of global food demand. The United Nations Sustainable Development Goals, or SDGs, ask countries to make measurable progress in reducing poverty, achieving zero hunger, and supporting every individual in realizing good health. While also mitigating climate change, sustaining the environment and responsible consumption and production habits. Researchers have recommended sustainable diets - planetary health diets. For example, the Eat Lancet Planetary Health Diet. However, others have criticized some of these diets for not addressing the economic and social impacts of transitioning to such diets. Is it possible to balance changing diets, rising incomes, and economic growth with economic feasibility, environmental impact, and long-term sustainability? Well, that's what our goals are today. Our guests today are Andrew Muhammad of the University of Tennessee Institute of Agriculture, and Emiliano Lopez Barrera from Texas A&M. They are my co-authors on a new paper in the Annual Review of Resource Economics entitled Global Food Demand: overcoming Challenges to Healthy and Sustainable Diets.

Interview Summary

Andrew let's begin with you. Why is it important to study the economics of dietary habits and food choices in a global context?

Well, it's important for several reasons, right? When we think both about food security as well as environmental outcomes and maintaining biodiversity, in keeping both human beings and the planet healthy, we really do need to think about this in a global context. One could see agriculture as a global ecosystem where decisions in one country clearly have impacts on outcomes in others. While at the same time, we need to see food as a means by which we satisfy the demands of a global community. Whether it be through our own domestic production or international trade. And then the last thing I'll say, which is really most important are all the actual things we want to tackle and mitigate and correct, fix or improve. Whether it be the environmental issues, global food security outcomes, individual diets, mitigating obesity issues globally, right? It's pretty clear that most of the things affecting human beings in the environment as it relates to agriculture are global in nature, and there's an economic component that we need to consider when addressing these issues in a global context.

Thank you for sharing that. And I am interested to understand what the role of economics in dietary habits is as we explored it in this review paper.

In economics, this is a pretty long history, one could say going back centuries, right? This idea of how income growth impacts food spending on a household or individuals, as well as what economic affluence in development does to sort of how diets transition. And so, for example, it's been long established, right, as individuals get richer, a smaller and smaller share of their income is spent on food. So therefore, food dynamics become less important in [a developed, rich country versus a developing country where a large percentage of income is still spent on food. And what does that mean? That means that while I may find price shocks annoying, and while I may find higher grocery prices annoying, in a developing world that clearly has some implications on the nutritional needs and food decisions far more than it would have on me, for example. But the other thing which is something that has been highlighted for quite some time, and that is this transition from basic staples - from rice, grain, corn, cassava, potatoes, etc. - to more complex food products like high protein dense meat products, fish, milk, dairy, and even highly processed products that are deemed unhealthy. But the point is, as we look at the full spectrum of countries from least developed to most developed, you see this transition from basic staples to these protein dense products as well as complex processed products.

This is a really important point about what are the trends across countries and over time as incomes change and as global prices affect choices. And I do appreciate what you're saying about those of us in, say a country like the United States, where we may be able to absorb some of the shocks that may happen with food prices, we also recognize that there are folks from lower income households where those kinds of price shocks can be really challenging.

That's true.

But this is a different story when we're then talking about developing countries and some of the challenges that they face. Thank you for sharing that. I'm also interested in understanding what do economists mean by a nutritious and sustainable food demand, especially in the context of global or cross-country comparisons. What are some of the things that you uncovered in this review?

Yes, and I think the main thing, which is particularly interesting, is how early diets transition. How quick countries go from being staple dependent to sort of relying more on protein in consumption and demand. And that happens pretty early and so long before you get to say, countries like the United States with a per capita income of around $50,000 per person, you start seeing transitions quite early, right? Whereas income goes from say less than a $1,000 per person to maybe $5,000 and $10,000, you see these transitions right away. And in fact, you begin to see things level off. And what that means is when we think about, for example, animal protein production, which is in the context of dairy and beef, which is considered relatively more harmful to the environment than say poultry production. What you do find is that in these developing countries, they really do transition right away to meat with just minimal income growth. Whereas at the same time, when you start seeing income growth at the higher end of the spectrum, you don't see that much of a change. Now, something that's also unfortunate, what you find is that with income growth, you do see decrease in consumption of vegetables. A part of that is that some staples are counted as vegetables, but another part of that is that wealth and influence doesn't necessarily lead to improved diets. And that's something that's unfortunate. And what it says is that interventions are possibly needed for these improved diets. But to really get back to your question, this idea when we say sort of a nutritious diet, obviously we're thinking about diets that satisfy the nutritional needs of individuals. While at the same time mitigating unhealthy outcomes. Mitigating obesity, cardiovascular disease, etc. But then coupled with that is this whole notion of sustainable agricultural production. And I think one of the difficult things about both nutritious and abundant food as well as environmental outcomes, is we really are thinking about sort of trade-offs and complementarities. Then I think economics gives us a real keen insight into how these things play out.

Andrew, you make me worry that we're locked in. That is as soon as income start to rise, people move to more animal protein-based products. They move away from some fruits and vegetables. And knowing that the environmental consequences of those choices and even the health consequences, my question to you is what kinds of interventions or how do you think about interventions as a way to shape that demand? Is that an appropriate way to think about this?

Alright, so there's a few things. One is just sort of provide nutrition education globally. Having countries and their governments sort of understand these outcomes and then making a concerted effort to educate the public. The other thing is what you often do see is incentivized, for example, fish consumption. Incentivizing poultry production. And you do actually see a lot of incentives for poultry and egg consumption. And I think of like the Gates Foundation in that One Egg a Day initiative to help with child stunting and child growth in the developing world. And so, they're clearly protein alternatives to bovine type products. And I have to be clear here. Like I'm only speaking about this in the context of what's being said, in terms of the environment and animal production. But the other thing I think, it's probably even more important, right? Is this idea that we really do need to rethink how we, both in the developing world as well as in the developed world, rethink how we think about nutrition and eating. And that's just not for developing countries. That's for all countries. And obviously there's one last thing I'll highlight. You do have to be sort of concerned about, say something like taxes. Which would be clearly regressive in the developing world, and probably much more harmful to overall consumer welfare. The point is that taxes and subsidies seem to be the policy instruments of choice.

Great. Thank you for that. Andrew has just shared with us some of the issues of what happens as incomes rise and the changing patterns of behavior. And that there are some implications for sustainable diets. Emiliano, how can we use the type of data that, Andrew talked about to model food systems in terms of health and nutrition. What can we learn from these models and, what should we do with them?

Emiliano – Yes, thank you. Andrew really pointed to like many very important issues, aspects. We see some worrisome trends in the sense that current diets are going in the direction of showing less nutritious. Also, we are looking at a lot of issues in the environmental externalities, embedded resources. A lot of that within the current diet trajectory. Economic models, they have this advantage that they can connect these things together, right? Each time that we decide what we are purchasing for eating each day we are deciding in a combination of these resources embedded in the food that also some potential nutritional outcomes or health outcomes related to that diet. And the models help to connect these things very well. We can trace this back from more, sort of naive approach where we do have lifecycle assessments where you just track the account numbers through the different stages of the food. And you can just basically trace the footprint or head print of the foods. But you can come up with more advanced models. We have seen a huge advance on that area in the last 10-15 years where models can really connect the things in a more holistic approach. Where you can connect the demand systems and the supply system both together. And then from and calibrate the models. And then also they're very useful to project to the future, different states of the world in the future. By doing that sort of exercises, we can learn a lot of how these things are connected, and how potential different pathways towards the future will also have potential different outcomes in terms of nutrition. But also, in terms of environmental pressure. We can model things, for instance, we were talking a little bit on how to shape these different sorts of diets. That's a thing that is advancing more and more in the modeling literature. We can see that people are going from these earlier approaches where we just get a particular diet that we have as a goal, and then we use that as a sort of counterfactual compared to the baseline sort of trajectory. Now we are looking more and more people doing exercises like how we can actually get there with this, for example, differential value added taxes where you kind of harm some type of food and then you kind of incentivize the consumption of others, as Andrew was saying. And we are looking at a lot of those sort of exercises at the global level, localized, and we are learning a lot of these intricate relations from the models. I think that's bottom line. And in that sense is models are really well equipped to this problem in the sense that show this holistic picture of the issue.

Thank you for that. And what we've been learning from these models is this holistic picture, but can you tell us anything about how these models help show these relationships between diet and health outcomes and environmental sustainability? I mean, what's happening? Are we seeing models help predict the greenhouse gas emissions or changes in cardiovascular outcomes? What are you seeing?

Well, typically when we do baseline projections, we use a lot of end use information where we have been studying things backwards, and in these integrated relationships. And when we look into the future, these relationships get stronger. Like some low income, middle countries tend to sort of repeat similar patterns of things that we have seen already in more industrialized countries. We have all this nutrition transition that comes strong. Pretty fast and pretty strong within the models. And when we look forward, the problems are not only going to be like the ones we see now, but probably somewhat worse. Especially in the pressure on the use of natural resources. So that's one thing that we have seen. Another thing that we have seen is that there can be a lot of potential multiple dividends of alternative pathways, right? We have this sort of baseline situation where diets kind of go that way and they become less sustainable, less healthy. We have dual burdens, multiple burdens of malnutrition rising in many countries at the same time. But then when we kind of model this counterfactual situation where what if we get a different diet that can follow certain guidelines or a flexitarian diet or even a vegan diet, whatever. All of those things can bring together some multiple dividends in the sense that you can certainly reduce the pressure on the use of natural resources in many degrees. And then also at the same time, you can reduce the burden of the health outcomes. That's a thing that we have been learning. Another thing that is interesting and is really strong in the model is that you can actually see a lot of synergistic things, synergistic goals that we can learn, but also a lot of potential tradeoffs, right? When we shift towards these sorts of alternative diets in an ideal world, well then, a lot of sub populations in certain parts of the world may suffer that thing too. There are multiple benefits, but also there are a lot of tensions. And we are learning more and more about those as well. And models actually showing those synergistics, but also some of these potential trade-offs in a very, very interesting way.

Thank you for sharing that because one of the topics I was interested in understanding is can folks actually afford these diets? I mean, there was a lot of controversy around, or concern around an Eat Lancet diet in saying can people afford this. And we actually review that in the paper. What you're telling me is that there is a possibility of understanding distributional effects within societies of if we move our diets in this certain way who's able to afford it. Whether the implications for lower income folks in that society as compared to other model diets. Is that a fair assessment of some of the work that you've seen?

Yes, absolutely. If, for instance, when we're doing the models, I'm going to put an example, we do this sort of incentivizing certain kind of foods and we put high taxes on other kinds of foods. Well one thing that is interesting is that all of these potential benefits or spillovers or global spillovers are really interconnected with also trade policies. And global models can tell us a really compelling story about that. In a more connected sort of world, when you do something in certain region that can have some benefits, then that creates spillovers to others. Let's say you reduce the demand of food in certain regions, certain countries, you can shape that. Then that globally through global markets can affect the accessibility or affordability of food in other regions. In that sense, those two things are connected and bring some benefit. But when you look at deeper in that particular region where you're trying to intervene with certain taxes for certain kind of foods, it is obviously going to bring some challenges. Some equity challenges because those particular areas that are devoted to produce that kind of food are also related to a lot of workers, a lot of producers, farmers, etc. And a lot of those are going to get the negative effects of this sort of policies. So that's one side. Then the other side is, yeah, when you affect prices, prices affect obviously the consumers as well. And again, in those certain regions when you have some population that is already are having some challenges to afford certain kind of food, if you impose a tax, then that again will handle those population. There is a lot of work to do to look at the details. And sometimes global models or two aggregated models can fail short in that direction. But we see that in an aggregated world, let's say.

Yes, I appreciate and want to pick up on both something you and Andrew have been really pushing. Is this interconnectedness. Once we intervene in one part of the market or in even one part of the world, there are reverberations throughout. And these models sound really rich, and you started to hit on something that I want to learn a little bit more. And it's this idea that the models aren't perfect. Can you tell us a little bit more about some of the limitations of these models, especially as it relates to policy design or policy discussion?

Yes. Well one thing that is, and the more you look at these things, is some of these models or mostly global models, they do have again this benefit that you can see many things interconnected at the same time. But that then you have to neglect something. There is a trade off in that decision. And typically, you are looking at things at a slightly aggregated sort of level. So typically, you have a average representative consumer or an average representative producer in a different region or a different country. With that, you then could miss a lot of the heterogeneous effects that a policy or a counterfactual state of the world will have on a certain population. In many cases we will fall short on that. And one thing that we have seen, and it's really cool, and I think it's a really good advancement in recent years more, people is doing, is that sort of multi-scale kind of approach where you do have a sort of global model to solve certain situation and then with that you calibrate in a more granular type of level of model. That sort of multi-scale approach it's working pretty well to see more of these multi-level effects. But sometimes global models can fail short on getting a heterogeneous result, I guess.

Thank you for sharing that. And it's important to understand that models are not perfect, and that we're regularly as a discipline, as a field, we're always working on improving the models, making them more realistic, and more responsive to policy shifts. And so that begs this question, and then I'm going to open this up first to Andrew and then back to you, Emiliano. In this review paper, we were looking at the state of the world, the state of the art of research in this space. And my question to you both is what are some places where you see a need for new research or new research questions that we haven't really dealt with? What are you seeing as important places to go here?

Here's the thing. I wouldn't necessarily refer to it as sort of new research, but certainly where we definitely need more research. And so, for those studies that continue to link greenhouse gas emissions with animal protein production, and really trying to think about what that would necessarily mean if we in some way mitigate animal protein production. Particularly let's say cattle and dairy. What does that necessarily mean for countries at the lower end of the spectrum where that initial demand for protein is needed. While at the same time we're not seeing changes in the developing world. The point is, where do we get the most bang for our buck? Do we get the most bang for our buck environmentally by trying to mitigate consumption globally? Or in some way trying to mitigate consumption, say in the United States and Europe, while at the same time letting Botswana and other countries carry through on that dietary transition that would otherwise occur. And I do think I've seen studies like that. But I do think this whole issue of where best to mitigate meat production and where best to sort of let it go.

The other thing, and we're going to continue with this going forward. And that is particularly in the developing world this idea of how one manages both rising obesity and rise in malnutrition all at the same time. Like that is a very sort of precarious position for governments to find themselves in. One, having to both feed people more than what's available, while at the same time having a subset of the population eating too much. Whereas unlike the United States where we could pretty much have a blanketed dietary strategy to try to reduce size, girth, and just sort of eating habits. In the developing world, you really do have to manage the dual negative outcomes of both obesity as well as malnutrition.

Great. Thank you. And I really appreciate this idea of where do we target interventions? Where do we, as you said, where do we get the biggest bang for our buck? And then this really complicated tension of some folks is experiencing food security challenges, others are facing issues around obesity. And we actually see in some places where those two things come together really complex ways. What's the right set of policies to actually solve both of those problems? And how do you do that well? Emiliano, what are you thinking about in terms of new directions or areas to go?

So, in terms of approaches like more in a technical way, but I'm going to be brief from this I promise, I feel that there is a lot of work to do in multilayer modeling. I think that's a really exciting avenue that people are trying. And there are different ways to go from top bottom sort of approaches in the demand spectrum, but also in the resource embedded spectrum. So that's pretty exciting. But then topically, I think Andrew covered pretty well. I will say also that we do have the multiple burdens of malnutrition. On top of that thing that I would mention is the food waste. A thing that I have learned in the past that food waste is a big portion of the overall purchasing basket. And it's coming pretty clear still is way sort of underdeveloped kind of area because it's a very difficult thing to measure. There are not a lot of papers that can address this globally or look at long run trends and things like that. But it's typically mirroring the dietary transition as well. But we really need to learn how that looks. Is this a thing that we used to think 5-10 years ago? It was more like a sort of static problem in rich countries that they tend to waste food. But now we're looking more and more that this is an increasing problem in more developing countries, emerging economies. And as soon as we get certain threshold of income, people start purchasing more than what they need. And then we see more and more food waste. And that area I think is somewhat overlooked or still a good challenge to be addressed. And then from there, when you look at that, we should look at how that again enters the big picture, right? I mean, there are a couple of papers that have combined these changes in diets, reducing food waste as a part of it, and so like that. But still there is a lot of work to do on that. We tend to think also, and again, similarly to with the other things, that food waste is not a great thing. It's a clear sign of inefficiency in the global food system. Food waste itself also has a lot of embedded resources, right? One of them is labor. So, we just try or do a huge amount of effort to just reduce or eliminate food waste or reduce in a big portion of food waste. Then what's going to happen with a lot of employment that it was devoted to that. I think that particular fact is somewhat overlooked too. But again, those are the sort of areas I would be excited to look in the near future.

I really appreciate this point about food waste. That's an area that I've been working on mostly in the US. And I agree, I think there's some critical places for us to consider. And also thinking about what that means for modeling. I know with the Thrifty Food Plan here in the United States, there's an assumption of a 5% food waste and that's a big assumption. When you can imagine just how different households may respond to incentives or how prices may influence their choice or maybe even lack of choice as food waste does occur. So, I think you are touching on some really important points, and I really like how, Andrew, you're talking about the importance of targeting.

Bios

Andrew Muhammad is a professor of Agricultural and Resource Economics at the University of Tennessee Knoxville. He is an expert in international trade and agricultural policy. He assists state and national agricultural decision-makers in evaluating policies and programs dealing with agricultural commodities, food and nutrition, natural resources, and international trade.

Emiliano Lopez Barrera is a visiting assistant professor in the Department of Agricultural Economics at the University of Texas A&M University. His current research focuses on understanding how future patterns of global food consumption will affect human health, and how the agricultural changes needed to support the ongoing global nutrition transition will affect the environment. He combines econometric tools with economic and nutrition modeling to explore the trade-offs and linkages among diets, human health, and environmental sustainability. Prior to his grad studies, he worked as a consultant for the Inter-American Development Bank at the Central Bank of Uruguay.

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Lots of talk these days about ultra-processed foods (UPFs). Along with confusion about what in the heck they are or what they're not, how bad they are for us, and what ought to be done about them. A landmark in the discussion of ultra-processed foods has been the publication of a book entitled Ultra-processed People, Why We Can't Stop Eating Food That Isn't Food. The author of that book, Dr. Chris van Tulleken, joins us today. Dr. van Tulleken is a physician and is professor of Infection and Global Health at University College London. He also has a PhD in molecular virology and is an award-winning broadcaster on the BBC. His book on Ultra-processed People is a bestseller.

Interview Summary

Chris, sometimes somebody comes along that takes a complicated topic and makes it accessible and understandable and brings it to lots of people. You're a very fine scientist and scholar and academic, but you also have that ability to communicate effectively with lots of people, which I very much admire. So, thanks for doing that, and thank you for joining us.

Oh, Kelly, it's such a pleasure. You know, I begin some of my talks now with a clipping from the New York Times. And it's a picture of you and an interview you gave in 1995. So exactly three decades ago. And in this article, you just beautifully communicate everything that 30 years later I'm still saying. So, yeah. I wonder if communication, it's necessary, but insufficient. I think we are needing to think of other means to bring about change.

I totally agree. Well, thank you by the way. And I hope I've learned something over those 30 years. Tell us, please, what are ultra-processed foods? People hear the term a lot, but I don't think a lot of people know exactly what it means.

The most important thing to know, I think, is that it's not a casual term. It's not like 'junk food' or 'fast food.' It is a formal scientific definition. It's been used in hundreds of research studies. The definition is very long. It's 11 paragraphs long. And I would urge anyone who's really interested in this topic, go to the United Nations Food and Agricultural Organization website. You can type in NFAO Ultra and you'll get the full 11 paragraph definition. It's an incredibly sophisticated piece of science. But it boils down to if you as a consumer, someone listening to this podcast, want to know if the thing you are eating right now is ultra-processed, look at the ingredients list. If there are ingredients on that list that you do not normally find in a domestic kitchen like an emulsifier, a coloring, a flavoring, a non-nutritive sweetener, then that product will be ultra-processed. And it's a way of describing this huge range of foods that kind of has taken over the American and the British and in fact diets all over the world.

How come the food companies put this stuff in the foods? And the reason I ask is in talks I give I'll show an ingredient list from a food that most people would recognize. And ask people if they can guess what the food is from the ingredient list. And almost nobody can. There are 35 things on the ingredient list. Sugar is in there, four different forms. And then there are all kinds of things that are hard to pronounce. There are lots of strange things in there. They get in there through loopholes and government regulation. Why are they there in the first place?

So, when I started looking at this I also noticed this long list of fancy sounding ingredients. And even things like peanut butter will have palm oil and emulsifiers. Cream cheese will have xanthum gum and emulsifiers. And you think, well, wouldn't it just be cheaper to make your peanut butter out of peanuts. In fact, every ingredient is in there to make money in one of two ways. Either it drives down the cost of production or storage. If you imagine using a real strawberry in your strawberry ice cream. Strawberries are expensive. They're not always in season. They rot. You've got to have a whole supply chain. Why would you use a strawberry if you could use ethyl methylphenylglycidate and pink dye and it'll taste the same. It'll look great. You could then put in a little chunky bit of modified corn starch that'll be chewy if you get it in the right gel mix. And there you go. You've got strawberries and you haven't had to deal with strawberry farmers or any supply chain. It's just you just buy bags and bottles of white powder and liquids. The other way is to extend the shelf life. Strawberries as I say, or fresh food, real food - food we might call it rots on shelves. It decays very quickly. If you can store something at room temperature in a warehouse for months and months, that saves enormous amounts of money.

So, one thing is production, but the other thing is the additives allow us to consume to excess or encourage us to consume ultra-processed food to excess. So, I interviewed a scientist who was a food industry development scientist. And they said, you know, most ultra-processed food would be gray if it wasn't dyed, for example. So, if you want to make cheap food using these pastes and powders, unless you dye it and you flavor it, it will be inedible. But if you dye it and flavor it and add just the right amount of salt, sugar, flavor enhancers, then you can make these very addictive products. So that's the logic of UPF. Its purpose is to make money. And that's part of the definition.

Right. So, a consumer might decide that there's, you know, beneficial trade-off for them at the end of the day. That they get things that have long shelf life. The price goes down because of the companies don't have to deal with the strawberry farmers and things like that. But if there's harm coming in waves from these things, then it changes the equation. And you found out some of that on your own. So as an experiment you did with a single person - you, you ate ultra-processed foods for a month. What did you eat and how did it affect your body, your mood, your sleep? What happened when you did this?

So, what's really exciting, actually Kelly, is while it was an n=1, you know, one participant experiment, I was actually the pilot participant in a much larger study that we have published in Nature Medicine. One of the most reputable and high impact scientific journals there is. So, I was the first participant in a randomized control trial. I allowed us to gather the data about what we would then measure in a much larger number.

Now we'll come back and talk about that study, which I think was really important. It was great to see it published.

So, I was a bit skeptical. Partly it was with my research team at UCL, but we were also filming it for a BBC documentary. And I went into this going I'm going to eat a diet of 80% of my calories will come from ultra-processed food for four weeks. And this is a normal diet. A lifelong diet for a British teenager. We know around 20% of people in the UK and the US eat this as their normal food. They get 80% of their calories from ultra-processed products. I thought, well, nothing is going to happen to me, a middle-aged man, doing this for four weeks. But anyway, we did it kind of as a bit of fun. And we thought, well, if nothing happens, we don't have to do a bigger study. We can just publish this as a case report, and we'll leave it out of the documentary. Three big things happened. I gained a massive amount of weight, so six kilos. And I wasn't force feeding myself. I was just eating when I wanted.

In American terms, that's about 15 pounds in four weeks.

And that's very consistent with the other published trials that have been done on ultra-processed food. There have been two other RCTs (randomized control trials); ours is the third. There is one in Japan, one done at the NIH. So, people gain a lot of weight. I ate massively more calories. So much so that if I'd continued on the diet, I would've almost doubled my body weight in a year. And that may sound absurd, but I have an identical twin brother who did this natural experiment. He went to Harvard for a year. He did his masters there. During his year at Harvard he gained, let's see, 26 kilos, so almost 60 pounds just living in Cambridge, Massachusetts.

But how did you decide how much of it to eat? Did you eat until you just kind of felt naturally full?

I did what most people do most of the time, which is I just ate what I wanted when I felt like it. Which actually for me as a physician, I probably took the breaks off a bit because I don't normally have cocoa pops for breakfast. But I ate cocoa pops and if I felt like two bowls, I'd have two bowls. It turned out what I felt like a lot of mornings was four bowls and that was fine. I was barely full. So, I wasn't force feeding myself. It wasn't 'supersize' me. I was eating to appetite, which is how these experiments run. And then what we've done in the trials.

So, I gained weight, then we measured my hormone response to a meal. When you eat, I mean, it's absurd to explain this to YOU. But when you eat, you have fullness hormones that go up and hunger hormones that go down, so you feel full and less hungry. And we measured my response to a standard meal at the beginning and at the end of this four-week diet. What we found is that I had a normal response to eating a big meal at the beginning of the diet. At the end of eating ultra-processed foods, the same meal caused a very blunted rise in the satiety hormones. In the 'fullness' hormones. So, I didn't feel as full. And my hunger hormones remained high. And so, the food is altering our response to all meals, not merely within the meal that we're eating.

Then we did some MRI scans and again, I thought this would be a huge waste of time. But we saw at four weeks, and then again eight weeks later, very robust changes in the communication between the habit-forming bits at the back of the brain. So, the automatic behavior bits, the cerebellum. Very conscious I'm talking to YOU about this, Kelly. And the kind of addiction reward bits in the middle. Now these changes were physiological, not structural. They're about the two bits of the brain talking to each other. There's not really a new wire going between them. But we think if this kind of communication is happening a lot, that maybe a new pathway would form. And I think no one, I mean we did this with very expert neuroscientists at our National Center for Neuroscience and Neurosurgery, no one really knows what it means. But the general feeling was these are the kind of changes we might expect if we'd given someone, or a person or an animal, an addictive substance for four weeks. They're consistent with, you know, habit formation and addiction. And the fact that they happened so quickly, and they were so robust - they remained the same eight weeks after I stopped the diet, I think is really worrying from a kid's perspective.

So, in a period of four weeks, it re-altered the way your brain works. It affected the way your hunger and satiety were working. And then you ended up with this massive weight. And heaven knows what sort of cardiovascular effects or other things like that might have been going on or had the early signs of that over time could have been really pretty severe, I imagine.

I think one of the main effects was that I became very empathetic with my patients. Because we did actually a lot of, sort of, psychological testing as well. And there's an experience where, obviously in clinic, I mainly treat patients with infections. But many of my patients are living with other, sort of, disorders of modern life. They live with excess weight and cardiovascular disease and type two diabetes and metabolic problems and so on. And I felt in four weeks like I'd gone from being in my early 30, early 40s at the time, I felt like I'd just gone to my early 50s or 60s. I ached. I felt terrible. My sleep was bad. And it was like, oh! So many of the problems of modern life: waking up to pee in the middle of the night is because you've eaten so much sodium with your dinner. You've drunk all this water, and then you're trying to get rid of it all night. Then you're constipated. It's a low fiber diet, so you develop piles. Pain in your bum. The sleep deprivation then makes you eat more. And so, you get in this vicious cycle where the problem didn't feel like the food until I stopped and I went cold turkey. I virtually have not touched it since. It cured me of wanting UPF. That was the other amazing bit of the experience that I write about in the book is it eating it and understanding it made me not want it. It was like being told to smoke. You know, you get caught smoking as a kid and your parents are like, hey, now you finish the pack. It was that. It was an aversion experience. So, it gave me a lot of empathy with my patients that many of those kinds of things we regard as being normal aging, those symptoms are often to do with the way we are living our lives.

Chris, I've talked to a lot of people about ultra-processed foods. You're the first one who's mentioned pain in the bum as one of the problems, so thank you.

When I first became a physician, I trained as a surgeon, and I did a year doing colorectal surgery. So, I have a wealth of experience of where a low fiber diet leaves you. And many people listening to this podcast, I mean, look, we're all going to get piles. Everyone gets these, you know, anal fishes and so on. And bum pain it's funny to talk about it.

No, not the...

it destroys people's lives, so, you know, anyway.

Right. I didn't want to make light of it.

No, no.

Okay. So, your own experiment would suggest that these foods are really bad actors and having this broad range of highly negative effects. But what does research say about these things beyond your own personal experience, including your own research?

So, the food industry has been very skillful at portraying this as a kind of fad issue. As ultra-processed food is this sort of niche thing. Or it's a snobby thing. It's not a real classification. I want to be absolutely clear. UPF, the definition is used by the World Health Organization and the United Nations Food and Agricultural Organization to monitor global diet quality, okay? It's a legitimate way of thinking about food. The last time I looked, there are more than 30 meta-analyses - that is reviews of big studies. And the kind of high-quality studies that we use to say cigarettes cause lung cancer. So, we've got this what we call epidemiological evidence, population data. We now have probably more than a hundred of these prospective cohort studies. And they're really powerful tools. They need to be used in conjunction with other evidence, but they now link ultra-processed food to this very wide range of what we euphemistically call negative health outcomes. You know, problems that cause human suffering, mental health problems, anxiety, depression, multiple forms of cancer, inflammatory diseases like Crohn's disease and ulcerative colitis, metabolic disease, cardiovascular disease, Alzheimer's and dementia. Of course, weight gain and obesity. And all cause mortality so you die earlier of all causes. And there are others too. So, the epidemiological evidence is strong and that's very plausible. So, we take that epidemiological evidence, as you well know, and we go, well look, association and causation are different things. You know, do matches cause cancer or does cigarettes cause cancer? Because people who buy lots of matches are also getting the lung cancer. And obviously epidemiologists are very sophisticated at teasing all this out. But we look at it in the context then of other evidence. My group published the third randomized control trial where we put a group of people, in a very controlled way, on a diet of either minimally processed food or ultra-processed food and looked at health outcomes. And we found what the other two trials did. We looked at weight gain as a primary outcome. It was a short trial, eight weeks. And we saw people just eat more calories on the ultra-processed food. This is food that is engineered to be consumed to excess. That's its purpose.

So maybe to really understand the effect of it, you have to imagine if you are a food development engineer working in product design at a big food company - if you develop a food that's cheap to make and people will just eat loads of it and enjoy it, and then come back for it again and again and again, and eat it every day and almost become addicted to it, you are going to get promoted. That product is going to do well on the shelves. If you invent a food that's not addictive, it's very healthy, it's very satisfying, people eat it and then they're done for the day. And they don't consume it to excess. You are not going to keep your job. So that's a really important way of understanding the development process of the foods.

So let me ask a question about industry and intent. Because one could say that the industry engineers these things to have long shelf life and nice physical properties and the right colors and things like this. And these effects on metabolism and appetite and stuff are unpleasant and difficult side effects, but the foods weren't made to produce those things. They weren't made to produce over consumption and then in turn produce those negative consequences. You're saying something different. That you think that they're intentionally designed to promote over consumption. And in some ways, how could the industry do otherwise? I mean, every industry in the world wants people to over consume or consume as much of their product as they can. The food industry is no different.

That is exactly right. The food industry behaves like every other corporation. In my view, they commit evil acts sometimes, but they're not institutionally evil. And I have dear friends who work in big food, who work in big pharma. I have friends who work in tobacco. These are not evil people. They're constrained by commercial incentives, right? So, when I say I think the food is engineered, I don't think it. I know it because I've gone and interviewed loads of people in product development at big food companies. I put some of these interviewees in a BBC documentary called Irresistible. So rather than me in the documentary going, oh, ultra-processed food is bad. And everyone going, well, you are, you're a public health bore. I just got industry insiders to say, yes, this is how we make the food. And going back to Howard Moskovitz, in the 1970s, I think he was working for the Campbell Soup Company. And Howard, who was a psychologist by training, outlined the development process. And what he said was then underlined by many other people I've spoken to. You develop two different products. This one's a little bit saltier than the next, and you test them on a bunch of people. People like the saltier ones. So now you keep the saltier one and you develop a third product and this one's got a bit more sugar in it. And if this one does better, well you keep this one and you keep AB testing until you get people buying and eating lots. And one of the crucial things that food companies measure in product development is how fast do people eat and how quickly do they eat. And these kind of development tools were pioneered by the tobacco industry. I mean, Laura Schmidt has done a huge amount of the work on this. She's at University of California, San Francisco (UCSF), in California. And we know the tobacco industry bought the food industry and for a while in the '80s and '90s, the biggest food companies in the world were also the biggest tobacco companies in the world. And they used their flavor molecules and their marketing techniques and their distribution systems. You know, they've got a set of convenience tools selling cigarettes all over the country. Well, why don't we sell long shelf-life food marketed in the same way?

And one thing that the tobacco industry was extremely good at was figuring out how to get the most rapid delivery of the drug possible into the human body when people smoke. Do you think that some of that same thing is true for food, rapid delivery of sugar, let's say? How close does the drug parallel fit, do you think?

So, that's part of the reason the speed of consumption is important. Now, I think Ashley Gearhardt has done some of the most incredible work on this. And what Ashley says is we think of addictive drugs as like it's the molecule that's addictive. It's nicotine, it's caffeine, cocaine, diamorphine, heroin, the amphetamines. What we get addicted to is the molecule. And that Ashley says no. The processing of that molecule is crucially important. If you have slow-release nicotine in a chewing gum, that can actually treat your nicotine addiction. It's not very addictive. Slow-release amphetamine we use to treat children with attention and behavioral problems. Slow-release cocaine is an anesthetic. You use it for dentistry. No one ever gets addicted to dental anesthetics. And the food is the same. The rewarding molecules in the food we think are mainly the fat and the sugar. And food that requires a lot of chewing and is slow eaten slowly, you don't deliver the reward as quickly. And it tends not to be very addictive. Very soft foods or liquid foods with particular fat sugar ratios, if you deliver the nutrients into the gut fast, that seems to be really important for driving excessive consumption. And I think the growing evidence around addiction is very persuasive. I mean, my patients report feeling addicted to the food. And I don't feel it's legitimate to question their experience.

Chris, a little interesting story about that concept of food and addiction. So going back several decades I was a professor at Yale, and I was teaching a graduate course. Ashley Gerhardt was a student in that course. And, she was there to study addiction, not in the context of food, but I brought up the issue of, you know, could food be addictive? There's some interesting research on this. It's consistent with what we're hearing from people, and that seems a really interesting topic. And Ashley, I give her credit, took this on as her life's work and now she's like the leading expert in the world on this very important topic. And what's nice for me to recall that story is that how fast the science on this is developed. And now something's coming out on this almost every day. It's some new research on the neuroscience of food and addiction and how the food is hijacking in the brain. And that whole concept of addiction seems really important in this context. And I know you've talked a lot about that yourself.

She has reframed, I think, this idea about the way that addictive substances and behaviors really work. I mean it turns everything on its head to go the processing is important. The thing the food companies have always been able to say is, look, you can't say food is addictive. It doesn't contain any addictive molecules. And with Ashley's work you go, no, but the thing is it contains rewarding molecules and actually the spectrum of molecules that we can find rewarding and we can deliver fast is much, much broader than the traditionally addictive substances.

For policy, it's vital because part of regulating the tobacco industry was about showing they know they are making addictive products. And I think this is where Ashley's work and Laura Schmidt's work are coming together. With Laura's digging in the tobacco archive, Ashley's doing the science on addiction, and I think these two things are going to come together. And I think it's just going to be a really exciting space to watch.

I completely agree. You know when most people think about the word addiction, they basically kind of default to thinking about how much you want something. How much, you know, you desire something. But there are other parts of it that are really relevant here too. I mean one is how do you feel if you don't have it and sort of classic withdrawal. And people talk about, for example, being on high sugar drinks and stopping them and having withdrawal symptoms and things like that. And the other part of it that I think is really interesting here is tolerance. You know whether you need more of the substance over time in order to get the same reward benefit. And that hasn't been studied as much as the other part of addiction. But there's a lot to the picture other than just kind of craving things.

And I would say that the thing I like about this is it chimes with my. Personal experience, which is, I have tried alcohol and cigarettes and I should probably end that list there. But I've never had any real desire for more of them. They aren't the things that tickle my brain. Whereas the food is a thing that I continue to struggle with. I would say in some senses, although I no longer like ultra-processed food at some level, I still want it. And I think of myself to some degree, without trivializing anyone's experience, to some degree I think I'm in sort of recovery from it. And it remains that tussle. I mean I don't know what you think about the difference between the kind of wanting and liking of different substances. Some scientists think those two things are quite, quite different. That you can like things you don't want, and you can want things you don't like.

Well, that's exactly right. In the context of food and traditional substances of abuse, for many of them, people start consuming because they produce some sort of desired effect. But that pretty quickly goes away, and people then need the substance because if they don't have it, they feel terrible. So, you know, morphine or heroin or something like that always produces positive effects. But that initial part of the equation where you just take it because you like it turns into this needing it and having to have it. And whether that same thing exists with food is an interesting topic.

I think the other really important part of the addiction argument in policy terms is that one counterargument by industrial scientists and advocates is by raising awareness around ultra-processed food we are at risk of driving, eating disorders. You know? The phenomenon of orthorexia, food avoidance, anorexia. Because all food is good food. There should be no moral value attached to food and we mustn't drive any food anxiety. And I think there are some really strong voices in the United Kingdom Eating Disorder scientists. People like Agnes Ayton, who are starting to say, look, when food is engineered, using brain scanners and using scientific development techniques to be consumed to excess, is it any wonder that people develop a disordered relationship with the food? And there may be a way of thinking about the rise of eating disorders, which is parallel to the rise of our consumption of ultra-processed food, that eating disorders are a reasonable response to a disordered food environment. And I think that's where I say all that somewhat tentatively. I feel like this is a safe space where you will correct me if I go off piste. But I think it's important to at least explore that question and go, you know, this is food with which it is very hard, I would say, to have a healthy relationship. That's my experience. And I think the early research is bearing that out.

Tell us how these foods affect your hunger, how full you feel, your microbiome. That whole sort of interactive set of signals that might put people in harmony with food in a normal environment but gets thrown off when the foods get processed like this.

Oh, I love that question. At some level as I'm understanding that question, one way of trying to answer that question is to go, well, what is the normal physiological response to food? Or maybe how do wild animals find, consume, and then interpret metabolically the food that they eat. And it is staggering how little we know about how we learn what food is safe and what food nourishes us. What's very clear is that wild mammals, and in fact all wild animals, are able to maintain near perfect energy balance. Obesity is basically unheard of in the wild. And, perfect nutritional intake, I mean, obviously there are famines in wild animals, but broadly, animals can do this without being literate, without being given packaging, without any nutritional advice at all. So, if you imagine an ungulate, an herbivore on the plains of the Serengeti, it has a huge difficulty. The carnivore turning herbivore into carnivore is fairly easy. They're made of the same stuff. Turning plant material into mammal is really complicated. And somehow the herbivore can do this without gaining weight, whilst maintaining total precision over its selenium intake, its manganese, its cobalt, its iron, all of which are terrible if you have too little and also terrible if you have too much. We understand there's some work done in a few wild animals, goats, and rats about how this works. Clearly, we have an ability to sense the nutrition we want. What we understand much more about is the sort of quantities needed. And so, we've ended up with a system of nutritional advice that says, well, just eat these numbers. And if you can stick to the numbers, 2,500 calories a day, 2300 milligrams of sodium, no more than 5% of your calories from free sugar or 10%, whatever it is, you know, you stick to these numbers, you'll be okay. And also, these many milligrams of cobalt, manganese, selenium, iron, zinc, all the rest of it. And obviously people can't really do that even with the packaging.

This is a very long-winded answer. So, there's this system that is exquisitely sensitive at regulating micronutrient and energy intake. And what we understand, what the Academy understands about how ultra-processed food subverts this is, I would say there are sort of three or four big things that ultra-processed does that real food doesn't. It's generally very soft. And it's generally very energy dense. And that is true of even the foods that we think of as being healthy. That's like your supermarket whole grain bread. It's incredibly energy dense. It's incredibly soft. You eat calories very fast, and this research was done in the '90s, you know we've known that that kind of food promotes excessive intake. I guess in simple terms, and you would finesse this, you consume calories before your body has time to go, well, you've eaten enough. You can consume an excess. Then there's the ratios of fat, salt, and sugar and the way you can balance them, and any good cook knows if you can get the acid, fat, salt, sugar ratios right, you can make incredibly delicious food. That's kind of what I would call hyper palatability. And a lot of that work's being done in the states (US) by some incredible people. Then the food may be that because it's low in fiber and low in protein, quite often it's not satiating. And there may be, because it's also low in micronutrients and general nutrition, it may be that, and this is a little bit theoretical, but there's some evidence for this. Part of what drives the excess consumption is you're kind of searching for the nutrients. The nutrients are so dilute that you have to eat loads of it in order to get enough. Do you think, does that, is that how you understand it?

It does, it makes perfect sense. In fact, I'm glad you brought up one particular issue because part of the ultra-processing that makes foods difficult for the body to deal with involves what gets put in, but also what gets taken out. And there was a study that got published recently that I think you and I might have discussed earlier on American breakfast cereals. And this study looked at how the formulation of them had changed over a period of about 20 years. And what they found is that the industry had systematically removed the protein and the fiber and then put in more things like sugar. So there, there's both what goes in and what gets taken out of foods that affects the body in this way. You know, what I hear you saying, and what I, you know, believe myself from the science, is the body's pretty capable of handling the food environment if food comes from the natural environment. You know, if you sit down to a meal of baked chicken and some beans and some leafy greens and maybe a little fruit or something, you're not going to overdo it. Over time you'd end up with the right mix of nutrients and things like that and you'd be pretty healthy. But all bets are off when these foods get processed and engineered, so you over consume them. You found that out in the experiment that you did on yourself. And then that's what science shows too. So, it's not like these things are sort of benign. People overeat them and they ought to just push away from the table. There's a lot more going on here in terms of hijacking the brain chemistry. Overriding the body signals. Really thwarting normal biology.

Do you think it's important to add that we think of obesity as being the kind of dominant public health problem? That's the thing we all worry about. But the obesity is going hand in hand with stunting, for example. So, height as you reach adulthood in the US, at 19 US adults are something like eight or nine centimeters shorter than their counterparts in Northern Europe, Scandinavia, where people still eat more whole food. And we should come back to that evidence around harms, because I think the really important thing to say around the evidence is it has now reached the threshold for causality. So, we can say a dietary pattern high in ultra-processed food causes all of these negative health outcomes. That doesn't mean that any one product is going to kill you. It just means if this is the way you get your food, it's going to be harmful. And if all the evidence says, I mean, we've known this for decades. If you can cook the kind of meal, you just described at home, which is more or less the way that high income people eat, you are likely to have way better health outcomes across the board.

Let me ask you about the title of your book. So, the subtitle of your book is Why We Can't Stop Eating Food That Isn't Food. So, what is it?

The ultra-processed definition is something I want to pay credit for. It's really important to pay a bit of credit here. Carlos Montero was the scientist in Brazil who led a team who together came up with this definition. And, I was speaking to Fernanda Rauber who was on that team, and we were trying to discuss some research we were doing. And every time I said food, she'd correct me and go, it is not, it's not food, Chris. It's an industrially produced edible substance. And that was a really helpful thing for me personally, it's something it went into my brain, and I sat down that night. I was actually on the UPF diet, and I sat down to eat some fried chicken wings from a popular chain that many people will know. And was unable to finish them. I think our shared understanding of the purpose of food is surely that its purpose is to nourish us. Whether it's, you know, sold by someone for this purpose, or whether it's made by someone at home. You know it should nourish us spiritually, socially, culturally, and of course physically and mentally. And ultra-processed food nourishes us in no dimension whatsoever. It destroys traditional knowledge, traditional land, food culture. You don't sit down with your family and break, you know, ultra-processed, you know, crisps together. You know, you break bread. To me that's a kind of very obvious distortion of what it's become. So, I don't think it is food.

You know, I think it's not too hard of a stretch to see a time when people might consider these things non-food. Because if you think of food, what's edible and whether it's food or not is completely socially constructed. I mean, some parts of the world, people eat cockroaches or ants or other insects. And in other parts of the world that's considered non-food. So just because something's edible doesn't mean that it's food. And I wonder if at some point we might start to think of these things as, oh my God, these are awful. They're really bad for us. The companies are preying on us, and it's just not food. And yeah, totally your book helps push us in that direction.

I love your optimism. The consumer facing marketing budget of a big food company is often in excess of $10 billion a year. And depends how you calculate it.

I'll give you a quick quiz on this. So, for a while, the Robert Wood Johnson Foundation was by far the biggest funder of research in the world on childhood obesity. And they were spending $500 million a year to address this problem. Just by which day of the year the food industry has already spent $500 million just advertising just junk food just to children.

Okay, so the Robert V. Wood Foundation is spending it and they were spending that annually.

Annually, right. So, what's, by what day of the year is the food industry already spent that amount? Just junk food advertising just to kids.

I'm going to say by somewhere in early spring.

No. January 4th.

I mean, it's hysterical, but it's also horrifying. So, this is the genius of ultra-processed food, of the definition and the science, is that it creates this category which is discretionary. And so at least in theory, of course, for many people in the US it's not discretionary at all. It's the only stuff they can afford. But this is why the food industry hate it so much is because it offers the possibility of going, we can redefine food. And there is all this real food over there. And there is this UPF stuff that isn't food over here. But industry's very sophisticated, you know. I mean, they push back very hard against me in many different ways and forms. And they're very good at going, well, you're a snob. How dare you say that families with low incomes, that they're not eating food. Are you calling them dupes? Are you calling them stupid? You know, they're very, very sophisticated at positioning.

Isn't it nice how concerned they are about the wellbeing of people without means?

I mean they have created a pricing structure and a food subsidy environment and a tax environment where essentially people with low incomes in your country, in my country, are forced to eat food that harms them. So, one of the tells I think is if you're hearing someone criticize ultra-processed food, and you'll read them in the New York Times. And often their conflicts of interest won't be reported. They may be quite hidden. The clue is, are they demanding to seriously improve the food environment in a very clear way, or are they only criticizing the evidence around ultra-processed food? And if they're only criticizing that evidence? I'll bet you a pound to a pinch of salt they'll be food-industry funded.

Let's talk about that. Let's talk about that a little more. So, there's a clear pattern of scientists who take money from industry finding things that favor industry. Otherwise, industry wouldn't pay that money. They're not stupid in the way they invest. And, you and I have talked about this before, but we did a study some years ago where we looked at industry and non-industry funded study on the health effects of consuming sugar sweetened beverages. And it's like the ocean parted.

It's one of my favorites. And it was something like 98 or 99% of the independently funded studies found that sugar sweetened beverages do cause harm. And 98 or 99% of the industry funded studies funded by Snapple and Coke and a whole bunch of other companies found that they did not cause harm. It was that stark, was it?

It was. And so you and I pay attention to the little print in these scientific studies about who's funded them and who might have conflicts of interest. And maybe you and I and other people who follow science closely might be able to dismiss those conflicted studies. But they have a big impact out there in the world, don't they?

I had a meeting in London with someone recently, that they themselves were conflicted and they said, look, if a health study's funded by a big sugary drink company, if it's good science, that's fine. We should publish it and we should take it at face value. And in the discussion with them, I kind of accepted that, we were talking about other things. And afterwards I was like, no. If a study on human health is funded by a sugary drink corporation, in my opinion, we could just tear that up. None of that should be published. No journals should publish those studies and scientists should not really call themselves scientists who are doing it. It is better thought of as marketing and food industry-funded scientists who study human health, in my opinion, are better thought of as really an extension of the marketing division of the companies.

You know, it's interesting when you talk to scientists, and you ask them do people who take money from industry is their work influenced by that money? They'll say yes. Yeah, but if you say, but if you take money from industry, will your work be influenced? They'll always say no.

Oh yeah.

There's this tremendous arrogance, blind spot, whatever it is that. I can remain untarnished. I can remain objective, and I can help change the industry from within. In the meantime, I'm having enough money to buy a house in the mountains, you know, from what they're paying me, and it's really pretty striking.

Well, the money is a huge issue. You know, science, modern science it's not a very lucrative career compared to if someone like you went and worked in industry, you would add a zero to the end of your salary, possibly more. And the same is true of me. I think one of the things that adds real heft to the independent science is that the scientists are taking a pay cut to do it.

So how do children figure in? Do you think children are being groomed by the industry to eat these foods?

A senator, I think in Chile, got in hot water for comparing big food companies to kind of sex offenders. He made, in my view, a fairly legitimate comparison. I mean, the companies are knowingly selling harmful products that have addictive properties using the language of addiction to children who even if they could read warning labels, the warning labels aren't on the packs. So, I mean, we have breakfast cereals called Crave. We have slogans like, once you stop, once you pop, you can't stop. Bet you can't just eat one. Yeah, I think it is predatory and children are the most vulnerable group in our society. And you can't just blame the parents. Once kids get to 10, they have a little bit of money. They get their pocket money, they're walking to school, they walk past stores. You know, you have to rely on them making decisions. And at the moment, they're in a very poor environment to make good decisions.

Perhaps the most important question of all what can be done.

So, I'm speaking to you at a kind of funny moment because I've been feeling that a lot of my research and advocacy, broadcasting... you know, I've made documentaries, podcasts, I've written a book, I've published these papers. I've been in most of the major newspapers and during the time I've been doing this, you know, a little under 10 years I've been really focused on food. Much less time than you. Everything has got worse. Everything I've done has really failed totally. And I think this is a discussion about power, about unregulated corporate power. And the one glimmer of hope is this complaint that's been filed in Pennsylvania by a big US law firm. It's a very detailed complaint and some lawyers on behalf of a young person called Bryce Martinez are suing the food industry for causing kidney problems and type two diabetes. And I think that in the end is what's going to be needed. Strategic litigation. That's the only thing that worked with tobacco. All of the science, it eventually was useful, but the science on its own and the advocacy and the campaigning and all of it did no good until the lawyers said we would like billions and billions of dollars in compensation please. You know, this is an exciting moment, but there were a great many failed lawsuits for tobacco before the master settlement agreement in the '90s really sort of changed the game.

You know, I agree with you.

Are you, are you optimistic? I mean, what do you think?

I am, and for exactly the same reason you are. You know, the poor people that worked on public health and tobacco labored for decades without anything happening long, long after the health consequences of cigarette smoking were well known. And we've done the same thing. I mean, those us who have been working in the field for all these years have seen precious little in the ways of policy advances. Now tobacco has undergone a complete transformation with high taxes on cigarettes, and marketing restrictions, and non-smoking in public places, laws, and things like that, that really have completely driven down the consumption of cigarettes, which has been a great public health victory. But what made those policies possible was the litigation that occurred by the state attorneys general, less so the private litigating attorneys. But the state attorneys general in the US that had discovery documents released. People began to understand more fully the duplicity of the tobacco companies. That gave cover for the politicians to start passing the policies that ultimately made the big difference. I think that same history is playing out here. The state attorneys general, as we both know, are starting to get interested in this. I say hurray to that. There is the private lawsuit that you mentioned, and there's some others in the mix as well. I think those things will bring a lot of propel the release of internal documents that will show people what the industry has been doing and how much of this they've known all along. And then all of a sudden some of these policy things like taxes, for example, on sugared beverages, might come in and really make a difference. That's my hope. But it makes me optimistic.

Well, I'm really pleased to hear that because I think in your position it would be possible. You know, I'm still, two decades behind where I might be in my pessimism. One of the kind of engines of this problem to me is these conflicts of interest where people who say, I'm a physician, I'm a scientist, I believe all this. And they're quietly paid by the food industry. This was the major way the tobacco industry had a kind of social license. They were respectable. And I do hope the lawsuits, one of their functions is it becomes a little bit embarrassing to say my research institute is funded [by a company that keeps making headlines every day because more documents are coming out in court, and they're being sued by more and more people. So, I hope that this will diminish the conflict, particularly between scientists and physicians in the food industry. Because that to me, those are my biggest opponents. The food industry is really nice. They throw money at me. But it's the conflicted scientists that are really hard to argue with because they appear so respectable.

Bio

Dr. Chris van Tulleken is a physician and a professor of Infection and Global Health at University College London. He trained at Oxford and earned his PhD in molecular virology from University College London. His research focuses on how corporations affect human health especially in the context of child nutrition and he works with UNICEF and The World Health Organization on this area. He is the author of a book entitled Ultraprocessed People: Why We Can’t Stop Eating Food That Isn’t Food. As one of the BBC's leading broadcasters for children and adults his work has won two BAFTAs. He lives in London with his wife and two children.

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The Food and Drug Administration or FDA regulates roughly 78% of the US food supply. This includes packaged products, food additives, infant formula, ultra-processed foods, and lots more. However, an analysis by the Environmental Working Group found that 99% of new food ingredients enter our food supply through a legal loophole that skirts FDA oversight and seems, to me at least, to be incredibly risky. Today we're speaking with two authors of a recent legal and policy analysis published in the Journal Health Affairs. They explain what this loophole is and its risks and suggest a new user fee program to both strengthen the FDA's ability to regulate food ingredients and address growing concerns about food safety. Our guests are Jennifer Pomeranz Associate Professor of Public Health Policy and Management at New York University School of Global Public Health and Emily Broad, director of Harvard Law School Center for Health Law and Policy Innovation.

Interview Summary

So Jennifer, let's start with you, help our listeners understand the current situation with food ingredient oversight. And what is this legal loophole that allows food companies to add new ingredients without safety reviews.

Sure. So, Congress passed the Food Additives Amendment in 1958, and the idea was to divide food additives and generally recognized as safe ingredients into two different categories.

That's where the GRAS term comes from generally recognized as safe?

‘Generally Recognized As Safe’ is GRAS. But it circularly defines food additives as something that's not GRAS. So, there's not actually a definition of these two different types of substances. But the idea was that the food industry would be required to submit a pre-market, that means before it puts the ingredient into the marketplace, a pre-market petition to the FDA to review the safety. And then the FDA promulgates a regulation for safe use of a food additive.

GRAS ingredients on the other hand, initially thought of as salt, pepper, vinegar, are things like that would just be allowed to enter the food supply without that pre-market petition. The problem is the food industry is the entity that decides which category to place each ingredient. There's no FDA guidance on which category they're supposed to ascribe to these ingredients. What has happened is that the food industry has now entered into the food supply an enormous amount of ingredients under what we call the GRAS loophole, which is allowing it to just bring it to the market without any FDA oversight or even knowledge of the ingredient. So, in essence, what we're having now is that the food industry polices itself on whether to submit this pre-market petition for a food additive or just include it in its products without any FDA knowledge.

When you said ‘enormous number of such things,’ are we talking dozens, hundreds, thousands?

Nobody knows, but the environmental working group did find that 99% of new ingredients are added through this loophole. And that's the concerning part.

Well, you can look at some ultra-processed foods and they can have 30 or 40 ingredients on them. That's just one food. You can imagine that at across the food supply, how many things there are. And there are these chemicals that nobody can pronounce. You don't know what's going on, what they are, what they're all about. So, what you're saying is that the food industry decides to put these things in foods. There's some processing reason for putting them in. It's important that the public be protected against harmful ingredients. But the food industry decides what's okay to put in and what's not. Are they required to do any testing? Are there criteria for that kind of testing? Is there any sense that letting the industry police itself amounts to anything that protects the public good?

Well, the criteria are supposed to be the same for GRAS or food additives. They're supposed to be meeting certain scientific criteria. But the problem with this is that for GRAS ingredients, they don't have to use published data and they can hold that scientific data to themselves. And you mentioned food labels, the ingredient list, right? That doesn't necessarily capture these ingredients. They use generic terms, corn oil, color additive, food additive whatever. And so, the actual ingredient itself is not necessarily listed on the ingredient list. There is no way to identify them and it's unknown whether they're actually doing the studies. They can engage in these, what are called GRAS panels, which are supposed to be experts that evaluate the science. But the problem is other studies have found that 100% of the people on these GRAS panels have financial conflicts of interest.

Okay, so let me see if I have this right. I'm a food company. I develop a new additive to provide color or flavor or fragrance, or it's an emulsifier or something like that. I develop a chemical concoction that hasn't really been tested for human safety. I declare it safe. And the criteria I use for declaring it set safe is putting together a panel of people that I pay, who then in a hundred percent of cases say things are. That's how it works?

I can't say that in a hundred percent of cases they say it's safe, but a hundred percent of the people have financial conflicts of interest. That's one of the major concerns there.

Well, one can't imagine they would continue to be paid...

Exactly.

This sounds like a pretty shaky system to be sure.

Emily: I wanted to add a couple other really quick things on the last discussion. You were saying, Kelly, like they're using a panel of experts, which indeed are paid by them. That would be best case in some cases. They're just having their own staff say, we think this is generally recognized as safe. And I think there's some examples we can give where there isn't even evidence that they went to even any outside people, even within industry. I think that the takeaway from all of that is that there's really the ability for companies to call all the shots. Make all the rules. Not tell FDA what they're doing. And then as we talked about, not even have anything on the label because it's not a required ingredient if it's, used as part of a processing agent that's not a substance on there.

So I was feeling pretty bad when Jennifer is talking about these panels and the heavy conflict...

Even worse.

Of interest, now I feel worse because that's the best case.

Totally. And one other thing too is just you kind of warmed this up by talking about this loophole. When we put an earlier article out that we wrote that was about just this generally recognized as safe, the feedback we got from FDA was this isn't a loophole. Why are you calling this a loophole? And it's pretty clear that it's a loophole, you know?

It's big enough to drive thousands of ingredients through.

Yes, totally.

Emily, you've written about things like partially hydrogenated vegetable oils, trans fats, and red dye number three in particular. Both of which FDA has now prohibited in food. Can you walk us through those cases?

You asked about partially hydrogenated oils or trans-fat, and then red dye three, which are two examples that we talk about a little bit in our piece. Actually, one of those, the partially hydrogenated oils was allowed in food through the generally recognized as safe definition. And the other was not. But they are both really good examples of another real issue that FDA has, which is that not only are they not doing a good job of policing substances going into food on the front end, but they do an even worse job of getting things out of food on the backend, post-market once they know that those substances are really raising red flags. And you raised two of the prime examples we've been talking about.

With partially hydrogenated oils these are now banned in foods, but it took an extremely long time. Like the first evidence of harm was in the mid-nineties. By 2005, the Institute of Medicine, which is now the National Academies, said that intake of trans fat, of partially hydrogenated oils, should be as low as possible. And there was data from right around that time that found that 72,000 to 228,000 heart attacks in the US each year were caused by these partially hydrogenated oils. And on FDA's end, they started in early 2000s to require labeling. But it wasn't until 2015 that they passed a final rule saying that these substances were not generally recognized as safe. And then they kept delaying implementation until 2023. It was basically more than 20 years from when there was really clear evidence of harm including from respected national agencies to when FDA actually fully removed them from food. And red dye number three is another good example where there were studies from the 1980s that raised concerns about this red dye. And it was banned from cosmetics in 1990. But they still allowed it to be added to food. And didn't ban it from food until early this year. So early 2025. In large part because one of the other things happening is states are now taking action on some of these substances where they feel like we really need to protect consumers in our states. And FDA has been doing a really poor job. California banned red dye about 18 months before that and really spurred FDA to action.

So that 20-year delay with between 72,000 and 228,000 heart attack deaths attributable to the trans fats is the cost of delay and inaction and I don't know, conflicts of interest, and all kinds of other stuff that happened in FDA. So we're not talking about something trivial by any means. These are life and death things are occurring.

Yes.

Give us another example, if you would, about something that entered the food supply and caused harm but made it through that GRAS loophole.

The example that I've talked about both in some of the work we've done together and also in a perspective piece in the New England Journal of Medicine that really focused on why this is an issue. There was this substance added to food called tara flour. It came on the scene in 2022. It was in food prepared by Daily Harvest as like a protein alternative. And they were using it from a manufacturer in South America who said we have deemed this generally recognized as safe. Everything about that is completely legal. They deemed it generally recognized as safe. A company put it into food, and they sold that. Up until that point, that's all legal. What happened was very quickly people started getting really sick from this. And so there were, I think, about 400 people across 39 states got sick. Nearly 200 people ended up in the hospital, some of them with liver failure because of this toxicity of tara flour. And so FDA followed the thread they did help work with the company to do a voluntary recall, but it then took them two years, until May, 2024, to declare tara flour not generally recognized as safe. So I think, in some ways, this is a great example because it shows how it's so immediate, the impact of this substance that, again, was legally added to food with no oversight. In some ways it's a misleading example because I think so many of the substances in food, it's not going to be so clear and so immediate. It's going to be year over year, decade over decade as part of a full diet that these are causing cardiovascular risk, thyroid disease, cancer risk, those kinds of things.

I'd love to hear from either of you about this. Why is FDA falling down on the job so badly? Is it that they don't have the money to do the necessary testing? Do they not have the authority? Is there not the political will to do this? Is there complete caving into the food industry? Just let them do what they want and we're going let it go?

Jennifer: All of the above? Everything you just said? It's all of the above.

Emily: Jen, do you wanna talk about the money side? Because that sort of gets to the genesis of the article we worked on, which was like maybe there's a creative solution to that piece.

Yes, I'd love to hear about that because I thought that was a very creative thing that you guys wrote about in your paper. That there would be an industry user fee to help produce this oversight. Tell us what you had in mind with that. And then then convince me that FDA would appropriately use this oversight and do its job.

So, the idea in the paper was proposing a comprehensive user fee program for the food branch of the FDA. The FDA currently collects user fees for all of human drugs, animal drugs, medical devices, etc. With Tobacco, it's a hundred percent funded by user fees. But food, it only gets 1% of its funding through user fees. And it's important to note user fees fund processes. They don't fund outcomes. It's not like a bribe. And the idea behind user fees and why industry sometimes supports them is actually to bring predictability to the regulatory state. It brings efficiency to reviews. And then this all allows the industry to anticipate timelines so they can bring products to market and know when they're going be able to do it. In the food context, for example, the FDA is required to respond to those food additives petitions that we talked about within 180 days. But they can't respond in time. And they have a lot of timelines that are required of them in the food context that they can't meet. They can't meet their timelines because they're so underfunded. So, we proposed a comprehensive user fee. But one of the main reasons that we think a user fee is important is to address the pre-market issues that I talked about and the post-market issues that Emily talked about.

In order to close that GRAS loophole, first of all, FDA needs to either reevaluate its authorities or Congress needs to change its authorities. But it would need resources to be able to do something pre-market. Some of the ideas we had was that the user fee would fund some type of either pre-market review, pre-market notification, or even just a pre-market system where the FDA determines whether a proposed ingredient should go through the GRAS avenue, or through food additive petition. So at least that there will be some type of pre-market oversight over all the ingredients in the food supply. And then also the FDA is so severely lacking in any type of comprehensive post-market into play, they would have the resources to engage in a more comprehensive post-market review for all the ingredients.

Could you see a time, and I bring this up because of lawsuits against the food industry for some of these additives that are going on now. The state attorney's generals are starting to get involved, and as you said, Emily, the some states are taking legislative action to ban certain things in the food supply. Do you think there could come a time when the industry will come to government pleading to have a user fee like this? To provide some standardization across jurisdictions, let's say?

So, there's two things. The first is Congress has to pass the user fee, and historically, actually, industry has done exactly what you said. They have gone to Congress and said, you know what? We want user fees because we want a streamlined system, and we want to be able to know when we're bringing products to market. The problem in the context of food for the issues we're talking about is that right now they can use the GRAS loophole. So, they have very little incentive to ask for user fees if they can bring all their ingredients into the market through the GRAS loophole. There are other areas where a user fee is very relevant, such as the infant formula 90 day pre-market notification, or for different claims like health claims. They might want user fees to speed those things up, but in terms of the ingredients, unless we close the GRAS loophole, they'd have little incentive to actually come to the table.

But wouldn't legal liability change that? Let's say that some of these lawsuits are successful and they start having to pay large settlements or have the State Attorneys General, for example, come down on them for these kinds of things. If they're legally liable for harm, they're causing, they need cover. And wouldn't this be worth the user fee to provide them cover for what they put in the food supply? Yes, it's great to have the flexibility to have all these things get through the loophole, but it'd be great as well to have some cover so you wouldn't have so much legal exposure. But you guys are the lawyers, so I'm not sure it makes sense.

I think you're right that there are forces combining out in the world that are pushing for change here. And I think it's hard to disentangle how much is it that industry's pushing for user fees versus right now I think more willing to consider federal regulatory changes by either FDA or by Congress. At the state level this is huge. There's now becoming a patchwork across states, and I think that is really difficult for industry. We were tracking this year 93 bills in 35 states that either banned an additive in the general public, banned it in schools. Banned ultra-processed foods, which most of the states, interestingly, have all defined differently. But where they have had a definition, it's been tied to various different combinations of additives. So that's going on. And then I think you're right, that the legal cases moving along will push industry to really want clear and better standards. I think there's a good question right now around like how successful will some of these efforts be? But what we are seeing is real movement, both in FDA and in Congress, in taking action on this. So interestingly, the Health Affairs piece that we worked on was out this spring. But we had this other piece that came out last fall and felt like we were screaming into the void about this is a problem generally recognized as safe as a really big issue. And suddenly that has really changed. And so, you know, in March FDA said they were directed by RFK (Robert F. Kennedy), by HHS (Health and Human Services) to really look into changing their rule on generally recognized as safe. So, I know that's underway. And then in Congress, multiple bills have been introduced. And I know there are several in the works that would address additives and specifically, generally recognized as safe. There's this one piece going on, which is there's forces coalescing around some better method of regulation. I think the question's really going to also be like, will Congress give adequate resources? Because there is also another scenario that I'm worried about that even if FDA said we're going now require at least notification for every substance that's generally recognized as safe. It's a flood of substances. And they just, without more resources, without more staff devoted to this, there's no way that they're going to be able to wade through that. So, I think that either the resources need to come from user fees, or at least partially from user fees, from more appropriations and I think, In my opinion, they are able to do that on their own. Even given where current administrative law stands. Because I think it's very clear that the gist of the statute is that FDA should be overseeing additives. And I think a court would say this is allowing everything to instead go through this alternative pathway. But I really think FDA's going to need resources to manage this. And perhaps more of a push from Congress to make sure that they really do it to the best of their ability.

I was going to say there's also an alternative world where we don't end up spending any of these resources, and they require the industry just to disclose all the ingredients they've added to food and put it on a database. This is like low hanging fruit, not very expensive, doesn't require funding. And then the NGOs, I hope, would go to work and say, look at this. There is no safety data for these ingredients. You know, because right now we just can't rely on FDA to do anything unless they get more funding to do something. So, if FDA doesn't get funding, then maybe this database where houses every ingredient that's in the food supply as a requirement could be a low resource solution.

Jennifer, I'll come back to you in a minute because I'd like to ask how worried should we be about all this stuff that's going into food. But Emily, let me ask you first, does FDA have the authority to do what it needs to do? Let's say all of a sudden that your wish was granted and there were user fees would it then be able to do what needs to be done?

I think certainly to be able to charge these user fees in almost all areas, it right now doesn't have that authority, and Congress would need to act. There's one small area which is within the Food Safety Modernization Act for certain types of like repeat inspections or recalls or there's a couple other. FDA isn't charging fees right now because they haven't taken this one step that they need to take. But they do have the authority if they just take those steps. But for everything else, Congress has to act. I think the real question to me is because we now know so many of these substances are going through this GRAS pathway, the question is really can they do everything they need to do on their own to close that loophole? And again, my opinion is Congress could make it clear and if Congress were to act, it would be better. Like they could redefine it in a way that was much more clear that we are drawing a real line. And most things actually should be on the additive side of the line rather than the generally recognized as safe side of the line. But even with their current authority, with the current definition, I think FDA could at least require notification because they're still drawing a line between what's required for additives, which is a very lengthy pre-market process with, you know, a notice and comment procedure and all of these things. My take is FDA do what you can do now. Let's get the show on the road. Let's take steps here to close up the loophole. And then Congress takes time. But they definitely can even strengthen this and give a little more, I think, directives to FDA as to how to make sure that this loophole doesn't recur down the line.

In talks that I've given recently, I've shown an ingredient list from a food that people will recognize. And I ask people to try to guess what that food is from its ingredient list. This particular food has 35 ingredients. You know, a bunch of them that are very hard to pronounce. Very few people would even have any idea at all what those ingredients do. There's no sense at all about how ingredient number 17 would interact with ingredient 31, etc. And it just seems like it's complete chaos. And I don't want to take you guys outside your comfort zone because your backgrounds are law. But Jennifer, let me ask you this. You have a background in public health as well. There are all kinds of reasons to be worried about this, aren't there? There are the concerns about the safety of these things, but then there's a concern about what these ultra-processed ingredients do to your metabolism, your ability to control your weight, to regulate your hunger and things like that. It sounds this is a really important thing. And it's affecting almost everybody in the country. The percentage of calories that are now coming from ultra-processed foods is over 50% in both children and adults. So it sounds like there's really reason to worry. Would you agree?

Yes. And also, the FDA is supposed to be overseeing the cumulative effects of the ingredients and it doesn't actually enforce that regulation. Its own regulation that it's supposed to evaluate the cumulative effects. It doesn't actually enforce this.

So by cumulative effects do you mean the chronic effects of long term use?

And, having these ingredients across multiple products within one person's consumption. Also, the FDA doesn't look at things like the effect on the gut microbiome, neurotoxicity, even cancer risk, even though they're supposed to, they say that if something is GRAS, they don't need to look at it because cancer risk is relegated only to food additives. So here we're at a real issue, right? Because if everything's entering through the GRAS loophole, then they're not looking at carcinogen effects. So, I think there is a big risk and as Emily had said earlier, that these are sometimes long-term risks versus that acute example of tara flour that we don't know. And we do know from the science, both older and emerging science, that ultra-processed food has definite impact on not only consumption, increased consumption, but also on diet related diseases and other health effects. And by definition what we're talking about here are ultra-processed foods. These ingredients are only found in ultra-processed foods. So, we do know that there is cause for concern.

It's interesting that you mentioned the microbiome because we've recorded a cluster of podcasts on the microbiome and another cluster of podcasts on artificial sweeteners. Those two universes overlap a good bit because the impact of the artificial sweeteners on some of them, at least on the microbiome, is really pretty negative. And that's just one thing that goes into these foods. It really is pretty important. By the way, that food with 35 ingredients that I mentioned is a strawberry poptart.

Jennifer: I know that answer!

Emily: How do you know that?

Jennifer: Because I've seen Kelly give a million talks.

Yes, she has.

Emily: I was wondering, I was like, are we never going to find out?

So the suspense is lifted. Let me end with this. This has been highly instructive, and I really appreciate you both weighing in on this. So let me ask each of you, is there reason to be optimistic that things could improve. Emily, I'll start with you.

So, I've been giving this talk the past few months that's called basically like Chronic Disease, Food Additives and MAHA, like What Could Go Right and What Could Go Wrong. And so, I'm going give you a very lawyerly answer, which is, I feel optimistic because there's attention on the issue. I think states are taking action and there's more attention to this across the political spectrum, which both means things are happening and means that the narrative changing, like people are getting more aware and calling for change in a way that we weren't seeing.

On the flip side, I think there's a lot that could go wrong. You know, I think some of the state bills are great and some of them are maybe not so great. And then I think this administration, you have an HHS and FDA saying, they're going to take action on this in the midst of an administration that's otherwise very deregulatory. In particular, they're not supposed to put out new regulations if they can get rid of 10 existing ones. There are some things you can do through guidance and signaling, but I don't think you can really fix these issues without like real durable legislative change. So, I'm sorry to be one of the lawyers here. I think the signals are going in the right direction, but jury is out a little bit on how well we'll actually do. And I hope we can do well given the momentum.

What do you think, Jennifer?

I agree that the national attention is very promising to these issues. The states are passing laws that are shocking to me. That Texas passing a warning label law, I would never have thought in the history of the world, that Texas would be the one to pass a warning label law. They're doing great things and I actually have hope that something can come of this. But I am concerned at the federal level of the focus on deregulation may make it impossible. User fees is an example of where they won't have to regulate, but they could provide funding to the FDA to actually act in areas that it has the authority to act. That is one solution that could actually work under this administration if they were amenable to it. But I also think in some ways the states could save us. I worry, you know, Emily brought up the patchwork, which is the key term the industry uses to try to get preemption. I do worry about federal preemption of state actions. But the states right now are the ones saving us. California is the first to save the whole nation. The food industry isn't going to create new food supply for California and then the rest of the country. And then it's the same with other states. So, the states might be the ones that actually can make some real meaningful changes and get some of the most unsafe ingredients out of the food supply, which some of the states have now successfully done.

Bios

Emily Broad Leib is a Clinical Professor of Law, Director of Harvard Law School Center for Health Law and Policy Innovation, and Founding Director of the Harvard Law School Food Law and Policy Clinic, the nation’s first law school clinic devoted to providing legal and policy solutions to the health, economic, and environmental challenges facing our food system. Working directly with clients and communities, Broad Leib champions community-led food system change, reduction in food waste, food access and food is medicine interventions, and equity and sustainability in food production. Her scholarly work has been published in the California Law Review, Wisconsin Law Review, Harvard Law & Policy Review, Food & Drug Law Journal, and Journal of Food Law & Policy, among others.

Professor Jennifer Pomeranz is a public health lawyer who researches policy and legal options to address the food environment, obesity, products that cause public harm, and social injustice that lead to health disparities. Prior to joining the NYU faculty, Professor Pomeranz was an Assistant Professor at the School of Public Health at Temple University and in the Center for Obesity Research and Education at Temple. She was previously the Director of Legal Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. She has also authored numerous peer-reviewed and law review journal articles and a book, Food Law for Public Health, published by Oxford University Press in 2016. Professor Pomeranz leads the Public Health Policy Research Lab and regularly teaches Public Health Law and Food Policy for Public Health.

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Every day, with few exceptions, I eat a handful of nuts. Usually a combination of almonds, walnuts, pecans, cashews, and pistachios. And they taste good for sure. But I'm responding mainly to research showing that consumption of nuts is related to less chronic disease. In particular, eating nuts lowers levels of inflammation related to heart disease and diabetes, and may improve cholesterol levels among other benefits. So, I saw it as welcome news that someone has just published a book about nuts, all aspects of nuts, actually. Today we're joined by NPR, food Writer Elspeth Hay author of a new book called Feed Us with Trees- nuts, and The Future of Food. And I had no idea. Nuts were so interesting until I dove in a little bit. Elspeth has gathered stories from dozens of nut growers, scientists, indigenous knowledge keepers, researchers and food professionals. She writes that humans once grew their staple crops in forest gardens of perennial nuts, such as oaks, chestnuts, and hazelnuts in these species. Particularly important to the environment as well as to human wellbeing.

Interview Summary

Elspeth, thanks so much for joining us and for writing such an amazing book.

Thank you so much for having me. And it sounds like you have the same habit as my dad. He makes sure to eat a little bit of mixed nuts every night, ever since I can remember for his health.

Let’s start by having you describe your book. Tell us about Feed us with Trees. Why did you write it and what's it about?

I wrote it because I've been reporting on food in the environment for a long time, a little more than 15 years. And I had never heard anyone mention anything about eating acorns until a few years ago. And someone sent me a TEDx talk by a woman in Greece named Marcie Mayer, and she said, you can eat acorns. And not only that, but they're a super food nutritionally, and one of humanity's oldest foods. And I live in this giant oak forest that's protected on Cape Cod as part of the Cape Cod National Seashore. And I had always seen this forest as a sort of impediment to local food production, right? There's all this land that can't be farmed. And all that time, it turns out there was food literally raining down on my roof, underfoot in my driveway, and I just wasn't equipped to see it. The stories that I had grown up with hadn't mentioned that. And so that was a real eyeopener for me and I just couldn't stop thinking about it and I kept researching.

So, have you started consuming acorns?

I have, yes. I've collected them the past probably five falls and, you know, oaks do something called masting. Some years they have a really big production and some years smaller production. Some years I've gotten more than others. But I have started processing them at home and experimenting with different ways of using the flour. And I've also ordered online acorn oil. There are actually three food products that you can make from acorns. You can make starch, which works just like corn starch or potato starch. Thickens things. You can make flour and with some species you can make oil. It's actually a pretty diverse crop.

That's so interesting. You know, I have a series of oak trees right outside my window and I never thought that they might be producing food I could consume. It's so interesting to hear your history with that.

Yes, I mean I had no idea. And it turns out that actually acorns are very similar to olives in the way that they need to be processed. They're very high in these compounds that are very bitter, called tannins, just like an olive. I had the experience once of going to Italy with my husband, and we saw this olive grove and we thought, oh cool. Olives growing right here. And we picked one off the tree and he put his in his mouth and immediately spat it out and said, oh, that's awful. Tannins are not something that we want to eat. They don't taste good, but obviously they haven't hampered the olives rise to glory in terms of a human food source. And Acorns need the same kind of processing. So, tannins are water soluble. You pull them out with water. You know, you always get olives in brine, right? And so Yes, just started learning more about how to work with them and then also more about our relationship with oak trees. And I started seeing them differently in that light too. Going from sort of the species that I'd always seen as natural and wild and better off without humans, to actually understanding that we have a really long history with oak trees and in some places, they actually really depend on us. So that was total game changer for me.

There's more to the story than oaks and acorns. Tell us what you learned about the history of humans eating nuts like acorns, but also things like chestnuts and hazelnut.

Yes, I was really surprised. At first, I thought, okay, this is going to be an isolated thing where some people in really hilly areas or areas that aren't good for row crops are eating these nuts as staple foods. But when I looked back, actually all over the Northern Hemisphere in a huge variety of cultures, people have been in relationship with these nut trees as a staple food for a lot of the past 12,000 years. So, there's records in Japan of this ancient society that was sort of the first known chestnut cultivators in Japan. The burr size increased a lot. The nut size increased a lot during that early era of cultivation. There's a really interesting history of chestnut cultivation throughout Europe during what we call the quote unquote dark ages, although I'm starting to think maybe it was lighter than we thought during that time. There was a lot of cool stuff happening with Agroforestry. And in some areas of Europe, people ate an average of 330 pounds of chestnuts per person, per year. To put that in perspective, today, the average American eats about 150 pounds of grains per person per year. So that is a pretty serious level of chestnut consumption. You know, it's called in some places the bread tree. And I just started finding all these examples. There was a time in the British Isles known as the Nut Age, between about 7,000 and 5,000 years ago. There were just all these examples of different people at different times tending to these trees and harvesting a huge amount of food from them.

You've written that trees like oaks and chestnut and hazels and also humans are what ecologists call keystone species.

Yes.

Tell us what you mean by that and how such species play an outsized role in local ecosystems.

So, a keystone species, the first time I ever heard of them I think I was in Jamaica, and someone was talking about the sea urchins on the reef and the beach there. And it turned out that when they disappeared, for a variety of reasons, this whole ecosystem fell apart. And there's different types of keystone species, but a keystone species is as important to its ecosystem as the keystone in a Roman arch, right? So, if you pull that keystone out, you have this cascade of effects where everything kind of falls apart. And oaks are a huge life support tree. I don't know if listeners have heard of the work of entomologist, Doug Tallamy. He's done some really interesting studies on different families of plants and how much life they support by looking at insects. And in most counties where they occur, oaks are the top life support plant in North America. They're this incredibly important basis of the food chain. They provide food for a ton of insects. Those insects in turn feed birds and mammals and other creatures. And you know, at first as I am learning all this, I thought, okay, great oaks are important. Well, you know, I kind of already knew that, but that's exciting that we can eat from them. But then I started getting to know some fire practitioners. Especially an indigenous man in present day Northern California named Ron Reed. And he's a member of the Karuk Tribe there. And he started telling me about the relationship between cultural fire, prescribed fire, and oak trees. And what I learned is that oaks and human fire have actually been in relationship for millennia. And there's this whole, on the east coast, this hypothesis called the Oak Fire Hypothesis. And most ecologists that I've spoken with ascribe to it and believe that the reason that white oak and hickory have been this sort of dominant forest type through a lot of Eastern North America for the past 9,000 years, despite some really dramatic climate changes, is because humans have burned to keep them dominant on the landscape. And that in doing that we actually play a role as a keystone species too, right? So, if our fire is supporting this incredibly important keystone species, oaks, and other nut trees, we're in the category that they call ecosystem engineers.

Mm-hmm.

So, a beaver is an example of an ecosystem engineer, right? You take the beaver out of the wetland and the whole thing falls apart. And a lot of fire historians and ecologists see us as the fire animal. And historically, in a lot of different ecosystems, that has been our largest and most important role is creating ecosystems for other wildlife habitat, for other wildlife, with fire.

So, it sounds like there was a time in human history when humans would selectively burn other things in order to protect these trees.

Yes, and truly not just these trees. If you look at other places, other continents, there's human burning in Australia, there's human burning in the Amazon, there's tons of examples. But around here where I live, at least in New England and in the East, fire has been used intentionally to keep these nut trees dominant. Because what happens is. oaks are a mid-succession species. If folks don't know a lot about succession, early is like bare dirt, right? When we have an open field that's been plowed up, that's the beginning of succession. And then it proceeds all the way to an old growth forest. And oaks, if they get shaded out, they're not a particularly shade tolerant species. So, a lot of these nut trees like that kind of middle, sweet spot of succession. Where it's still a little open, there's still plenty of sun for regeneration. And so that can be intentionally preserved with fire or with other methods. But that's been a major one historically.

Well, that's so interesting. In your book, you draw a comparison between the yield from these trees to more modern agriculture or industrial farming of things like corn and soybeans. That tell us about that. That's a very interesting point to make.

Yes. I spent a lot of time on what I started calling the yield thing because it seemed really important, right? If these trees are actually a viable alternative to the industrial monocultures that we're struggling to maintain, well then, they need to really feed us, right? There needs to be enough food. And there are a number of different ways to look at it. I think, you know, one thing that we don't talk about a lot is when we talk about a monoculture of corn, for instance, I think the record, I'm not going to remember the exact statistics. But the average is maybe12,000 tons per acre or something. But there have been these huge records, and what we don't talk about is that yield is a ratio, right? If land is the limiting factor for us to produce food. And we're just talking about what's coming off this one acre, but we're not talking about the land it took to produce the fertilizer. We're not talking about the land it took to produce the tractor or the fuel or all these other inputs. And when you factor those in, those high yields completely disappear. When we actually look at how much land we need to produce food, an ecosystem based on these keystone trees will always produce the most because they produce the most life, right? And, you know, we tend to get caught up in other measures, but ultimately life comes from photosynthesis and these relationships between different species. And when you have a piece of land that is producing an abundance of life, you also have an abundance of food. And I broke the yield question down in a lot of different ways, but there have been some direct comparisons between oak savannah versus cornfield ecosystems and the amount of photosynthesis and food production that's happening. And the oak ecosystems, I mean, if you just think about the size of an oak tree and its photosynthetic capacity versus the sort of short grass, it can do a lot more.

Well, if you happen to park your car under an oak tree, you get a good sense of exactly how many acorns one can produce.

Yes, it's quite a bit. And actually, another cool thing about acorns, is that because of the tannins, which are kind of a pain, right, for processing. People often wish they didn't have these tannins. But tannins are an incredible preservative. So, from a food security standpoint, if you gather some acorns and you dry them out a little, just by letting them sit in an airy, dry spot, they can store for decades. So, even if the acorn production isn't consistent year to year, like say a hazelnut or a chestnut or a field of corn might be. Those fluctuations are not as big of a deal because of that food security potential. There's a lot of different ways to break it down. But I was a skeptic, a yield skeptic. And by the end of the research, I felt quite confident in saying that these trees produce plenty and it's definitely not a yield issue why we moved away from them.

Well, I'm glad you decided to dive into the yield thing because it's actually very interesting once you get into it. Let's talk about something else that you wrote about. A little-known part of US history. You wrote that in the not-so-distant past, the US government considered keystone nut trees as a solution to some of our biggest environmental and economic challenges. I had no idea about that. Tell us about it and what happened.

I had no idea either. When I first started researching the book, I went on this trip through Appalachia talking to different people who had some knowledge of this stand of trees that was planted in between the late 1920s and the 1960s by a guy named John Hershey. And I just thought, oh, cool, I'll go see these old nut trees. This sounds really interesting. But what I learned when I got there and started talking to the folks who had found where the trees were and were sort of caretaking them, was that Hershey was part of, Roosevelt's depression recovery plan. And he had this experimental fruit and nut tree nursery where he had ads in the newspaper and people all over the eastern seaboard were sending in entries of their best nut seeds, best trees. He got these genetics that probably represented, you know, hundreds if not thousands of years of human breeding in the east. And he started planting these experimental nurseries. And as part of Roosevelt's tree army, not only were they planting trees to try to prevent erosion and reforest areas that have been cut over. They were also planting these nut trees and seeing them as a really viable solution to hunger, to environmental crises, and to reviving rural economies. And unfortunately, Hershey ended up getting cancer. His other buddy who was doing the program with him got in a fight with one of the Roosevelt administrators, and the program fell apart. Also, World War II began. So that was another reason that things kind of fell apart. But for a moment there it was at the highest levels of government. The officials saw, wow, this could actually solve a lot of problems at once. And I think it's a bummer that it didn't catch on then. But it's not too late now. We still have a lot of problems as we unfortunately all know. And these trees still offer a lot of solutions.

So given the long human history of this, the story of indigenous cultures becomes really fascinating. And you've talked about how the indigenous cultures tended oak trees and other trees with what you called forest farming. And I'm interested in that concept and if you would tell us what that means and also, why haven't these things caught on? And why don't most Americans eat acorns or even know that one can eat them?

So, the history of forest farming in the US is pretty long and violent. Our government has pursued a policy of trying to eradicate a lot of these indigenous food production systems because people are easier to control when they're hungry and when they don't have access to the resources that they need. We often talk about our industrial style of farming that we have today as inevitable, right? Oh, well, these older methods didn't produce enough food and so we had to transition from quote unquote hunting and gathering to farming. And what I found as I looked through the history is that is a completely made-up story. Instead, what was happening is that as Euro-American colonists kept trying to expand our land base, you know, kept trying to move West, force into new areas, is that it was very hard to gain access to more land without also using violence and a tactic that, some historians have called a feed fight. Targeting indigenous food production and then forcing survivors to assimilate into grain crop culture. And that, we've been told was because it was a way of producing more food. But in fact, often it yielded less food and was actually a war tactic. And there's a lot of talk right now about regenerative farming and there's also a lot of talk about racial healing and having real conversations about racial history in the US and trying to move forward. And I think that this food aspect is really key to that conversation. And if we want to build a better future, it's something that we really have to reckon with and talk about, you know? We can't change what happened, but we also can't move forward without knowing what happened and really understanding it.

So interesting how the history of this particular food was so shaped by politics, colonialism, things like that. And also by things like Mr. Hershey getting cancer and, you know, his, his colleague having a fight. I mean, it's just an incredibly interesting history and it's too bad that it played out like it did for a million tragic reasons. But whoa, that's interesting.

I found some of the historic literature just totally confounding and fascinating because there would be, you know, sometimes the same people would be commenting on how they'd gotten to present day California. You know, these Euro-American soldier, settlers, they got there. They couldn't believe how much food there was. You know, wild geese, as far as you can see, wild oats as far as you can see, salmon filling up the rivers. And then in the same letter sometimes saying these indigenous people don't know how to produce food. They have nothing to eat. It was a really important reminder to me of the importance of stories and the stories that we internalize. Because I can now think of examples in my own life of, you know, I live in this national park and on the website of the National Park, there's one page about the importance of human fire in the ecosystem of this place over the past 10,000 years. And on another page of the same website, there's a description of this natural, pristine wilderness, that is supposedly also here. Of course, those two things can't really both be true. But until I started learning all this about oaks and these other trees, that didn't set off any alarm bells in my head. And we all have internalized narratives that we forget to question. For me, for whatever reason, these acorns have been this huge opener of like, okay, what else am I missing? What else do I need to reexamine about the stories around food that I've grown up with and the stories around our relationship with the living world around us. Because there's a lot of layers there to unpack.

Well, there sure are. One other thing I wanted to ask you about, because you brought up this issue earlier of forest succession. And in that context, tree pruning is an interesting topic. And you write that tree pruning, this could happen by fire, or it could also happen with other things like pollarding. I didn't know what pollarding was. But those could hold some surprising opportunities when it comes to food production and climate change. And you write that regularly pruned and burned landscapes aren't like the typical old growth forest that we often associate with climate solutions. So why is this?

So, we often think of old growth forests as simply a forest that looks really old, right? The trees are tall and they're broad. And there are forests that can be really old but can be in an earlier stage of succession. So, what happens with a lot of these interactions over time where people are either burning or coppicing or pollarding, which I'll define for your listeners. Because I also had no idea what those words meant when I first started researching. But coppicing is where you cut a woody plant back to the ground year after year. It could be every year. It could be in a rotation of every eight or 15 or 20 years to produce new stems. Like it's a plant that will resprout. And pollarding is the same idea but was often done in systems where livestock were also involved. You're cutting much higher off the ground, typically above animal head height, so that they can't graze those tasty young shoots. And there are a lot of traditionally managed forests in Europe that have been managed with coppice and pollard. What's happening is when we produce food in a farm field, right? We're taking succession back to zero every year. We're re plowing the field. Every time we do that the carbon that the plants had stored in their roots and had sent down to the soil gets burped back out into the atmosphere. I talked to a great soil scientist about this, and he was just like, oh, it's carbon dioxide burps everywhere. It's awful. But when we work with these woody plants where you're not taking out the roots, you're not taking out the trunk necessarily, if you're pollarding, right? You're leaving these trees. And these trees can get really old and really big around the trunk, and then they're getting pruned up top and sending out these new shoots. It is more like giving the plant a haircut. You're not killing it back. You're not losing all that carbon that's stored in the soil. And you're kind of renewing its youth and vigor. There are some studies indicating that trees that are coppiced and pollarded can actually live longer than trees with no human interaction. And so, there's this really fine line between, you know, too much interference where we're messing up the succession cycle of the forest and taking it back to zero. And maybe some interference, but not going all the way back to zero. And that has huge climate implications.

Bio

Elspeth Hay is the author and creator of Feed Us with Trees and the Local Food Report on NPR, and proponent of place-based living. Deeply immersed in her own local-food system, Elspeth’s work focuses on food, the environment, and the people, places, and ideas that feed us. She spent the past 15+ years interviewing local food producers, harvesters, processors, cooks, policymakers and visionaries about what it means to be human and live thoughtfully in place. In the process, she’s come to understand that we humans are, in fact, perfectly adapted to a wide range of places—and to believe that reconnecting with our home ecosystems is both the great challenge and great joy of our times. In addition to her work as a writer and public radio host, Elspeth is deeply immersed in the local food system of her own home community of Wellfleet, MA on the Outer Cape. She is part of the team behind the Wicked Oyster restaurant in Wellfleet, a co-founder of the Wellfleet Farmers Market, co-founder of the newly launched Commons Keepers, and a passionate student and teacher of place-based living.

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Interview Summary

So, you two, along with a number of other people in the field, wrote a chapter for a recently published book called The Handbook of Children and Screens. We discussed that book in an earlier podcast with its editors, Dmitri Christakis and Kris Perry, the executive director of the Children and Screens organization. And I'd like to emphasize to our listeners that the book can be downloaded at no cost. I'd like to read a quote if I may, from the chapter that the two of you wrote. 'Screen time continues to evolve with the advent of continuous and immersive video reels, voice activated assistance, social media influencers, augmented and virtual reality targeted advertising. Immersive worlds where children can virtually shop for food and beverages, cook or work in a fast-food outlet from a smartphone, a tablet, a computer, or an internet connected tv and more.' So as much as I follow the field, I still read that and I say, holy you know what. I mean that's just an absolutely alarming set of things that are coming at our children. And it really sounds like a tidal wave of digital sophistication that one could have never imagined even a short time ago.

Amanda, let's start with you. Can you tell us a little bit more about these methods and how quickly they evolve and how much exposure children have?

I think you're right, Kelly, that the world is changing fast. I've been looking at screen media for about 20 years now as a researcher. And in the earlier years, and Tom can attest to this as well, it was all about TV viewing. And you could ask parents how much time does your child spend watching TV? And they could say, well, they watch a couple shows every night and maybe a movie or two on the weekend, and they could come up with a pretty good estimate, 1, 2, 3 hours a day. Now, when we ask parents how much time their children spend with media, they have to stop and think, 'well, they're watching YouTube clips throughout the day. They're on their smartphone, their tablet, they're on social media, texting and playing all these different games.' It really becomes challenging to even get a grasp of the quantity of screen time let alone what kids are doing when they're using those screens.

I will say for this book chapter, we found a really great review that summarized over 130 studies and found that kids are spending about three and a half or four hours a day using screens. Yet some of these studies are showing as high as seven or eight hours. I think it's probably under-reported because parents have a hard time really grasping how much time kids spend on screens. I've got a one-year-old and a five-year-old, and I've got some nieces and nephews and I'm constantly looking over their shoulder trying to figure out what games are they playing and where are they going online and what are they doing. Because this is changing really rapidly and we're trying to keep up with it and trying to make sure that screen time is a safe and perhaps healthy place to be. And that's really where a lot of our research is focused.

I can only imagine how challenging it must be to work through that landscape. And because the technology advances way more quickly than the policies and legal landscape to control it, it really is pretty much whatever anybody wants to do, they do it and very little can be done about it. It's a really interesting picture, I know. We'll come back later and talk about what might be done about it. Tom, if you will help us understand the impact of all this. What are the effects on the diets of children and adolescents? I'm thinking particularly when Amanda was mentioning how many hours a day children are on it that three to four hours could be an underestimate of how much time they're spending. What did kids used to do with that time? I mean, if I think about when you and I were growing up, we did a lot of different things with that time. But what's it look like now?

Well, that's one of the important questions that we don't really know a lot about because even experimental studies that I can talk about that look at reducing screen time have not been very good at being able to measure what else is going on or what substitutes for it. And so, a lot of the day we don't really know exactly what it's displacing and what happens when you reduce screen time. What replaces it? The assumption is that it's something that's more active than screen time. But, you know, it could be reading or homework or other sedentary behaviors that are more productive. But we really don't know. However, we do know that really the general consensus across all these studies that look at the relationship between screen time and nutrition is that the more time children spend using screens in general, the more calories they consume, the lower the nutritional quality of their diets and the greater their risk for obesity. A lot of these studies, as Amanda mentioned, were dominated by studies of television viewing, or looking at television viewing as a form of screen use. And there's much less and much more mixed results linking nutrition and obesity with other screens such as video games, computers, tablets, and smartphones. That doesn't mean those relationships don't exist. Only that the data are too limited at this point. And there's several reasons for that. One is that there just haven't been enough studies that single out one type of screen time versus another. Another is what Amanda brought up around the self-report issue, is that most of these studies depend on asking children or the parents how much time they spend using screens. And we know that children and adults have a very hard time accurately reporting how much time they're using screens. And, in fact when we measure this objectively, we find that they both underestimate and overestimate at times. It's not all in one direction, although our assumption is that they underestimate most of the time, we find it goes in both directions. That means that in addition to sort of not having that answer about exactly what the amount of screen time is, really makes it much tougher to be able to detect relationships because it adds a lot of error into our studies. Now there have been studies, as I mentioned, that have tried to avoid these limitations by doing randomized controlled trials. Including some that we conducted, in which we randomized children, families or schools in some cases to programs that help them reduce their screen time and then measure changes that occur in nutrition, physical activity, and measures of obesity compared to kids who are randomized to not receive those programs. And the randomized trials are really useful because they allow us to make a conclusion about cause-and-effect relationships. Some of these programs also targeted video games and computers as well as television. In fact, many of them do, although almost all of them were done before tablets and smartphones became very common in children. We still don't have a lot of information on those, although things are starting to come out. Most of these studies demonstrated that these interventions to reduce screen use can result in improved nutrition and less weight gain. And the differences seen between the treatment and control groups were sometimes even larger than those commonly observed from programs to improve nutrition and increased physical activity directly. Really, it's the strongest evidence we have of cause-and-effect relationships between screen use and poor nutrition and risk for obesity. Of course, we need a lot more of these studies, particularly more randomized controlled studies. And especially those including smartphones because that's where a lot of kids, especially starting in the preteen age and above, are starting to spend their time. But from what we know about the amount of apparent addictiveness that we see in the sophisticated marketing methods that are being used in today's media, I would predict that the relationships are even larger today than what we're seeing in all these other studies that we reviewed.

It's really pretty stunning when one adds up all that science and it looks pretty conclusive that there's some bad things happening, and if you reduce screen time, some good things happen. So, Amanda, if you know the numbers off the top of your head, how many exposures are kids getting to advertisements for unhealthy foods? If I think about my own childhood, you know, we saw ads for sugar cereals during Saturday morning cartoon televisions. And there might have been a smattering if kids watch things that weren't necessarily just directed at kids like baseball games and stuff like that. But, and I'm just making this number up, my exposure to those ads for unhealthy foods might have been 20 a week, 30 a week, something like that. What does it look like now?

That is a good question. Kelly. I'm not sure if anyone can give you a totally accurate answer, but I'll try. If you look at YouTube ads that are targeting children, a study found that over half of those ads were promoting foods and beverages, and the majority of those were considered unhealthy, low nutritional value, high calorie. It's hard to answer that question. What we used to do is we'd take, look at all the Saturday morning cartoons, and we'd actually record them and document them and count the number of food ads versus non-food ads. And it was just a much simpler time in a way, in terms of screen exposure. And we found in that case, throughout the '90s and early 2000s, a lot of food ads, a lot of instances of these food ads. And then you can look at food placement too, right? It's not an actual commercial, but these companies are paying to get their food products in the TV show or in the program. And it's just become much more complicated. I think it's hard to capture unless you have a study where you're putting a camera on a child, which some people are doing, to try to really capture everything they see throughout their day. It's really hard to answer, but I think it's very prolific and common and becoming more sophisticated.

Okay, thanks. That is very helpful context. Whatever the number is, it's way more than it used to be.

Definitely.

And it also sounds as if and it's almost all for unhealthy foods, but it sounds like it's changed in other ways. I mean, at some point as I was growing up, I started to realize that these things are advertising and somebody's trying to sell me something. But that's a lot harder to discern now, isn't it with influencers and stuff built in the product placements and all that kind of stuff. So, to the extent we had any safeguards or guardrails in the beginning, it sounds like those are going to be much harder to have these days.

That's right. It really takes until a child is 6, 7, 8 years old for them to even identify that this is a commercial. That this is a company that's trying to sell me something, trying to persuade. And then even older children are having to really understand those companies are trying to make money off the products that they sell, right? A lot of kids, they just look at things as face value. They don't discriminate against the commercial versus the non-commercial. And then like you're suggesting with social influencers, that they're getting paid to promote specific products. Or athletes. But to the child that is a character or a person that they've learned to love and trust and don't realize, and as adults, I think we forget sometimes too.

That's very true. Amanda, let me ask about one thing that you and Tom had in your chapter. You had a diagram that I thought was very informative and it showed the mechanisms through which social media affects the diet and physical activity of children. Can you describe what you think some of the main pathways of influence might be?

That figure was pretty fun to put together because we had a wonderful wealth of knowledge and expertise as authors on this chapter. And people provided different insight from the scientific evidence. I will say the main path we were trying to figure out how does this exposure to screen really explain changes in what children are eating, their risk for obesity, the inactivity and sedentary behavior they're engaging in? In terms of food, really what is I believe the strongest relationship is the exposure to food advertisement and the eating while engaging in screen time. You're getting direct consumption while you're watching screens, but also the taste preferences, the brand loyalty that's being built over time by constantly seeing these different food products consistently emerge as one of the strongest relationships. But we identified some other interesting potential mechanisms too. While kids are watching screens or engaging in screens, there's some evidence to indicate that they're not able to read their body as well. Their feelings of hunger, their feelings of satiety or fullness. That they're getting distracted for long periods of time. Also, this idea of instant gratification, just like the reward process of instant gratification with using the screen. They're so interactive. You can go online and get what you want and reach what you want. And the same thing is happening with food. It becomes habitual as well. Children get off of school and they go home, and they grab a snack, and they watch tv or they watch their YouTube clips or play their games. And it becomes an eating occasion that may not have otherwise existed. But they're just associating screen time with eating. There's some evidence even on screen time impacting inhibition and controlling impulse and memory. And that's more emerging, but it's interesting to just consider how this prolonged screen time where you're not interacting with someone in person, your eyes are focused on the screen, might actually be having other cognitive impacts that we may not even be aware of yet.

If we ask the question why Is screen time having a bad impact on children and their diets? It's almost let us count the ways. There are a lot of possible things going on there. And speaking of that, there's one question in particular I'd like to ask you, Tom. Certainly marketing might affect what kids prefer. Like it might make them want to have a cereal or a beverage A or snack food B or whatever it happens to be. But could it also affect hunger? How much kids want to eat? I mean, you think, well, hunger is biological, and the body sends out signals that it's time to eat. How does that all figure in?

The research suggests it can. Advertising in particular but even non-advertising references or images of food can trigger hunger and eating whether or not you felt hungry before you saw them. And I'm guessing almost everyone's experienced that themselves, where they see an image of food, and all of a sudden, they're craving it. It can be as simple as Pavlov's dogs, you know, salivating in response to cues about food. In addition, I think one of the mechanisms that Amanda brought up is this idea that when you're distracted with a screen, it actually overruns or overwhelms your normal feelings of fullness or satiety during eating. When distracted, people are less aware of how much they're eating. And when you're eating while using a screen, people tend to eat until they've finished the plate or the bag or the box, you know? And until that's empty, till they get to the bottom, instead of stopping when they start to get full.

Well, there's sort of a double biological whammy going on there, isn't there? It is affecting your likelihood of eating in the first place, and how hungry you feel. But then it also is affecting when you stop and your satiety happening. And you put those two together there's a lot going on, isn't there?

Exactly. And it's really one of the reasons why a lot of our programs to reduce weight gain and improve nutrition really put a lot of emphasis on not eating in front of screens. Because our studies have shown it accounts for a large proportion of the calories consumed during the day.

Oh, that's so interesting. Amanda, you mentioned influencers. Tell us a little bit more about how this works in the food space.

These social influencers are everywhere, particularly Instagram, TikTok, et cetera. Kids are seeing these all the time and as I mentioned earlier, you often build this trusting relationship with the influencer. And that becomes who you look to for fads and trends and what you should and shouldn't do. A lot of times these influencers are eating food or cooking or at restaurants, even the ones that are reaching kids. As you analyze that, oftentimes it's the poor nutrition, high calorie foods. And they're often being paid for the ads too, which as we discussed earlier, kids don't always realize. There's also a lot of misinformation about diet and dieting, which is of concern. Misinformation that could be harmful for kids as they're growing and trying to grow in a healthy way and eat healthy foods. But kids who may look to overly restrict their foods, for example, rather than eating in a healthier manner. So that's definitely a problem. And then also, oftentimes these social influencers really have these unattainable beauty standards. Maybe they're using a filter or maybe they are models or whatnot. They're projecting these ideal body images that are very difficult and sometimes inappropriate for children to try to attain. Now, we've seen this in other forms, right? We've seen this in magazines going back. We've seen this on websites. But now as soon as a kid turns on their smartphone or their tablet and they're online, it's in front of them all the time. And, and they're interacting, they're liking it, they're commenting and posting. I think the social influencers have just really become quite pervasive in children's lives.

Somebody who's an influencer might be recording something that then goes out to lots and lots of people. They're eating some food or there's some food sitting in the background or something like that. And they're getting paid for it, but not saying they're getting paid for it. Probably very few people realize that money is changing hands in all of that, I'm suspecting, is that right?

Yes, I do believe they're supposed to do hashtag ad and there are different indicators, but I'm not sure the accountability behind that. And I'm also not sure that kids are looking for that and really understand what that means or really care what that means.

Okay.

Because they're looking to sense what's popular. But there's an opportunity to perhaps further regulate, or at least to educate parents and kids in that regard that I think would be helpful.

Tom, while we're on this issue of conflicts of interest, there was recent press coverage, and then there were reports by reporters at the Washington Post and The Examination showing that the food industry was paying dieticians to be influencers who then posted things favorable to industry without disclosing their funding. How big of a problem do you think this is sort of overall with professionals being paid and not disclosing the payments or being paid even if they disclose things. What kind of a negative impact that's having?

Yes, I find it very concerning as you would guess, knowing me. And I believe one of the investigations found that about half of influencers who were being paid to promote foods, drinks, or supplements, didn't disclose that they were paid. It was quite a large magnitude. It goes throughout all types of health professionals who are supposed to be sources of quality information and professional organizations themselves which take advertising or take sponsorships and then don't necessarily disclose it. And you know in this day when we're already seeing drops in the public's trust in science and in research, I think this type of information, or this type of deception just makes it a lot worse. As you know, Kelly, there's quite a bit of research that suggests that being paid by a company actually changes the way you talk about their products and even conduct research in a way that's more favorable to those products. Whether you think it does or not, whether you're trying to be biased or not.

Tom, just to insert one thing in my experience. If you ask people in the field, does taking money from industry affect the way scientists do their work and they'll almost always say yes. But if you say, does it influence your work, they'll almost always say no. There's this unbelievable blind spot. And one might conclude from what you were telling us is that disclosure is going to be the remedy to this. Like for the half of people who didn't disclose it, it would be okay if they took the money as long as they disclosed it. But you're saying that's obviously not the case. That there's still all kinds of bias going on and people who are hearing some disclosure don't necessarily discount what they're hearing because of it. And it's still a pretty bad kettle of fish, even if disclosure occurs. It's especially pernicious when it doesn't, but it seems even when disclosure happens, it's not much of a remedy to anything. But you may not agree.

No, I definitely agree with that. And that's only, you know, part of it too because there's the other side of the audience that Amanda brought up as well. And in particular what kids, but also adults, how they react to disclosures. And, while it's been possible to teach people to recognize potential bias, you know, when there's a disclosure. And to make people aware, which is a good thing, we want disclosure, I guess, so people are aware to be more vigilant in terms of thinking about what biases may be in the messages. There's not much evidence that teaching people that or making them aware of that changes their behavior. They still believe the advertising.

Right.

They still act in the same way. It's still just as persuasive to them.

One more little editorial insertion. The thing that has always puzzled me about disclosure is that it implies that there's something bad going on or else, why would you have to disclose it? And the solution seems not to disclose it, but not to do the bad thing. And it's like, I could come up and kick you in the leg, but it's okay if I disclose that I kick you in the leg. I mean, it just makes no sense to me. But let me move on to something different. Amanda, I'd like to ask you this. I assume the food industry gets a lot more impact and reach per dollar they spend from when the only option was to run ads on national television and now, they're doing things at much less expense, I think, that can have, you know, orders of magnitude more impact and things. But is my perception correct? And how do you think through that?

I think of it like the Tupperware model, right? You're building these trusted local or national celebrities, spokespeople for kids. Oftentimes these young adults or teenagers who are doing funny things and they're engaging, and so you're building this trust like you did with the Tupperware. Where you go and train people to go out to people's homes and their neighbors and their friends and their church and sell the product. It's really similar just in an online space. I think you're right; the cost is likely much less. And yet the reach and even the way these influencers are paid is all about the interaction, the likes, the comments, that sort of thing. The reposts. It's become quite sophisticated, and clearly, it's effective because companies are doing this. And one other thing to mention we haven't talked about yet is the food companies themselves have hired young people who use humor as a way to create a following for the different brands or products. It's not a person now, it's either the branded character or the actual company itself. And I think that has great influence of building some loyalty to the brand early in life. So that child is growing up and not only persuading their parents to purchase these products, but as they have more disposable income, they're going to continue purchasing the product.

I wonder if Edward Tupper or I don't know if I remember his first name right, but I wonder if you could have ever imagined the how his plastic invention would permeate more of society than he ever thought? Tom, what about the argument that it's up to parents to decide and to monitor what their children are exposed to and the government needs to back off.

Oh, it would be so nice if they were that easy, wouldn't it? If we could depend on parents. And I think every parent would love to be able to do that. But we're talking about individual parents and their kids who are being asked to stand up against billions, literally billions and billions of dollars spent every year to get them to stay on their screens as long as possible. To pay attention to their marketing, as Amanda was talking about the techniques they use. And to really want their products even more. If you could think of a parent with endless knowledge and time and resources, even they are really unable to stand up to such powerful forces working against them. Unfortunately, and this is not unique to the issues of screens in children's health, but really many of the issues around health, that in the absence of government regulation and really lack of any oversight, this really difficult job is dumped on parents. You know, not their choice, but it's sort of in their lap. We still try and help them to be better at this. While we're waiting for our elected representatives to stand up to lobbyists and do their jobs, we still in a lot of our interventions we develop, we still try and help parents as well as schools, afterschool programs, teachers, health professionals, develop the skills to really help families resist this pool of media and marketing. But that shouldn't be the way it is. You know, most parents are really already doing the best they can. But it's drastically unfair. It's really an unfair playing field.

That all makes good sense. We've been talking thus far about the negative impacts of media, but Amanda, you've done some work on putting this technology to good use. Tell us about that if you will.

I do enjoy trying to flip the script because technology is meant to help us, not harm us. It's meant to make our lives more efficient, to provide entertainment. Now with video chatting, to provide some social connection. A lot of my work over the past 20 years has been looking at what's commercially available, what kids are using, and then seeing let's test these products or these programs and can we flip them around to promote healthier eating? To promote physical activity? Can we integrate them for kids who are in a weight management program? Can we integrate the technology to really help them be successful? It doesn't always work, and we certainly aren't looking to increase screen time, but we also need to recognize that achieving zero hours of screen time is really unattainable pretty much universally. Let's try to evaluate the screen time that is being used and see if we can make it healthier. A few examples of that include when the Nintendo Wii came out about 18 years ago now. I was part of a group that was one of the first to test that video game console system because up until that point, most of the games you sat down to play, you held a remote in your hand. There were Dance Dance Revolution games and arcade halls so you could do a little bit of movement with games. But pretty much they were sedentary. Nintendo Wii came out and really changed a lot because now you had to get up off the couch, move your body, move your arms and legs to control the game. And we found it cut across all demographics. Men, women, boys, girls, different age groups. There was content available for a lot of different groups. These types of games became really popular. And I did some of the earlier studies to show that at least in a structured program that kids can engage in what we call moderate levels of physical activity. They're actually moving their bodies when they play these games. And over time, I and others have integrated these games into programs as a way to be an in with kids who may not be involved in sports, may not go outside to play, but they're willing to put on a video game and move in their living room at home. Building from that, we've developed and tested various apps. Some of these apps directly reach the parents, for example, teaching the parents. These are strategies to get your child to eat healthier. Prepare healthier meals, grocery shop, be more physically active as a family. We've looked at different wearables, wristwatches that can help kids and parents. Maybe they'll compete against each other to try to get the most steps of a day and that sort of thing. And then some of my recent work is now integrating chatbots and artificial intelligence as ways to provide some tailored feedback and support to kids and families who are looking to be more physically active, eat healthier.

And then one study I'm really excited about uses mixed reality. This is virtual reality where you're putting on a headset. And for that study we are integrating children's homework that they would otherwise do on their Chromebook. And we're removing the keyboard and computer mouse so that they now have to use their body to click and point and drag and move the screen. And these are just a few examples. I do not think this is the magical solution. I think as Tom alluded to, there are different levels of government regulation, educating parents, working with schools. There's working with the food industry. There's a lot that we need to do to make this a healthier media space for kids. But I think this is something we should be open to, is figuring out if people are going to spend a lot of time using screens, what can we do to try to make those screens healthier?

You make me smile when I'm hearing that because all these things sound really exciting and like there's plenty of potential. And you're right, I mean, if they're going to be on there anyway, maybe there can be some positive way to harness that time. And those all sound really important and really good. And let's hope that they spread enough to really touch lots and lots of children and their families.

Tom, you and I keep caught up. We see each other at professional meetings or we just have periodic phone calls where we tell each other what we're up to. And you've been telling me over the past couple years about this really amazing project you're heading up tracking screen usage. Could you tell us a little bit about that?

I'd love to. Really it addresses the problem that came up before, which is really how we measure what people are doing and seeing on their screens. Basically all the studies of media effects for the past a hundred plus years that the field has been studying media, has been dependent on people telling us what they do and what they saw. When in fact, we know that's not particularly accurate. So now we have technology that allows us to track exactly what people are doing and seeing on their screens. We call this screenomics, like genomics, except instead of studying how genes affect us, it's studying how screens affect us and how the screens we experience in our lives really are a reflection of our lives. The way we are doing this is we put software on your phone or your laptop, and it can be on other screens as well, and it runs in the background and takes a screenshot every five seconds. And it covers everything on the screen because it's just taking a picture of the screen. All the words, all the images. Then we use AI to help us decipher [00:34:00] what was on those screens. And so far, we've collected over 350 million screenshots from several hundred adults and teenagers who've participated in our studies for periods of six months to a year. Some of our most interesting findings, I think, is how much idiosyncrasy there is in people's screen use. And this has a huge impact on how we do research on the effects of screens, I believe. Because no two people really have the same screenomes, which is what we call the sequence of screenshots that people experience. And even for the same person, no two hours or days or weeks are the same. We're looking at both how different people differ in their screen use, and how that's related to their mental health, for example. But also how changes over time in a single person's screenome is related to their mental health, for example. Comparing your screen use this afternoon to your screen use this morning or yesterday, or last week or last month. And how that changes your health or is at least associated with changes in your health at this point. Eventually, we hope to move this into very precise interventions that would be able to monitor what your screen experience is and give you an appropriate either change in your screen or help you change your behavior appropriate to what you're feeling.

One of our current studies is to learn really the details of what, when, how, why, and where foods and beverages appear in adolescent screenomes. And how these factors relate to foods and beverages they consume and their health. In fact, we're currently recruiting 13- to 17-year-olds all over the US who can participate in this study for six months of screenome collection and weekly surveys we do with them. Including detailed surveys of what they're eating. But this sort of goes back to an issue that came up before that you had asked us about how much is advertising? I can tell you that at least some of our preliminary data, looking at a small number of kids, suggests that food, it varies greatly across kids and what they're experiencing, especially on their phones. And, we found, for example, one young girl who 37% of all her screens had food on them. About a third, or more than a third of her entire screenome, had food in it. And it wasn't just through advertising and it wasn't just through social media or influencers. It was everywhere. It was pictures she was taking of food. It was influencers she was following who had food. It was games she was playing that were around food. There are games, they're all about running a restaurant or making food and serving and kitchen work. And then there were also videos that people watched that are actually fairly popular among where you watch other people eat. Apparently it's a phenomenon that came out of Korea first. And it's grown to be quite popular here over the last several years in which people just put on their camera and show themselves eating. I mean, nothing special, nothing staged, just people eating. There's all kinds of food exists everywhere throughout the screenome, not just in one place or another, and not just in advertising.

Tom, a study with a hundred data points can be a lot. You've got 350 million, so I wish you the best of luck in sorting all that out. And boy, whatever you find is going to be really informative and important. Thanks for telling us about this. I'd like to end with kind of a basic question to each of you, and that is, is there any reason for hope. Amanda, let's, let's start with you. Do you see any reason to be optimistic about all this?

We must be optimistic. No matter how we're facing.

We have no choice.

I think there's greater awareness. I think parents, policy makers, civic leaders are really recognizing this pervasive effective screen use on mental health, eating, obesity risk, even just the ability to have social interactions and talk to people face to face. And I think that's a good sign. I've seen even in my own state legislature in Louisiana, bills going through about appropriately restricting screens from schools and offering guidance to pediatricians on counseling related to screen use. The American Academy of Pediatrics changed their guidelines a number of years ago. Instead of just saying, no screens for the really little ones, and then limit to fewer than two hours a day for the older ones. They recognized and tried to be more practical and pragmatic with family. Sit down as a family, create some rules, create some boundaries. Make sure you're being healthy with your screen use. Put the screens away during mealtime. Get the screens out of the bedroom. And I think going towards those more practical strategies that families can actually do and sustain is really positive. I'd like to remain optimistic and let's just keep our eyes wide open and talk to the kids too. And ask the kids what they're doing and get them part of this because it's so hard to stay up to date on the technology.

Thanks. I appreciate that positive note. Tom, what do you think?

Yeah, I agree with Amanda. I can be positive about several things. First of all, I think last year, there were two bills, one to protect child privacy and the other to regulate technology aimed at children. COPPA 2.0 (Children’s Online Private Protection Act) and KOSA (Kid’s Online Safety Act). And they passed the Senate overwhelmingly. I mean, almost unanimously, or as close as you can get in our current senate. Unfortunately, they were never acted upon by the house, but in the absence of federal legislature regulation, we've had, as Amanda mentioned, a lot of states and also communities where they have actually started to pass bills or regulate social media. Things like prohibiting use under a certain age. For example, social media warning labels is another one. Limiting smartphone use in schools has become popular. However, a lot of these are being challenged in the courts by tech and media industries. And sadly, you know, that's a strategy they've borrowed, as you know well, Kelly, from tobacco and food industry. There also have been attempts that I think we need to fight against. For the federal legislature or the federal government, congress, to pass legislation to preempt state and local efforts, that would not allow states and local communities to make their own laws in this area. I think that's an important thing. But it's positive in that we're hearing advocacy against that, and people are getting involved. I'm also glad to hear people talking about efforts to promote alternative business models for media. I believe that technology itself is not inherently good or bad, as Amanda mentioned, but the advertising business models that are linked to this powerful technology has inevitably led to a lot of these problems we're seeing. Not just in nutrition and health, but many problems. Finally, I see a lot more parent advocacy to protect children and teens, especially around tech in schools and around the potential harms of social media. And more recently around AI even. As more people start to understand what the implications of AI are. I get the feeling these efforts are really starting to make a difference. Organizations, like Fair Play, for example, are doing a lot of organizing and advocacy with parents. And, we're starting to see advocacy in organizing among teens themselves. I think that's all really super positive that the public awareness is there, and people are starting to act. And hopefully, we'll start to see some more action to help children and families.

Bios

Developmental psychologist Dr. Amanda Staiano is an associate professor and Director of the Pediatric Obesity & Health Behavior Laboratory at Pennington Biomedical Research Center at Louisiana State University. She also holds an adjunct appointment in LSU's Department of Psychology. Dr. Staiano earned her PhD in developmental psychology and Master of Public Policy at Georgetown University, followed by a Master of Science in clinical research at Tulane University. Her primary interest is developing and testing family-based healthy lifestyle interventions that utilize innovative technology to decrease pediatric obesity and its comorbidities. Her research has involved over 2500 children and adolescents, including randomized controlled trials and prospective cohorts, to examine the influence of physical activity and sedentary behavior on body composition and cardiometabolic risk factors.

Thomas N. Robinson, MD, MPH is the Irving Schulman, MD Endowed Professor in Child Health, Professor of Pediatrics and of Medicine, in the Division of General Pediatrics and the Stanford Prevention Research Center at Stanford University School of Medicine, and Director of the Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford. Dr. Robinson focuses on "solution-oriented" research, developing and evaluating health promotion and disease prevention interventions for children, adolescents and their families to directly inform medical and public health practice and policy. His research is largely experimental in design, conducting school-, family- and community-based randomized controlled trials to test the efficacy and/or effectiveness of theory-driven behavioral, social and environmental interventions to prevent and reduce obesity, improve nutrition, increase physical activity and decrease inactivity, reduce smoking, reduce children's television and media use, and demonstrate causal relationships between hypothesized risk factors and health outcomes. Robinson's research is grounded in social cognitive models of human behavior, uses rigorous methods, and is performed in generalizable settings with diverse populations, making the results of his research more relevant for clinical and public health practice and policy.

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Today we're talking with health and nutrition expert Dr. Stuart Gillespie, author of a new book entitled Food Fight: from Plunder and Profit to People and Planet. Using decades of research and insight gathered from around the world, Dr. Gillespie wants to reimagine our global food system and plot a way forward to a sustainable, equitable, and healthy food future - one where our food system isn't making us sick. Certainly not the case now. Over the course of his career, Dr. Gillespie has worked with the UN Standing Committee on Nutrition in Geneva with UNICEF in India and with the International Food Policy Research Institute, known as IFPRI, where he's led initiatives tackling the double burden of malnutrition and agriculture and health research. He holds a PhD in human nutrition from the London School of Hygiene and Tropical Medicine.

Interview Summary

So, you've really had a global view of the agriculture system, and this is captured in your book. And to give some context to our listeners, in your book, you describe the history of the global food system, how it's evolved into this system, sort of warped, if you will, into a mechanism that creates harm and it destroys more than it produces. That's a pretty bold statement. That it destroys more than it produces, given how much the agriculture around the world does produce. Tell us a bit more if you would.

Yes, that statement actually emerged from recent work by the Food Systems Economic Commission. And they costed out the damage or the downstream harms generated by the global food system at around $15 trillion per year, which is 12% of GDP. And that manifests in various ways. Health harms or chronic disease. It also manifests in terms of climate crisis and risks and environmental harms, but also. Poverty of food system workers at the front line, if you like. And it's largely because we have a system that's anachronistic. It's a system that was built in a different time, in a different century for a different purpose. It was really started to come together after the second World War. To mass produce cheap calories to prevent famine, but also through the Green Revolution, as that was picking up with the overproduction of staples to use that strategically through food aid to buffer the West to certain extent from the spread of communism. And over time and over the last 50 years of neoliberal policies we've got a situation where food is less and less viewed as a human right, or a basic need. It's seen as a commodity and the system has become increasingly financialized. And there's a lot of evidence captured by a handful of transnationals, different ones at different points in the system from production to consumption. But in each case, they wield huge amounts of power. And that manifests in various ways. We have, I think a system that's anachronistic The point about it, and the problem we have, is that it's a system revolves around maximizing profit and the most profitable foods and products of those, which are actually the least healthy for us as individuals. And it's not a system that's designed to nourish us. It's a system designed to maximize profit. And we don't have a system that really aims to produce whole foods for people. We have a system that produces raw ingredients for industrial formulations to end up as ultra processed foods. We have a system that produces cattle feed and, and biofuels, and some whole foods. But it, you know, that it's so skewed now, and we see the evidence all around us that it manifests in all sorts of different ways. One in three people on the planet in some way malnourished. We have around 12 million adult deaths a year due to diet related chronic disease. And I followed that from colonial times that, that evolution and the way it operates and the way it moves across the world. And what is especially frightening, I think, is the speed at which this so-called nutrition transition or dietary transition is happening in lower income or middle income countries. We saw this happening over in the US and we saw it happening in the UK where I am. And then in Latin America, and then more Southeast Asia, then South Asia. Now, very much so in Sub-Saharan Africa where there is no regulation really, apart from perhaps South Africa. So that's long answer to your intro question.

Let's dive into a couple of things that you brought up. First, the Green Revolution. So that's a term that many of our listeners will know and they'll understand what the Green Revolution is, but not everybody. Would you explain what that was and how it's had these effects throughout the food systems around the world?

Yes, I mean around the, let's see, about 1950s, Norman Borlag, who was a crop breeder and his colleagues in Mexico discovered through crop breeding trials, a high yielding dwarf variety. But over time and working with different partners, including well in India as well, with the Swaminathan Foundation. And Swaminathan, for example, managed to perfect these new strains. High yielding varieties that doubled yields for a given acreage of land in terms of staples. And over time, this started to work with rice, with wheat, maize and corn. Very dependent on fertilizers, very dependent on pesticides, herbicides, which we now realize had significant downstream effects in terms of environmental harms. But also, diminishing returns in as much as, you know, that went through its trajectory in terms of maximizing productivity. So, all the Malthusian predictions of population growth out running our ability to feed the planet were shown to not to be true. But it also generated inequity that the richest farmers got very rich, very quickly, the poorer farmers got slightly richer, but that there was this large gap. So, inequity was never really properly dealt with through the Green Revolution in its early days. And that overproduction and the various institutions that were set in place, the manner in which governments backed off any form of regulation for overproduction. They continued to subsidize over production with these very large subsidies upstream, meant that we are in the situation we are now with regard to different products are being used to deal with that excess over production.

So, that idea of using petroleum-based inputs to create the foods in the first place. And the large production of single crops has a lot to do with that Green Revolution that goes way back to the 1950s. It's interesting to see what it's become today. It's sort of that original vision multiplied by a billion. And boy, it really does continue to have impacts. You know, it probably was the forerunner to genetically modified foods as well, which I'd like to ask you about in a little bit. But before I do that, you said that much of the world's food supply is governed by a pretty small number of players. So who are these players?

If you look at the downstream retail side, you have Nestle, PepsiCo, Coca-Cola, General Mills, Unilever. Collectively around 70% of retail is governed by those companies. If you look upstream in terms of agricultural and agribusiness, you have Cargill, ADM, Louis Dreyfus, and Bunge. These change to a certain extent. What doesn't change very much are the numbers involved that are very, very small and that the size of these corporations is so large that they have immense power. And, so those are the companies that we could talk about what that power looks like and why it's problematic. But the other side of it's here where I am in the UK, we have a similar thing playing out with regard to store bought. Food or products, supermarkets that control 80% as Tesco in the UK, Asta, Sainsbury's, and Morrisons just control. You have Walmart, you have others, and that gives them immense power to drive down the costs that they will pay to producers and also potentially increase the cost that they charge as prices of the products that are sold in these supermarkets. So that profit markup, profit margins are in increased in their favor. They can also move around their tax liabilities around the world because they're transnational. And that's just the economic market and financial side on top of that. And as you know, there's a whole raft of political ways in which they use this power to infiltrate policy, influence policy through what I've called in Chapter 13, the Dark Arts of Policy Interference. Your previous speaker, Murray Carpenter, talked about that with regard to Coca-Cola and that was a very, yeah, great example. But there are many others.

In many ways these companies have been brilliant at adapting to the regulatory landscape, to the financial incentives, to the way the agriculture system has become warped. I mean, in some ways they've done the warping, but in a lot of ways, they're adapting to the conditions that allow warping to occur. And because they've invested so heavily, like in manufacturing plants to make high fructose corn syrup or to make biofuels or things like that. It'd be pretty hard for them to undo things, and that's why they lobby so strongly in favor of keeping the status quo. Let me ask you about the issue of power because you write about this in a very compelling way. And you talk about power imbalances in the food system. What does that look like in your mind, and why is it such a big part of the problem?

Well, yes. And power manifests in different ways. It operates sometimes covertly, sometimes overtly. It manifests at different levels from, you know, grassroots level, right up to national and international in terms of international trade. But what I've described is the way markets are captured or hyper concentrated. That power that comes with these companies operating almost like a cartel, can be used to affect political or to dampen down, block governments from regulating them through what I call a five deadly Ds: dispute or dispute or doubt, distort, distract, disguise, and dodge. And you've written very well Kelly, with I think Kenneth Warner about the links between big food and big tobacco and the playbook and the realization on the part of Big Tobacco back in the '50s, I think, that they couldn't compete with the emerging evidence of the harms of smoking. They had to secure the science. And that involved effectively buying research or paying for researchers to generate a raft of study shown that smoking wasn't a big deal or problem. And also, public relations committees, et cetera, et cetera. And we see the same happening with big food. Conflicts of interest is a big deal. It needs to be avoided. It can't be managed. And I think a lot of people think it is just a question of disclosure. Disclosure is never enough of conflict of interest, almost never enough. We have, in the UK, we have nine regulatory bodies. Every one of them has been significantly infiltrated by big food, including the most recent one, which has just been designated to help develop a national food stretch in the UK. We've had a new government here and we thought things were changing, beginning to wonder now because big food is on that board or on that committee. And it shouldn't be, you know. It shouldn't be anywhere near the policy table anyway. That's so it's one side is conflict of interest.

Distraction: I talk about corporate social responsibility initiatives and the way that they're designed to distract. On the one hand, if you think of a person on a left hand is doing these wonderful small-scale projects, which are high visibility and they're doing good. In and off themselves they're doing good. But they're small scale. Whereas the right hand is a core business, which is generating harm at a much larger scale. And the left hand is designed to distract you from the right hand. So that distraction, those sort of corporate CSR initiatives are a big part of the problem.

And then 'Disguise' is, as you know, with the various trade associations and front groups, which acted almost like Trojan horses, in many ways. Because the big food companies are paying up as members of these committees, but they don't get on the program of these international conferences. But the front groups do and the front groups act on in their interests. So that's former disguise or camouflage. The World Business Council on Sustainable Development is in the last few years, has been very active in the space. And they have Philip Morris on there as members, McDonald's and Nestle, Coke, everybody, you know. And they deliberately actually say It's all fine. That we have an open door, which I, I just can't. I don't buy it. And there are others. So, you know, I think these can be really problematic. The other thing I should mention about power and as what we've learned more about, if you go even upstream from the big food companies, and you look at the hedge funds and the asset management firms like Vanguard, state Capital, BlackRock, and the way they've been buying up shares of big food companies and blocking any moves in annual general meetings to increase or improve the healthiness of portfolios. Because they're so powerful in terms of the number of shares they hold to maximize profit for pension funds. So, we started to see the pressure that is being put on big food upstream by the nature of the system, that being financialized, even beyond the companies themselves, you know?

You were mentioning that these companies, either directly themselves or through their front organizations or the trade association block important things that might be done in agriculture. Can you think of an example of that?

Yes, well actually I did, with some colleagues here in the UK, the Food Foundation, an investigation into corporate lobbying during the previous conservative government. And basically, in the five years after the pandemic, we logged around 1,400 meetings between government ministers and big food. Then we looked at the public interest NGOs and the number of meetings they had over that same period, and it was 35, so it was a 40-fold difference.

Oh goodness.

Which I was actually surprised because I thought they didn't have to do much because the Tory government was never going to really regulate them anyway. And you look in the register, there is meant to be transparency. There are rules about disclosure of what these lobbying meetings were meant to be for, with whom, for what purpose, what outcome. That's just simply not followed. You get these crazy things being written into the those logs like, 'oh, we had a meeting to discuss business, and that's it.' And we know that at least what happened in the UK, which I'm more familiar with. We had a situation where constantly any small piecemeal attempt to regulate, for example, having a watershed at 9:00 PM so that kids could not see junk food advertised on their screens before 9:00 PM. That simple regulation was delayed, delayed. So, delay is actually another D you know. It is part of it. And that's an example of that.

That's a really good example. And you've reminded me of an example where Marian Nestle and I wrote an op-ed piece in the New York Times, many years ago, on an effort by the WHO, the World Health Organization to establish a quite reasonable guideline for how much added sugar people should have in their diet. And the sugar industry stepped in in the biggest way possible. And there was a congressional caucus on sugar or something like that in our US Congress and the sugar industry and the other players in the food industry started interacting with them. They put big pressure on the highest levels of the US government to pressure the WHO away from this really quite moderate reasonable sugar standard. And the US ultimately threatened the World Health Organization with taking away its funding just on one thing - sugar. Now, thankfully the WHO didn't back down and ultimately came out with some pretty good guidelines on sugar that have been even stronger over the years. But it was pretty disgraceful.

That's in the book that, that story is in the book. I think it was 2004 with the strategy on diet, physical activity. And Tommy Thompson was a health secretary and there were all sorts of shenanigans and stories around that. Yes, that is a very powerful example.

It was a crazy power play and disgraceful how our government acted and how the companies acted and all the sort of deceitful ways they did things. And of course, that's happened a million times. And you gave the example of all the discussions in the UK between the food industry and the government people. So, let's get on to something more positive. What can be done? You can see these massive corporate influences, revolving doors in government, a lot of things that would argue for keeping the status quo. So how in the world do you turn things around?

Yeah, good question. I really believe, I've talked about a lot of people. I've looked a lot of the evidence. I really believe that we need a systemic sort of structural change and understanding that's not going to happen overnight. But ultimately, I think there's a role for a government, citizens civil society, media, academics, food industry, obviously. And again, it's different between the UK and US and elsewhere in terms of the ability and the potential for change. But governments have to step in and govern. They have to set the guardrails and the parameters. And I talk in the book about four key INs. So, the first one is institutions in which, for example, there's a power to procure healthy food for schools, for hospitals, clinics that is being underutilized. And there's some great stories of individuals. One woman from Kenya who did this on her own and managed to get the government to back it and to scale it up, which is an incredible story. That's institutions.

The second IN is incentives, and that's whereby sugar taxes, or even potentially junk food taxes as they have in Columbia now. And reforming the upstream subsidies on production is basically downregulating the harmful side, if you like, of the food system, but also using the potential tax dividend from that side to upregulate benefits via subsidies for low-income families. Rebalancing the system. That's the incentive side.

The other side is information, and that involves labeling, maybe following the examples from Latin America with regard to black octagons in Chile and Mexico and Brazil. And dietary guidelines not being conflicted, in terms of conflicts of interest. And actually, that's the fourth IN: interests. So ridding government advisory bodies, guideline committees, of conflicts of interests. Cleaning up lobbying. Great examples in a way that can be done are from Canada and Ireland that we found. That's government. Citizens, and civil society, they can be involved in various ways exposing, opposing malpractice if you like, or harmful action on the part of industry or whoever else, or the non-action on the part of the government. Informing, advocating, building social movements. Lots I think can be learned through activist group in other domains or in other disciplines like HIV, climate. I think we need to make those connections much more. Media. I mean, the other thought is that the media have great, I mean in this country at least, you know, politicians tend to follow the media, or they're frightened of the media. And if the media turned and started doing deep dive stories of corporate shenanigans and you know, stuff that is under the radar, that would make a difference, I think. And then ultimately, I think then our industry starts to respond to different signals or should do or would do. So that in innovation is not just purely technological aimed at maximizing profit. It may be actually social. We need social innovation as well.

There's a handful of things. But ultimately, I actually don't think the food system is broken because it is doing the wrong thing for the wrong reason. I think we need to change the system, and I'll say that will take time. It needs a real transformation. One, one last thing to say about that word transformation. Where in meetings I've been in over the last 10 years, so many people invoke food system transformation when they're not really talking about it. They're just talking about tweaking the margins or small, piecemeal ad hoc changes or interventions when we need to kind of press all the buttons or pull all the levers to get the kind of change that we need. And again, as I say, it was going to take some time, but we have to start moving that direction.

Do you think there's reason to be hopeful and are there success stories you can point to, to make us feel a little bit better?

Yeah, and I like that word, hope. I've just been reading a lot of essays from, actually, Rebecca Solnit has been writing a lot about hope as a warrior emotion. Radical hope, which it's different to optimism. Optimism went, oh, you know, things probably will be okay, but hope you make it. It's like a springboard for action. So I, yes, I'm hopeful and I think there are plenty of examples. Actually, a lot of examples from Latin America of things changing, and I think that's because they've been hit so fast, so hard. And I write in the book about what's happened in the US and UK it's happened over a period of, I don't know, 50, 60 years. But what's happened and is happening in Latin America has happened in just like 15 years. You know, it's so rapid that they've had to respond fast or get their act together quickly. And that's an interesting breed of activist scholars. You know, I think there's an interesting group, and again, if we connect across national boundaries across the world, we can learn a lot from that. There are great success stories coming out Chile from the past that we've seen what's happening in Mexico. Mexico was in a terrible situation after Vicente Fox came in, in the early 2000s when he brought all his Coca-Cola pals in, you know, the classic revolving door. And Mexico's obesity and diabetes went off to scale very quickly. But they're the first country with the sugar tax in 2014. And you see the pressure that was used to build the momentum behind that. Chile, Guido Girardi and the Black Octagon labels with other interventions. Rarely is it just one thing. It has to be a comprehensive across the board as far as possible. So, in Brazil, I think we will see things happening more in, in Thailand and Southeast Asia. We see things beginning to happen in India, South Africa. The obesity in Ghana, for example, changed so rapidly. There are some good people working in Ghana. So, you know, I think a good part of this is actually documenting those kind of stories as, and when they happen and publicizing them, you know.

The way you portrayed the concept of hope, I think is a really good one. And when I asked you for some examples of success, what I was expecting you, you might say, well, there was this program and this part of a one country in Africa where they did something. But you're talking about entire countries making changes like Chile and Brazil and Mexico. That makes me very hopeful about the future when you get governments casting aside the influence of industry. At least long enough to enact some of these things that are definitely not in the best interest of industry, these traditional food companies. And that's all, I think, a very positive sign about big scale change. And hopefully what happens in these countries will become contagious in other countries will adopt them and then, you know, eventually they'll find their way to countries like yours and mine.

Yes, I agree. That's how I see it. I used to do a lot of work on single, small interventions and do their work do they not work in this small environment. The problem we have is large scale, so we have to be large scale as well.

BIO

Dr. Stuart Gillespie has been fighting to transform our broken food system for the past 40 years. Stuart is a Non-Resident Senior Fellow in Nutrition, Diets and Health at theInternational Food Policy Research Institute (IFPRI). He has been at the helm of the IFPRI’s Regional Network on AIDs, Livelihoods and Food Security, has led the flagship Agriculture for Nutrition and Health research program, was director of the Transform Nutrition program, and founded the Stories of Change initiative, amongst a host of other interventions into public food policy. His work – the ‘food fight’ he has been waging – has driven change across all frontiers, from the grassroots (mothers in markets, village revolutionaries) to the political (corporate behemoths, governance). He holds a PhD in Human Nutrition from the London School of Hygiene and Tropical Medicine.

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Interest and grave concern have been mounting over the impact of agriculture and the food choices we all make on the environment, particularly on climate change. With natural weather disasters occurring much more frequently and serious threats from warming of the atmosphere in general, it's natural to look for places to make change. One person who has thought a lot about this is our guest today, Dr. William Dietz of George Washington University. He's been a prominent voice in this space. Bill, you're one of the people in the field I respect most because our relationship goes back many years. Bill is professor and director of research and policy at the Global Food Institute at George Washington University. But especially pertinent to our discussion today is that Dr. Dietz was co-chair of the Lancet Commission on the global syndemic of obesity, under nutrition and climate change. Today, we'll focus on part of that discussion on beef in particular.

Interview Summary

Bill, let's start out with a basic question. What in the heck is a syndemic?

A syndemic is a word that reflects the interaction of these three pandemics that we're facing. And those are obesity, under nutrition, and we've also called climate change a syndemic insofar as it affects human health. These three pandemics interact at both the biologic and social levels and have a synergistic adverse impact on each other. And they're driven by large scale social forces, which foster clustering and have a disparate impact on marginalized populations. Both in the developed and equally important, in the developing world. Here are a couple of examples of syndemics. So, increased greenhouse gases from high income countries reduce crop yields in the micronutrient content of crops, which in turn contribute to food insecurity and undernutrition in low and middle income countries. And eventually the reduction in crop yields and the micronutrient content of crops is going to affect high income countries.

Beef production is a really important driver of the climate change, and we're a major contributor in terms of the US' contribution. And beef production drives both methane and nitrous oxide emissions, and in turn, the consumption of red and processed meat causes obesity, diabetes, colon cancer, and cardiovascular disease. And finally, obesity, stunting and nutrition insecurity occur in the same children and in the same population in low- and middle-income countries.

Okay, so we'll come back to beef in a moment, but first, help us understand the importance of agriculture overall and our food choices in changing climate.

Well, so I think we have to go back to where this, the increase in mean global surface temperatures began, in about 1950. Those temperatures have climbed in a linear fashion since then. And we're now approaching a key level of increase of 1.5 degrees centigrade. The increase in mean surface temperature is driven by increased greenhouse gases, and the US is particularly culpable in this respect. We're it's second only to China in terms of our greenhouse gas emissions. And on a per capita basis, we're in the top four with China, India, and Brazil and now the US. And in the US, agriculture contributes about 10% of greenhouse gas emissions, and about 30% of fossil fuels are responsible for greenhouse gas emissions. But when you look at the actual contribution of car use among the fossil fuel use, it's pretty close to the contribution of greenhouse gases from agriculture. The important point here is each one degree increase centigrade in air temperatures associated with a 7% increase in water vapor. And this is responsible for the major adverse weather events that we're seeing today in terms of increased frequency and severity of hurricanes, the droughts. And I learned a new term from the New York Times a couple of days ago from the science section, which is atmospheric thirst. I had trouble understanding how climate change would contribute to drought, but that same effect in terms of absorbing moisture that occurs and drives the adverse weather events also dries out the land. So increasingly there's increased need for water use, which is driven by atmospheric thirst. But that increase in air temperature and the increase in water vapor, is what really drives these storms. Because in the Pacific and in the Atlantic and the Gulf of Mexico, this increase in air temperature is associated with an increase in water temperature, which further drives the increase in the severity of these storms.

Thanks for that background. Now let's get to beef. You and I were not long ago at the Healthy Eating Research conference. And you gave what I thought was a very compelling talk on beef. We'll talk in a minute about how much beef figures into this overall picture, but first, tell us how beef production affects both climate and health. And you mentioned nitrous oxide and methane, but how does this all work?

Cattle production is a big driver of the release of methane. And methane comes from cow burps. The important thing to understand about methane is that it's 80 times more powerful than CO2 in terms of its greenhouse gas emission.

And that's because it has a very long half-life when it gets up into the atmosphere?

Well, actually it's interesting because the half-life of methane is shorter than the half-life of nitrous oxide. So, it's an appropriate target for reduction. And the reduction has to occur by virtue of reduced beef consumption, which would reduce beef production. The other piece of this is that nitrous oxide is derived from fertilizer that's not absorbed by plants. And the application of fertilizer is a very wasteful process and a huge percent of fertilizer that's applied to crops is not absorbed by those plants. And it washes into the Mississippi River and down to the Gulf of Mexico. But also, increases the genesis of nitrous oxide. And nitrous oxide is an even more powerful greenhouse gas than methane. About 260 times more powerful than CO2 with a very, very long half-life. So, as a target, we really ought to be focused on methane, and if we're going to focus on methane, we need to focus on beef.

You could imagine people who are opposed to these views on climate change making fun of cows burping. I mean, are there enough cows, burping enough where the methane that's coming out is a problem?

Yes. Maybe a better term that we can use is enteric fermentation, which is in effect cow burps. But enteric fermentation is the major source of methane. And nitrous oxide, the same thing. The agricultural system which supports cattle production, like the feedlot fattening from corn and wheat. The genesis of nitrous oxide is a product of fertilizer use and fertilizer use is a real important source of nitrous oxide because of the amount of fertilizer which is not absorbed by plants. But which washes into the Mississippi River and causes the dead zone in the Gulf, but also generates an enormous amount of nitrous oxide. So, between those two, the enteric fermentation and the origin of nitrous oxide from fertilizer use, are a lethal combination in terms of increasing greenhouse gas emissions. And it's important to know that those greenhouse gas emissions are associated with important declines in crop yields. Crop yields have declined by about 5% for maize for wheat, for soybeans, and somewhat less for rice. These crop yields have yet to affect the US but are clearly a problem in the Global South.

In your talk, you cited a paper by Scarborough and colleagues that was published in the Journal Nature Food that modeled the environmental impact of various diets. Could you please explain what they found?

This was a really nice study of four diets in the United Kingdom. Actually it was five diets. They looked at vegans, vegetarians, low meat eaters, medium meat eaters and high meat eaters. And looked at the contribution of these diets to the genesis of methane, nitrous oxide, and also importantly, land use and water use. And the most expensive, and the most detrimental environmental impact of these diets, were the among the high meat eaters. These were substantially greater than than the genesis of for example, methane by vegans. For example, high meat eaters generated about 65 kilograms per day of methane compared to vegans, which generated only four kilograms per day of methane. And when you reduce beef, and there were two lower categories, these measures come much more into line with what we'd like to have. The low meat eaters generate about half of methane that the high meat eaters generate. This is also true for their genesis of nitrous oxide. And importantly, the land use among vegans and vegetarians is about a third of the land use required for the production of beef. And water use by meat production is about twice that generated by the water use by the production of plant-based diets. I think these are important data because they, they really reflect the importance of a lower meat consumption and higher plant-based diet. Not just in terms of greenhouse gases, but also in terms of land use and water use.

Not to mention health.

Not to mention health. Yes. I think it's important to continue to remind ourselves that beef consumption is associated with a variety of chronic diseases like obesity, like diabetes, like colon cancer and like cardiovascular disease. So, there's this double whammy from beef consumption, not only on the climate but also on human health.

In your talk that I heard it was interesting to see how you interpreted this information because you weren't arguing for no beef consumption. Because you were saying there could be tremendous benefit from people going from the high beef consumption category to a lower category. If you could take all the people who are consuming beef and drop them down a category, it sounds like there would be tremendous benefits. People could still have their beef but just not have it as often.

Right. I think that's an important observation that we're not talking about the elimination of beef. We're talking about the reduction in beef. And the Eat Lancet Commission pointed out that protein consumption in the US was six times what it should be in terms of human needs. And a lot of that protein comes from beef. And there's this belief, widespread, popular belief that beef is the most important source of protein. But comparisons of plant-based diets and plant-based proteins have an equivalent impact and equivalent absorption pattern like beef and are equally nourishing.

That's a really important thing to make prominent because people are thinking more and more about protein and it's nice to know there are various healthier ways to get protein than from a traditional meat diet.

Well, one of the, one of the important reports from the dietary guidelines advisory committee was to reclassify lentils, beans and peas as proteins rather than vegetables. And I think that's a, something which has not been widely appreciated, but it gives us a real important area to point to as an alternative protein to beef.

Bill, on this calculus, how important is the way the cattle are raised? So, you know, you have big cattle farms that might have a hundred thousand cattle in a single place being raised in very close quarters. And it's industrial agriculture, the kind of the epitome of industrial agriculture. But more and more people are beginning to study or experiment with or actually implement regenerative agriculture methods. How much would that help the environment?

That's kind of a complicated question. If we just start with beef production, we know that grass fed beef has a healthier fatty acid profile than feedlot fat and beef. But the total generation of greenhouse gases among grass fed beef is greater because they're fostered on land for a longer period of time than those cattle which are committed to feedlots. My understanding is that most of the cattle that go to feedlots are first raised on grass and then moved to feedlots where they're fed these commodity products of corn and wheat and, and maybe not soy. But that feedlot fattening is a critical step in beef production and is associated with overcrowding, antibiotic use, the generation of toxic dust really. An enormous amount of fecal material that needs to be adequately disposed of. It's the feedlot fattening of beef is what adds the adverse fatty acid content, and also contributes to the local environment and the damage to the local environment as a consequence of the cattle that are being raised.

Appreciate you weighing in on that. Let's talk about what might be done. So how do we go about increasing awareness, and the action, for that matter, in response to the contributions of beef production to climate change?

It begins with understanding about the contribution of beef production to climate change. This is not a well understood problem. For example, there was a study of 10 major news sources a couple of years ago which asked what the major contributions were of climate change. And they surveyed a hundred articles in each of 10 sources of information, which were popular press like New York Times, Washington Post, etc. And, at the top of that list, they characterize climate change as a consequence of fossil fuels. Whereas a recognition of the contribution of the agricultural system was at the bottom of that list and poorly covered. It's no surprise that people don't understand this and that's where we have to start. We have to improve people's perception of the contribution of beef. The other thing is that I don't think we can expect any kind of progress at the federal level. But in order to build the critical mass, a critical focus, we need to look at what we can personally change. First in our own behavior and then engaging family, peers and organizational networks to build the political will to begin to generate federal response.

Now, this brings up a really critical point that I'm not sure we have the time to do this. I don't think we are facing the whole issue of climate change with the kind of emphasis and concern that it deserves. I mentioned at the outset that the mean surface temperature is increasing rapidly. And the expectation was, and the goal was to achieve no greater than a 1.5 degrees centigrade increase by 2050. Well, in 2024, there was already a report that the mean surface temperature had already increased in some places by 1.5 degrees centigrade. So there has to be an urgency to this that I don't think people, are aware of. Youth understand this and youth feel betrayed and hopeless. And I think one of the important characteristics of what we can personally change, in engaging our family and peers, is a way of beginning to generate hope that change can occur. Because we can see it if it's our family and if it's our peers. Another important and critical strategy at the institution and state level is procurement policies. These, I think, are the most powerful tool that we have to change production at the municipal or local level, or at the state level. And we were part of an effort to get the HHS to change their procurement policy for their agencies. And although at the very last minute in the Biden administration, they agreed to do this, that's been superseded now by the changes that Trump has instituted. Nonetheless, this can be a local issue and that's where local change has to occur if we're going to build political will from the ground up.

Bill, tell me a little bit more about procurement because a lot of people don't even think about that term. But it turns out that the federal government and local and state governments buy lots of food. How is it that they buy lots of food and how they could have sway over the food environment just by their purchasing decisions?

So, let's take schools. Schools are a logical place. They have large contracts with vendors and if they set standards for what those vendors were supplying, like insisted on alternative proteins in at least some of their meal services that would have a big impact on reducing greenhouse gas emissions from school meals. And would have a positive impact on the health of students in those schools. This is known as value-based purchasing. Purchasing of products related to values that have to do with not only greenhouse gases, but also animal husbandry and fair workers' rights, and strategies like that. These are possible. They should be beginning in our universities. And this is an effort that we have underway here at George Washington University. But there are even better examples where universities have used plants as a default option in their cafeterias, which has, shown that when you do that and when you make the plant-based option the only visible choice, people choose it. And, in three universities, Lehigh, Rensselaer at Polytech, and Tulane, when they made plant-based options the only visible option, although you could ask for the alternative, the choices went up to 50 to almost 60 to 80% when the plant-based option was offered. And these were things like a lentil olive and mushroom spaghetti, which has a very low greenhouse gas emission. In fact, the net effect of these choices was a 24% reduction in greenhouse gases on days when the default was offered. These are practical types of initiatives. We need to increase the demand for these options as an alternative to beef.

Bill, I like how you're approaching this from kind of the big top level down, but also from the ground up. Because you talk about things that the federal government could do, for example, but also how important individual choices are. And how people can work with their families and friends and have an inspirational effect by changing their own behavior. Those sorts of things make me hopeful. But let me ask, how hopeful are you? Because I'm hearing from you this sort of dire picture that we might be too late, and that the climate change is happening so rapidly and that the social change needed to overcome that is painfully slow. But on the other hand, you're speaking some optimistic things. So how do you feel overall about where this is going?

I'm moderately hopeful. And moderately hopeful because I think young people are engaged. And we need to address the hopelessness that many of them feel. They feel betrayed by us. They feel like the adults in this country have let them down and have not focused enough. That's understandable. Particularly now given the distractions of the new administration. And I think we're in a real crisis and things all of a sudden are very fluid in terms of national initiatives. They've been dominated by the Trump administration, but I think that's changing. And I think that the kind of despotism that led to the station of troops in California, in Los Angeles, is a case in point of overreach of the government. The kind of ICE activities really deserve resistance. And all of that, I think, plays into this notion that we're in a fluid time. This is not a time that people are necessarily going to focus on beef consumption. But the fact that all of these climate changes, clearly a major issue at least for those who admit it, means that we need to begin and continue to build the political will for changes in beef consumption as well as changes in transportation policy. I think that actually beef consumption is an easier target then changes in transportation policy, which is driven by the way our communities are constructed. And in many cases, the only way to get from one place to another is by car, which means that we're going to have a continued dependence on fossil fuels. I don't think we can say the same thing about beef consumption because if we institute reductions in beef consumption, I think we can have a very immediate and longer-term impact on greenhouse gas emissions and therefore on climate change.

Bio

William (Bill) Dietz is the Director of Research and Policy for the Global Food Institute and a Professor in the Department of Exercise and Nutritional Sciences. Dietz is a member of the National Academy of Medicine (formerly the Institute of Medicine) and serves as a consultant to the Roundtable on Obesity Solutions. He also is the Director of the STOP Obesity Alliance at The George Washington University. He served as Director of the The Sumner M. Redstone Global Center for Prevention & Wellness until June 30, 2024. He is Co-Chair of the Washington, DC Department of Health’s Diabesity Committee, a Commissioner on the Washington, DC Office of the State Superintendent of Education’s Healthy Youth & Schools Commission, and Chair of its Subcommittee on Physical Activity. Dietz is also Co-Chair of The Lancet Commission on Obesity.

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I was at a professional meeting recently and I heard an inspiring and insightful and forward-looking talk by journalist and author Roger Thurow. Roger was a reporter for the Wall Street Journal for 30 years, 20 of them as a foreign correspondent based in Europe and Africa. Roger has written a number of books including one on world hunger and another what I thought was a particularly important book entitled The First 1000 Days, A Crucial Time for Mothers and Children and the World. Now comes a new book on farmers around the world and how they are coping with the unprecedented changes they face. It was hearing about his book that inspired me to invite Mr. Thurow to this podcast and thankfully he accepted. His new book is entitled Against the Grain: How Farmers Around the Globe are transforming Agriculture to Nourish the World and Heal the Planet.

Interview Summary

I really admire your work and have loved the new book and what I've read before. So, let's talk about something that you speak about: the wisdom of farmers. And you talk about their wisdom in the context of modern agriculture. What do you mean by that?

Farmers of the world, particularly the small holder farmers, indigenous farmers, family farmers as we know them in this country, they're really bold and pioneering in what they're doing. And these farmers, kind of around the world as we go on this journey around the world in the book, they've seen their efforts to earn a living and feed nourish their families and communities turn against. So, while conforming to the orthodoxies of modern industrial agriculture practices: the monocropping, the increased use of fertilizers and pesticides and insecticide chemicals, the land expansion, at the expense of savannas, forest wetlands, biodiverse environments. In the face of this, they've really witnessed their lands degrading. Their soils depleting. Their waters dwindling. Their pollinators fleeing. Their biodiversity shrinking and becoming less diverse. Their rains becoming ever more mercurial., Their temperatures ever hotter. And their children and families and their communities becoming ever more hungry and malnourished.

So, they've really seen the future of their own impacts on the environment, and then the impacts of changing climates, of more extreme weather conditions. They've really seen this future. They've experienced, lived it, and it's ugly what they see and what they've experienced on their farms. So, that's their wisdom, and they'll really tell us that it doesn't have to be that way if we listen. That such a future isn't inevitable. Because out of their desperation, you know, these farmers have begun farming against the grain. So, there's the title of the book Against the Grain of this modern agriculture orthodoxy to reconcile their roles as both food producers and nourishers of us all, and stewards in the land. They're pushing forward with practices like agroforestry, agroecology, regenerative agriculture, kind of whatever one calls it. Farming with nature instead of bending nature to their will, which is what we too often done and with kind of the larger modern industrial agriculture techniques. So, farming with nature as opposed to against it as they strive to both nourish us all and heal our planet.

Give us a sense, if you will, about how important these small farmers are to the world's food supply? So how important are these?

They're really important. Extremely vital for the global food chain, certainly for their own families and communities, and their countries. In a lot of places, say in Africa, in many of the countries, on the continent, it's the small holder farmers that are producing the majority of the food. In their communities and in their countries and across the continent. Still not enough. Africa then must become a substantial importer of food. But these small holder farmers are so key and the more success that they have in feeding their communities and families, the more success we all have then in this great goal of ending hunger and malnutrition.

Equally important, these farmers are the stewards of the land. And they're on the front lines of these environmental challenges. The threats from the changing climate and more extreme weather conditions. They're the first impacted by it, but they also increasingly see, and that's what stories in the book are about, how they see that their own actions are then impacting their environment and their climates. And this is why they're so important for all of us is that they find themselves at the center of what I think is this great collision of humanities two supreme imperatives. One, nourish the world, so nourish us all. That's the one imperative. And then the other imperative, kind of colliding with that, is to preserve, protect, and heal our planet from the very actions of nourishing us. So, these are these two colliding forces. You know as I think we already know agriculture and land use activities are responsible for about a third of the greenhouse gases impacting our climate and weather patterns. And the greatest impact of this then is felt by the farmers themselves. And they see what's happening to their soils and the depletion of their soils. Their lands being so terribly degraded by their very actions of nourishing their families and then contributing to nourishing us all. I think that's why they're so important for us. I mean, there's certainly kind of the canaries in the coal mine of climate change. Of these environmental challenges that we're all facing. And how they're then able to adjust their farming, as we kind of see in the book and that's this wisdom again. How can we learn from them and what are they seeing in their own situations. They're then having to adjust because they have no other options. They either have to adjust or their farms will continue to degrade and their children and their families increasingly malnourished and hungry.

Roger let's talk through this issue of colliding imperatives just a bit. The fact that protecting the planet and nourishing people are colliding in your view, suggests that these two priorities are competing with one another. How is that the case?

Some of the techniques of the monocropping, which is basically planting one crop on the same plot of land year after year, after year, season after season, right? And by doing that, these crops that are pulling nutrients out of the soil, many of the crops don't put nutrients back in. Some of them do. They'll restore nitrogen they'll put other nutrients in. But with the mono cropping, it's kind of the same depletion that goes on. And, has been particularly practiced in this country, and the bigger farmers and more commercial farmers, because it's more efficient. You are planting one crop, you have the same technique of kind of the planting and tending for that. And the harvesting, kind of the same equipment for that. You don't need to adjust practices, your equipment for various other crops that you're growing on that land. And so, there's an efficiency for that. You have then the price stability if there is any price stability in farming from that crop. That can be a weakness if the price collapses and you're so dependent on that. And so, the farmers are seeing, yeah, that's where the degrading and the weakening their of their soils comes from. So, what's their response to that when their land's degrading? When their soils become weak, it's like, oh, we need additional land then to farm. So they'll go into the forest, they'll cut down trees. And now there's virgin soil. They do the same practices there. And then after a number of years, well that land starts depleting. They keep looking for more. As you do these things, then with the soils depleting, the land degrading, becoming really hard, well, when the rain comes, it's not soaking in. And it just kind of runs away as the soil becomes almost like concrete. Farmers aren't able to plant much there anymore or get much out of the ground. And then so what happens then if the water isn't soaking into the soil, the underground aquifers and the underground springs they become depleted. All of a sudden, the lakes and the ponds that were fed by those, they disappear. The wildlife, the pollinators that come because of that, they go. The bushes, the plants, the weeds that are also so important for the environment, they start disappearing. And so you see that in their efforts to nourish their families and to nourish all of us, it's having this impact on the environment. And then that drives more impacts, right? As they cut down trees, trees drive the precipitation cycle. Tthen the rains become ever more mercurial and unpredictable. Without the trees and the shade and the cooling and the breezes, temperatures get hotter. And also, as the rains disappear and become more unpredictable. It has all this effect. And so, the farmers in the book, they're seeing all this and they recognize it. That by their very actions of cutting down trees to expand their land or to go to a different crop. Because again, that's what the commercial agriculture is demanding, so maybe its sugar cane is coming to the area. Well, sugar cane doesn't get along with trees. And so, the farmers in this one part of Uganda that I write about, they're cutting down all their trees to plant sugarcane. And then it's like, wow, now that the trees are gone, now we see all these environmental and ecosystem results because of that. And so that's where this collision comes from then of being much more aware, and sensitive in their practices and responding to it. That they are both nourishing their families and then also being even better stewards of their land. And they're not doing any of this intentionally, right? It's not like they're going 'we have to do all this to the land, and you know, what do we care? We're just here for a certain amount of time.' But no, they know that this is their land, it's their wealth, it's their family property. It's for their children and future generations. And they need to both nourish and preserve and protect and heal at the same time.

Well, you paint such a rich picture of how a single decision like mono cropping has this cascade of effects through the entire ecosystem of an area. Really interesting to hear about that. Tell me how these farmers are experiencing climate change. You think of climate change as something theoretical. You know, scientists are measuring these mysterious things up there and they talk about temperature changes. But what are these farmers actually experiencing in their day-to-day lives?

So along with the monocropping, this whole notion that then has expanded and become kind of an article of faith through industrial and modern agriculture orthodoxies, is to get big or get out, and then to plant from fence post to fence post. And so, the weeds and the flowers and plants that would grow along the edges of fields, they've been taken down to put in more rows of crops. The wetland areas that have either been filled in. So, it was a policy here, the USDA would then fund farmers to fill in their wetlands. And now it's like, oh, that's been counterproductive. Now there's policies to assist farmers to reestablish their wetland. But kind of what we're seeing with climate change, it's almost every month as we go through the year, and then from year after year. Every month is getting hotter than the previous months. And each year then is getting subsequently hotter. As things get hotter, it really impacts the ability of some crops in the climates where they're growing. So, take for instance, coffee. And coffee that's growing, say on Mount Kenya in Africa. The farmers will have to keep going further and further up the mountains, to have the cooler conditions to grow that type of coffee that they grow. The potato farmers in Peru, where potatoes come from. And potatoes are so important to the global food chain because they really are a bulwark against famine. Against hunger crises in a number of countries and ecologies in the world. So many people rely on potatoes. These farmers, they call themselves the guardians of the indigenous of the native potato varieties. Hundreds of various varieties of potatoes. All shapes, sizes, colors. As it gets warmer, they have to keep moving further and further up the Andes. Now they're really farming these potatoes on the roof of Earth. As they move up, they're now starting to then farm in soils that haven't been farmed before. So, what happens? You start digging in those soils and now you're releasing the carbon that's been stored for centuries, for millennia. That carbon is then released from the soils, and that then adds to more greenhouse gases and more impact on the climate and climate change. It kind of all feeds each other. They're seeing that on so many fronts. And then the farmers in India that we write about in the book, they know from history and particularly the older farmers, and just the stories that are told about the rhythm of the monsoon season. And I think it was the summer of the monsoon season of 2022 when I was doing the reporting there for that particular part of the book. The rains came at the beginning, a little bit. They planted and then they disappear. Usually, the monsoons will come, and they'll get some rain for this long, long stretch of time, sometimes particularly heavy. They planted and then the rains went away. And as the crops germinated and came up, well, they needed the water. And where was the water and the precipitation? They knew their yields weren't going to be as big because they could see without the rains, their crops, their millet, their wheat crops were failing. And then all of a sudden, the rains returned. And in such a downpour, it was like, I think 72 hours or three days kind of rains of a biblical proportion. And that was then so much rain in that short of time than added further havoc to their crops and their harvest. And it was just that mercurial nature and failing nature of the monsoons. And they're seeing that kind of glitches and kinks in the monsoon happening more frequently. The reliability, the predictability of the rains of the seasons, that's what they're all finding as kind of the impacts of climate change.

You're discussing a very interesting part of the world. Let's talk about something that I found fascinating in your book. You talked about the case of pigweed in Uganda. Tell us about that if you will.

Amaranth. So here, we call it pigweed. That's a weed. Yeah, destroy that. Again, fence post to fence post. Nah, so this pig weed that's growing on the side or any kind of weeds. The milkweed, so I'm from northern Illinois, and the milkweed that would kind of grow on the edges of the corn fields and other fields, that's really favored by monarch butterflies, right? And so now it's like, 'Hey, what happened to all the monarch butterflies that we had when we were growing up?' Right? Well, if you take out the milkweed plants, why are the monarch butterfly going to come? So those pollinators disappear. And they come and they're great to look at, and, you know, 'gee, the monarchs are back.' But they also perform a great service to us all and to our environment and to agriculture through their pollinating.

And so, the pigweed in Africa - Amaranth, it's like a wonder crop. And one of these 'super crops,' really nutritious. And these farmers in this area of Uganda that I'm writing about, they're harvesting and they're cultivating Amaranth. And they're mixing that in their homemade porridge with a couple of other crops. Corn, some millet, little bit of sugar that they'll put in there. And that then becomes the porridge that they're serving to the moms, particularly during their pregnancies to help with their nutritional status. And then to the babies and the small children, once they started eating complimentary food. Because the malnutrition was so bad and the stunting so high in that area that they figured they needed to do something about that. And the very farmers that this program from Iowa State University that's been working with them for 20 years now, first to improve their farming, but then wow, the malnutrition is so bad in these farming families. What can we do about that? Then it was, oh, here's these more nutritional crops native to the area. Let's incorporate them into farming. This crop is Amaranth. Basically, neglected in other parts of the world. Destroyed in other parts of the world. That is something that's actually cultivated and harvested, and really cared for and prized in those areas.

It's a really interesting story. Let's turn our attention to the United States, which you also profile in your book. And there was a particular farmer in Kansas named Brandon that you talk about. And he said he was getting divorced from wheat. Tell us about that.

Yes, thank you. That's a really interesting story because he's standing there kind of on the edge of his farm, looking at the wheat crops across the road that his neighbor was planting and he had some himself. And he's saying, yeah, I need to get a divorce from wheat. Because of the impact that that was having on the environment. Again, the planting of the wheat, you know, year after year. It's the wheat belt of our Great Plains, which then is legendarily known as the breadbasket, not only of America, but the breadbasket of the world. This wheat is particularly good and appropriate for the label of Breadbasket because it's really good for breads, baking materials. But he's looking at here's the impact it had on his soil. The organic matter on the soil has been dwindling. In the season that the wheat is underground, and the topsoil is uncovered, then you have the problems with erosion. He's seen the impact over time of the year after year after year of growing the wheat. What's interesting, he says, you know, I need to get a divorce from wheat. Well, it's his relatives, because he's a fifth descendant, of the Mennonite farmers from what is now Ukraine - one of the world's original grain belts, who brought their hard red winter wheat seeds with them when they came to the Great Plains in the 1870s. They're the ones that wed Kansas, the Great Plains, the United States to wheat. So now this farmer, Brandon-I-need-to-get-a-divorce-from-wheat, well, it's your ancestors and your descendants that wed us to that. There's kind of historic irony that's taking place. But along with the wheat seeds that came, then also came the plowing up the prairie lands for the first time. And wheat is an annual crop. It's planted year after year one harvest. With each planting, the soil is disturbed, releasing carbon that had been stored, that had been stored in the soil for millennium when they first started plowing. Carbon along with methane released by agricultural activities is, again, one of the most potent greenhouse gases.

And in addition, you know, this annual plowing exposes the soil to erosion. You know, relentless erosion with the wind and the rain in the plains. That's what eventually led to the Dust Bowl in the 1930s. Some environmental and conservation agricultural practices come along because of that, but now that continues. And Brandon himself is seeing the impact as he measures the organic matter in the soil. These are the microorganisms in the soils that naturally work with the soils to grow the crops to feed us all. The nutrients in the soil are weakened and depleted, which then results in the need for more and more chemical enhancements and fertilizers, particularly nitrogen and all the rest. And then you see the runoff of the nitrogen into the water system. And so, yeah, he's seen the impact of all of this, and he's like I need to do something else. And so, he's taken a rather radical step than of planting and growing perennial crops, which you plant one season and then they'll grow for three or four years, maybe more and longer. He has some cattle, so he is able to graze that on those perennial crops. One in particular called kernza, which is an ancient intermediate wheat grass. Has some of the properties of wheat. And so the Land Institute in Kansas then is also working on perennial crops and how can they then be cultivated and harvested also as crops that we all eat.

And so Kernza is very high in protein. There's all sorts of breads and pasta, pastries, that you can make with it. Cereals. It's a good ingredient for brewing. There's Kernza beer. And there's promise with that. And then so these perennial crops, then it's like, okay, so we don't have to plow every year. We plant, they grow, they provide a cover crop, but they also provide food for all of us. So perennials, good for our nutrition, good for the soils, good for the environment.

You know, we've recorded a series of podcasts with farmers who've been doing regenerative agriculture. And the kind of story that you talk about Brandon, quite similar to what you hear from some of the other farmers. Farming was in their family for many generations. They were accustomed to a particular type of industrial agriculture. They saw it harming the land, thought it bad for the planet, and decided to really retool and do things entirely different. And they're making a go of it, which is really exciting. Roger, I wanted to ask you about Native Americans. As you write about their agriculture, spirituality, kinship, and how all these things come together. Tell us about that.

Exactly. Thank you. And so, if you go travel a little bit further in our great plains from Kansas up to South Dakota, and the Sicangu Lakota communities in the southern part of South Dakota close to the Nebraska border. They're trying to reestablish their food sovereignty and the agriculture practices of the Native Americans destroyed, as we tried to destroy them and their communities. By taking of their land, forced relocations, the Trail of Tears, the Trail of Death, in various parts of the country, from various of the Native American communities. And they realize that, as you and the researchers at Duke, know really well, the health impacts that has had on the Native American communities and the high rates of diabetes and obesity, the shortened life expectancies in those communities. And one of the main factors then is their food pathways, and their nutrition being disturbed through all this. So how can they reestablish their food sovereignty? The emphasis on the crops that they used to grow, particularly the three sisters’ crops, the maize, the beans, the squash. And then that they would have crops and taste and nutrients that were so vital to their systems traditionally. To recapture that in various growing projects that they have. And then also, with the Sicangu Lakota, they are trying to reestablish the buffalo herd, which was basically decimated from upwards of 30 million or more size of the herd basically down to several hundred with the intentional slaughter of the buffalo in order to really oppress and impact the Native American community. So vital not only to their food sources and nutrition, but basically everything. Clothing, tools - so using every inch of the buffalo. And then spiritually. And as they explain their approach to regenerative agriculture, they would put a picture of a buffalo as the very definition of regenerative agriculture. Just by the way that the buffalo grazes and then moves around. It doesn't graze to the soil it leaves something behind. Then the grasses grow quicker because there's something that's left behind. They leave things behind for other animals. The way that they migrate, and then kind of knead the soil as they go along. That also helps with the soil. So, all these regenerative agriculture, regenerative soil, healthy soil healing practices of it. And then they also say, look the spiritual nature of things that the buffalo represents their kinship. Their kinship of the people to the buffalo, to their land, to the environment. And to them, regenerative agriculture isn't just about food, about soils, about the cultivation and the planting, but also about this kinship. It is a kinship and a spirituality of kind of all of us together. We're all combined on this global food chain. And so that whole kinship element to regenerative agriculture, I think is also really important for us to all understand.

Getting back to your original question about the wisdom. This is the wisdom of these farmers, these indigenous farmers, small holder farmers, family farmers. Like Brandon, the small holder farmers of African, India and Latin America are learning so much about their crops that we have so much to learn from.vIt's inspiring to think that some of the remedies that people are coming up with now in the face of all these challenges actually have historic roots that go back thousands of years is pretty inspiring. And it's nice to know that the resurrection of some of these techniques might really make a difference in the modern world.

Roger, there are so many questions I'd love to ask you. And I'd urge people to read your book Against the Grain to further explore some of these issues. But I wanted to end with something. Are you hopeful that things will change in a positive direction?

I am. I'm also concerned that we need to recognize the need to both nourish and heal. Recognize that this collision is looming, but it's already happening. And I think my hope, and cautious optimism I guess, then comes from the farmers themselves. They're very resilient, and they have to be, right? If you'd asked them the question about where their hope comes from or their optimism or their motivation and inspiration to keep going, it's they don't have any other option. I mean, this is their land. This is what they do. They're farmers, they're nourishing their families. If their families are to be nourished and to end the effects of poor nutrition as we see in this country, which is then common around the world, they need to adjust.

So Abebe, a farmer Ethiopia this is kind of where my hope and inspiration comes from. And he begins the book. He's at the outset of the book and in the prologue. His land in Ethiopia was utterly degraded and you couldn't plant there anymore. They had already cut down trees, moved into areas that had been forested. The humble forest in the area had basically disappeared, in kind of the greater area of where Abebe lives. The bigger kind of ecosystem, environmental changes that then come from that, or the disappearance of a forest. And he had been following then the practices and the orthodoxies of modern agriculture. He realized that that was then behind the degradation of his land and the soil. He couldn't plant anymore. And the World Food Program, the Ethiopian government, other kind of NGOs, were then seeing, look these farm communities, these families, we're going to have to be assisting with food assistance forever because their lands are so degraded. They're not able to nourish their families from them unless we do something to restore and heal the land and bring the land back. And so, Abebe and his family and many others in his community, the kind of wider neighborhood and in this area, the humble forest, a lot of them, they stop farming on their land and they're given assistance saved by the World Food Program, kind of food for work. And they set about rehabbing their land. Kind of terracing their land so it'll hold the water. Digging shallow water pans to collect the rain so it then soaks into the soil, into the ground, and then regenerates the underground springs and sources of water. Planting grasses, bushes, letting kind of the land heal and regenerate itself.

After a number of years, they see that happening. They move back to the land, and now he has this wide diversity as opposed to planting say corn every year or other mono cropping. Now he has this wide, wild, riotous array of different crops and vegetables and fruit trees. Some of the staple crops that he's grown also in rotation. Working with trees that have then grown up. Springs, a little pond has reformed that he didn't even know was there had come up because of the conservation the water. And he says, you know, my land, which once was dead, he's living again. Right? A profound statement and a realization from this farmer of this is how we can bring it back.

So again, as I say, they've seen the future and it's ugly, right? He's seen his land degraded. He couldn't nourish his family anymore. He then does these practices, takes heed of this. I need to heal my land at the same time as farming it. And now his land is living again. So that to me is kind of a wonderful parable. So again, the wisdom of the farmers. It's through the stories and the wisdom of Abebe, that kind of the hope comes forward.

Bio

Roger Thurow is a journalist and author who writes about the persistence of hunger and malnutrition in our world as well as global agriculture and food policy. He was a reporter at The Wall Street Journal for thirty years, including twenty years as a foreign correspondent based in Europe and Africa. In 2003, he and Journal colleague Scott Kilman wrote a series of stories on famine in Africa that was a finalist for the Pulitzer Prize in International Reporting. Thurow is the author of four books: Enough: Why the World’s Poorest Starve in an Age of Plenty (with Scott Kilman); The Last Hunger Season: A Year in an African Farm Community on the Brink of Change; The First 1,000 Days: A Crucial Time for Mothers and Children – And the World; and, Against the Grain – How Farmers Around the Globe Are Transforming Agriculture to Nourish the World and Heal the Planet. He has also been a senior fellow for Global Agriculture and Food Policy at the Chicago Council on Global Affairs, as well as a Scholar-in-Residence at Auburn University’s Hunger Solutions Institute.

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Recently I was asked to review a forthcoming book for American Scientist magazine. The book was entitled, Sweet and Deadly: How Coca-Cola Spreads Disinformation and Makes us Sick. I did the review, and now that the book has been published, I'm delighted that its author, Murray Carpenter, has agreed to join us. Mr. Carpenter is a journalist and author whose work has appeared in publications such as the New York Times, and the Washington Post, and has been featured in places like NPR's All Things Considered and Morning Edition.

Interview Summary

So, let's start with your career overall. Your journalism has covered a wide range of topics. But a major focus has been on what people consume. First, with your book Caffeinated and now with Sweet and Deadly. What brought you to this interest?

My interest in caffeine is longstanding. Like many of us, I consume caffeine daily in the form of coffee. And I just felt like with caffeine, many of us don't really discuss the fact that it is a drug, and it is at least a mildly addictive drug. And so, I became fascinated with that enough to write a book. And that really led me directly in an organic fashion to this project. Because when I would discuss caffeine with people, mostly they just kind of wanted the cliff notes. Is my habit healthy? You know, how much caffeine should I take? And, and in short, I would tell them, you know, if you don't suffer from anxiety or insomnia and you're consuming your caffeine in a healthy beverage, well, that's fine. But, what I realized, of course, is that by volume, the caffeinated beverage people consume most of is sodas. And so that led me to thinking more about sodas because I got a lot of questions about the caffeine in sodas. And that led me to realize just the degree to which they are unhealthful. We've all known sodas not to be a health food, but I think that the degree to which they are not healthy surprised me. And that's what led me to this book.

Yes, there's some very interesting themes aren't there with addiction and manipulation of ingredients in order to get people hooked on things. So let's talk about Coca-Cola a bit. Your book focuses on Coca-Cola. It's right there in the title. And certainly, they're giants in the beverage field. But are there other reasons that led you to focus on them? Other than that, the fact that they're the biggest?

They're the biggest and really almost synonymous with sodas worldwide. I mean, many people don't say ‘I want a pop, I want a soda.’ They say, ‘I want a Coke.’ I quote a source as saying that. You know, what that means is you want a sugar sweetened beverage. And it's not just that they're the most successful at this game, and the biggest. But as I started doing this research, I realized that they have also been the most aggressive and the most successful at this sort of disinformation that's the focus of the book. At generating these health campaigns, these science disinformation campaigns, we should say. This is not to say Pepsi and Dr. Pepper have not been at this game as well, and often through the American Beverage Association. But it is to say that I think Coca-Cola has been the most sophisticated. The most invested in these campaigns. And I would argue the most successful. And so, I really think it's a league apart and that's why I wanted to focus on Coca-Cola.

That makes good sense. So, in reading your book, I was struck by the sheer number of ways Coca-Cola protected their business interest at the expense of public health and also the degree to which it was coordinated and calculated. Let's take several examples of such activities and discuss exactly what the company has done. And I'd love your opinion on this. One thing you noted that Coke acted partly through other organizations, one of which you just mentioned, the American Beverage Association. There were others where there was sort of a false sense of scientific credibility. Can you explain more about what Coke did in this area?

Yes, and one of the organizations that I think is perhaps the exemplar of this behavior is the International Life Sciences Institute. It's a very successful, very well-funded group that purports to you know, improve the health of people, worldwide. It was founded by a Coca-Cola staffer and has, you know, essentially carried water for Coke for years through a variety of direct and indirect ways. But so front groups, the successful use of front groups: and this is to say groups that don't immediately appear to be associated, say with Coca-Cola. If you hear the International Life Sciences Institute, no one immediately thinks Coca-Cola, except for people who study this a lot. The International Food Information Council, another very closely related front group. This is one of the ways that Coke has done its work is through the use of front groups. And some of them are sort of these more temporary front groups that they'll establish for specific campaigns. For example, to fight soda taxes in specific areas. And they often have very anodyne names, and names again that don't directly link them to Coca-Cola or a beverage, the beverage industry. And the reason that this is so important and the reason this is so effective is journalists know if they were saying, Coca-Cola says soda isn't bad for you, of course that raises red flags. If they say, the International Life Sciences Institute says it's not bad for you, if they say the International Food Information Council says it's not bad for you. The use of front groups has been one of the very effective and persistent, strategies.

It almost sounds like the word deception could be written the charter of these organizations, couldn't it? Because it was really meant to disguise Coca-Cola's role in these things from the very get go.

That's right. Yes. And the deception runs very deep. One of the things that I happened onto in the course of reporting this book, Sweet and Deadly, is Coca-Cola two different times, organized three-day seminars on obesity in Colorado. These two attendees appeared to be sponsored by a press organization and the University of Colorado. They were funded and structured entirely at the behest of Coca-Cola. And it wasn't until after people had attended these seminars and reported stories based on the findings that they'd learned there. Much, much later did people find out that yes, actually these were Coca-Cola initiatives. So yes, deception, runs deep and it's a huge part of their public relations strategy.

It's like reputation laundering, almost.

Well, it is, and, you know, I make frequent analogies to the tobacco industry in the book. And I think one of the things that's important to remember when we're looking at tobacco and when we're looking at Coca-Cola, at the soda industry writ large, is that these are industries that are producing products that science now shows unequivocally are unhelpful. Even at moderate levels of consumption. So, in order for the industry to continue selling this product, to continue leading, they really have to fight back. It's imperative. It's a risk to their business model if they don't do something to fight the emerging health science. And so, yes, it's very important to them.

You know, it's easy, I guess, to ascribe this kind of behavior to ill meaning people within these organizations. But it's almost written into the DNA of these organizations. I mean, you said they have to do this. So, it’s pretty much be expected, isn't.

It is. I think young people when they hear something like this, they often shrug and say capitalism. And, yes, there's something to that. But capitalism thrives also in a regulated environment. I think that's maybe a little bit too simplistic. But the aspect of it that does apply here is that Coca-Cola is in the business of selling sugar water. That's what they're there to do. Granted, they've diversified into other products, but they are in the business of selling sugar water. Anything that threatens that business model is a threat to their bottom line. And so, they are going to fight it tooth and nail.

So how did Coca-Cola influence big health organizations like the World Health Organization and any equivalent bodies in the US?

Well, so a few different ways. One of the ways that Coca-Cola has really extended its influence is again, through the use of the front groups to carry messages such as, you know, a calorie is a calorie. Calories and calories out. That's, that's one of the strategies. Another is by having allies in high places politically. And sometimes these are political appointees that happen to be associated with Coca-Cola. Other times these are politicians who are getting funding from Coca-Cola. But, yes, they have worked hard. I mean, the WHO is an interesting one because the WHO really has been out a little bit ahead of the more national bodies in terms of wanting soda taxes, et cetera. But there's a subtler way too, I think, that it influences any of these political entities and these science groups, is that Coca-Cola it's such an all-American beverage. I don't think we can overstate this. It's almost more American than apple pie. And I think we still have not sort of made that shift to then seeing it as something that's unhealthful. And I do think that that has, sort of, put the brakes slightly on regulatory actions here in the US.

Let's talk about the Global Energy Balance Network, because this was an especially pernicious part of the overall Coca-Cola strategy. Would you tell us about that and how particular scientists, people of note in our field, by the way, were being paid large sums of money and then delivering things that supported industries positions.

Yes. This was a Coca-Cola initiative. And we have to be clear on this. This was designed and created at the behest of Coca-Cola staffers. This was an initiative that was really an effort to shift the balance to the calories outside of the equation. So energy balance is one of these, sort of, themes that Coca-Cola and other people have, sort of, made great hay with. And this idea would be just calories and calories out. That's all that matters. If you're just balanced there, everything else is to be okay. We can talk about that later. I think most of your listeners probably understand that, you know, a calorie of Coca-Cola is not nutritionally equivalent to a calorie of kale. But that's what the Global Energy Balance Network was really trying to focus on. And yes, luminaries in the field of obesity science, you know, Stephen Blair at the University of South Carolina, Jim Hill, then at the University of Colorado's Anschutz Center, the Global Energy Balance Network funded their labs with more than a million dollars to specifically focus on this issue of energy balance. Now, what was deceptive here, and I think it's really worth noting, is that Coca-Cola developed this project. But once it developed the project and gave the funding, it did not want to be associated with it. It wasn't the Global Energy Balance Network 'brought to you by Coca-Cola.' It appeared to be a freestanding nonprofit. And it looked like it was going to be a very effective strategy for Coca-Cola, but it didn't turn out that way.

So, we'll talk about that in a minute. How much impact did this have? Did it matter that Coke gave money to these several scientists you mentioned?

Well, I think yes. I think in the broader scheme of things that every increment of scientific funding towards this side matters. You know, people talk about the science of industrial distraction or industrial selection. And, you know, partly this is this idea that even if you're funding legitimate science, right, but it's focused on this ‘calories outside of the equation,’ it's sucking up some of the oxygen in the room. Some of the public conversation is going to be shifted from the harmful effects of a product, say Coca-Cola, to the benefits of exercise. And so, yes, I think all of this kind of funding can make a difference. And it influences public opinion.

So how close were the relationships between the Coca-Cola executives and the scientist? I mean, did they just write them a check and say, go do your science and we will let you come up with whatever you will, or were they colluding more than that?

And they were colluding much more than that. And I've got a shout out here to the Industry Documents Library at the University of California at San Francisco, which is meticulously archived. A lot of the emails that show all of the interrelationships here. Yes, they were not just chatting cordially - scientists to Coca-Cola Corporation. They were mutually developing strategies. They were often ready at a moment's notice to appear at a press conference on Coca-Cola's behalf. So, yes, it was a very direct, very close relationship that certainly now that we see the conversations, it's unseemly at best.

How did this all come to light? Because you said these documents are in this archive at UCSF. How did they come to light in the first place and how did shining light on this, you know, sort of pseudo-organization take place?

Well, here we have to credit, New York Times reporter, now at the Washington Post, Anahad O'Connor, who did yeoman's work to investigate the Global Energy Balance Network. And it was his original FOIA (Freedom of Information Act) requests that got a lot of these emails that are now in the industry document library. He requested these documents and then he built his story in large part off of these documents. And it was a front-page New York Times expose and, Coke had a lot of egg on its face. It's then CEO, even apologized, you know, in an op-ed in the Wall Street Journal. And you know, the sort of a secondary aspect of this is after this funding was exposed, Coca-Cola was pressured to reveal other health funding that it had been spending money on. And that was, I think over a few years like $133 million. They spread their money around to a lot of different organizations and in some cases the organizations, it was just good will. In other cases, you had organizations that changed their position on key policy initiatives after receiving the funding. But it was a lot of money. So, the Global Energy Balance Network, it is sort of opened a chink in their armor and gave people a view inside the machine. And there's something else that I'd love to mention that I think is really important about the Global Energy Balance Network and about that initiative. As Coca-Cola seems, and this became clear in the reporting of the book over and over again, they seem always to be three moves ahead on the chess board. They're not just putting out a brush fires. They're looking way down the road. How do we head off the challenge that we're facing in public opinion? How do we head off the challenge we're facing in terms of soda science? And in many cases, they've been very, very effective at this.

Were Coca-Cola's efforts mainly to influence policies and things in the US or did they have their eyes outside the US as well?

I focused the book, the reporting of the book, really on Coca-Cola in the US. And also, and I just want to mention this tangentially, it's also focused not on non-nutritive sweetened beverages, but the sugary beverages. It's pretty tightly focused. But yes, Coca-Cola, through other organizations, particularly the International Life Sciences Institute, has very much tried to influence policy say in China, for example, which is a huge market. So yes, they've exported this very successful PR strategy globally.

So, the corporate activities, like the ones you describe in your book, can be pretty clearly damaging to the public's health. What in the heck can be done? I mean, who will the change agents be? And do you think there's any hope of curtailing this kind of dreadful activity?

Well, this is something I thought about a lot. One of the themes of the book is that the balance of public opinion has never tipped against Coca-Cola. And we talked about this earlier, that it's still seen as this all American product. And we see with other industries and other products. So, you know, Philip Morris, smoking, Marlboro. Eventually the balance of public opinion tips against them and people accept that they're unhealthful and that they've been misleading the public. The same thing happened for Exxon and climate change, Purdue pharma and Oxycontin. It's a pattern we see over and over again. With Coca-Cola, it hasn't tipped yet. And I think once it does, it will be easier for public health advocates to make their case. In terms of who the change agents might be, here we have a really interesting conversation, right? Because the foremost change agent right now looks like it's RFK Jr. (Robert F. Kennedy), which is pretty remarkable and generates an awful lot of shall we say, cognitive dissonance, right? Because both the spending of SNAP Supplemental Nutrition Assistance Program funds for sodas, he's opposed to that. He has just as recently as the week before last called sugar poison. He said sugar is poison. These are the kinds of very direct, very forceful, high level, initiatives that we really haven't seen at a federal level yet. So, it's possible that he will be nudging the balance. And it puts, of course, everybody who's involved, every public health advocate, I think, who is involved with this issue in a slightly uncomfortable or very uncomfortable position.

Yes. You know, as I think about the kind of settings where I've worked and this conflict-of-interest problem with scientists taking money and doing things in favor of industry. And I wonder who the change agents are going to be. It's a pretty interesting picture comes with that. Because if you ask scientists whether money taints research, they'll say yes. But if you ask, would it taint your research, they'll say no. Because of course I am so unbiased and I'm so pure that it really wouldn't affect what I do. So, that's how scientists justify it. Some scientists don't take money from industry and there are no problems with conflicts of interest. But the ones who do can pretty easily justify it along with saying things like, well, I can help change the industry from within if I'm in the door, and things like that. The universities can't really police it because universities are getting corporate funding. Maybe not from that particular company, but overall. Their solution to this is the same as the scientific journals, that you just have to disclose. The kind of problem with disclosure as I see it, is that it - sort of editorializing here and you're the guest, so I apologize for intruding on that - but the problem with disclosure is that why do you need to disclose something in the first place because there's something potentially wrong? Well, the solution then isn't disclose it, it's not to do it. And disclosing is like if I come up and kick you in the leg, it's okay if I disclose it? I mean, it's just, there's something sort of perverse about that whole system. Journals there, you know, they want disclosure. The big scientific association, many of them are getting money from industry as well. So, industry has so permeated the system that it's hard to think about who can have any impact. And I think the press, I think it's journalists like you who can make a difference. You know, it wasn't the scientific organizations or anything else that got in the way of the Global Energy Balance Network. It was Anahad O'Connor writing in the New York Times, and all the people who were involved in exposing that. And you with your book. So that's sort of long-winded way of saying thank you. What you've done is really important and there are precious few change agents out there. And so, we have to rely on talented and passionate people like you to get that work done. So, thank you so much for sharing it with us. Let me just end with one final question. Do you see any reason to be optimistic about where this is all going?

I do. And I've got to say maybe you're giving scientists a little bit of short shrift here. Because, as the science develops, as it becomes more compelling and a theme of the book is that soda science really, over the past 15, 20 years has become more compelling. More unequivocal. We know the harms and, you know, you can quantify them and identify them more specifically than say, 15 years ago. So, I think that's one thing that can change. And I think slowly you're seeing, greater public awareness. I think the real challenge, in terms of getting the message out about the health risks, is that you really see like a bifurcated consumption of Coca-Cola. There are many people who are not consuming any Coca-Cola. And then you have a lot of people who are consuming, you know, say 20 ounces regularly. So, there is a big question of how you reach this other group of people who are still high consumers of Coca-Cola. And we know and you know this well from your work, that soda labeling is one thing that works and that soda taxes are another. I think those are things to look out for coming down the pike. I mean, obviously other countries are ahead of us in terms of both of these initiatives.

One of the things occurred to me as you were speaking earlier, you mentioned that your book was focused on the sugared beverages. Do you think there's a similar story to be told about deception and deceit with respect to the artificial sweeteners?

I suspect so, you know. I haven't done the work, but I don't know why there wouldn't be. And I think artificial sweeteners are in the position that sugary beverages were 10 to 15 years ago. There's a lag time in terms of the research. There is increasing research showing the health risks of these beverages. I think people who are public health advocates have been loath to highlight these because they're also a very effective bridge from sugar sweetened beverages to no sugar sweetened beverages. And I think, a lot of people see them as a good strategy. I do think there probably is a story to tell about the risks of non-nutritive sweeteners. So, yes.

I can remind our listeners that we've done a series of podcasts, a cluster of them really, on the impact of the artificial sweeteners. And it's pretty scary when you talk to people who really understand how they're metabolized and what effects they have on the brain, the microbiome, and the rest of the body.

Bio

Murray Carpenter is a journalist and author whose stories have appeared in the New York Times, Wired, National Geographic, NPR, and PRI’s The World. He has also written for the Boston Globe, the Christian Science Monitor, and other media outlets. He holds a degree in psychology from the University of Colorado and a Master of Science in environmental studies from the University of Montana, and has worked as a medical lab assistant in Ohio, a cowboy in Colombia, a farmhand in Virginia, and an oil-exploring “juggie” in Wyoming. He lives in Belfast, Maine. He is the author of Caffeinated: How Our Daily Habit Helps, Hurts, and Hooks Us and Sweet and Deadly: How Coca-Cola Spread

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As someone who's been mostly vegetarian for a number of years, I have tried a lot of plant-based foods and there's a variety of them. And so how do they really taste, not just from my perspective? Well, it's really important to do really careful analysis, and this is going to be the subject of our conversation today. Plant-based foods are becoming increasingly healthier and cheaper. But one large question really remains for consumers. How do they taste. NECTAR, a nonprofit initiative on a mission to accelerate the alternative protein transition sets out to answer this question. Through large scale blind taste tests with thousands of consumers. NECTAR is amassing the largest publicly available sensory database on alternative protein products. In its latest report, Taste of the Industry 2025, NECTAR conducted blind sensory panels of 122 products across 14 categories and uncovered which products have achieved the taste that's on par with their animal-based counterparts. Today we talk with NECTAR's Director, Caroline Cotto, about which products are meeting and exceeding consumer taste expectations and what the alternative protein industry needs to do to get more products to this level. And how NECTAR's novel dataset can be used to get there faster.

Interview Summary

I understand you've conducted the world's largest clinical sensory test for plant-based and alternative meats compared to real animal meat. Tell me about how you conducted this study and why NECTAR is focused on this research.

Absolutely. So, for us, we're really focused on this research because we know that taste is a major purchase driver for consumers and it's often the key reason people cite for not repurchasing plant-based meats once they've purchased them. We really want people to come back to the category and so in order for that to happen, we need taste to be where consumers expect it to be.

As you mentioned, we set out to conduct a large study and sort of understand where the products on the market taste today. So, we tested 122 products across 14 categories. And we chose those categories by looking at the highest volume selling categories of animal meat, and then mapping the plant-based products to those categories. And then 43 of those products were from Europe as well. So, we were trying to get a real landscape analysis.

Different than traditional sensory testing, we conducted all of our studies in restaurant settings to give a more natural experience for the participants. And all of our testing is done with omnivore consumers. So, we love vegans and vegetarians, but we're really trying to go after that hardcore meat eater and see if we can get them to switch because they love the taste of these products. And then the other difference is that we serve everything in what we call a full build. We serve burger patties and buns, hot dogs and buns. We really allow consumers to apply condiments as long as they do it equally across all of the products that they're testing, um, to give that authentic experience as they would experience the product in their own kitchen. And we ended up having 2,684 participants in this city. Each product was tried by a minimum of 100 consumers.

Wow, that's pretty extensive. What were some of the surprising results of this?

Yeah, I think we found that the average plant-based product was not quite ready for mainstream adoption. The average plant-based product was generally disliked more frequently than the animal product was, with 35% of tasters rating the product. Some form of dislike. And only 9% of tasters rating animal products as some form of dislike. That said, we did find 20 products out of the 122 that were worth celebrating. We created the Tasty Awards based on this data. And we set a threshold for top performance. And that threshold was that of the people that tried the product, if at least 50% of them said that it, that plant-based meat was the same or better than the animal meat that it was considered a winner product in this study. I'm super exciting to see that we saw 20 products meet that threshold. However, these products were not distributed equally across categories. Some categories had up to five products that met the winner threshold and other categories had none. And we also found that no products in this year's study actually achieved parody with animal meat. So, four products came very close, and we're expecting that in next year's study, that there will be some products that achieve that milestone. But we're not there quite yet. And then lastly, we found that there really is a correlation between great taste and financial return. So, we found that the plant-based products that perform best in our sensory tests are actually capturing 50% more market share than the average products in that category. And the categories that taste better are capturing more market share than the lower performing categories.

Wow. That's really fascinating and there are lots of ways of sort of thinking through the data. I'd like to hear a little bit more about how those consumer preferences vary across different categories of plant-based products such as burgers, nuggets, and hot dogs. Are there specific sensory attributes that consistently influence consumer satisfaction?

Yes, so overall we found that flavor is the top opportunity for plant-based meats at large. Currently these products are described as savory 35% less often than the animal products. And they're described as having a weird aftertaste or off flavor five to six times more often than their animal counterparts. As we look at plant-based meat as a whole, flavor is definitely still needing some improvement. And then we also saw that texture is really the secondary opportunity. So, plant-based meats were described as juicy 62% less often than the animal products. And there's a big need to increase tenderness and reduce mushiness. So that's why I was mentioning there are some categories like burgers and nuggets where we had multiple winner products and those products have had a lot of R&D done on them. Their texture is a little bit easier to replicate than something like whole cut steak or bacon or pulled pork.

You talked about some of the difficulties when you look at different sensory aspects. And I'm interested to understand what some of the key challenges are facing the alternative protein industry in terms of improving taste of the plant-based meats. And how can NECTAR's database help address these challenges?

Yes, I think the key opportunity here is that NECTAR's data provides a roadmap for each product to improve. So, it might be the case that a certain product actually performed well on flavor but needs to improve its texture. Our research can really help you pinpoint exactly what it is about your texture that needs to change. So maybe it's, you know, reducing that mushiness or increasing firmness. And I think overall for the entire category of plant-based meat, it's what we were just talking about, flavor is sort of the biggest opportunity. And then closely followed by texture. But it does seem to vary quite a bit within each category for each product. And we saw on the whole, there was a wide range of ingredients and production methods used. So, we tested the category of unbreaded chicken filet. Within that category, we had extruded products, soy-based products, pea based products, mycelium products. And there were multiple products in that category that were all winners using each of those different techniques and ingredients. But they all have their own slight differences and tweaks that need to be made to meet mainstream consumer expectations.

Oh, this is fascinating. And I have to say, we haven't had many opportunities to talk about how alternative proteins or products are actually produced. Thank you for sharing that. You know what's really interesting, you've touched on this a little bit, but I think there's a little more that we can learn from you on this. So, your research highlights that some plant-based products like nuggets are approaching taste parody with their animal counterparts. Are there specific factors that contribute to the success and how can these insights be applied to other product categories?

So, the Taste of the Industry 2025 is a second annual report that NECTAR has released. In our 2024 research, we found that breaded products tended to outperform unbreaded ones. So, we actually saw similar success from the nugget category in this year's research. But on the whole, I think we see that texture is much easier to replicate for some categories and nuggets is one of those. The other would be burgers where all of the products are ground and so it's much easier to replicate that with existing technologies than to replicate things like muscle fibers for whole cut steak.

We did find four products that are within striking distance of achieving parody. And two of those products were nuggets. One of them was a burger, and the last was an unbreaded chicken filet. And as I mentioned, I think we'll see next year one of these products achieve parody or surpass the animal product in overall liking. But on the whole, we see that chicken is an easier flavor to replicate than beef and pork. And so, we saw more products from the chicken categories that were winners this year than from the other types of animal based meat.

Looking forward, how do you envision NECTAR's work impacting the broader food industry? Particularly in terms of driving innovation and adoption of plant-based products among consumers who are honestly hesitant due to taste concerns.

We really believe that tasting is believing. So, we are using this data to drive stakeholders across the supply chain towards the best tasting products so that they taste it and they immediately are sold on the product. So that means we're working with retailers and food service buyers to help direct them towards the best tasting products. And even consumers we have an Instagram page and a consumer facing lens where we're trying to show them which products taste great and help with the demand side for the industry. And then we really see chefs in food service as the beachhead market for alternative proteins. I think it's an easier sell to have someone try a delicious plant-based product on a menu or in a cafeteria. And then want to go home and replicate that experience after having a really positive experience out in the world.

Okay. So how do you see the broader industry, from meat producers to policymakers to retailers, using the dataset that you all are constructing?

We see that as sort of no matter your role in the industry, this data can support your efforts. So, for brand and manufacturers, we're hoping that they'll embrace an iterative taste centric product development approach. And the report offers pre-competitive sensory insights to provide a roadmap for focused innovation where we feel like it matters most. As I mentioned for retailers and food service operators, we want them to recognize their crucial role as venues for consumer discovery and to help them prioritize products on shelf and on menus that really deliver on these taste claims.

And then for investors and funders, we see alternative protein as a true climate solution. And so we want them to consider the outsized impact potential of plant-based products that are able to achieve mainstream adoption through superior taste and really double down on their efforts there.

And then lastly, we are working with researchers and academics that can build upon NECTAR's foundational work and use our data sets to advance the understanding of consumer preferences and sensory science. We're actually working with some researchers currently to build a large language model tool that will ingest the sensory data and suggest specific experiments to improve the sensory aspects of those products. So, it'll basically be a food scientist's best friend and be able to reduce the number of benchtop trials needed to get to a better outcome.

Wow, that's really fascinating. And I think there's something that I want to highlight. Because you all are a nonprofit, the data that you're generating is being made publicly available. Is that a fair statement?

That's correct. Yes, so we have a whole digital dashboard where you can look at all of the category level data. You can see how the average product performed, how the leading product in that category performed, and how the animal benchmark product in each category performed. And we provide insight into what are the biggest opportunities for improvement at a category level. And then we also share the data on an individual brand's performance with that brand so that they can make improvements themselves.

May I ask, how did you get buy-in from the industry to allow their products to be considered?

We make sure that there's only upside for participating, so we only publish the brand names of brands that are top performers. And we do a lot of marketing and PR support for those top performers. We provide them with a marketing credential for the Tasty Awards that they can use on sell sheets and to socialize their products with the larger consumer base.

If the products were not top performers, we don't publish the name of the brand. But as I mentioned we do provide that data to them so that they can have a roadmap for how to improve their product and hopefully be Tasty Award winners next year.

Okay, great. So I want to wrap up by asking where do you see hope in the plant-based industry in the next five years?

Yes, to be honest, it's been a little bleak for the plant-based meat space for the last few years. And so, we founded NECTAR because we believe that there are great tasting products out there and we want to bring some hope and inspiration back to this industry. Our goal is that in five years all of the products on shelf will meet consumer taste expectations. And we're really able to show that products could be both sustainable and delicious and crave worthy, and that consumers will demand them. We have started to see that with the 20 products that really rose to the top. And our goal is that you know, all of the products are sort of meeting that threshold when we're through here. We're also seeing hope in that there's a lot of positive research around plant-based defaults on menus. So, hospitals and universities are starting to put plant-based options on the menu as the default. And I think that is especially supported by great tasting products. If people, as I mentioned, have a positive experience out in the world, hopefully that will continue to get that snowball effect and demand generation going. And we're also seeing some hope with a new category called balanced protein, which are products that combine some conventional animal meat with plant-based ingredients in the same product. NECTAR actually conducted a taste test of balanced proteins this fall and found that in two categories, burgers and nuggets, balanced products actually outperformed their animal counterparts. And so, kind of like the hybrid car, we're hoping that the balanced protein will sort of get the hardcore meat skeptics on board and help ultimately move us towards a more plant-based future. And if there's anybody listening that wants to access our data or partner with us, we definitely welcome those conversations.

BIO

Caroline Cotto is a Director at Food System Innovations (FSI) where she leads NECTAR, an initiative accelerating the protein transition with taste. By conducting large-scale sensory panels of alternative protein products and operationalizing the resulting data, NECTAR aims to create category-level value and empower stakeholders to make sensory-informed decisions. Prior to FSI, Caroline co-founded Renewal Mill, an award-winning upcycled food startup. She served as the inaugural board president of the Upcycled Food Association, the world’s first trade association for upcycled brands. She regularly mentors food, tech, and circular economy startups. Caroline studied at Georgetown University and served as a Fulbright Fellow. She has been named to both Forbes 30 Under 30 and the 50 NEXT lists.

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Do you pay attention to information printed on food labels? From eye-catching designs companies use to entice you to buy a product to nutrition facts panels to the tiny dates printed on packages. There's a lot going on to be sure. For policymakers, they hope that refining date labels on food packaging will help reduce the amount of uneaten food ending up in landfills. Food Waste is a major contributor to greenhouse gas emissions. The Food and Drug Administration and the Food Safety and Inspection Service recently asked for public input on food date labels. So, we decided to gather some experts together to talk about this important policy tool. Roni Neff is a professor in the Johns Hopkins Bloomberg School of Public Health and Senior Advisor at the School's Center for a Livable Future. Her research looks at the intersection of food waste policy, climate change, and food system resilience. Brian Roe is a professor at the Ohio State University Department of Agricultural, Environmental and Developmental Economics. His work focuses on issues including agricultural marketing, information policy, behavioral economics, and product quality. Ruiqing Miao is an associate professor of agricultural economics and rural sociology at Auburn University's College of Agriculture. His research emphasizes sustainability, innovation, and decision making.

Interview Summary

Brian, let's begin with you and let's make sure everyone's on the same page. Can you talk to us a little bit about what date labels are and where they are on packaging. And what is industry required to include in terms of these date labels?

Yes, so date labels, we see them anytime we pick up a food package. Most packages are going to have some type of date label on them. Oddly, federal law doesn't regulate these or really require these other than the exception of infant formula, which is the only federal requirement domain out there. But in the absence of federal regulation, states have kind of done their own thing. About 40 different states require date labels on at least some food products. And about 20 states prohibit or restrict the sale or donation of food past the label date. And even though states that require date labels, manufacturers can still choose the dates. There are no real regulations on them.

So, recognizing that confusion over date labels can lead to unnecessary food waste, Government and industry actors have made, you know, some efforts to try to standardize date labeling language. But nothing terribly authoritative. Now, some states have introduced bills that seek to standardize date labels, with the motivation to try to get rid of and reduce food waste. California being perhaps the most recent of these. In 2024, they passed a bill that prohibits the use of any date label other than 'Best if Used By,' the phrase that goes along with foods where the date represents kind of a quality indicator. And then the phrase 'Use By,", if that date has some implications for product safety. The bill doesn't go into effect until July of '26, so we're going to see if this is going to create a domino effect across other states, across the food manufacturing center or even bubble up and be dealt with at the federal legislation level.

Now, industries tried to do things before. Back in 2017, the Food Marketing Institute and the Grocers Manufacturers Association had a standardized date labeling suggestion that some firms bought into. FDA has given out some guidance about preferring 'Best if Used By' on certain food products to indicate quality. But again, we're all kind of waiting to see if there might be a federal legislation that kind of brings these state labels into check.

Thanks, Brian. And it's really important to know about the policy landscape and the fact that there hasn't been a federal policy across all foods. And it's interesting to see the efforts of, say, in California. I think this begs the question; how do consumers actually process the information of date labels?

This fascinated us too. A very clever person at Ohio State that I work with, Dr. Aishwarya Badiger, led a study I was part of. We enlisted consumers to come into the Consumer Evaluation Lab that we have here on campus and evaluate samples of milk. They were presented with the label of each milk. We gave them a little glass with a nose full of the milk that they could sniff. So, they're looking at the date label, they're given the sample they could smell, and then we kind of asked them, Hey, if this were in your fridge, would you keep it or toss it? But the entire time we actually had them fitted with special glasses that precisely track their eye movements so we could understand kind of which information they were looking at while they went through the whole process of evaluating and then making their decision. Consumers overwhelmingly looked at the date itself on the package and largely ignored the phrase or the words that go along with the date. In fact, for more than half of the evaluations, the consumer's eyes never went anywhere near the phrase.

This is important. And actually, we'll talk about that a little bit more with some of our other guests. So, what are the implications of date label policies?

So the eye tracking research really drove home to me that dates are much more salient than phrases. Although all the policies largely deal with the phrases. Dates give you actionable information. People can look at the date on the label, look at the calendar, and man, that's something they can do something about. They can act based upon that. The phrases are a little bit more ambiguous as Roni will talk about later. I think that people have a hard time interpreting what those phrases really mean. That doesn't mean we should not try to unify those phrases, but rather this is going to be a longer-term investment in educational infrastructure that until those phrases really become salient and actionable to consumers. And then become more of a critical component of the policies. But right now, policies are generally silent on dates. And dates seem to be the real action mover.

Yeah. So why don't we just get rid of all of this? What would be the implications?

Yes. We did this experiment too. Same kind of setup. Had people come in, they had the jug of the milk in front of them. They had a glass of milk that they could sniff. Same thing. And we had a bunch of different milks. We had some that were only like 15 days post pasteurization. Some that went out to like 40 days past pasteurization.

So, the youngest or the freshest had about three days, quote unquote, left on its date label. The 40-day old milk was like two or three weeks past the date. And we did two things. We had them evaluate the milk with the dates on the jugs, and then we had ones where we took the dates and the labels off the milk. Not surprisingly, when they did not have the dates on the milk, they were much more likely to say that they would keep the milk. Even that 40-day old milk, about half of them said, yeah, I'd drink this. I'd keep this if it were in my fridge. But it wasn't a slam dunk. So, our youngest and freshest milk had an odd flavor note. You know, sometimes as the seasons change, feed sources change for cattle, you get an odd flavor note. It's not spoilage, it's just a slightly different note. And when people have the date label, they were much more willing to give that milk a second chance and say that they would keep it. But if the date label wasn't on there, they took that odd flavor note and said, I'm going to toss this milk. So, it's really kind of a nuanced thing. And if you would take those off, I think you're going to get some consumers who are going to kind of freak out without any guidance. And they might have kind of an itchy trigger finger when it comes to throwing away that milk or other products. So, it's compelling. We've seen England, the UK, do this; take dates off of certain products. But I would probably want to see a little more example of how consumers are responding to that before I fully endorse that as kind of a policy movement forward.

Brian, thank you for that. And I have got to say, I was not expecting to have a conversation about the bouquet of a glass of milk. But this is really an interesting finding, and it does help us understand some other things that we're going to talk about. Roni, I want to turn our attention to you. And I know you are someone who's been involved in understanding date labels for a while. And I really appreciate it and I've said it before, but you're the reason I got into this work. I want to understand a little bit more about what are important things to understand about the misconceptions that consumers may have about food date labels? And why does it matter for policymakers?

Well, I'll start with just saying that conceptions are what we know rationally. And it's not the whole picture because as Brian was alluding to a lot of our decision making is going on in our emotions. And like I can tell my son all day long the fact that that milk is okay, he's going to toss it because he doesn't trust it. There's a lot more going on than conceptions. But I want to talk about two misconceptions. The first one is that despite what Brian just said about the fact that these date labels other than infant formula aren't federally regulated, about two in five people think that they are. We just did a national consumer survey in January 2025, and this is one of the findings. And I did that along with Emily Broad Lieb from the Harvard Food Law and Policy Project and Akif Khan also from there, and then Dana Gunders from ReFED. And in addition to this idea that they're federally regulated, I'll say that these kinds of beliefs were most common among those who were 18 to 34, parents with children under age 18, and black and Hispanic consumers. Our earlier work also found that those who think that food date labels are federally regulated are more likely to discard food based on them. All this speaks to a real challenge. And, you know, it kind of makes sense, like if you see something and you trust it, that it's from the federal government. And of course, we all trust the federal government these days. If you trust it, then you're going to respond to it. So that's an implication for food policy. And then the next thing we did also is that we tested understanding of five different food date label phrases: a date with no text, and then two of those phrases accompanied by icon images. And since none of these actually have a federally recognized meaning the correct answer for all of them in terms of the meaning is like other. But we also accepted answers that were aligned with that voluntary industry standard, just to kind of see how people were perceiving it. And, across all of these labels, only an average of 53% of people answered correctly about what these labels meant.

Now, consumers were pretty good at identifying 'Best if Used By' as a quality label. But the real challenge comes in with 'Use By' which under the voluntary industry standards should be a safety label. And more people thought it was a quality label than thought it was a safety label; 44% versus 49%. And so, we need to clear up these misconceptions in support of food safety, in support of food waste prevention. But in order to do that, we need to be able to tell people clearly what the labels mean. And we can't really do that if there's no standardized meaning of what they mean. So, we really need a national standard, and that is the policy implication.

Thank you for that. And I know Ruiqing and I have done some work in this space and in part learning from what you all have done. I'm interested because you mentioned the 2025 survey, but of course you also mentioned the 2016 survey. Are there any big shifts or anything that you want to tell us about changes that you see from those two different surveys?

We asked a number of the same or almost identical questions in those two surveys. And since that time, we've adopted a voluntary industry standard and there's been a lot of education and communication about wasted food. And yet in our survey we actually found that things were going in the wrong direction. Consumer misunderstandings of date labels increased. Those who quote always or usually discard food based on the label: in 2016, that was 37%, and this year it was 43%. And then in terms of belief that these are federally regulated: in 2016 it was 36% and now it's 44%. We're going in the wrong direction despite all these activities, and I don't know why. I think for those who are looking for future research questions, this would be a really interesting one.

This is really disturbing because all of the information that's come out about date labels. I thought people would understand this. And that this is where we would be in a different place. So, this work is really important. So, how did people's response to date labels vary by food item? Did you see any differences? Because this is something that comes up often that people may be more responsive to some food products versus others?

Yeah, indeed. We asked about five different foods, and we showed a bunch of different labels for each food. And the responses did vary both based on the item and based on what label was on it. And I'll start with where caution is needed. Deli meats are one example of where we really want people to pay attention to that label. And while there's no federal standard that label's the best piece of information people has, so they should use it. And we found that only 65% would throw out the deli meat before, on, or just after the 'Use By' label. And the number of people that would respond to it reduced with other labels that were used, and older adults were most likely to disregard those labels. And they may be particularly vulnerable in terms of foodborne illness. So that's when lack of caution leads to risk. On the other hand, when caution leads to waste, we looked at raw chicken, pasteurized milk, lettuce, and breakfast cereal. And for all of those there, like the label is really only telling you about quality, and consumers should use their senses to decide, and knowledge of how that was, stored to decide whether to eat it. And so, the most common out of all five foods, including the deli, the one that they responded the strongest to was raw chicken. And that chicken can be contaminated as we know, but if you cook it, you're killing those bacteria, so it's okay. And averaging across all those different date labels, we found 54% would discard these four foods based on the date. And the piece that was most striking to me was that for breakfast cereal, 43% said they were discarded based on the date. So, we've got some education to do.

Yeah. In the earlier paper I did with colleagues at Cornell, we used breakfast cereal and we were surprised to see how much people willing to throw away breakfast cereal if it were passed to date. There is confirmation and we see this happen in many other products. And we'll definitely talk about some of those product differences with Ruiqing. The last question I'd like to ask you is you found that many consumers thought they knew the meanings of the various food date labels, but they were incorrect. And in some of the work that you've done in the past, you found that many people answered incorrectly even after viewing information about the labels. So even when you educated folks or gave people information, they still made incorrect choices. Why do you think this is, and what should we do about it?

And some people's responses do improve when you show them the information, but it was striking in that study that seconds after having read the definition, according to the voluntary industry standard, people were giving the wrong answer. Even though they had previously said that they thought they understood it. So, to me, this suggests that they already think they know the answer and so they're not tuning in. And this speaks to a real challenge that we're going to have when we do standardize these date labels. How are we going to reach people and capture their attention. Like, if we just change the policy, that does nothing. We've got to reach people and we've got to do it in a sophisticated and well-planned way. And I think the education should also emphasize that misunderstandings are common because that might be something that would help wake people up. But beyond that, we've got to capture their attention. So, you know, dancing clowns, whatever it is that wakes people up.

I have a fear of clowns, so I'm not sure if I want that as a policy recommendation. However...

For the deli meats we want you to be afraid, so it's okay.

Yes, I agree. I agree. One of the things that this conversation has helped us see is that there's some real concerns around whether or not people are paying attention to the label. Or there may be paying more attention to the dates. And even when people are taught or encouraged to think about the dates, there seems to be a mismatch. And Ruiqing, I want to now turn to you because one of the things in the study that we were a part of, there's some questions about differences among people. So, in the paper that we recently published on the relationship between date labels and anticipated food waste, and people's individual orientation to risk and loss, can you tell us a little bit about what some of the key findings of that paper are?

Right. So, the paper is published recently in Applied Economics Perspective Policy. It's one of the official journals of Agricultural and Applied Economics Association (AAEA). Norbert is the leading author. So, this paper built on the framework of prospect theory and is based on the data from a series of experiments we conducted in Alabama and also the state of New York. We find that consumers do adjust their anticipated food waste by date labels and by how much they tolerate risk and losses. In the experiment, we particularly measured their tolerance to risk and losses. We found that the 'Use By' date labels tend to lead to more anticipated food waste than 'Best Buy'. Maybe this echo what Roni has said. So, people may tend to link 'Use By' with quality and food safety. We also found that the consumers with low tolerance to losses and are associated with higher anticipated foot waste regardless of date labels and the products. So, we can see a heterogeneity of the responses of different consumers to date labels and food items based on their tolerance to losses and risks.

Thank you for that. And I think this is a really important aspect of looking at this set of studies because we see that people are different. They respond differently. And they have different ideas about how they handle losses. This idea that it can be worse to lose a hundred dollars versus to gain a hundred dollars. Or the way we understand how we'll negatively respond versus how positively we respond. Using this economic framework of prospect theory, something that is drawn from actually the psychology literature to better understand how people react to food labels while shopping. What are some key features of this approach to explaining people's behaviors and why do you think it's a good choice? Why do you think it's important to do this?

One of the key features of prospect theory is it divides the possible outcomes of a risky event into two domains. One is a gain domain and one is a loss domain. So, in terms of the food consumption, probably the most likely status quo is do not eat the food items. So, the gain domain might be gaining nutrition from the food item. The loss domain might be the loss of health if the food item is bad. So, I think this framework fits particularly well to describe the consumer's trade off in their mind when they face a food item with a date label that is maybe one day or two days past the expiration date. So, one possibility is you consume this food. If it is good, you get nutrition and if it is bad, you potentially get lost health or lose one day of work or so on. So, I think this model can capture the trade off or the decision-making procedure in a consumer's mind pretty well. And experiments data support the theoretical prediction that loss aversion may affect people's food waste decisions.

Thank you for that. And I think what's one of the sort of take home messages that I've learned out of this process is this heterogeneity, the fact that people are different and may respond differently to these date labels, really does put the onus upon policymakers to think critically what date labels, if we were to use them, or if we think they have an effect, which are the right ones. And so I actually want to open up the question to all of you. In your view, what next steps make sense for date labels to help address the food waste challenges that we see in this country? Let's start with you, Brian.

Ooh, yeah. So, to me a compelling issue that needs to be addressed is how do we get 'Use By' to really translate to be people to be about safety? Is it a different color? I know we don't want to mess with the phrases, but do we just call this safety date and put it in red or put a clown by it if that scares you. Something along those lines to make that stand out. And then on the relevance side, I think it might be out of policy, but perhaps, industry collaboration to really push printed dates to the end of that quality horizon. So that everybody has confidence that they're not going to get undercut by somebody else having an earlier date printed for cereals or for canned goods or something like that. To have a kind of a truce among commercial interests to say, okay, typically canned beans, has this type of 180 days or 360 days. Let's push it to the end of that acceptable horizon so that we don't have unwarranted waste happening as often. Those are two ideas that I've kind of chewed on a lot and think could be positive steps forward. But I'm fascinated to hear what others think.

Thank you, Brian and I really don't like the idea of putting clowns anywhere near this. I want to go to you, Roni.

All right, well first, I'll a thousand percent echo everything that Brian just said. And I'll note also in terms of the 'Use By' date, the label that was most commonly associated with food safety was 'Expires On' by consumers. But that isn't part of what has been under [policy] discussion. But anyway, in addition to echoing that, I'll just say we do need a standardized policy and it has to be accompanied by a well-designed education campaign. And this policy change, it's just a no-brainer. It's not controversial. It's fairly minimal cost. And given the high food prices and the struggles that consumers are having right now, they need every tool that they can to save money and food, and this is one of them.

Great. Thank you, Roni. I'll give the last word to you, Ruiqing.

Yeah. I will echo what Brian and Roni said. So, a well-designed policy and public education campaign. Particularly for the education campaign. I think regardless of if there is a policy change or not, I think it is time to do a public education campaign. Norbert, we have done the research on food waste for almost nine years, right? So, I learned a little bit about the date label's meaning. But still, I cannot change my wife's opinion. When she sees sell by yesterday for the milk, she would suggest we throw it away. But I said this is not for us, this is for sellers. But she wouldn't believe so because I cannot persuade her. But maybe an education campaign from more authoritative institutional federal government can change people's mind as a researcher or like even husband cannot change.

Roni - And can I just add to that, just please. I think that the economics and psychology expertise that all of you have can really contribute to that. Because I think that's a really important point that you're making. And it's not just factual, it's emotional too. And so how do we, you know, get in there and change what people do beyond their knowledge?

Bios

Roni Neff is a Professor at the Johns Hopkins Bloomberg School of Public Health’s Department of Environmental Health & Engineering and the Johns Hopkins Center for a Livable Future, an academic center focused on food systems and public health. Her research focuses on wasted food through the lens of equity and public health. She is a co-Director of the RECIPES national food waste research network, and she recently served on the National Academies of Science and Medicine consensus panel on consumer food waste.

Brian Roe is the Van Buren Professor in the Department of Agricultural, Environmental and Development Economics at Ohio State University. Roe has worked broadly in the areas of agricultural and environmental economics focusing on issues including agricultural marketing, information policy, behavioral economics and product quality. He was recently named as a fellow of the Agricultural and Applied Economics Association and has previously served as an editor for the Association's flagship journal, the American Journal of Agricultural Economics. He currently leads the Ohio State Food Waste Collaborative, a collection of researchers, practitioners, and students working together to promote the reduction and redirection of food waste as an integral part of a healthy and sustainable food system, and co-leads the RECIPES Network, a National Science Foundation Sustainable Regional System's Research Network focused on increasing food system sustainability, resilience and equity by addressing the issue of food waste. In addition to research on food waste, his other recent research includes a USDA funded project focused on local foods and school lunch programs and participation in an NSF-funded multidisciplinary team seeking to understand human-ecosystem feedbacks in the Western Lake Erie basin, including understanding how farms and agribusinesses respond to voluntary environmental programs and how Ohio residents respond to different options to manage Lake Erie water quality.

Ruiqing Miao is an agricultural economist at Auburn University. Miao is interested in sustainability, innovation, and decision-making. His research focuses on the interaction between agricultural production and its environment, aiming to understand and quantify 1) agriculture’s impact on land use, water use, water quality, and biodiversity, and 2) how agricultural production is affected by farmers’ behaviors, public policies, agricultural innovation, technology adoption, and climate change.

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So even the people that follow the topic closely are stunned by the digital landscape that engulfs our children, how quickly it evolves, and the potential social cost. Two people in a unique position to explain all this are our guest today, Jeffrey Chester and Kathryn Montgomery, both from the Center for Digital Democracy. Jeff is executive director of the Center, and Kathryn is its research director and senior strategist, as well as professor emerita of communication at American University. Jeff and Kathryn have been pioneers in this work and have been uniquely strong voices for protecting children.

Interview Summary

Let me congratulate the two of you for being way ahead of your time. I mean the two of you through your research and your advocacy and your organizational work, you were onto these things way before most people were. I'm really happy that you're joining us today, and welcome to our podcast. Kathryn, let me begin with you. So why be concerned about this digital landscape?

Kathryn - Well, certainly if we're talking about children and youth, we have to pay attention to the world they live in. And it's a digital world as I think any parent knows, and everybody knows. In fact, for all of us, we're living in a digital world. So young people are living their lives online. They're using mobile phones and mobile devices all the time. They're doing online video streaming. They form their communications with their peers online. Their entire lives are completely integrated into this digital media landscape, and we must understand it. Certainly, the food and beverage industry understand it very well. And they have figured out enormously powerful ways to reach and engage young people through these digital media.

You know, the extent of the kids' connection to this is really remarkable. I just finished a few minutes ago recording a podcast with two people involved with the Children and Screens organization. And, Chris Perry, who's the executive director of that organization and Dmitri Christakis who was with us as well, were saying that kids sometimes check their digital media 300 times a day. I mean, just unbelievable how much of this there is. There's a lot of reasons to be concerned. Let's turn our attention to how bad it is, what companies are doing, and what might be done about it. So, Jeff, tell us if you would, about the work of the Center for Digital Democracy.

Jeff - Well, for more than a quarter of a century, we have tracked the digital marketplace. As you said at the top, we understood in the early 1990s that the internet, broadband what's become today's digital environment, was going to be the dominant communications system. And it required public interest rules and policies and safeguards. So as a result, one of the things that our Center does is we look at the entire digital landscape as best as we can, especially what the ultra-processed food companies are doing, but including Google and Meta and Amazon and GenAI companies. We are tracking what they're doing, how they're creating the advertising, what their data strategies are, what their political activities are in the United States and in many other places in the world. Because the only way we're going to hold them accountable is if we know what they're doing and what they intend to do. And just to quickly follow up, Kelly, the marketers call today's global generation of young people Generation Alpha. Meaning that they are the first generation to be born into this complete digital landscape environment that we have created. And they have developed a host of strategies to target children at the earliest ages to take advantage of the fact that they're growing up digitally.

Boy, pretty amazing - Generation Alpha. Kathryn, I have kind of a niche question I'd like to ask you because it pertains to my own career as well. So, you spent many years as an academic studying and writing about these issues, but also you were a strong advocacy voice. How did you go about balancing the research and the objectivity of an academic with advocacy you were doing?

Kathryn - I think it really is rooted in my fundamental set of values about what it means to be an academic. And I feel very strongly and believe very strongly that all of us have a moral and ethical responsibility to the public. That the work we do should really, as I always have told my students, try to make the world a better place. It may seem idealistic, but I think it is what our responsibility is. And I've certainly been influenced in my own education by public scholars over the years who have played that very, very important role. It couldn't be more important today than it has been over the years. And I think particularly if you're talking about public health, I don't think you can be neutral. You can have systematic ways of assessing the impact of food marketing, in this case on young people. But I don't think you can be totally objective and neutral about the need to improve the public health of our citizens. And particularly the public health of our young people.

I agree totally with that. Jeff let's talk about the concept of targeted marketing. We hear that term a lot. And in the context of food, people talk about marketing aimed at children as one form of targeting. Or, toward children of color or people of color in general. But that's in a way technological child's play. I understand from you that there's much more precise targeting than a big demographic group like that. Tell us more.

Jeff - Well, I mean certainly the ultra-processed food companies are on the cutting edge of using all the latest tools to target individuals in highly personalized way. And I think if I have one message to share with your listeners and viewers is that if we don't act soon, we're going to make an already vulnerable group even more exposed to this kind of direct targeted and personalized marketing. Because what artificial intelligence allows the food and beverage companies and their advertising agencies and platform partners to do is to really understand who we are, what we do, where we are, how we react, behave, think, and then target us accordingly using all those elements in a system that can create this kind of advertising and marketing in minutes, if not eventually milliseconds. So, all of marketing, in essence, will be targeted because they know so much about us. You have an endless chain of relationships between companies like Meta, companies like Kellogg's, the advertising agencies, the data brokers, the marketing clouds, et cetera. Young people especially, and communities of color and other vulnerable groups, have never been more exposed to this kind of invasive, pervasive advertising.

Tell us how targeted it can be. I mean, let's take a 11-year-old girl who lives in Wichita and a 13-year-old boy who lives in Denver. How much do the companies know about those two people as individuals? And how does a targeting get market to them? Not because they belong to a big demographic group, but because of them as individuals.

Jeff - Well, they certainly are identified in various ways. The marketers know that there are young people in the household. They know that there are young people, parts of families who have various media behaviors. They're watching these kinds of television shows, especially through streaming or listening to music or on social media. Those profiles are put together. And even when the companies say they don't exactly know who the child is or not collecting information from someone under 13 because of the privacy law that we helped get enacted, they know where they are and how to reach them. So, what you've had is an unlimited amassing of data power developed by the food and beverage companies in the United States over the last 25 years. Because really very little has been put in their way to stop them from what they do and plan to do.

So presumably you could get some act of Congress put in to forbid the companies from targeting African American children or something like that. But it doesn't sound like that would matter because they're so much more precise in the market.

Yes. I mean, in the first place you couldn't get congress to pass that. And I think this is the other thing to think about when you think about the food and beverage companies deploying Generative AI and the latest tools. They've already established vast, what they call insights divisions, market research divisions, to understand our behavior. But now they're able to put all that on a fast, fast, forward basis because of data processing, because of data clouds, let's say, provided by Amazon, and other kinds of tools. They're able to really generate how to sell to us individually, what new products will appeal to us individually and even create the packaging and the promotion to be personalized. So, what you're talking about is the need for a whole set of policy safeguards. But I certainly think that people concerned about public health need to think about regulating the role of Generative AI, especially when it comes to young people to ensure that they're not marketed to in the ways that it fact is and will continue to do.

Kathryn, what about the argument that it's a parent's responsibility to protect their children and that government doesn't need to be involved in this space?

Kathryn - Well, as a parent, I have to say is extremely challenging. We all do our best to try to protect our children from unhealthy influences, whether it's food or something that affects their mental health. That's a parent's obligation. That's what a parent spends a lot of time thinking about and trying to do. But this is an environment that is overwhelming. It is intrusive. It reaches into young people's lives in ways that make it virtually impossible for parents to intervene. These are powerful companies, and I'm including the tech companies. I'm including the retailers. I'm including the ad agencies as well as these global food and beverage companies. They're extremely powerful. As Jeff has been saying, they have engaged and continue to engage in enormous amounts of technological innovation and research to figure out precisely how to reach and engage our children. And it's too much for parents. And I've been saying this for years. I've been telling legislators this. I've been telling the companies this. It's not fair. It's a very unfair situation for parents.

That makes perfect sense. Well, Jeff, your Center produces some very helpful and impressive reports. And an example of that is work you've done on the vast surveillance of television viewers. Tell us more about that, if you would.

Jeff - Well, you know, you have to keep up with this, Kelly. The advocates in the United States and the academics with some exceptions have largely failed to address the contemporary business practices of the food and beverage companies. This is not a secret what's going on now. I mean the Generative AI stuff and the advanced data use, you know, is recent. But it is a continuum. And the fact is that we've been one of the few groups following it because we care about our society, our democracy, our media system, et cetera. But so much more could be done here to track what the companies are doing to identify the problematic practices, to think about counter strategies to try to bring change. So yes, we did this report on video streaming because in fact, it's the way television has now changed. It's now part of the commercial surveillance advertising and marketing complex food and beverage companies are using the interactivity and the data collection of streaming television. And we're sounding the alarm as we've been sounding now for too long. But hopefully your listeners will, in fact, start looking more closely at this digital environment because if we don't intervene in the next few years, it'll be impossible to go back and protect young people.

So, when people watch television, they don't generally realize or appreciate the fact that information is being collected on them.

Jeff - The television watches you now. The television is watching you now. The streaming companies are watching you now. The device that brings you streaming television is watching you now is collecting all kinds of data. The streaming device can deliver personalized ads to you. They'll be soon selling you products in real time. And they're sharing that data with companies like Meta Facebook, your local retailers like Albertsons, Kroger, et cetera. It's one big, huge digital data marketing machine that has been created. And the industry has been successful in blocking legislation except for the one law we were able to get through in 1998. And now under the Trump administration, they have free reign to do whatever they want. It's going to be an uphill battle. But I do think the companies are in a precarious position politically if we could get more people focused on what they're doing.

Alright, we'll come back to that. My guess is that very few people realize the kind of thing that you just talked about. That so much information is being collected on them while they're watching television. The fact that you and your center are out there making people more aware, I think, is likely to be very helpful.

Jeff - Well, I appreciate that, Kelly, but I have to say, and I don't want to denigrate our work, but you know, I just follow the trades. There's so much evidence if you care about the media and if you care about advertising and marketing or if you care, just let's say about Coca-Cola or Pepsi or Mondalez. Pick one you can't miss all this stuff. It's all there every day. And the problem is that there has not been the focus, I blame the funders in part. There's not been the focus on this marketplace in its contemporary dimensions.

I'd like to ask you both about the legislative landscape and whether there are laws protecting people, especially children from this marketing. And Kathy, both you and Jeff were heavily involved in advocacy for a landmark piece of legislation that Jeff referred to from 1998, the Children's Online Privacy Protection Act. What did this act involve? And now that we're some years in, how has it worked?

Kathryn - Well, I always say I've been studying advertising in the digital media before people even knew there was going to be advertising in digital media. Because we're really talking about the earliest days of the internet when it was being commercialized. But there was a public perception promoted by the government and the industry and a lot of other institutions and individuals that this was going to be a whole new democratic system of technology. And that basically it would solve all of our problems in terms of access to information. In terms of education. It would open up worlds to young people. In many ways it has, but they didn't talk really that much about advertising. Jeff and I working together at the Center for Media Education, were already tracking what was going on in that marketplace in the mid-1990s when it was very, very new. At which point children were already a prime target. They were digital kids. They were considered highly lucrative. Cyber Tots was one of the words that was used by the industry. What we believed was that we needed to get some public debate and some legislation in place, some kinds of rules, to guide the development of this new commercialized media system. And so, we launched a campaign that ultimately resulted in the passage of the Children's Online Privacy Protection Act. Now it only governs commercial media, online, digital media that targets children under the age of 13, which was the most vulnerable demographic group of young people. We believe protections are really, really very important for teenagers. There's a lot of evidence for that now, much more research actually, that's showing their vulnerable abilities. And it has required companies to take young people into account when developing their operations. It's had an impact internationally in a lot of other countries. It is just the barest minimum of what we need in terms of protections for young people. And we've worked with the Federal Trade Commission over the years to ensure that those rules were updated and strengthened so that they would apply to this evolving digital media system. But now, I believe, that what we need is a more global advocacy strategy. And we are already doing that with advocates in other countries to develop a strategy to address the practices of this global industry. And there are some areas where we see some promising movement. The UK, for example, passed a law that bans advertising on digital media online. It has not yet taken effect, but now it will after some delays. And there are also other things going on for ultra processed foods, for unhealthy foods and beverages.

So, Kathryn has partly answered this already, Jeff, but let me ask you. That act that we've talked about goes back a number of years now, what's being done more recently on the legislative front? Perhaps more important than that, what needs to be done?

Well, I have to say, Kelly, that when Joe Biden came in and we had a public interest chair at the Federal Trade Commission, Lena Khan, I urged advocates in the United States who are concerned about unhealthy eating to approach the Federal Trade Commission and begin a campaign to see what we could do. Because this was going to be the most progressive Federal Trade Commission we've had in decades. And groups failed to do so for a variety of reasons. So that window has ended where we might be able to get the Federal Trade Commission to do something. There are people in the United States Congress, most notably Ed Markey, who sponsored our Children's Privacy Law 25 years ago, to get legislation. But I think we have to look outside of the United States, as Kathryn said. Beyond the law in the United Kingdom. In the European Union there are rules governing digital platforms called the Digital Services Act. There's a new European Union-wide policy safeguards on Generative AI. Brazil has something similar. There are design codes like the UK design code for young people. What we need to do is to put together a package of strategies at the federal and perhaps even state level. And there's been some activity at the state level. You know, the industry has been opposed to that and gone to court to fight any rules protecting young people online. But create a kind of a cutting-edge set of practices that then could be implemented here in the United States as part of a campaign. But there are models.

And how do the political parties break down on this, these issues?

Kathryn - I was going to say they break down.

Jeff - The industry is so powerful still. You have bipartisan support for regulating social media when it comes to young people because there have been so many incidences of suicide and stalking and other kinds of emotional and psychological harms to young people. You have a lot of Republicans who have joined with Democrats and Congress wanting to pass legislation. And there's some bipartisan support to expand the privacy rules and even to regulate online advertising for teens in our Congress. But it's been stymied in part because the industry has such an effective lobbying operation. And I have to say that in the United States, the community of advocates and their supporters who would want to see such legislation are marginalized. They're under underfunded. They're not organized. They don't have the research. It's a problem. Now all these things can be addressed, and we should try to address them. But right now it's unlikely anything will pass in the next few months certainly.

Kathryn - Can I just add something? Because I think what's important now in this really difficult period is to begin building a broader set of stakeholders in a coalition. And as I said, I think it does need to be global. But I want to talk about also on the research front, there's been a lot of really important research on digital food marketing. On marketing among healthy foods and beverages to young people, in a number of different countries. In the UK, in Australia, and other places around the world. And these scholars have been working together and a lot of them are working with scholars here in the US where we've seen an increase in that kind of research. And then advocates need to work together as well to build a movement. It could be a resurgence that begins outside of our country but comes back in at the appropriate time when we're able to garner the kind of support from our policymakers that we need to make something happen.

That makes good sense, especially a global approach when it's hard to get things done here. Jeff, you alluded to the fact that you've done work specifically on ultra processed foods. Tell us what you're up to on that front.

Jeff - As part of our industry analysis we have been tracking what all the leading food and beverage companies are doing in terms of what they would call their digital transformation. I mean, Coca-Cola and Pepsi on Mondelez and Hershey and all the leading transnational processed food companies are really now at the end of an intense period of restructuring to take advantage of the capabilities provided by digital data and analytics for the further data collection, machine learning, and Generative AI. And they are much more powerful, much more effective, much more adept. In addition, the industry structure has changed in the last few years also because of digital data that new collaborations have been created between the platforms, let's say like Facebook and YouTube, the food advertisers, their marketing agencies, which are now also data companies, but most notably the retailers and the grocery stores and the supermarkets. They're all working together to share data to collaborate on marketing and advertising strategies. So as part of our work we've kept abreast of all these things and we're tracking them. And now we are sharing them with a group of advocates outside of the United States supported by the Bloomberg Philanthropies to support their efforts. And they've already made tremendous progress in a lot of areas around healthy eating in countries like Mexico and Argentina and Brazil, et cetera.

And I'm assuming all these technological advances and the marketing muscle, the companies have is not being used to market broccoli and carrots and Brussels sprouts. Is that right?

Jeff - The large companies are aware of changing attitudes and the need for healthy foods. One quick takeaway I have is this. That because the large ultra processed food companies understand that there are political pressures promoting healthier eating in North America and in Europe. They are focused on expanding their unhealthy eating portfolio, in new regions specifically Asia Pacific, Africa, and Latin America. And China is a big market for all this. This is why it has to be a global approach here, Kelly. First place, these are transnational corporations. They are creating the, our marketing strategies at the global level and then transmitting them down to be tailored at the national or regional level. They're coming up with a single set of strategies that will affect every country and every child in those countries. We need to keep track of that and figure out ways to go after that. And there are global tools we might be able to use to try to protect young people. Because if you could protect young, a young person in China, you might also be able to protect them here in North Carolina.

This all sounds potentially pretty scary, but is there reason to be optimistic? Let's see if we can end on a positive note. What do you think. Do you have reason to be optimistic?

Kathryn - I've always been an optimist. I've always tried to be an optimist, and again, what I would say is if we look at this globally and if we identify partners and allies all around the world who are doing good work, and there are many, many, many of them. And if we work together and continue to develop strategies for holding this powerful industry and these powerful industries accountable. I think we will have success. And I think we should also shine the spotlight on areas where important work has already taken place. Where laws have been enacted. Where companies have been made to change their practices and highlight those and build on those successes from around the world.

Thanks. Jeff, what about you? Is there reason to be optimistic?

Well, I don't think we can stop trying, although we're at a particularly difficult moment here in our country and worldwide. Because unless we try to intervene the largest corporations, who are working and will work closely with our government and other government, will be able to impact our lives in so many ways through their ability to collect data. And to use that data to target us and to change our behaviors. You can change our health behaviors. You can try to change our political behaviors. What the ultra-processed food companies are now able to do every company is able to do and governments are able to do. We have to expose what they're doing, and we have to challenge what they're doing so we can try to leave our kids a better world.

It makes sense. Do you see that the general public is more aware of these issues and is there reason to be optimistic on that front? That awareness might lead to pressure on politicians to change things?

Jeff - You know, under the Biden administration, the Federal Trade Commission identified how digital advertising and marketing works and it made it popular among many, many more people than previously. And that's called commercial surveillance advertising. The idea that data is collected about you is used to advertise and market to you. And today there are thousands of people and certainly many more advocacy groups concerned about commercial surveillance advertising than there were prior to 2020. And all over the world, as Kathryn said, in countries like in Brazil and South Africa and Mexico, advocates are calling attention to all these techniques and practices. More and more people are being aware and then, you know, we need obviously leaders like you, Kelly, who can reach out to other scholars and get us together working together in some kind of larger collaborative to ensure that these techniques and capabilities are exposed to the public and we hold them accountable.

Bios

Kathryn Montgomery, PhD. is Research Director and Senior Strategist for the Center for Digital Democracy (CDD). In the early 90s, she and Jeff Chester co-founded the Center for Media Education (CME), where she served as President until 2003, and which was the predecessor organization to CDD. CME spearheaded the national campaign that led to passage of the 1998 Children’s Online Privacy Protection Act (COPPA) the first federal legislation to protect children’s privacy on the Internet. From 2003 until 2018, Dr. Montgomery was Professor of Communication at American University in Washington, D.C., where she founded and directed the 3-year interdisciplinary PhD program in Communication. She has served as a consultant to CDD for a number of years and joined the full-time staff in July 2018. Throughout her career, Dr. Montgomery has written and published extensively about the role of media in society, addressing a variety of topics, including: the politics of entertainment television; youth engagement with digital media; and contemporary advertising and marketing practices. Montgomery’s research, writing, and testimony have helped frame the national public policy debate on a range of critical media issues. In addition to numerous journal articles, chapters, and reports, she is author of two books: Target: Prime Time – Advocacy Groups and the Struggle over Entertainment Television (Oxford University Press, 1989); and Generation Digital: Politics, Commerce, and Childhood in the Age of the Internet (MIT Press, 2007). Montgomery’s current research focuses on the major technology, economic, and policy trends shaping the future of digital media in the Big Data era. She earned her doctorate in Film and Television from the University of California, Los Angeles.

Jeff Chester is Executive Director of the Center for Digital Democracy (CDD), a Washington, DC non-profit organization. CDD is one of the leading U.S. NGOs advocating for citizens, consumers and other stakeholders on digital privacy and consumer protections online. Founded in 1991, CDD (then known as the Center for Media Education) led the campaign for the enactment of the Children’s Online Privacy Protection Act (COPPA, 1998). During the 1990s it also played a prominent role in such issues as open access/network neutrality, diversity of media ownership, public interest policies for children and television, as well the development of the FCC’s “E-Rate” funding to ensure that schools and libraries had the resources to offer Internet services. Since 2003, CDD has been spearheading initiatives designed to ensure that digital media in the broadband era fulfill their democratic potential. A former investigative reporter, filmmaker and Jungian-oriented psychotherapist, Jeff Chester received his M.S.W. in Community Mental Health from U.C. Berkeley. He is the author of Digital Destiny: New Media and the Future of Democracy (The New Press, 2007), as well as articles in both the scholarly and popular press. During the 1980s, Jeff co-directed the campaign that led to the Congressional creation of the Independent Television Service (ITVS) for public TV. He also co-founded the National Campaign for Freedom of Expression, the artist advocacy group that supported federal funding for artists. In 1996, Newsweek magazine named Jeff Chester one of the Internet's fifty most influential people. He was named a Stern Foundation “Public Interest Pioneer” in 2001, and a “Domestic Privacy Champion” by the Electronic Privacy Information Center in 2011. CDD is a member of the Transatlantic Consumer Dialogue (TACD). Until January 2019, Jeff was the U.S. co-chair of TACD's Information Society (Infosoc) group, helping direct the organization’s Transatlantic work on data protection, privacy and digital rights.

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As any parent knows, it is really important to help our children to make healthy food choices. I know as a father who cooks for my child, it is really critical that I introduce her to fruits and vegetables and encourage whole grains and try to manage the amount of additional sugars, but it's hard. We do this with the goal of trying to make sure that our child is able to eat healthy once she leaves the home. That she's able to make healthy choices there. But it's not just about the future. My child is making choices even today at school and outside of school, and the question is, can we help her make those choices that are going to lead to healthy food outcomes?

Do food labels on products encourage children to make healthy food choices if it indicates good ingredients? Or would labels that warn against nutrients of concern actually discourage kids from using those or consuming those products? Today we're going to actually explore those questions in a particular context- in Chile. In 2016, the Chilean government implemented a comprehensive set of obesity prevention policies aimed at improving the food environment for children. Last year on this podcast, we actually explored how the Chilean food laws affected school food purchases. But now today, we're going to explore how food labels are influencing youth outside of school. It is my pleasure to welcome back my colleagues, Gabriela Fretes, who is an associate research fellow at the International Food Policy Research Institute, or IFPRI; and Sean Cash, who is an economist and chair of the Division of Agriculture, food and Environment at Tufts University at the Friedman School of Nutrition, Science and Policy.

Interview Summary

Gabi and Sean, I'm excited to discuss our new paper, Front of Pack Labels and Young Consumers an Experimental Investigation of Nutrition and Sustainability Claims in Chile that was recently published in a Journal of Food Quality and Preference. Gabi, let's begin with you. So why look at Chile? Can you explain the focus of the Chilean labeling and food environment policies there?

So, the setting of our study, as in the previous study, was Chile because recently the country implemented the law of food labeling and advertising, which includes three main components. The first one being mandatory front of package warning labels on packaged goods and beverages. The second one being restrictions on all forms of food marketing directed to children younger than 14 years. So, including printed media, broadcast, and also all digital media. And the third component being at school regulations at different levels including preschool, elementary, and high school levels.

Briefly, food manufacturers in Chile must place front of package labels on packaged foods or beverages that are high in specific nutrients of concern, including added sugars, saturated fats, sodium, and or energy. This law was implemented in three stages, starting in June 2016. The last stage was implemented in June 2019. So, it has been already six or seven years since the full implementation of the regulation. Specifically talking about the school component because this, yeah, it relates to children and adolescents. The law mandates that foods and beverages with at least one front of pack warning label cannot be sold, promoted, or marketed inside schools. And this includes the cafeteria, the school kiosks, and even events that are happening inside the schools. And additionally, food and beverages that have at least one front pack warning label cannot be offered as part of school meal programs. In addition to this front of pack warning label regulation, Chile also implemented voluntary eco labels starting in 2022 that provide information about the recyclability of food packages specifically. There is a certification process behind this labeling regulation and the eco label can be displayed if the food or beverage package is at least 80% recyclable.

Wow. This is a really comprehensive set of policies to encourage healthier food choices, both at the school and then also outside of the school. I'm excited to discuss further what this may do to food choices among children. Sean, that really brings up the question, why is it important to look at young consumers and their food choices and what makes them unique compared to adults?

Thanks for asking Norbert. This is an area where I've been interested in for a while. You know, young consumers play a crucial role in shaping the demand for food and long-term dietary habits. And young consumers might be more open to incorporating dietary advice into those long-term habits than adults might be. Just perhaps kids are less set in their ways. Children and adolescents are both current, but also future consumers with growing autonomy in what they choose around food as they get older. To marketers, we sometimes would say they might represent a three-in-one market. First, they spend their own money on snacks. What you could think of as the primary market. And how children spend money autonomously is really something that hasn't been studied enough by researchers. Although it's an area where I have tried to make a contribution. Second, kids influence household purchases. This is sometimes called pester power. You can think of a kid in the supermarket begging a parent to buy a favorite snack or a certain brand of cereal. But this can also be more socially positive in that kids might be agents of change within their households. Encouraging perhaps other family members to buy healthier food items if they get more interested in that. And third, this three-in-one market is rounded out by the fact that children represent future purchasing power as future adults. So, the habits that they're forming now might influence what they do when they're older.

Despite this importance for marketers, but also for pro-social behavior change, there really hasn't been a lot of research on youth food purchasing behaviors. And this question that we are looking at here of how kids might respond to front to package labels has been particularly limited.

In this project, we wanted to understand how Chilean adolescents might respond both to nutrition warning labels, but also eco labels, and how they consider price when choosing snacks. We were lucky to be able to recruit a sample of over 300 kids, aged 10 to 14, to participate in these experiments. I know we're going to chat a bit more about what we found, but in general, our results suggest that while price is perhaps the biggest factor in explaining what the kids chose in our experiment, that some of these youth showed preferences for the eco labels, which could be indicative of an emerging interest in sustainability issues.

But overall, understanding these behaviors is really important because the food choices made during childhood and adolescence can persist in adulthood. And this can be really something that helps change long-term health outcomes.

Gabi, let's talk a little bit more about eco labels for a moment. What are they, and how do these echo labels influence children's snack choices? What did they tell us about their awareness of sustainability?

That's a great question, Norbert. Thanks. In our study specifically, we found that eco labels, had a greater influence on adolescents' snack choices than nutrition warning labels these black and white octagons that are displayed on the front of the package of products in Chile. And this suggests that some young consumers are becoming more aware of environmental issues, or at least in our sample. One possible explanation for this could be that eco labels suggest positive emotions rather than warnings, as with the nutrition labels. Which might feel more restrictive. Unlike the nutrition labels that tell consumers what not to eat, eco labels, on the other hand, highlight a product's benefits, making it more appealing. This could be one of the reasons. Related to that, adolescents may also associate eco-friendly products with social responsibility aligning with increasing youth-driven environmental movements that are very prevalent around the world.

However, not all adolescents in our sample responded equally to the eco labels that were presented to them in the snacks. Our study specifically found that those who receive pocket money were more likely to choose eco label snacks. And this could be possibly because they have more autonomy over their purchases and their personal values could be playing a bigger role in their choices. If eco labels are really influencing children and adolescents with choices, one intervention that could be potentially beneficial could be to incorporate sustainability messaging in school food and nutrition education in order to reinforce those positive behaviors. And make them part of the daily food choices that they make. In making sustainable food more affordable, government incentives or retailer promotions could encourage youth to choose more eco-friendly snacks. Given that price, as we saw in our study, remains a key factor for choice. Lastly, not all eco labels are created equal. And this suggests that clear standardization and regulation are needed to prevent misleading claims. And ensure that adolescents receive accurate information about the sustainability of their food choices.

Ultimately, the eco labeling, of course, is not a silver bullet. It's not going to solve all the environmental issues, but it represents a promising tool to nudge consumers. So our better dietary and environmental behaviors.

Gabi, you talked about how the eco labels have a bigger effect than nutrition warning. And overall, the nutrition warning labels didn't really have that big of an effect on snack food choices. Why do you think that's the case?

Yes, this was really one surprising finding in our study. That front of pack nutrition warning labels did not significantly impact children's and adolescents' snack choices. And this kind of contradicts some previous research suggesting that warning labels can help consumers make healthcare choices. And there are several possible explanations for why this could be happening. The first one could be just lack of interest. So compared to adults, children and adolescents may be just more responsive to positive rather than negative messaging. Because negative messages related to nutrition might not seem relevant to them because they feel healthy in the present. They just are not interested in those kinds of messages. The second could be label fatigue. We discuss this in our paper and basically it is because Chile's regulation was already introduced in 2016. Given that it has been already some time since implementation, young consumers may have become habituated to seeing the warning labels on food products. So, like how adults also experience label fatigue, and this is documented in the evidence, children and adolescents might no longer pay attention or pay less attention to the warning. Third possible explanation is it relates to taste and brand loyalty. For this point, research shows that for youth specifically, taste remains the top priority when they choose food. So often outweighing any other factors including health concerns. If a favorite snack, for example, has warning labels but remains tasty and familiar to the kid, the label alone may not discourage them from choosing that snack. And lastly, social and environmental factors. Our study found, as we already mentioned, that eco labels had a stronger influence that nutrition warnings, and this could indicate that children and adolescents are just more responsive to messages about sustainability than to warnings, which they may perceive as less immediate.

Thank you for sharing that. And at this moment in the US there is a conversation about front of pack labels. And the work that you are showing in this paper may even point to some of the things that may happen if we see similar front of pack labels here in the US. I'll be looking forward to see what happens with that effort right now. Sean, I want to turn to you and ask an economist type question. What role does price play in adolescent food choices? Not only price, but the availability of pocket money? And how do you think that should influence policy?

Our study shows that price is the most significant factor influencing the snack choices of the kids in our study. And higher prices definitely reduce the likelihood of seeing a certain product being selected. It was kind of interesting. Interestingly, this effect was consistent regardless of whether the kids regularly received pocket money. Suggesting that even those that don't receive spending money still are paying attention to price. And this was a little bit different from what we found in some other studies that I've been able to work on, in the US and Germany, that suggested that previous experience with pocket money, or getting an allowance, was really important for understanding which kids might be most careful about spending their own money. I don't know if that's something different in the Chilean context than those other contexts. Or if that was just about what the kids in this particular study were paying attention to because we're asking about different things.

But when we look more closely at the kids in our Chilean study, we found some important differences. As Gabi already mentioned, those kids who received pocket money were the ones who were more positively inclined to choosing products with the eco labels. And that suggests that they might be valuing sustainability a little bit more when making their own choices. Perhaps because they're already a little bit more familiar with some of those dynamics of spending their own money. Whereas those without pocket money were more likely to choose cheaper options or sometimes the healthier options like the apples that we provided as an option in our study. And suggesting they're focused more on affordability or health.

So, what this means for policy, given the strong influence of price, it means that policy interventions that focus on price, like taxes on unhealthy foods or perhaps subsidies for healthier options, might be effective tools in guiding better choices for these kids. But also, programs promoting budgeting skills and food literacy might help adolescents make more informed decisions both about the nutrition and the sustainability of the foods they're eating. Finally, since some kids are responding positively to eco labels, integrating sustainability messages with the nutrition education could enhance the impact of food labeling policies. Overall, combining price policies and education labeling strategies could be really effective in driving meaningful changes in children and adolescent food choices.

Sean, thank you. And it's really important to appreciate the differences that may occur when we think about a country like Chile versus the US or in some of your other work in Germany. And understanding that youth culture may be different and may be shaping these behaviors. But it's very clear that all people, it sounds like, are responding to price. And that's a constant that we're seeing here. Sean, here's my final question for you. What is the take home implications of this study?

Well, first and foremost, our findings here suggest that nutrition labeling alone isn't necessarily going to be enough to drive healthier choices among children and adolescents. It can be part of an answer, but policymakers looking to promote healthier food choices might need to compliment labeling with education campaigns that reinforce the meaning of these warnings and integrate them into school-based nutrition programs. That said, I think that Chile has already been a leader in this regard, because the food items that get the warning labels in the Chilean context are the same ones that are subject to different restrictions on marketing or sales in schools, as well. I do think that we're going to see kids and eventually adults just become more familiar with these categorizations because of the consistency in the Chilean law. Also, on the eco label side, leveraging that kind of eco labeling alongside nutrition messaging might be an effective combination to help promote both healthier and more sustainable food choices. And finally we've been talking about new front to pack labeling schemes here in the United States. And it's really important to make sure we learn as much as possible from the experiences with such policies in other countries. Chile's really been a world leader in this regard and so I'm very happy to have tried to contribute to an understanding of how people use these labels through this study and through some of the other projects that Gabi, you and I have all been involved in.

Bios

Gabriela (Gabi) Fretes is an Associate Research Fellow in the Nutrition, Diets, and Health (NDH) Unit of the International Food Policy Research Institute. She received her PhD in Food and Nutrition Policies and Programs at the Friedman School of Nutrition Science and Policy, Tufts University, USA in 2022 and holds a master’s in food and nutrition with a concentration on Health Promotion and Prevention of Non-Communicable Diseases from the Institute of Nutrition and Food Technology, University of Chile. Her research interests are at the intersection of child obesity prevention, food policy and consumer behavior, and her doctoral thesis involved evaluation of a national food labeling and advertising policy designed to improve the healthfulness of the food environment and address the obesity epidemic in Chile, particularly among children. She has worked with a broad range of government, international organizations, academia, public and private sector stakeholders and decision-makers in Paraguay, Chile, and the United States of America.

Sean Cash is an economist and Chair of the Division of Agriculture, Food and Environment at the Friedman School of Nutrition Science and Policy at Tufts University. He conducts research both internationally and domestically on food, nutrition, agriculture and the environment. He is interested in environmental impacts on food and beverage production, including projects on crop quality and climate change, consumer interest in production attributes of tea and coffee, and invasive species management. He also focuses on how food, nutrition, and environmental policies affect food consumption and choice, with specific interest in children’s nutrition and consumer interest in environmental and nutritional attributes of food. He teaches courses in statistics, agricultural and environmental economics, and consumer behavior around food. He is currently Specialty Chief Editor of the Food Policy and Economics section of Frontiers in Nutrition, and has previously served as an Editor of the Canadian Journal of Agricultural Economics as well as the Chair of the Food Safety and Nutrition Section of the Agricultural and Applied Economics Association.

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The amount of time children and adolescents spend with a screen is absolutely stunning. Lots of people, including parents, health leaders, educators, elected leaders from both parties I might mention, and even children themselves, are highly concerned and are discussing what might be done about all this. I'm delighted to begin this series of podcasts on children and screen time. Today we're welcoming two very special guests who can talk about this topic in general, and especially about what's being done to protect children and adolescents. Several podcasts will follow this one that deal with food and nutrition in particular. Our first guest, Kris Perry, is Executive Director of Children and Screens, an organization devoted to protecting children. In the digital world by addressing media's impact on child development, communicating state-of-the-art information, and working with policymakers. Prior to joining children in Screens, Kris was senior advisor of the Governor of California and Deputy Secretary of the California Health and Human Services Agency. Our other guest, Dr. Dimitri Christakis is a professor of pediatrics at the University of Washington School of Medicine, and director of the Center for Child Health Behavior and Development at Seattle Children's. He's also editor-in-chief of JAMA Pediatrics and both Chief Scientific Officer and Chair of the Scientific Advisory Board of Children and Screens. He's also the co-editor of a new book that I'm very excited to discuss.

Interview Summary

Download The Handbook of Children and Screens: https://link.springer.com/book/10.1007/978-3-031-69362-5

Kris, let's start with you. Could you set the stage and give us some sense of how much time children spend in front of screens, children and adolescents, and what devices are being used and what kind of trends are you seeing?

Yes, I'd be happy to. I had better news for your listeners, but as you might imagine, since the advent of the smartphone and social media, the youth digital media use has been increasing each year. Especially as children get older and have increasing demands on their time to use screens. But let's just start at the beginning of the lifespan and talk about kids under the age of two who shockingly are spending as much as two hours a day on screens. Most spend about 50 minutes, but there's a significant chunk spending up to two hours. And that rises to three or three to five hours in childhood. And eventually in adolescence, approximately eight and a half hours a day our adolescents are spending online.

Also wanted to talk a little bit about middle childhood children, six to 12 years of age. 70% of them already have a social media account, and we all know social media wasn't designed for children. And there are restrictions on children under 13 using them, and yet children six to 12 most have an account already. Over half of four-year-olds have a tablet and two thirds of children have their own device by the age of eight; and 90% of teens. This probably won't be surprising, and yet we should really think about what this means; that 90% of teens are using YouTube, 60% are on TikTok and Instagram, and 55% use Snapchat. I'll stop by ending on a really alarming statistic.

Oh my, there's more?

There's more. I know it! I told you. I'll be the bearer of bad news so that we can talk about solutions later. But, children are checking their devices as often as 300 times per day.

300 times.

300 times per day, and we're talking about screen time right now. And we know that when you're using time to be on screens, you are not doing something else. And we know that childhood is full of challenges and skill building and mastery that requires repetition and tenacity and grit and effort. And the more children are on their screens, whether it's social media or other entertainment, they're not doing one of these other critical child development tasks.

That's pretty amazing. And the fact that the older kids are spending more time on before a screen than they are in school is pretty alarming. And the younger, the really youngest kids, that's especially alarming. So, Dimitri, why should we fret about this? And I realize that fret is kind of a mild word here. Maybe all I'll panic would be better. But what are some of the major concerns?

Well, I don't think panic is ever the right reaction, but the numbers Kris conveyed, you know, I think do paint a, let's say, concerning story. You know, the simple reality is that there's only so much time in a day. And if you think about it, teenagers in particular should sleep for eight to 10 hours a day at a minimum. They really should be in school six and a half, seven hours a day. And then when you add the numbers, Kris conveyed, you realize that something's giving because there isn't enough time left to spend eight and a half hours a day. The two things at a minimum that are giving are sleep. Kids are losing sleep to be on screens. And I'm sorry to say that they're losing school while they're on screens. We just published a paper that used passive sensing to see where and when children are on their screens. And found that the typical child in the United States spends an hour and a half during the school day on their device. And it's not, before any of your guests ask, on Wikipedia or Encyclopedia Britannica. It's on the usual suspects of social media, TikTok, etc. So, you know, we talk about displacement, and I think it's pretty obvious what's being displaced during school hours. Its time focused on learning if it's in the classroom, and time focused on being authentically present in real time and space if it's during recess. School hours are precious in that way, and I think it is concerning that they're spending that much time in school. And I told you the median. Of course, some kids are above that, a significant half of them are above it. And at the high end, they're spending 30 to 40% of school time on screens.

Now, some schools have enacted policies. They don't typically enforce them very well. One of the things that drives me nuts, Kelly, is that as an academic, you know we love to argue amongst ourselves and hem and haw. And this issue about whether or not there's such a phenomenon as digital addiction is still being hotly debated. Honestly, the only behavioral addiction that's being seriously considered at this point is gaming disorder. The DSM-5 didn't consider gaming, considered it, but didn't include, it said it needed further study in 2013. In 2022, the WHO did include gaming disorder as an ICD-11 diagnosis. But just as further evidence how slow science is compared to technology., I mean gaming, while it's still an entity, represents a small fraction of most people's screen time. And the numbers that Kris conveyed, a small fraction of that for some on average was gaming. For some people, it's their screen use of choice, but for many, it's social media. YouTube, although I consider YouTube to be a social media, etc. And at the high end when you hear the numbers Kris conveyed in my mind that's a behavioral addiction any way you define it.

Well, and if you think about things that we all agree are addictive, like nicotine and alcohol and heroin, people aren't doing it 300 times a day. So it's really pretty remarkable.

And that's exactly right. One of the salient criteria for those addictions is that it's interfering with activities of daily living. Well, you can't be on a screen for nine hours a day when you're supposed to be asleep for 10 and at school for six without interfering with activities of day. The math isn't there.

And things like being physically active and going out and playing.

That's right. It doesn't add up. So, you don't need the DSM-5. You don't need a psychiatrist. You need a mathematician to tell you that there's too much time on this thing.

Alright, so Kris, talk to us if you will, about the Children and Screens organization. I have a lot of respect for the organization and its work. Tell us how it got started and what its objectives are.

Well, it's so great to be on this show with you and get to see you in your day job, Kelly. Because you've been an advisor, like Dimitri, to the institute almost since its inception, which is in 2013. As you know, our founder, Dr. Pamela Hurst-Della Pietra, really became concerned as a parent about the way digital media was impacting her children and sought out some answers. Well, what does this mean? Why is this happening? What should I do? And found out that this, of course, is 2013, this is a long time ago. There wasn't that much research yet. And it was multidisciplinary. In other words, there might be a study among neuroscientists or developmental psychologists, even ophthalmologists. But there really hadn't been, yet, a concerted effort to bring these different disciplines and the research together to try to answer some of these hard questions about the impact on kids. And lo and behold, here we are, almost 13 years since the advent of the smartphone and social media. And there is an astounding amount of research across disciplines. So, what we do at the institute is we try to translate it as fast as we can and make it actionable for parents, providers, and policy makers. And we do that through our Ask the Experts webinar series where we bring the experts themselves directly to our audience to talk about these impacts and answer questions. We also create printables, you might say, like tip sheets and Research at a Glance Digest, and newsletters and FAQs and we've upgraded our website to make it very navigable for parents of kids of all ages.

I even started my own podcast this year, which has been really fun. Dimitri was my first guest, so it's great to see him here. And we have convenings. We're having our third Digital Media Developing Mind Scientific Congress this summer where the experts come together in person to discuss issues. And we really try to focus them on advancing research and supporting it, translating it, and positioning the issue as a policy priority. We'll be in Washington, DC where we know lawmakers are grappling with the impact of digital media on child development, how to make online, products safer for kids and protect their data. The Institute is in the middle of all of this, trying to facilitate more discussion, more results and more support for parents primarily.

Kris, a couple of things occur to me. One is that the breadth of work you do is really very impressive because you're not only having very hands-on kind of in the real world ex advice for parents on how to navigate this world, but you have advice for and helpful resources for policy makers and for researchers and people. It's really quite an impressive breadth of work. The other thing that occurred to me is that I don't think you and I would have any podcast career at all if it hadn't been for Dimitri helping us out. So thanks Dimitri. Yeah. So, let me ask you, Dimitri, so I know that both you and Kris are committed to an evidence-based approach to making policy.

Yeah.

But technology advances way more quickly than scientists can evaluate it. Much less come up with policies to deal with it. And by the time research gets funded, completed, published, you're on to eight new levels of technology. So how does one handle this fundamental problem of pace?

It's a really good question. I mean, I can tell you that we should at a minimum learn from the mistakes we've made in the past. And, you know, one of the most critical, frankly, that most people don't really understand is that we talk about the age at which children get social media accounts in this country. Kris pointed out that actually pre-teens routinely have social media accounts. Social media companies do very little to age gate. They're trying to do more now, but even the age at which we've accepted it is being normative is 13. Few people know where that comes from. That doesn't come from talking to pediatricians, psychologists, parents about what age is the appropriate age. It comes entirely from COPPA (Children's Online Privacy Protection Act), which basically was the original privacy act that said that before the age of 13, companies could not collect data from children. So, because these companies were interested in collecting data, they set the age at 13 so as to not have any constraints on the data they collected.

Well, that's not even common sense-based policy, let alone evidence-based policy. And it's never been revisited since. It's very troubling to me. And as things move forward, I think we have to learn from those mistakes. Medicine has a maxim which is do no harm. We use that phrase a lot and I think it's a good one in this case. I think it's a particularly good one as we see the new technologies emerging around artificial intelligence. And you know, again, like any new technology, it has incredible upside. We made the mistake and we're still paying for it, about not appreciating the downsides of social network sites, and frankly, the internet in general. And I would hope we put guardrails in place now. And if you will apply the same standard we apply to other non-technology based products. You can't introduce a new pharmaceutical to anybody, let alone to children, until you show it's safe and effective. You can't bring toys to the world that are dangerous. Why do we have more safety precautions around toys than we do around websites for children?

You know, a lot of it involves changing defaults, doesn't it? Because if the default is that government or somebody out there has to prove that something is harmful before it gets taken away. That changes everything then if you began at a different point where these companies have to prove that these things are safe.

Correct.

Or they're permitted. Then the companies would find workarounds and they would play games with that too, but at least that would help some.

Well, it would help some. And at least we'd be philosophically in the right place. By the way, Kris didn't say it, so I'll say it. You know, the mission of Children and Screens, lest we sound like Luddites here, is not get kids away from technology. Take away their smartphones. We all recognize that technology is here to stay. I think all of us appreciate the incredible upside that it brings to children's lives. The mission of Children and Screens is to help children lead healthy lives in a digital world. And part of the reason she and I often talk about the concerns we have is because the pros make the case for themselves. I mean, you know, no one needs to come here and tell you how amazing it is that you could Google something or that you could get somewhere with GPS. I mean, we know it's amazing and we all rely on it. And none of us are ever talking about getting rid of that stuff.

That makes good sense. It's like, you know, children benefit from the fact that they can get around with their parents in the automobile. But you want to have car seats in there to protect them.

Exactly. And that's exactly right. There needs to be assurances of safety and they're none. I mean, they're really virtually none. The age getting is a joke. And even if we accept it as effective, the age set of 13 is too young, in my opinion. We started this conversation talking about these medias being addictive, I believe they're addictive. There are legitimate academics that will debate me on that, and I'm happy to join that debate. But as I said before, it's a tough argument to win when people spending upwards of 10 to 16 hours a day doing it. I don't know what you call that besides addictive. We can argue about what percentage are doing that, but nevertheless, once you accept something as addictive, for other addictive things we immediately age gate it above 18 or 21, right?

Mm-hmm.

We don't believe that the teenagers have the ability to regulate their alcohol or tobacco or gambling, all of which we accept are addictive. In fact, in the case of alcohol, we raised the age from 18 to 21 because we thought even 18-year-olds weren't able to do it. And yet somehow for this behavior, we think of it as just so different that it doesn't require greater cognitive capacity. And I don't believe that.

Yeah, very good point. Kris, let me ask you a question about how you and your colleagues at Children and Screens set priorities because there are a lot of things that one could potentially worry about as outcomes. There's violence that kids see on social media. There's cognitive and brain development, social developments, social interactions, and bullying. Mental health, body image, diet, all these things are out there. How do you decide what to work on?

Well, we try to work on all of it. And in fact, we've built up a fair amount of expertise and resources around almost 25 different topics. And we also understand that, you know, childhood is a long period of time. Birth to 18, birth to 21, birth to 25, depending on who you talk to. So, we're able to take those 25 topics and also provide deeper, you might say, resources that address the different stages of development. We're really trying to do as much as we can. What's been interesting over these last few years is trying to figure out when to be reactive, when to be proactive. And by being proactive, we go out looking for the research, translating it, digesting it, and creating materials with it that we think are really accessible and actionable. At the same time, as Dimitri points out, there are policy windows and there are opportunities that present themselves that you have to react to. If you just only talk about what you want to talk about to each other you're missing some of these external opportunities to inform policy and policy makers. Help influence the way that parents and providers are talking about the issue. Framing it in such a way that engages youth and makes them want what we want for them. We're really excited by increasing opportunities to partner in coalitions with others that care about kids and teachers and nurses and doctors. But we also are speaking directly to leaders in states and school districts at the federal level, at the local level. You would be, I'm sure, not surprised to hear that we are contacted every day by groups that support parents and families. Asking for resources, asking for support, because they're seeing the impact now over many years on their children, their development. Their academic ability. Their cognitive and analytical ability. Their social emotional ability. Their ability to pay attention to tasks that we all know are critical in building that foundation for essentially, you know, future success. The Institute is being pulled in many directions. Ee try really hard to be strategic about what are people asking us for? What does the research say and how can we get that to them as quickly as possible?

Dimitri - Can I add to that? You know, I want to emphasize that the concern around the effects of screen use on children's lives is shared by parents on both sides of the aisle. 75% of parents are concerned about the impact of screens on their children's lives. 35% of teenagers are concerned about their dependents on screens and that it has a negative effect on their lives. Actually by some studies, some surveys, even more than 35 to 50% of teenagers are concerned. And both sides of the political aisle agree in large part of this. And Kris and Kelly, you guys are the policy wonks, you can speak more to that. So it's a serious indictment on us as grownups and as a society that we have not done more to deliver on this issue. Why? When there's bipartisan agreement amongst many policymakers. This is not a political [00:22:00] issue to speak of and there is widespread concern on the part of parents and even teenagers. Why is nothing happening? Well, one has to look no further than where the money is. And that's a problem. I mean, that's a serious indictment on our political system when we can't deliver something that is needed and basically wanted by everybody but the industry itself.

We'll come back and talk in a few moments about the policy issues and where industry gets involved here. But let me take just a bit of a detour from that and talk about the book that I mentioned earlier, because I think it's such a valuable resource. Now, when I mention the name of this book I'm urging our listeners to write this down or to remember it because you can get the book at no cost. And I'll come back, Kris, and explain what made that possible and why the decision was to make this an open access book. But Dimitri, let's begin with you. So you, along with Lauren Hale, edited this book that's entitled, The Handbook of Children and Screens: Digital Media Development and Wellbeing From Birth Through Adolescence. I think it's an extraordinary piece of work, but tell, tell us about the book.

It was an extraordinary undertaking. There's I think 178 or 180 authors. Literally, it's a who's who of experts in children and media research in all disciplines. It represents pediatrics, psychiatry, psychology, communications experts, demography, lawyers, neuroscientists. I don't know who I'm forgetting. Every single discipline is represented. Leading scientists in all of those areas. Virtually every topic that someone might be of interest to people. And we deliberately made the chapters short and easily accessible. So, it is, I think, a great resource for the constituents we serve. For teachers, for parents, for researchers, for policymakers. And it is free. The hardest part of it, to be honest, as an editor, was getting peer reviewers because unfortunately, every expert was conflicted since they all had an article in it. But it was a long time coming. And again, this was really the brainchild of Pam (Pamela Hurst-Della Pietra) and we're grateful to have brought it along.

So, you go all the way from the neuroscience, how children's brains are reacting to this, all the way out there into the public policy and legal arena about what can be done about it. And then kind of everything in between. It's remarkable how much the book covers.

It's almost a thousand pages. I mean, it is a tome to be sure. And don't forget to mention, Dimitri, we aren't even two months post publication, and we have 1.6 million views of the document, despite its gargantuan size. I think that is really a tribute to experts like you and others that have really studied this issue and can speak directly to its impacts. It's been great to see the success so far.

You know, not a small number of those views is from me logging on.

And then a million from me and then we got there. So, it is free because it's online and you can download it. You can also order a hard copy for I think, $60, but I'm not sure why you would do that if you can download it for free. But it's up to you.

So, Kris, it's unusual for a book like this to be made open access and free to the general public. What made that possible and why was that so important?

We want the maximum number of people to use it and treat it like the premier resource that it is. And the only way you can really do that is to fund it to be open access and find a publisher that does open access publishing, which we did with Springer. I mean, most journal articles are behind a paywall and publishers do require you to purchase either a subscription or the document itself to download it or order it. And we just really wanted maximum access. So, we funded it to be published in that way. And I think honestly, it helped us even sort of create it in the first place. People want to be a part of something that has that level of access and is available so widely. So, I think it was a kind of mutually beneficial. It gets more people to read it, but it got more people to write for it too, I think. Right, Dimitri?

Dimitri - I agree. I mean, you know, the numbers 1.6 million are extraordinary. I mean, Kelly, you've been internal editor. I mean, as a editor of JAMA Pediatrics, if an article gets 70,000 views, it's in our top 1%, you know, 200,000 views is 0.01%. 1.6 million in growing is really extraordinary.

And that's about the number of people that read my articles. 1.6.

And of course, they're not all scientists. I mean, many of them are parents and maybe are policy makers, but that's Kris's point, you know. The moment anyone hits a paywall, even if it's a dollar or two, they're going to walk away. It's great to see it get so much traction.

Alright, so again, for our listeners, the title of the book is The Handbook of Children and Screens. And it's really a terrific resource. Alright, so let's turn our attention to a really important matter. And we've sort of touched on this, but who's in charge of protecting our children? You know, Dimitri at the end of the day help survey this landscape for us. I mean, is it congress, is it the administrative branch of government? What role do the courts play? Are there legal actors taking meaningful action? What's being done does it come anywhere near, meeting the need. Tell us about what that landscape is like?

Well, there isn't adequate protections for children. And we talked a little bit about that earlier. There's been an enormous loophole, unfortunately, created by Congress when they added the Section 230 to the Communications Decency Act in 1996. And that was put in place essentially to provide protections for internet companies. And it basically said that they should be treated like bookstores and not publishers. That they weren't responsible for content they were just conveying it. And what that means, in effect, was that the companies had sort of carte blanche to do whatever they want. And they've used that very effectively, legally, to argue that any restriction, any culpability on their part, is protected by that Act. That they're exonified for any ill that occurs as a result of their product.

The only exception that's been made of it, to date, was around sex trafficking on back page, if anyone remembers that. But other than that, social media sites and internet sites in general have been able to say that they're not liable for anything that's done. And I think that was a huge mistake that was made. It needs to be rectified. It's being challenged in the courts presently. My own belief is that, and I'm not speaking as a lawyer, is that when that law was passed, it was under the assumption as I said, that they were just conveying information. No one at the time foresaw the development of algorithms that would feed the information. It's really not a bookstore when you are making recommendations. Once you start recommending things, I think you're no longer merely a purveyor of product. You're actually pushing it.

So, Kris, tell us about the Children and Screens and the role the organization plays in this space. And how do you deal with policy and is it possible to be bipartisan?

Yeah, I mean, it's essential. There's no way to get anything done, anywhere on these policy matters at a population level without working in a bipartisan or non-partisan manner, which is what we've always done. And it's easy to do that when you're following the science, not ideology. And you're putting the science first and you're creating resources and tools and support for those mostly staffers, honestly, that are trying to help their bosses get smarter and better at talking about these issues as they evolve and become more complicated over time. It takes more effort to staff a lawmaker on this front. And they're very anxious to learn and understand because they're meeting with parents of children who have been harmed. Or frankly didn't even survive their childhood because of the social media platform. There's great urgency on the part of policymakers. We've heard everything from school phone bans to outright social media bans proposed as policies. And one thing I like to come back to is it's one thing to want to take action and make your best guess at what would have the best impact. But it's another thing to study whether or not that policy actually achieved its result. And it's a part of this that by staying bipartisan, nonpartisan allows us to say, 'Hey lawmaker, if you're able to get that to happen, we'd really like to come in and help study whether or not your idea actually achieves the results that you wanted, or if it needs to be adjusted or amended over time.'

Fantastic. That's so important to be doing that work, and I'm delighted the organization is doing it. Let me ask a question here. If you think about some of the areas of public health that I've been following, like tobacco, for example. Opioids more recently. Vaping products. And in the case of my own particular work food policy. The administrative legislative branches of government have been almost completely ineffective. If I think about food policy over the years, relatively little has been accomplished. Even though lots of people have worked really hard on it. Same thing happened with tobacco for many years. Opioids, same thing. And it's until you get the third branch of government involved, the judiciary, and you start suing the actors who were causing the harm do you get much action. Not only do the lawsuits seem to have an effect, but they soften the ground for legislative things that then can occur because public opinion has changed. And then those things help make a difference as well. What do you think about that kind of issue in this space?

I think you're exactly right. I mean, I think the failure of our legislative branch to enact policy leaves us with very few options at this point anyway, except to try to pursue it through the judiciary. There are challenges there. First and foremost, it's a big and well-funded industry, not unlike tobacco or big food, as you mentioned and there's this Section 230 that's given them kind of blanket immunity to date. But there are many, many very large pending cases in several jurisdictions brought by individuals, brought by school districts, brought by states. And those, at least provisionally have gotten further than prior cases have with which have been thrown out based on Section 230. So, we'll see what happens with that litigation. But right now, my guess is it's the best chance we have to set some guardrails. And I think there are plenty of guardrails that could be set. Everything that these companies have done to make their products addictive can be undone. Can be made protective. The tobacco company deliberately designed their products to be addictive. While they tried to make the claims that they were less addictive, you know. They made light cigarettes that had holes in the filter so that it would diffuse the carbon and nicotine, but people quickly learned they could cover those up with their fingers and think they were smoking light cigarettes, and smoke more of them. There's a lot of things that can be done in this space to undesign the problematic nature of the products. And quite apart from the financial settlements, which will get companies attention, I hope that that's part of any settlement if it gets that far.

It'll be interesting to see where those go. And, also historically, one important part of these lawsuits is what gets turned up in discovery. And what sort of intent the companies have and how much do they know about harms. And how much do they know about addiction and things like that. And how they might have proceeded in the face of that information that then doesn't get disclosed to the public. In any event, we'll see where that goes. Dimitri, what about the argument that responsibility resides with parents. It's up to parents to protect their kids from this, and government doesn't need to be involved.

I've never understood that argument. I mean parents obviously are children's most important safeguard, but as a society, we enact policies and laws to assist parents in that. I mean to me, if I made the argument, well, why, why do we have minimum ages of drinking. It's parents' job to make sure their kids don't drink. How would that possibly play out? Look, it's hard enough as a parent anyway, because kids do get around these laws. But we still have them and it's a lot easier as a parent. I think most parents would agree their life's made easier by minimum age restrictions on certain things. We have seatbelt laws. I mean, why do we have seatbelt laws? Why don't we just tell its parents' job to make sure their kids buckle up? The truth is its society and parents working hand in hand to try and keep children safe. And I think it also helps parents to be able to say that there are laws around this, and I expect you to follow the laws. So, I don't think it's an either or.

Okay, well, I think that's a very good way to frame it. There are many, many precedents where we protect children. And why not do it here too? So let me end with a question I'd like to ask both of you. So, in this sea of concerns that we've discussed, is there a reason for optimism? And Kris, let me start, start with you. What do you think?

Absolutely. I think the young people I've met that are leading among their peers are incredibly impressive and are armed with the research and their energy and their own lived experience in ways that are very compelling. At the same time, I think the vast amount of research that has now been compiled and translated and acted upon, whether in courtrooms or in state houses, it's becoming more, and we're all getting more steeped and aware of more nuanced information. And finally, I would just say, there is a tipping point. We are reaching as a society, adults and kids alike, we are reaching a tipping point where we can't withstand the pressure of technology in every aspect, every corner of our day, our life. And we want relief. We deserve relief. And I think that's what's going to take us over the finish line.

Good. Well, I'm glad to hear those optimistic notes. Dimitri, what about you?

I can find reasons to be optimistic. I mean, look, the reality is that technologies have enriched our lives in many ways. And I think if we put guardrails in place, we can make sure that future ones do even better. I have a piece coming out in JAMA Pediatrics around the use of AI, which people are very concerned about, I think rightly. But specifically, about the use of AI and people with intellectual developmental disabilities, making the use case, that there are ways in which it could be extremely beneficial to that population. A population I care deeply about in my role as the Chief Health Officer at Special Olympics International. And in particular, let's say in terms of the doctor patient interaction where it could facilitate their communication with their provider, and it could also help the provider better communicate with them. Look, that use case isn't going to be a priority for the purveyors of artificial intelligence. It's a small, non-lucrative use of a technology. But it's a good one. And if we created the right incentives and put in the right guardrails, we could find many other ways that technology can serve the needs of all of us going forward.

I think the problem is that we've tended to be reactive rather than proactive. And to not start with the do no harm first premise, particularly when it comes to children. AI is another example of that where I hope we don't make the same mistake we made with social media.

Bios

Kris Perry is the executive director of the Children and Screens Institute. Kris most recently served as Senior Advisor to Governor Gavin Newsom of California and Deputy Secretary of the California Health and Human Services Agency where she led the development of the California Master Plan for Early Learning and Care and the expansion of access to high-quality early childhood programs. She led systems change efforts at the local, state and national levels in her roles as executive director of First 5 San Mateo, First 5 California and of the First Five Years Fund. Through it all, Perry has fought to protect children, improve and expand early learning programs, and increase investments in low-income children. Perry was instrumental in returning marriage equality to California after the landmark 2013 U.S. Supreme Court ruling Hollingsworth v. Perry, which she wrote about in her book Love on Trial (Roaring Forties Press, 2017).

Dimitri Christakis, MD, MPH is the Children and Screens Institute’s inaugural Chief Science Officer. He is also the George Adkins Professor at the University of Washington, Editor in Chief of JAMA Pediatrics, and the Chief Health Officer at Special Olympics International. Christakis is a leading expert on how media affects child health and development. He has published over 270 peer reviewed articles (h-index 101) including dozens of media-related studies and co-authored a groundbreaking book, The Elephant in the Living Room: Make Television Work for Your Kids. His work has been featured on Anderson Cooper 360, the Today Show, ABC, NBC, and CBS news as well as all major national newspapers. Christakis received his undergraduate degree at Yale University and his medical training at the University of Pennsylvania School of Medicine and completed his residency and Robert Wood Johnson Clinical Scholar Fellowship at the University of Washington School of Medicine.

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How big is too big? When it comes to corporate concentration many observers raise concerns about the tech industry. However, in the new book, Titans of Industrial Agriculture: how a few giant corporations came to dominate the farm sector and why it matters, political economist Jennifer Clapp draws attention to the overwhelming shadow a small handful of transnational corporations cast over the global agricultural sector. Professor Clapp argues that these corporations hold concentrated power over the agricultural sector that keep industrial agricultural practices entrenched in patterns of production, despite the concerns of the social, ecological and health impacts to society. She explains how we got to this point and what it might take to make changes. Jennifer's work at the intersection of the global economy, food security, and food systems, and the natural environment, looks specifically at issues of global governance. She is currently a member of the International Panel of Experts on Sustainable Food Systems, and a member of the Scientific Advisory Committee of the UN Food Systems Coordination Hub.

Interview Summary

Norbert - Jennifer, let's just jump right in and I'd love for you to help our listeners understand a little bit more about your book. You write about corporate concentration in the agricultural input sector. Can you explain what this involves and what products are we really talking about?

Yes. The book is about what we call the agricultural inputs industry. And that's really four different product types typically, and maybe a fifth that we can talk about. So, one of them is farm machinery, and that's really referring to things like plows and tractors, harvesters, etc. That kind of machinery on the farm. The second industry is the fertilizer industry, which is all about, you know, the nutrients that we bring to the soil through fertilizer products like nitrogen, phosphorus, and potash. And the seed industry. That's another industry that is a key input for farmers. And then also pesticides. And when we talk about pesticides, we're referring to things like insecticides, chemicals that kill insects, but also chemicals that kill weeds and fungus. And so those are the four sort of big inputs that I talk about in the book. But also, the book covers a fifth input, an emerging input, which is data. And this is, especially as we're seeing the datafication and digitalization of farming. Increasingly data has now become a commodity that is bought and sold as an input into farming.

Norbert - Great. I have to ask, what drew you to the input industry? I mean, let's be honest, that's not the thing that most people get excited about. Why should we be concerned?

Yeah, that's a great question. I've actually had a very long interest in the seed in chemical industry. That goes way back to the start of my career because I did studies in agriculture for my PhD dissertation. But then I got quite interested in toxic waste and then that sort of drew me to this question of the global pesticide trade. And when I learned that, you know, oftentimes, like in the US there might be a banning of a pesticide that's no longer in use. But it was still being traded globally. And this, I found this very fascinating and how that industry worked. And that kind of drew me into understanding the connections between seeds and chemicals. And then when the digitalization of farming came along and in recent decades it became really clear that it wasn't just chemical and seed industry involved in that digitalization. It was also the fertilizer and the farm machinery sector. It made me want to understand the interconnections between these industries. I know it's like, maybe a bit specific, but they have huge consequences in terms of the way our food systems look like. And so that really drew me to understand where did these inputs come from? And why are they controlled by just a few large companies?

Erika - Jennifer, I want to ask you a question about why this sector, especially related to the inputs, is so important when we're talking about food systems. And especially their social and ecological dimensions. And specifically in the book, you tease out many of the social and ecological costs of inputs such as pesticides. Also the social and ecological consequences of even farm machinery. So it would be great if you could elaborate on their importance.

Thanks, Erika. That's a great question and that's part of the reason why I was really drawn to study these inputs. Because I'm in a school of environmental studies, I'm very interested in these interconnections between food systems and environmental outcomes. I was really interested in learning more about where these industries came from, and as I was teasing out where they came from. And how they became dominated by such large companies, I also learned in much more depth about the ecological consequences of these inputs. I can just say a little bit about some of them because these consequences are so big that we almost forget to talk about them. They become embedded in the product itself. And so, one example is farm machinery. Farm machinery was originally seen as quite revolutionary and that it allowed farmers to harvest their fields much more quickly than they used to be able to before. But that also meant then that to make the equipment efficient and pay for them they might as well extend the size of their farm. And as farmers extended the size of their farm, in the US anyway, they moved west and displaced its indigenous people from the land, in terms of taking that land for farm production. But also, as farms began to consolidate and get larger, as mechanization continued, it also displaced others from the land. Poor farmers, black farmers, those who were renting land and didn't have access to their own. And so, people who were marginalized and we still considered marginalized in society today, were really being displaced from the land as a direct consequence of farm machinery. It's not that farm machinery is like necessarily something that we want to do away with today, but I think we need to recognize those historical connections. And really understand that when, you know, you see a book for a small child about farming and there might be a picture of a farmer and it's usually a white guy sitting on a tractor. We can forget that image has a lot of baggage associated with it in terms of displacement and inequality. And I think we need to recognize that. But it does not just stop there. There's also plowing disturbs the soil, heavy machinery compacts the soil so it can harm fertility of the soil as well. And the machinery part of the equation has long been a source of inequality in terms of being very expensive for farmers. It's been one of the main reasons farmers have often been driven into debt. Farm machinery might have been liberating in one sense to allow increased production, but it did come with costs that we should acknowledge.

We also need to recognize the ecological and social costs associated with the fertilizer industry. And this industry goes way back to the 1840s and we saw the rise of the guano trade. And we can think immediately of the working conditions of the workers who were digging the guano in the Chincha islands of Peru. And often they were coming from Asia and facing really harsh working conditions. But then when we saw the rise of synthetic nitrogen in the early 20th Century, the cost shifted in a way towards the cost of fossil fuels. The huge amount of natural gas used in the synthesis of nitrogen. And also, the climate consequences of the nitrous oxides that come from the application of synthetic nitrogen into the soil. So again, there's like enormous ecological and social impacts from that particular input.

Similarly, when we talk about seeds, the hybridization of seeds in the 1920s and 1930s also raise huge concerns about plant genetic diversity. And we know that in the last century or so we've lost around 75% of plant genetic diversity for crop genetic diversity. And this is because of the way in which we started to see the uniformity of the genetic makeup of seeds. The monocultural planting of seeds really reduced that kind of diversity. And then intellectual property protection on seeds that came with the hybridization of seeds also led to a decreased ability of farmers to save their own seed and exchange their own seed with their neighbors. So again, social ecological costs.

And finally, when we talk about pesticides, we have seen enormous issues with respect to pollution runoff. This kind of bioaccumulation of these toxic chemicals that have enormous health consequences.

So, all of these inputs have very large impacts in terms of their social and ecological costs. And we can even extend that to the issue of data today. There's a lot of concern about data platforms for digital farming where farmers are signing away the rights to the data that are coming from their own farms. And they don't have the kind of interoperability with other data sharing systems. And there's also a lack of clarity about who owns that data.

So again, there's big issues with respect to these inputs and how they are affecting both social and ecological dynamics within the food system.

Erika - Thank you for helping us understand the social and ecological impacts of these inputs into the farming industry.

Norbert - This is a really rich conversation and I want to understand a little bit more. There's a big part of your text that's about the concentration in the input sector. What does it look like today and was it always this way?

That's a great question because it's almost a trick question because we tend to assume that this high level of concentration that we see today is something that's new. But what I found in my research is that the high degree of concentration actually has a long history that goes back about a century or more in some cases. And when we're looking at each of these sectors, the farm machinery, for example, is controlled. Most of the market is controlled by about just four firms. And they control around 50% of the global market. But when you look specifically at national markets in the US, for example, John Deere, you know, the largest company that makes farm machinery, it controls over 50% of the tractor market. So that's just one firm alone. It's similar dynamics when we look at fertilizer, seeds and pesticides and fertilizer, for example. Just two firms control a hundred percent of North American potash production. The four key companies control a large amount of the global fertilizer trade. In seeds, it's also very similar and in pesticides. In the seeds and pesticides that's especially interesting because since the 1980s and 1990s, the seed and pesticide companies actually merged with each other. We can't even say there's a set of seed companies and a set of chemical companies. It's actually seed and chemical companies. That's one set. And they control around 60% of the global seed market and around 70% of the global pesticide market. And that's really what prompted me to want to work on this book is that after 2015, there was a set of mergers in the seed and chemical sector that concentrated those firms even further. They used to be dominated by six firms. We used to call them the Big Six, and then they had major mergers where Bayer bought Monsanto, Dow and DuPont merged and formed Corteva. Syngenta group was bought by Chem China, and then bought by Sino Chem, a big Chinese chemical company. And then BASF bought up all the bits that the other companies were forced to sell to pass regulatory hurdles. And so, we ended up with a Big Four. And these companies produce both seeds and chemicals and have a quite an enormous impact in terms of their market dominance.

Norbert - Wow. This is really important and I think it's a topic that many of us who look at the food industry aren't paying attention to. And I'm really appreciative of you laying out this concentration that's taking place. Jennifer, when reading the book, I was really struck by the fact that this is not just a book about the farmers themselves and the farming industry and the companies that provide the inputs. But you also touch upon the role of universities and university science and scientists; and also the role of government in helping to fuel or seed innovation in this sector. And, you know, here I was hoping you could talk about this important role for universities and also the government given that we're in a current moment where we're seeing a retrenchment from investments by government, and also the ability of universities to continue to seed innovation. So I was hoping you could share some of your insights.

Yes, it's certainly an interesting time on the landscape of spending on innovation and with a retrenchment of state pulling back away from supporting technological innovation and other innovations. And that's certainly true in the farm sector, and that's very different from the situation if we go back to the 1800s and see, as you mentioned, the role that the state played in terms of really trying to support innovation in these sectors. And what I argue in the book is that these firms, they got big in the first place, and they were able to consolidate in the first place, through a series of what I call market technology and policy factors. And it's kind of messy. I put them in these three big categories. But in terms of these market factors, that's what most people tend to think about when they think, 'oh, a firm got big. Maybe it's just more efficient. It's able to produce products more cheaply and therefore it just grew to be big.' And that's much more complicated than that of course. And that's because, as you said this role of technological change in which universities have played a really important role. And government support and throughout history in the US, a lot of the book focuses on the US because we have good information and data there. And the US set up the land grant college system really to support development in the agricultural sector. And that gave us, you know, a lot of the innovations that led to, for example, the hybridization of seeds. And the corporations that took up that innovation that the state supported through university research, those firms also work directly with universities in many instances, to have these kinds of collaborative relationships, to develop, herbicides, to develop seeds, to develop further farm machinery, etc. So that role of technological innovation is really important, and that innovation doesn't just come from nowhere. It doesn't just pop up. It doesn't just show up one day. Right? It comes from investment. Investment in universities and research and development. And so that has been a really important strand to develop this kind of industrial agriculture. And now we know from university research, etc., that there are some problems associated with it. Yet it's proving hard to get that kind of funding to spur a new transformation towards a more sustainable agriculture because we're not giving that kind of state support, and support to universities to do that research and innovative work to lead us towards more sustainable agriculture.

So, I think there's a lot there that we need to work on. And that's some of the recommendations that I make at the end of the book. Is that we need to shore up that kind of public investment in innovation, in alternative systems to address some of the problems.

So just let me tag on another question from that. Just what are the consequences then for having just a small number of firms dominating this sector and no longer having these investments in innovation?

Yeah, so what we're seeing increasingly as the state has pulled away from supporting agricultural research, is that most of that agricultural research now is being done by private corporations. And the big concern there is that as you have a smaller and smaller number of very large firms dominating in the sector, their incentive to innovate actually weakens. It weakens because if there's not a lot of players in the marketplace that are doing innovative work, there's just not a lot of competition. And so why would you innovate if you don't have to? If you're already a monopoly and you're able to sell your product, there's not a lot of incentive to innovate in a way that might then decrease the sales of your old products. And so, what we're seeing is a shift in innovation from the private sector, away from these kinds of transformative innovations and much more towards what we call defensive innovations. They're innovating in ways that actually enable them to sell existing products. And many would say that the rise of agricultural biotechnology was actually that kind of a defensive innovation. It was modifying seeds to make them resistant to the application of existing herbicides. And so there was innovation, but it was actually spurring further sales in an existing product. And part of the reason for that was that it became very expensive for these companies. The regulatory hurdles became quite expensive for them to develop new herbicides. And so, they were like, 'oh, it's cheaper and faster to work with seeds. Why don't we do it this way and then we'll continue to sell the herbicides.' Which by the way, got them a lot more profit than selling the seeds. So that's why they bought up a lot of the seed companies and really consolidated in that period.

And there's a longstanding concern among competition regulators, the regulators that try to prevent a huge concentration in the economy, about this question of innovation. And it's very relevant in the agricultural sector. There's this sense that if you allow too much concentration to happen, it can dampen that innovation and that takes away that dynamic, innovative spirit within the sector. It's definitely a big concern.

Norbert - Jennifer, I really appreciate this. Earlier in my career I was a part of some research related to biotechnology and innovation that happens there. And one of the things that I learned about is this idea of building thickets. These sort of patent thickets where you create a series of patents that actually make it difficult for others to be able to innovate in that same way. There are these real challenges of this kind of defensive innovation. And that's just one of the challenges that you bring up in the book. And I am interested in understanding, as sort a last question, what are some of the recommendations? You mentioned public sector funding of agricultural research and many of my colleagues in my discipline have said we need more research for agriculture. Are there other areas of recommendation to address some of the concerns you raised in the book?

Thanks, Norbert. Yes, definitely. And I definitely do call for greater public support for agricultural research. And that's something within the agricultural sector. And I think there we really need to focus efforts on alternative agricultural production methods. For example, agroecology, which tries to reduce the amount of external inputs, not to increase them, by using nature's own processes to achieve the same functions of diversity and pest control, etc. And what's troubling is that when the firms don't have that incentive to innovate, you know, they're definitely not going to innovate in ways that would reduce their profits. They're not going to do that. The public sector has to step in if we want to see that kind of research done. But we also need measures outside of that food and agriculture system that will benefit food and agriculture. One area is stronger antitrust policies. Policies that would prevent further mergers and acquisitions that would allow those firms to continue to get bigger and bigger. Those antitrust policies are used largely, we've got merger guidelines, for example, in North America. And in Europe, when two firms want to merge, they have to get regulatory approval to do so. And those merger guidelines really walk the regulators through what would be a merger that might dampen competition, that might weaken innovation, you know, that kind of thing. It's important that we make those rules stronger. They had become progressively weaker after the 1980s. There was this move in the regulatory space that was this kind of idea that maybe it's okay if firms get really, really big because they can benefit from economies of scale. Maybe they can bring down consumer prices and maybe we shouldn't worry so much about these other areas of control. And there's been a bit of a shift in view around this in recent years where we've seen the rise of concern about these very big companies, especially with what we see with the big tech companies taking control over all these aspects of our lives. And people are saying, wait a minute, maybe we don't want to have this just a few companies controlling so much of our lives. And so, you know, we need to think about other ways to enforce antitrust policies to make them stronger so that we foster more competition and not just focus on whether something's more expensive or not.

And that's, I mean, it's a bit of a hard thing to explain to some people. Obviously, people want to see lower prices. But the idea that we have to get across is that when competition dies, when it's not there, that's when the monopoly can really raise prices. And so, we need to have that competitive marketplace in order to spur innovation and also to bring prices down. That's really important and that's a kind of agenda item that's involves food and agriculture, but it's outside of the food and agriculture sector. It encompasses more. And another area where I think we can do more is to reign in the kind of undue corporate influence on the policy process. And that's arising out of a concern that as we're seeing fewer and fewer dominant companies in the food sector, and in other sectors as well, they tend to gain more political power to influence the policy and governance process. And so, what we're seeing is heightened lobby activity. Sponsoring of scientific studies and yes, coming back to the question about universities. But as corporations get bigger, they can shape science in ways that can help them win regulatory approval for their products. We need broader policies on conflict of interest to prevent large companies from taking over the policy process. And I know that's a really salient topic in the US right now, given what's going on in the broader politics. And I think it is a broader politics issue that needs to be seriously addressed if we want to support a more transformative form of food and agriculture. These kinds of policies like stronger antitrust, better conflict of interest policies, and also support for public agricultural research are all really important steps. I don't think any one of them on their own is going to do the trick in terms of spurring this desperately needed transformation in our food systems. But together, I think, they can bring us closer to that goal.

Bio

Jennifer Clapp is a Tier I Canada Research Chair in Global Food Security and Sustainability and Professor in the School of Environment, Resources and Sustainability at the University of Waterloo, Canada. Dr. Clapp is currently a member of the International Panel of Experts on Sustainable Food Systems (IPES-Food) and a member of the Scientific Advisory Committee of the UN Food Systems Coordination Hub. From 2019-2023, she was a member of the Steering Committee of the High Level Panel of Experts on Food Security and Nutrition (HLPE-FSN) of the UN Committee on World Food Security, and served as Vice-Chair of that body from 2021-2023. Dr. Clapp has published widely on the global governance of problems that arise at the intersection of the global economy, food security and food systems, and the natural environment. Her most recent research projects have examined the political economy of financial actors in the global food system, the politics of trade and food security, and corporate concentration in the global food system. She has also written on policy and governance responses to the global food crisis, the political economy of food assistance, and global environmental policy and governance. Her most recent books include Food, 3rd Edition (Polity, 2020), Speculative Harvests: Financialization, Food, and Agriculture (with S. Ryan Isakson, Fernwood Press, 2018), Hunger in the Balance: The New Politics of International Food Aid (Cornell University Press, 2012), Paths to a Green World: The Political Economy of the Global Environment, 2nd Edition (with Peter Dauvergne, MIT Press, 2011), and Corporate Power in Global Agrifood Governance (co-edited with Doris Fuchs, MIT Press, 2009). Her forthcoming book, published with MIT Press (2025), is titled Titans of Industrial Agriculture: How a Few Giant Corporations Came to Dominate the Farm Sector and Why It Matters.

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The climate crisis is devastating the ability of African farmers to support themselves and their communities. Farmers struggle with a lack of running water, electricity, communications, and public transportation. Entire communities are often cut off from the larger world, exacerbating and extending the poverty crisis that grips large parts of the continent. To overcome these issues, our guest, Gwen Jones, co-founded Nzatu Food Group, a regenerative agriculture business designed to protect biodiversity and mitigate climate change. Nzatu Food Group has done some remarkable pioneering work. Gwen is connected to 15,000 Sub-Saharan farmers across 15 countries through beekeeping, sustainable agricultural and conservation  training, and by building an increasingly international market for farm products.

Interview Summary

So please begin by telling us why you and your sister founded this initiative and about its unique strategy for helping farmers.

Well, firstly, our strategy is based on an engage-to-support premise with an approach that focuses on uplifting farmer livelihoods. As you know, farmers are critical actors in agroecological transformation and important stewards of biodiversity. 80% of the world's food production is done by smallholder farmers, yet only a mere 3% of climate finance goes to our food systems. So, this presents a key avenue to increase intervention in this space through public policy and unlock climate transitional finance.

Helping farmers is so, so important, especially with these small farms. Tell me more about your own history and what led you to start your organization?

Denise, my sister and I, who are the co-founders of Nzatu, we come from a rural community in Southern Zambia. And we grew up alongside smallholder farmers. We understand inherently what the challenges, but as well as the opportunities that smallholder farmers face. What started off very informally helping our relatives and our tribal communities became Nzatu, we started it off by showcasing to our relatives and our farmers on how they could increase their income with simple interventions by keeping bees. And through training and education, we were able to show farmers that through the income on bees, they would earn three US dollars per kg on honey. Which gave two harvests a year compared to 20 US cents on maze. Which was a rain fed and only produced one harvest a year. It made economic sense for them to also keep bees alongside their maize production. And in this way, it would help with economic shocks and help to give a diversified income. So, we were so excited to share this with our farmers. And it grew like wildfire as you can imagine. The farmers in our program were more prosperous. And, from the income that they got from the honey, they were able to get better inputs for other production. And that engagement helped to bring other interventions as well to the communities.

So, how exciting that you were able to make such an important transformation. And I can see why farmers would be grateful for that sort of help. Tell us if you would, about the climate crisis and how it's affected African farmers?

In some cases, there's too much water from flooding. In some cases, too little water. So, you know, that volatility- how do you plan with that? In one year, you would have flooding and, so your crops would be washed out in the following two or three years you have absolutely no rain. There is just no way to plan in such kind of situations. Farmers are the ones that are mostly affected by climate change, and all we can do is just be there as a support mechanism. How can we work around that? How can we bring in the in-between periods, bringing in higher yielding seed where they can at least recoup whatever they can do in that season? It's very, very difficult for the farmers.

Tell us about your vision of regenerative agriculture. What does that concept mean in your context, and how can you help farmers adapt to this changing climate?

Yes. We started off in a very, very grassroots way. I was always fascinated to understand the ancient grains of Africa. Africa has 26 lost crops. These lost crops are including millet and sorghum and Teff and fornio. These are the indigenous grains of Africa. Indigenous to the diet, but indigenous to the environment. They're very drought resilient and also, they fix nitrogen into the soil. So, they help to bring more resilience and soil health, which is what is lacking in Africa across the continent. We have vast soil degradation, which is also contributing to climate change. By reintroducing what is already inherent in the food history of Africa, it's a very key intervention. Sometimes is the smallest innovation that can bring about the biggest change. Is bringing back the food that is indigenous to communities. There is a resistance though, because our communities have gotten used to maize. I myself are very used to having nshima, which is made from corn, which only offers 3% nutrition. And it's very hard to change that staple to go to, let's say, nshima using sorghum or millet because the taste, is a palate issue. But we have to bring in recipe days. How can we train farmers to use this in their everyday diets? It starts off with that connectivity. How can we help children to take boiled cowpeas to school? You know, making sure that they can use cow pea flour to make cookies and sausages and innovative ways to bring in the recipes on how they can use these crops. It's not enough to just say you've got to, you know, grow the intercrop with ancient grains, because of the nitrogen fixing aspect. You've also got to bring that cultural acceptance by connecting with communities and helping them find ways on how they can prepare their food. So that when you talk about innovation, it's cuisine innovation as well. Not just, soil health and using big words like carbon capture, etc. It's also about the everyday tactile innovation in a simple thing like having recipe field days in our communities.

You spoke, especially about introducing, well reintroducing, if you would, indigenous grains. Why were they lost in the first place and what have you done?

The crops were lost through commercialization. Maize was introduced as an export cash crop to support the war efforts in Europe. And along that commercialization, the tools and the inputs that were needed to produce maize is what was commercialized. And communities also had to pay the Hut Tax in Maize. So, because of those at policy level and at export level, the change happened slowly over time because it was easier to grow the crops that were meeting the mandatory requirements. Sorghum and millet became a second or third crop to produce because it wasn't something that was a mandatory crop. And over time, maize replaced the nutritious grains of sorghum and millet. I'm just taking like one example of that. The commercialization aspect.

Well, there are generations with little experience eating these products or growing them. Is that right?

That's true. Like I said, me included. Even though, academically I know and scientifically I understand that sorghum and millet is of higher nutrition, it's having that paradigm shift changing the dietary approach to it. And that is one of our key interventions that we can make in our communities. But by having this face-to-face contact with our farmers, we are able to pass that information on. We're able to transfer that knowledge and bring about including sorghum and millet. So, as you know, Nzatu works mainly with coffee farmers. Coffee is one of our main crops that, that we are engaged in. And our coffee producers focus mainly on coffee. Our work is by encouraging farmers to grow the millets and sorghums so that the coffee farmers themselves will start consuming millet and sorghum. But as well as finding a market for them for those crops.

And are the farmers receptive to the reintroduction of these grains?

It is challenging because as you can imagine, how you harvest coffee and how you harvest millet and sorghum is completely different. Millet and sorghums and most of the ancient grains, the grain is very small. It's having the tools, the harvesting techniques and the weeding techniques. There's so much involved in it. And this is where climate transitional finance can really help.

Tell us more about the process. How does your organization go about doing these things?

We engage with farmers. Most of the farmers that we're involved in are already practicing mulching and other organic practices and regenerative agricultural practices. It is much more common than we think. Farmers are already conservation in nature because it's inherent in traditional African practices. What we are doing is we are just really enhancing the knowledge that they already have and bringing out the historical practices. For example, when it comes to wildlife conservation, Africans in the tribal communities are already totemic in nature. Meaning that families identify with different animal groups. There is already an indigenous wildlife conservation that already is practiced for hundreds of years in the village. If your family has a totemic nature of, let's say, kudu, that is an animal that is sacred to your lineage and you would never hunt that kudu, et cetera. So that those age-old practices have been there for centuries. And it's really inculcating and bringing back that cultural understanding when it comes to the cuisine, when it comes to the wildlife totemic nature of those communities. It is truly lost knowledge that we are really committed to bringing back into our communities.

And as farmers begin to grow these products, is there a market for them?

Yes. This is where I know I get so excited just about the day-to-day work that we are doing. But we are a business, at the heart of it. We really have to make a profit somewhere. And we take product to market. Our team, we have an amazing team across Africa and in Europe and here in the US as well as Asia. And consumers today have become more conscious. They're looking at products that have an environmental and social value. And we communicate this through our brand positioning. Nzatu's brand is about taking that story to the consumer so that we can avail the product on the retail shelves by giving them the story of what happens in the field. Nzatu is the voice of the farmer. We are there to tell the farmer's voice to the consumer so that we can engage with consumers on every retail shelf that we can.

As a consumer, I would find it appealing to know more about the history of the grains that I see at the store or other products for that matter. And about the farmers who grow them. How are consumers responding?

Yes, the thing is, you know, how do we communicate? Consumers are more interested in how we can help a single farmer. Yes, there is an interest to know about how we reduce carbon emissions, etc. But if you can also add the story to it, that by helping a single farmer, you are reducing carbon emissions. You are helping to bring in higher livelihoods. You are helping to bring in increased health and safety measures to the production methods of those products. You are helping to uplift communities. Children are going to school. You are helping to reduce wildlife poaching. All by that single dollar that you are spending on that product. That is what the consumer of today wants to do is how can I make a difference in the way I live and in the way I consume? And that is our goal with Nzatu, is connecting that story to the consumers today.

What are some of the challenges that your organization faces?

Yes. You know, the higher the dream, the bigger the challenges. There's so many, ranging from trying to find ways that we can provide better honey straining equipment to our farmers so that they can offer better quality honey. But that's at a very micro level. On a macro level, the challenges are how do we get to change policy so we can increase climate transitional finance for farmers? As I mentioned earlier, only 3% of climate finance goes to food systems. How can we increase that number? And, you know, Kelly, one of the biggest problems that farmers face is with all the EUDR regulations, etc., that are in place now, and scientific based initiative targets and all, how does a farmer in rural Zambia- how are they able to change their method of production to meet those stringent targets? That takes money. It takes investment in their practices to be able to change from chemical-based agriculture to organically driven agriculture and regenerative agriculture. How do they access the inputs, the seeds to be able to intercrop with leguminous crops. That takes investment. You know, and then if they're only getting 20 US cents per kg from maize with rain fed agriculture, how is a farmer supposed to be able to now even think on investing? There is no money. This is the biggest challenge we face the smallholder farmers are the stewards of biodiversity. They need to be financed. They need to be equipped to be able to accelerate the change because really, they hold the power in their hands. And for us, this is where it's the most exciting, is if we can support the farmers to do what they need to do out there then it's a win-win for everyone. It's a win-win for the farmers. It's a win-win for the consumers. It's a win-win for our partners. We are partnered with art Cafe in Italy, who's our roasting division and Urban Afrik, who are our logistic partners. So, we have the system in place that at every point we have partners that have the same philosophy as we do to support and address climate change.

You mentioned investment in agriculture and in financing. Who are the players in this space? Must the funding come from international organizations or from the country Governments themselves?

The main actors are already in place, like IFC (International Finance Corporation), World Bank, are already channeling that money towards that space. They're committed, they're active in that space. But I would also encourage family offices, climate smart funding, social impact funding. The groups that are involved already in agriculture, the ones that are already engaged and already have the due diligence process in place to actually track that. But also, Kelly, I think that Ag Tech, it would be a very important component with the technology that exists today, whether it's through blockchain or any type of digital tech finance that can enable this. Because it's also tracking, you know, and the data needed to actually support this. It's an entire ecosystem that we need. Using digital tools to help to map out soil health and how we can improve soil health right up to the consumer tracking the story. But at the genesis, how do we finance the innovation on the digital tools? How do we finance better seed and how do we get it to the farmers in term terms of storage? How do we harvest so we can reduce waste? It's an entire ecosystem that is required. There is no one answer, but where does it start? It starts at the top. It starts with the awareness. It starts with telling the story so that we all have a stake in it to change.

Bio

Gwen Jones is the co-founder of Nzatu and Chief Partnerships Officer. The daughter of a Zambian mother and English father, Gwen grew up in Zambia, along the banks of the Kafue River. Alongside her sister and business partner, Denise Madiro, Gwen experienced firsthand the immense challenges sub-Saharan African farmers faced every day. Gwen moved to the United States more than 20 years ago and has spent her entire 30+ year career focused on global food security and community development initiatives throughout sub-Saharan Africa. Nzatu is Gwen’s latest initiative. As the climate crisis worsens, rural farmers are at even greater risk. Together, Gwen and Denise decided to do something about–and that’s where Nzatu comes in. Gwen and Denise have a vision that regenerative agriculture can be a nature-based solution, which can and will create value in Africa, for Africa. Her leadership helped foster partnerships with Artcafe, which is roasting coffee beans grown by Nzatu-supported farmers, and Urban Afrique, which is helping bring Nzatu’s products to the U.S. market.

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The food and nutrition landscape in our schools is really important. School meals affect the health, wellbeing, energy, vitality, and ability to learn for millions and millions of children. And for those whose family struggled to buy food, the importance of school meals cannot be overstated. This makes decisions about what foods are served in schools and where they come from. Highly consequential and raises issues about national and state nutrition policies, the influence of big food companies in shaping this picture and lots more. It's a good time to unravel all this, which we can do today. Thanks to two experts with us. Dr. Marlene Schwartz is Professor of Human Development and Family Sciences and Director of the Rudd Center for Food Policy health at the University of Connecticut. Mara Fleishman is CEO of the Chef Ann Foundation, where she has been a leader advancing school food change, advocating for scratch cook meals that promote children's health and for more sustainable food systems.

Interview Summary

In discussions about school food, it seems there first came a nutrition part, which in more recent years has been joined with a concern about where foods come from. Better connections, say between schools and low whole food systems. Let's talk about both, Marlene, let's start with nutrition. You have been a pioneer in working with schools, an interest that goes back a number of years. What was this food environment like in schools before change began to occur? It was my impression it was sort of a free for all.

So, yes, I would agree that it was a free for all. The actual school lunch, what we call the reimbursable school lunch, which is the meal that the federal government gives states and then states give the local food service directors funds to support, that has actually always had nutrition standards. But historically the problem was under nutrition. The standards were very focused on making sure students had enough to eat. There were no maximums. It was really all about making sure that there was at least the minimum number of calories and foods available. But the other foods that were sold in schools, which we call competitive foods, so these are foods that were vending machines and school stores and fundraisers and things like that, were hardly regulated at all. And that is really where we saw a complete free for all. We saw ice cream and chips and soda and sports drinks and things like that. And I remember going to one school here in Connecticut and counting 13 vending machines in the high school. It really was remarkable the amount of unhealthy food that was being sold in schools.

You know, I was thinking of that same thing when I was living in Connecticut, I went to my son's high school, a different school than what you're talking about. And I forget the number of soft drink machines they had around the school, but it was in the teens. And when I was a boy, I don't remember any soft drink machines in my schools. Maybe they hadn't been invented yet. I'm so old. But it was really pretty remarkable how much access children had to these things. And as I understand, the importance of those machines in the schools to the companies was more than just what food was being sold. There was a real branding opportunity. Is that right?

I think that's exactly right. And I remember over 20 years ago when we were talking to some of the soft drink companies about the vending machines, they were quick to point out that they didn't make all that much money selling soft drinks in schools. Which I felt was them basically admitting that they weren't there because of the income from the sales in schools. But rather it was a hundred percent branding. And that was also really evident by the fact that you had to have a contract. So, the school districts had to have contracts with Coke or Pepsi or Cadbury Schwepps to only sell that company's products. It was blatantly obvious that this was all about marketing and marketing to an audience that they had to go to school, and they were going to be exposed to those logos every time they walked past one of those machines.

Yeah. I remember in those days it felt like a victory when the companies agreed to change what was in the machines, but it was what was on the machines that was more important. So, you know, once again, that was a sign of the industry having upper hand. Let me ask you a different question. So there have been some important systemic changes discussed in context to school meals, ones that really could affect the nutrition landscape nationwide. And I'm thinking in particular universal free school meals. Can you tell us what this means and why it's important and what do you think ought to be done?

Sure. So universal free school meals, or as the advocates call it Healthy School Meals for All, is a policy that is providing meals at no cost to all students. So typically the way it works in most school districts is there's three categories of payment. There are students who pay quote, full price. There are students who pay a reduced price and there are students who receive the meal at no cost, and it has to do with the income of their household. But what has been shown, interestingly most significantly during the pandemic, there was a policy from the USDA that all students would receive meals at no cost because we were clearly in a national crisis. And in some ways, it was this silver lining of that time because what it showed, those of us who study school meals, is how wonderful it is to be able to provide meals at no cost for everyone there. There are a lot of benefits. Some of it is just the administrative burden of having to figure out each and every household and which category they're in is lifted. You don't have to track which student is which as they're picking up their lunch. But it also really removed the stigma. One of the most surprising things that we've seen in our data is that even students who would have gotten their meal at no cost already were more likely to take a meal when it was provided at no cost for everyone. Because it just became part of what you did. Everybody was eating the school meal. And I think that it always leads to higher rates of participation among all of those sorts of categories of kids. And I think it also really allows the people running the food service to focus on preparing the food and making it the best it can be and not having that burden of the paperwork.

And will there come a day, in your belief where this will happen?

I hope so. What we've seen is that a number of states, I think it's eight right now, actually passed state policy to keep universal free school meals after the federal guidance that had been out there was lifted after the pandemic was over. And so \ my hope is that they'll really demonstrate the benefits and that other states will join in. There's certainly a lot of advocacy in a lot of other states to try to do this. And some of the benefits that have also been shown are outcomes like attendance and academic achievement and just really showing that just like we use our public funds to fund the teachers and the building and the water and the library books. It's sort of seen as a basic tool that the school needs to make available to students so that they can succeed academically. And I think that shift in attitude as opposed to seeing the lunchroom as this sort of separate thing from the rest of the school building. I think that shift in attitude will be really helpful overall.

That makes good sense. Mara, let's turn to you. I'm really eager to hear about the work of the Chef Ann Foundation. I've followed its work for a number of years, but I'm eager to hear what the most recent iteration of this. So, I'm hoping you can tell us, and also give us some sense of why you got interested in these issues.

Well, the Chef Ann Foundation is actually celebrating its 15th birthday this year. And we help school food programs move from serving more processed heat and serve food to serving more freshly prepared scratch made meals in schools. And we do that through looking at what are the barriers to school food programs actually serving this freshly prepared meal. And there are a number of barriers: training, skill sets, equipment, access to healthier food, local farmers. The reimbursement rate, you know, how much money they get actually for serving these meals.

What about the power of the companies that are providing the prepared foods to schools?

Yes, that's a big piece. So those are very loud voices that have a [00:09:00] lot of power behind them. Through the passing of the Healthy Hunger-Free Kids Act in 2010, there was an increase in nutrition standards change and what Marlene was saying is that while there was some basic before that, after Healthy Hunger Free Kids Act, we had saturated fat standard, sodium, whole grain. But what happened was these big food companies just kind of R&D'd their food to meet these standards. So, we are in a better place today, right? Because we are serving more whole grains. We are serving less saturated fat, less sodium. But one of the big things that the passage of that Child Nutrition Reauthorization did not do was really reduce ultra processed food in school. And that I think is the next horizon for school food, is how to actually help them reduce that ultra processed food. Because there is, you know, a lot of research out there, I'm sure Marlene is familiar with this, that is linking more ultra processed food to diet related disease. So, we go in and really help these school food programs with more culinary training, we do assessments to tell them what kind of equipment they need to serve fresh food. A lot of it is financial training. So, when you're serving a chicken nugget. One chicken nugget that meets the standards. You bring it in frozen. All you have to do is reheat it and put it on the line. If you're making a chicken strip from scratch, you know you have to buy the chicken, you have to buy the breadcrumbs. You have to buy all the ingredients. You have to start looking at your program through a different lens. Your financial modeling is different. Your labor resources are different. Meeting meals per labor hour is different. We provide training on all these fronts to help them run that program.

Well, it sounds enormously beneficial. How much do, in the modern day, how much do schools care about these things and how much do parents care about them?

Well, I think something that's really exciting, and I think we have the best vantage point for it, is that schools, parents, communities, even government cares way more about it today than they did when the Chef Ann Foundation was launched. We were definitely considered more of a niche nonprofit organization that only worked with kind of districts that were very progressive. But today, we have, waiting lists for our grants. we work in every state in the country. And we now have a cooperative agreement with the USDA, which would never have really been possible 15 years ago. They just weren't looking for partnerships with organizations that were pushing the envelope to this level. So, I think now's our time.

It's so nice to hear that because I remember back when the Chef Ann Foundation got started. And that niche role that it played was clear, but there was so much hope that it would expand and it's really nice that it has. And the fact that you're in every state and the USDA is working with you, those are all really good signs. Well, let me ask you another question. This one about equity. How does this work fit into an equity point of view?

I mean, that's pretty much the heart of the matter, I think in many ways. I started this work because I worked for Whole Foods Market for 13 years and I was very interested in food systems work. I have three children and my oldest, who's now 23, when she started in kindergarten, I went to lunch with her. They were serving, this was before the Healthy Hunger Free Kids Act, they were serving a very highly processed, high sugar, low protein meal. And I was looking around at the cafeteria really looking at who is eating this meal and thinking to myself, what are we doing here? We are not providing the same springboard for every kindergartner to thrive and meet their true potential, right? There were kids coming to school with their very healthy packed lunches and little baby organic carrots and whole wheat bread and no-nitrate turkey sandwiches. And then there was a whole host of kids eating this very ultra processed high sugar, low fiber, no protein meal. And the equity issue that you're speaking of was right there and very blatant. And if we're not going to provide children that same springboard to thrive from, which, you know, is what K 12 is about, right? That's what we're trying to do for everyone then we have some big issues. And to Marlene's point, we disregard food in that equity issue. So, we don't make higher income kids pay for their bus rides or anything else. And we don't kind of create that divide. We don't devalue anything as significantly as we do food. And it's what makes you thrive.

I heard once a very interesting statement from a physician who worked on brain development. And he said that if children are not fed correctly during critical stages of their development amounts to a life sentence. That there are just certain things that will never recover no matter what happens. Having a better school food environment helps erase some of that for sure. Not all of it, but at least some of it. And then each of the children are more on a level playing field in terms of their academic achievement because some aren't so much more burdened by a terrible food environment. I can see why this would, would really be so important. Marlene, let's talk about what changes have been made. Both you and Mara have alluded to this, but specifically what's happened over the years in terms of school meals and have there been studies on the impacts on children?

Sure. Well, I completely agree with Mara that the Healthy Hunger Free Kids Act was a really bright spot, certainly in, in my career, in terms of seeing changes to school meals. So, as I mentioned before, we used to have only minimum calories and things like that. And now we finally have maximum calories based on the age of the child as well as sodium, saturated fat, increasing whole grains, low fat dairy, things like that. The other thing with the smart snacks, so the competitive foods that started to have nutrition regulations. That was a perfect example though of where the companies use their research and development dollars to essentially make a Dorito that fit the standards and a cookie that fit the standards. And I think in some ways that has highlighted the fact that our society is starting to look much more skeptically at highly processed foods. Because I remember standing in my kids' high school a number of years ago after smart snacks went into a fat, and I was in front of the vending machine, and a parent came up to me who knew this was what I studied and said: 'What are you talking about? That school food is healthier. Look at that!' And sort of pointing to all the packaged chips and cookies and other snacks. And I tried, I was like, well, but those are reduced fat Doritos and those cookies are lower in sugar and probably have some whole grains and nobody cared. Parents basically can recognize junk food when they see it. I one hundred percent agree that processed food is the next dimension that we need to really be able to assess, measure it so that we can start to regulate it. And to have that be a new way in which we try to manage the quality of school meals.

Before we get to the issue of what sort of research has been done to show the impact on kids, let me follow up on the Doritos example. Well, it sounds like what we were talking about earlier with a Coke machine being so important because of the logo and branding and stuff like that. Sounds like exactly the same things that work here. That the company wants to have Doritos in the school, not because they sell so much or make so much money. But that they brand, it's a chance to brand that particular product or that particular company. And then of course, kids want those when they get out of school and they talk to their parents about getting them. So, it seems like the fact that they get reformulated to be a tad healthier isn't much of a victory is it.

No, and I feel like it's almost like the worst of all situations. So, we've done some research on this at the Rudd Center and have a graphic where we show like the school version and then the grocery store version. And it's completely clear that it's the same branding. Nobody would mistake or not think it was the same product. But the grocery store version is not as healthy as the school version. So you're simultaneously - if someone were to know, for example, that about smart snacks and the nutrition standards they could say, well, they sell it in schools maybe it's better. They might be more likely to buy it in the grocery store, but of course what they're buying in the grocery store is worse. And then if you ask folks from the food industry, which I've done, well, why don't you just reformulate all of it? Why don't you only sell the school version in the grocery store? They say, 'oh, well, we are just worried that people won't like it because it's not, you know, as palatable.' It's like a lose-lose proposition. I would like, personally, to see all of those foods removed from schools. And to answer your question about the research though, it's really promising. I mean, there have been a couple of studies that I always go to, to sort of document the positive impact of the regulations that came from the Healthy Hunger Free Kids Act. One was a study showing that basically the meals that students eat in school for most American children are the healthiest meals that they eat all day. So that it's sort of the best source of nutrition. And then another study that was looking at BMI trajectories over time and found that particularly among lower income children there was a measurable impact on BMI in terms of reducing the risk of childhood obesity after the Healthy Hunger-Free Kids Act regulations were put into place. So, I feel like when you have those sort of large national data sets and you can look at impact across the country, it's pretty clear that even though we of course, want to see more change and keep going forward, even the changes we've made so far have had an important impact.

Do you think the changes are sufficient to produce impacts on learning and academic achievement and things like that?

We have a hard time having enough data to really get at that very specific outcome because so many things have impact on academic achievement. But there definitely have been some studies that have been able to show some impact. But it's a tricky thing to measure.

Mara, let's talk a little bit about how the school can be part of a vital and healthy food system overall. Tell us about your work in that space.

We look at health in its kind of larger capacity, right? So direct related nutrition results with kids eating certain foods. But in addition, the school lunch program is funded to the tune of $17 billion a year, right? So, if we think about spending those dollars in the food system and how we're going to change the food system we have to really think about how we empower these school food professionals to make the best choices they can to affect change. With approximately about a $4.30 reimbursable rate price of a lunch, it's not easy right now. Labor prices are going up and you have to pay for labor out of that. You have to pay for food cost out of that. But you can prioritize your choices.

Some of the things that we work with districts on are what are their top 20 highest volume purchases in the school food program. And how can we look at that top 20 and make some adjustments to purchase things that can impact the environment in a more significant way. Often it is animal protein that's in their top 20. That is really an opportunity for districts to make better choices. Local choices. Higher quality choices. You know, choices that impact not only the health of the environment, but the health of their local economy. But it is challenging because your district has to be able to manage raw animal protein. A lot of the processed animal protein products coming to the districts are pre-cooked, and so they don't have to always know how to manage in a kitchen raw animal protein. And that's usually this barrier that we help districts get over. But once we do, there is this huge opportunity for them to purchase higher quality animal protein. Also fruits and vegetables, right? I always get asked this from parent groups who are looking to change school food. Why can't we just purchase everything organic in schools, right? So that's hard on $4.30, right? You can't. But you can make choices and you can look at the highest volume products or the products that are more affected by pesticides, right? So, if you have a salad bar you know you're serving lettuce every day. You can move to serving an organic lettuce, and that is a huge opportunity to move forward. I think things like that are how we look at the food system in terms of school food. But it's really important not just for us food systems people to be looking at it like this, but for us to be training and teaching the school food professionals about their job and the impact they can make, both on student nutrition and environmental impact. And that's a lot of what we do in our workforce development initiatives.

How does seasonal things figure in? Because schools are in session during the months when it's colder in most parts of the country, and the agricultural system isn't going full bore like it might in the summer months. How do you deal with that?

It's really a great point. I know whenever I bring up any kind of exemplary food program in California, people say to me, 'Ugh, California. You can do a lot in California, but what can you do elsewhere?' Well, here where I live in Boulder, the Boulder Valley School district serves close to 15,000 lunches a day. They have 55 schools. It's kind of that perfect midsize district example. And they purchase 40% of their products locally. This is a Northern Climate District. This is Colorado. It takes time. It takes a real steadfast plan. But you, you know, you can purchase potatoes through December. There's a lot of indoor growing right now locally too. So that's also this great opportunity to purchase things like if you have a salad bar purchase, things like lettuce locally, all year long. There's, there's a lot of local wheat production that is happening these days in northern climates and then it's getting milled and processed into different products that you can buy locally. It's very much possible. Can you get to a hundred percent local procurement? Not right now, not at the current reimbursable rate, but there's a lot of room for improvement even in northern climates.

When the schools are buying such foods that come from local sources, are they buying directly from the farmers or is there some agent in the middle?

It depends. Mostly for local farmers, small local farmers, they're buying direct. And that's a challenge for small and even some midsize districts because of their capacity, their procurement capacity, their administrative capacity. But it is possible. Obviously, it's in some ways easier for big districts like, you know, LAUSD (Los Angeles Unified School District). We work with LAUSD. It's an amazing district that buys a lot locally. But they have the volume, they have the capacity, they have the administrative support. That's why a lot of our work focuses on small and midsize districts to actually provide them with that kind of structure and support to do it. And to really prioritize the buying processes through their local purveyors. There are some local distributors that have more local products than others. You know, gold Star is a distributor on the West coast that has more local products. But in reality, the prime vendors for these districts are mostly Sysco or US Foods. And they don't carry a ton of local farm product for these districts. So, they're really going to have to create those partnerships.

I'm thinking of the farmers and what impact it might have on them. And I could imagine for some farmers at least, it would provide a reliable income source and a reliable customer for their products, which would be helpful financially. And I imagine, although I don't know that there are probably cases where the schools are inviting the farmers to come in and meet the kids, and that's probably good for everybody. Does that kind of thing happen?

Yeah, I mean that is huge and as I kind of talked about ultra processed food being the next horizon to look at reducing in school food, I also think how we work with school food programs to connect them and actually have them be stronger customers of local farmers is also this next horizon. One of the new projects that we're working on is called Values Align Purchasing Collectives. So, we're currently doing assessments to determine how we can group small and mid-size districts together to form buying cohorts, basically, to purchase from local farmers. So how can we get them to look at serving some of the same menu items, purchasing together, working together to relieve some of the administrative stress on the districts, but also on the farmer side. So how do we create hubs to do and look at creating a process that can better support? And I think that's the future.

Oh boy. That sounds like a very exciting development. Marlene, just you have something you wanted add?

Yeah, I'm just so exciting to hear all of that. I was going to mention that we have a new project in Connecticut looking at farm-to-school practices across the state, and really trying to work with districts on both the procurement part of it as well as incorporating more into the classroom. So having that connection with local farmers, having that being part of the sort of educational curriculum. And then really what I've always thought was the goal was to have the cafeteria more of a learning lab. Not having it as this, I guess I said before, separate part of the school, but rather incorporating nutrition education, incorporating this is where that apple came from and teaching students where the food is from and particularly if it's from a local producer. I think there's a lot of excitement around there. I think the USDA is funding a lot of states to do more work in this area, and so it's a pretty exciting time.

You know, connecting up what the two of you have just said, Marlene, I remember in the time I was living in Connecticut. Connecticut has a lot of small to midsize towns that are feeding kids and the collaborative that Mara was talking about sounds like it might be a really interesting solution in that kind of a context.

I completely agree. I know some of the New England states, and maybe this happens in other parts of the country too, but it does feel like each school food authority is tiny. I mean, we have towns with one high school and to try to have any kind of buying power when you're so small, I think, is a real challenge. So, I know there are some collaboratives in Connecticut, but absolutely supporting, bringing people together to try to negotiate the best prices and things like that, and make those relationships with the local farmers. It feels like a really great strategy to pursue.

I'd like to ask you both, what is it going to take or what does it take to make these things happen? You're talking about some very good things when they do happen, but what does it take to make them happen? And Mara, let's start with you. What are the factors you think are really important?

We approach our work from a systems perspective. What is the system and what is the biggest barriers in the system that we can kind of selectively tackle, and kind of dig into from a programmatic engineering perspective. For us, and Marlene, I love that you brought up the lunchroom as a classroom, because I think that is really important. I think that's the kind of the ultimate goal and we're so grateful for programs across the country that are working on that kind of thing. What we want to stay focused on at the Chef Ann Foundation is school food professionals. We want to actually educate them. We want to figure out how to provide more professional development, learning, education so that they can start looking at their jobs differently. And the country can start looking at what they're doing differently; and start really looking at the value that they're providing during a school day.

So, what it takes, back to your question, is it really takes breaking down the problem to understand how to put some pieces together to test out programs that can look at breaking down that barrier. And for us right now, we're doing a lot with workforce because what we believe is that in 10 years from now, if we have a workforce in school food that has a different perspective of their job, has different skill sets, is a kind of a different workforce than is right now, than a lot of these things we want to tackle as food systems people will be a lot easier.

That makes good sense. And Marlene, you've been involved for many years in local and state and national policies. In your mind, what sort of things lead to change?

So, that's a good question. I would love to be able to say, oh, it's the research, clearly. That people do studies and they document, this is what we need to do. I think that's necessary, but not sufficient. I think the real answer is parents and people. I had a similar experience going to my daughter's when she was in first grade going and having lunch at her school and looking around and thinking, oh my goodness, what are we doing? I think that it's the fact that even though this is my profession, this is something I study, It's deeply personal. And I think there's a lot of passion behind the importance of making sure our children are healthy. And if I think about the policy makers along the way who have really been the ones that have made the biggest difference, it was off often because they cared about this deeply, personally. And so, I think continuing to tap into that and reminding people how important this is, is how you get the political will to pass the policies that make the real changes.

Well, you know, you both made that really important point about how important parents can be. But really impressive that this started as a personal thing, and you were caring for the welfare of your children and that helped inspire your professional work and look where it's gone. It's really very impressive. I'd like to end with a following question. Are you hopeful for the future? Mara, let's start with you.

I am very hopeful for the future. I think when you look at what's important to our society, school food is often the answer. I feel like when you look at achievement, school food is often the answer. When you look at diet related illness, school food is often the answer. When you look at building local economies, school food is often the answer. And I am really hopeful because I think there's a lot of incredible work being done right now, and we are moving past piloting and we're moving into research. And we're moving into institutionalizing the work. And I think you can see that through policies, through USDA cooperative agreements with organizations and work that they're doing and through the guidelines. And through the excitement and integration you're seeing in communities with superintendents, school food directors, parents, and advocates.

And Marlene, are you hopeful?

I am hopeful. I mean, if I think back to, you know, kind of the early days of working on this issue, I feel like we were met with a lot of skepticism. People felt like, oh, the industry's so powerful, you'll never be able to do anything. I feel like there have been a lot of changes. And I think another shift that I've sort of seen over the course of my career is early on, because of the rates of childhood obesity increasing, a lot of these initiatives that was the hook, that was sort of the anchor. And there were positive things about that because it was such a dramatic change that had occurred that you could point to. But sort of the downside is it wasn't just about that. It's about all children. It doesn't matter what your body weight is, it's about diet quality and having food security and getting adequate nutrition. I feel like we've broadened a lot in the field in terms of how we think about the reason why we're doing that. And that has made it much more inclusive, and we've been able to talk about, as Mara said, how it's affecting lots and lots of things outside of individual children.

Bios

Marlene Schwartz

Marlene Schwartz, Ph.D. is Director of the Rudd Center for Food Policy & Health and Professor of Human Development and Family Sciences at UConn. Dr. Schwartz studies how nutrition and wellness policies implemented in schools, food banks, and local communities can improve food security, diet quality, and health outcomes. Dr. Schwartz earned her Ph.D. in Psychology from Yale University in 1996. Prior to joining the Rudd Center, she served as Co-Director of the Yale Center for Eating and Weight Disorders from 1996 to 2006. She has received research grants from a variety of funders including the Robert Wood Johnson Foundation, the United States Department of Agriculture, and the National Institutes of Health to study federal food programs, school wellness policies, the effect of food marketing on children, and strategies to address food insecurity and diet quality. She is also the recipient of the 2014 Sarah Samuels Award from the Food and Nutrition Section of the American Public Health Association; the 2020 Faculty Service Award from the Department of Human Development and Family Sciences; and the 2021 Community-Engaged Health Research Excellence Award from the Institute for Collaboration on Health, Intervention and Policy at UConn.

Mara Fleishman

Mara Fleishman’s career in food systems advocacy started in her early 20’s when she looked to the power of food after being diagnosed with an autoimmune disease. Mara has over 20 years of experience in leading systems change initiatives in the for-profit and non-profit sectors including over a decade at Whole Foods Market where she served as Global Director of Partnerships. In Mara’s current role, CEO of the Chef Ann Foundation, she has spent the last 10 years fighting for healthier food for our nation’s kids. Mara’s niche is system-based change and although she takes on many roles as a leader, her favorite is programmatic engineering; breaking down problems to their foundation and building programmatic solutions through dynamic and integrated approaches. This type of programmatic engineering can be seen through the work of the Chef Ann Foundation, an organization recognized as the national leader in driving fresh, healthy scratch cook food in schools.

Mara also serves on regional and national boards, has spoken at conferences and academic institutions across the country, and has been recognized in publications as a champion and national advocate for change.

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Everyone knows that it's a good idea to be physically active, but behind that basic knowledge lies a fascinating field of research on the role that physical activity plays in health and in weight control, along with answers to questions such as how much exercise I should get, is there a best time of day to do it, is one type of exercise better than others, etc. Few people can rival Dr. John Jakicic in expertise in this arena. John is a professor in the Department of Internal Medicine in the Division of Physical Activity and Weight Management at the University of Kansas Medical Center. His work has led the field for many years.

Interview Summary

John, I'm not an expert myself on physical activity, but I've been a fan of yours and others in your field for many years. And it just seems to me that it's a vibrant, active, exciting field where almost every day some new finding comes along that confirms the benefits of physical activity or discusses different ways to do it. Can you give us an overview of why being physically active is such a good thing?

I think that if we could take the benefits of physical activity from a health perspective and bottle them up into one pill, we would probably have the most powerful pill that was ever invented. And I think that the reason for that, Kelly, is physical activity pretty much touches every system of the body. Every anatomical physiological system of the body in some way is touched by physical activity. And as long as you're not kind of overdoing it, abusing it, the body is adapting to allow you to do that activity. There's a lot of things that we do where we try to counteract certain things with medications and surgeries. But the one way that we can make the physiology of the body adapt and become healthier, the one real way to do that is through physical activity. And I think it touches so many systems that way, that's why I think we keep hearing about all the pure benefits that we can get from this activity.

Okay. It sounds like it would be easier to have a discussion on or try to find somewhere physical activity is not beneficial. And it's interesting that the body makes room for physical activity by adjusting to whatever the demands of it are. I'm assuming there's some evolutionary reason for this. That people evolved having to be physically active just to get by in day-to-day life. But is that true? Have we inherited something in that regard?

I think we have. And we went from hunter gatherers where you had to take your body and go out and find the food you needed to eat, to we don't have to hunt and gather very much anymore, at least in the US and other developed countries. The most hunting and gathering we do is go to the fast-food restaurant or the grocery store. The body has adapted to that. And I think that's one of the reasons that the body is so resilient. Now you think about it, Kelly, somebody who's had a pretty major coronary event. What's the one thing that gets recommended for them? Become more physically active, start exercising. And the body starts to bring itself back. Not maybe to the way it was before that, but it helps to regenerate the body in ways that other kind of things just don't do it. I think that there's definitely this physiology underpinning that we really need to keep thinking about.

Speaking of coronary events, and you probably know this history way better than I do, so correct me if I'm wrong. But I remember hearing about the important historical role that a cardiologist named Paul Dudley White played with Dwight Eisenhower when he was president. And as I understand the story, Eisenhower had a heart attack, and the prevailing wisdom of the day was let you rest for a really long time after a heart attack. Like the heart was worn out and needed to recover and mend itself. But he reversed that, put that on its ear, didn't he?

Yes, he did, and I think that kind of laid the groundwork for where we are with cardiac rehabilitation and cardiac treatment along the way. And that was probably the groundbreaking thing that happened where don't be afraid to start moving. And that has now evolved to diabetes, cancer treatment. You start to name all the conditions where it seems like activity is good. Even if you've had these conditions, as you go through your treatment plan.

We've focused mainly so far on the physical benefits of physical activity. What about the psychological ones?

I think that there's probably so many of those too, Kelly, and this is maybe where you know more than I about some of these types of things. But there's such great data that came out, maybe 20 years ago, where we were seeing studies coming out looking at depressive symptomatology, for example. And some of the stunning findings they were that people, even with known depression, could benefit and actually reduce their depressive symptomatology with at that time aerobic forms of physical activity. I think it's evolved to all types of different forms of physical activity. So, we have these depressive symptoms that can be dealt with, or maybe even prevented. We've seen it with mood and enjoyment, you start to just start going down the list. And I think the most evolving field that we're seeing right now is just in terms of the entire brain. You know, brain functioning, cognition. And we're realizing that the brain itself is an organ and physical activity in some way is actually impacting that as well. So, it's not just the physical, it's the emotional, it's the psychological. It's this overall wellbeing that we like to talk about.

You mentioned the work on the brain. Is this effect that you're talking about showing up in studies of risk for dementia and Alzheimer's and things like that?

It absolutely is. And I think we're still trying to completely understand the mechanisms by which this is occurring. Is it because activity is having some effect on inflammatory markers? Is it having something to do with blood circulation in the brain? Is it affecting other biomarkers that we hadn't thought about before? But yes, absolutely. It's affecting cognition. It's affecting dementia. It's affecting Alzheimer's. And we're finding that this is a really important thing for older adults. And I think the field is exploding at this point in this space.

Let's get back to the physical benefits of exercise and talk about how they occur. One might think that physical activity exerts its influenced by affecting something like a risk factor, which in turn is what's affecting health. So, you're being physically active, it helps regulate your blood pressure and it's the regulation of blood pressure that's producing the overall health benefit. So, it's exercise does X, fill in the blank, and then that creates Y benefit. But is there a direct line between the exercise and the physical health? It doesn't go through risk factors like that. How does that work?

Yeah, I think that it somewhat depends upon what the outcome is that you're looking for and what you're trying to move. And it gets a little, I'll say wonky. Because at some point there are intermediaries along the way that are probably impacted. Just for example, we've done studies in the field of obesity with physical activity that found that not only is the activity affecting the risk factors, the blood pressures, the insulin, the glucose. But it's affecting like the cardiac tissue itself. It's affecting the factors that are affecting that cardiac tissue. It's affecting the blood vessels themselves. Now, they're clearly intermediaries, but they're probably not the traditional risk factors we're thinking about. They're probably more signaling mechanisms, mitochondrial factors, these types of things that are more physiologically based as opposed to what we would consider our traditional risk factor base. I think the thing that we've known now for a long time, you go back to some of the Harvard fatigue laboratory studies where they were actually trying to get performance out of individuals. How do you get people to perform at a higher performance? Basically, the equivalent of being an athlete nowadays. And what you find is that, yeah, that's how you get people to perform at a high level. But that's also how you get people healthy in everyday life. We really learned how if you stress the body a little bit, the body adapts and makes it stronger as you go forward.

It's good to know that, and it doesn't hurt to get wonky sometimes. That's a very interesting description that you gave. You mentioned weight control. Let's turn our attention to that for a minute. You were the lead author on a consensus statement from the American College of Sports Medicine. A very highly regarded organization, on the role of activity in body weight. Let's talk causation. Most people appreciate the key role of diet in the genesis of weight problems, but less so the role of physical activity. How important is it?

I think it's critically important, but I also want to be very cautious about saying that it's more important than diet or energy intake. I don't like to take that stand because I think there's inputs coming from all angles here that are regulating body weight. And I think that we can get ourselves in a little bit of trouble if we say, what's only this, or it's only that, that it's one thing. It's a little bit of everything. And I think that what we're finding a bit in our research and others as well is that there's a variable response depending on the person. We know that if a person becomes active over six months without intentionally trying to change anything on their diet, they're probably going to lose a couple of kilograms. Two, three kilograms, maybe a little more depending on how much they do. But there are going to be some people that lose a lot more. Some people are going to lose a lot less. The question is, why is that? And in some of our work, Kelly, we have found, and others have found this as well, is that for some people, when they become physically active, the body has this adaptation where it says, hey, wait a minute, this is great. It can kind of turn off or help to better regulate the hunger satiety signals. But for other individuals, when they start becoming more active, all of a sudden they start to become more hungry. And, in that individual, if we ignore the intake side, if we ignore the dietary component, that person could start being active, but their body weight may never move because there's this counter regulatory mechanism for that person.

So, it's critically important to help with regulation of body weight, but how much and how often may vary. And I think the other key factor, Kelly, is I think you've heard me say this before, but I'll say it again. And that is activity can affect some of the health parameters and the outcomes we're interested in, that weight may not affect, or diet may not affect. If we're really thinking about a holistic outcome for patients, we've got to have activity as part of that discussion.

Plus, when you get diet and activity working together, I imagine you get this virtuous psychological and biological cycle. That if you're being physically active, you feel better about yourself. And you don't want to undermine your diet, so you stick to your diet better. That helps you be more physically active. Just a lot of things working in sync.

There's a lot of things when they start to come together. Your body can regulate itself pretty well. It's when we start to force other things into the system that kind of mess it up a bit. And I think the other challenge here is that I think over the years, many individuals don't know what hunger feels like. And so, we've lost that sense. But being active helps to help you to counter regulate that for many individuals. So, it's not just about the energy expenditure. It's not just about the effect it has on weight. It's about some of the other factors that are being affected that help to let the body get a little bit more on cruise control and let it do what it's supposed to do.

We've talked a little bit there about how these two systems, the diet and physical activity, might interact psychologically. And let's get a little more wonky and talk about the biology of it. I remember some studies, and I have a vague recollection of these because they were done a long time ago. And I thought they were done by Jean Maier's lab and at Harvard in the sixties and seventies, where they took lab animals, which of course is a way to isolate the biology because you don't have human psychology to worry about. And they had animals that were on a particular diet and then they either allowed them or forced them to be physically active. I forget which. And my recollection is that the animals started choosing a different mix of nutrients because they were physically active. And that mix of nutrients became a healthier profile for the animals. I'm not sure I'm remembering that right. But how are these two things linked biologically, do you think?

I think that they really link a lot biologically. And I think that we completely 100 percent don't fully understand it all. But I think, sometimes when we think about body weight regulation, the first thing we think about is cutting the calories, and then throwing the physical activity on top of that. And I think that sometimes maybe what we need to do is feed the body and put the activity on top of it so that we have enough energy coming through the system when we talk about it. And Maier's lab looked at this in terms of energy flux. So, if you feed the body enough and then have enough energy burn on the other side of it, that helps to regulate body weight a lot better, it appears, than someone who's trying to always restrict their calories and add all this activity. At some point, the body's going like, feed me. I need to eat at some point. These two things are not independent. And I think, Kelly, you know how it's been treated for decades. You have diet and you have activity and never show these things cross paths. And the reality is that we need that cross pollinization. We need these things talking to one another because that's how the body's properly regulating these things.

Yeah, that strikes me as a particularly important and exciting area of research with the way these two systems come together. And you just confirmed that. I know over the years people have written a lot about how physical activity might be especially important in people maintaining weight loss. Can you tell us more about that?

Yeah. And we contribute a lot to that. We talked a lot about this, and we found, at least in secondary analyses or observational data, how important the activity is. It seems to be a very important predictor. And the question becomes, well, why? Why is that? Why is it so important? I think part of it is, you know, that as people lose weight. And you've been involved in many of these studies too. You lose weight and you're cutting these calories back. You can only maintain this kinda low calorie intake for so long. And at some point in time, either you intentionally or unintentionally start to eat more calories. And these higher levels of activity, I think, help to give us some ability to kind of counter that intake. The activity becomes important that way. But also, and it takes us some time to get to that point in time. One, it's a calorie burn. But also, if you start thinking about substrate utilization and other things, what energies are we burning, what we do know is that individuals who become more at least cardiovascularly fit, also have an improvement in their ability to utilize fat as an energy source. So, they're going to become a bit more efficient at using fat and not always having to kind of struggle, you know, to do that. And, the other factors that really help to regulate weight, and there's a lot of them, don't get me wrong, we can't talk about them all today. But you start to think about how insulin and glucose regulation might be impacting hunger satiety, but also body weight regulation, and activity we know increases insulin sensitivity. You don't need to be dumping as much insulin into the system. I think there's all these factors that come into play and it hits that crescendo, I'll guess. When after you've done it for a period of time and these adaptations have happened after about 3 to 6 months, you'll start to get many of these adaptations occurring.

People are going to get excited when we're talking about substrate utilization. But let's go into this a little bit more. And actually, it was the next thing I was going to ask you anyway. Whether people, when they're burning calories, I mean, they're losing weight, are they burning fat or protein or, what's the body doing is a really interesting issue. And I know that's especially important in the context of the new weight loss drugs. So, let's talk about that. We've done several podcasts on the new generation of the GLP drugs like Ozempic and Wegovy and Mounjaro and Zepbound. So why is physical activity especially important when people are using those drugs in particular?

Yeah, so much of what we know about activity within the context of those medications is a bit hypothetical. A bit hypothesis driven. A bit this seems like the best practice because there have really been virtually zero studies, we keep looking at this, that have been published that have been appropriately well designed, appropriately powered kinds of studies. The one study that has been out there had people lose a lot of weight on basically a low energy diet and then added activity and the medication after they've already lost a lot of weight. It's really not the way these medications are really being used. And so, in our consensus paper from the American College of Sports Medicine, we talked about what we don't know as much as what we do know. And I think that activity becomes critically important in the context of these medications because beyond what it does for body weight, true body weight, the medications are taking care of helping people to lose weight. But as we hear about these weight loss medications, there is some concern about the loss of potentially lean mass. We don't know if it's muscle or not, but there's a potential that some of that is muscle.

I just heard some data over the weekend about some of the newer medications that are being looked at in phase two and three trials, where there's some concern about bone loss at this point as well. So, you start to think about that and you say what could you do to maybe not completely counter it, but to blunt the loss. And we know that activity affects all those things in very positive ways. The challenge you run into though, Kelly, is activity affects those things in very positive ways when there's adequate nutrients coming in. But if all the nutrients are coming in are being used for energy, there's very little to have as a building block.

So, we have to be careful about saying that exercise is going to prevent loss of muscle, prevent loss of lean, prevent loss of bone. It may help to counter regulate that, but I think that what's more important is whatever muscle and lean tissue and bone tissue you have left let's make it as healthy as it possibly could be. Because as you and I both know, individuals without obesity actually overall have less muscle mass than individuals with obesity. The difference is in their quality of their muscle. And so, let's make the muscle that is retained high quality as opposed to focusing so much on the volume

It sounds like the combination of really being vigilant to protein intake and physical activity is a pretty good way to help counteract some of the negative effects of the drugs on the potential loss of muscle mass.

I think that there's a chance that it could help. But if worst case scenario, we don't know if it's completely countering that, but it might blunt it. But the bottom line though is that even if it's not blunting it, even if it's not stopping it you're going to make the muscle stronger. You're going to make the muscle more functional, make the muscle more efficient with the muscle you have left with activity. And an example of that Kelly is, probably 30 years or so ago now, we published some papers on the very low-calorie diets, the five to 800 calorie a day diets. And we added resistance training, cardio training, or the combination to those diets. And, with a 20, 30-kilogram weight loss over three to six months, we saw losses of lean mass even with the exercise training. But the people who weight trained got stronger. The people who did cardio training got more fit. The people that did both had both effects. You still get the effect of the activity without focusing so much on the mass, but focusing on what I'll call the quality.

I had this image in my mind while you were talking, if muscles had a face, they'd be smiling at you if you're physically active, because you're helping make them stronger and more vital. And, it just so many good things happen, don't they?

That's it. I think that's exactly what I think the message should be because we're not trying to train athletes here. We're trying to train everyday humans and their everyday walk of life. So, how can we focus on making them the healthiest and most fit and most functional that they can be? And I think that's a lot different than trying to say, we're going to send you to the gym five days a week and really hammer you to try to preserve this. Most people can't do it and won't do it. What can we get from this? And I think this quality issue is really where we should be focusing our effort.

Let's get a little bit into the nuts and bolts, toward the end of this conversation about what type of exercise people might think about doing. We're bombarded by information: low versus medium versus high intensity. For how long should you do it a day? How many steps should you get? Strength training versus aerobic exercise? You just mentioned that. And of course, how to get it and stay motivated. So how do you respond to the question? What do I do?

Yeah, a very difficult question. And I think part of that comes from just the media is not understanding so they look for a good story. But part of it also comes from within the exercise community. Similar to what you see in the nutrition community, what's the optimal diet for someone, right? And so, you have people who are advocating for one type of activity versus another activity. And as I go out and I talk about this, I think this is critically important, Kelly. There's not one perfect exercise that will give you all the perfect health benefits. If you want to strengthen the muscle, you need to overload it with resistance. If you want to make the cardiovascular system strong, you need to stress it with some type of cardio activities. If you want the muscles to become pliable and the tendons and ligaments to become pliable to prevent injury and so on, you've got to do stretching, Yoga, tai chi type of activities, right? And you can go on and on and on. And in fact, if you want the brain to function, if you want the cognitive effects, you need to do things that make the body think a little bit and tie the brain to the movement that you're doing. Right? So, it has to be like a mindful type of movement, maybe a yoga or something like that. There's not one perfect activity, but I think that a little bit of all those activities is probably better than any one of them by themselves. That's the way I think about it. Now that's hard for people. Also, I think that for people that are starting out who probably have had bad experiences with exercise, bringing back to physical education class possibly, right? Get up and move more. If you can get up and move more, that's the gateway. Right? Get up and just start moving around more. If you can't get up and move more, there are things you can do. And if you're wheelchair bound or have mobility limitations, there are things that can be done in a seated position and so on. It's about getting started. The, the hardest part is taking that first step. Right? The hardest part is putting on those walking shoes and getting out the door. Once you're out there, people usually enjoy it. And I'll just give you an example. Kelly of when we did our bouts and you're familiar with our study where we did the 10-minute bout study where we asked people just to do 10 minutes. We found very quickly that individuals who started doing small 10-minute bouts and we're doing well, were turning those bouts into 12-minute bouts, 14-minute bouts, 15-minute bouts. So, it's about getting that first step. Don't think about this being this whole complex thing. Let's get started and build on it to a lifestyle of activity.

And if people are in search of a trustworthy place to look for information on physical activity, where would you suggest they go?

First, if they're looking for a website type of thing, I would point them to the American College of Sports Medicine. There's a program out there called exercises. Medicine has great resources, but also if they're looking for good advice, and it's, a lot of people can give good advice, but the American College of Sports Medicine has the premier certification in this space. Individuals who are getting American College Sports Medicine Certification, whether it be a personal trainer or clinical exercise physiologist, are going to be, in my view, the people who have the kind of the right perspective to try to help individuals with variety of different disease states.

That's very helpful to know. Let me peer ahead into the future a little bit and ask you, where do you see your field going? What will the future bring, you think?

There's a big study going on called the molecular transducers of physical activity. It's they. I call it the motor pack study. We were involved in that for a while, and that's to try to create a molecular map of how activity actually affects the body. Kind of like where we started today. We're learning a lot about this. And I think that what we're going to find in, and not just in that study, but across the board is this idea that again, there's not one perfect activity. But that the body responds to activity, depending on what it is that you're asking it to do. And I think that the holy grail, Kelly, is no longer what activity is should I do? I think the holy grail goes back to maybe where your roots were and my roots were, and that is how can we help individuals to initiate, engage, and sustain? I think it's about the intervention and translation of these findings. And that's the holy grail for our field because we know activity is good for us. It's about how do we get individuals to understand, engage, sustain, and overcome the barriers that they face. I think that's where the field has to go.

Bio

John M. Jakicic, PhD is a Professor at the University of Kansas Medical Center in the Department of Internal Medicine and the Division of Physical Activity and Weight Management. He has an interdisciplinary research program that examines lifestyle approaches to the prevention and treatment of chronic health conditions, with a particular focus on the role of increased physical activity and reduced sedentary behavior on these outcomes. Central to this research has been a focus on interventions for weight loss and weight loss maintenance, and this has more recent application to medical treatments for obesity that include metabolic and bariatric surgery and contemporary anti-obesity medications. He has served on numerous national committees focused on obesity, physical activity, and other chronic health conditions, which included his appointment by the US Department of Health and Human Services to the 2018 Physical Activity Guidelines Scientific Advisory Committee. He authored the 2024 American College of Sport Medicine’s Consensus paper and the 2001 position paper focused on physical activity and obesity and co-authored the 2009 position paper. He has also contributed to other consensus papers and clinical guidelines for the prevention and treatment of obesity. Dr. Jakicic has over 300 peer-reviewed publications and book chapters. Based on statistics provided by Google Scholar (effective August 11, 2024): 1) his research has been cited 50,192 times, 2) his H-Index is 95, and 3) his i10 Index is 258. Dr. Jakicic earned his doctorate in exercise physiology in 1995 from the University of Pittsburgh, and he is certified as a Clinical Exercise Physiologist by the American College of Sports Medicine.

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Today we're exploring civil society's efforts to shape the food system and land use in the United Kingdom. Our guest today is Sue Pritchard, Chief Executive of the Food, Farming, and Countryside Commission (FFCC). The deeply grassroots work of the commission brings people together to find practical solutions to climate, nature, and health challenges. The goal is to shape fairer and more sustainable food systems and a just transition for rural communities and the countryside.

Interview Summary

Well, Sue, I am really interested to start off learning a little bit more about you. Can you tell us why are you interested in food and farming and the countryside?

So, I'm talking to you from Wales, from my farm in Wales. I live and work on a small, organic, conservation orientated farm that produces native breed cattle and sheep. It's so authentic. I have a duck in my office with me at the moment. So, if any of your listeners hear any odd sounds, I promise you that's her, not me. I come from a family in Wales, which either went down the mines or farmed and had small holdings. My father went down the mines, but we always, as a family longed to get back to our deeply felt roots. And it was about 27 years ago that my parents and I, my family, were able to buy our farm here in Wales, which is, I suppose, the culmination of a dream. And although we were not naive about farming, when you're deeply embedded in the everyday life of the farmer and operating in the farming system (the food and farming system) you learn some different things pretty quickly. And so, for a fair few years, I was working out how to make the farm work economically. But also, how the farm could make a really good contribution to tackling the climate crisis and the nature crisis. How we could sequester more carbon on the farm. How we could build more natural infrastructure on the farm to help nature thrive here again.

You will recall, the UK had its own political, should we call it a little, a minor apocalypse back in 2016, when the UK voted to exit the European Union. And, the implications of that vote were pretty, pretty, extraordinary for farming and for food systems and the environment. As a result, civil society, business organizations got together and were able to get some philanthropic funding to set up a commission (Food, Farming, and Countryside Commission) to shape a different future for food and farming and the countryside outside of the European Union. And when that job was advertised, it was my dream job, bringing together, as it did, the future of farming, the future of food systems, and being able to impact and influence policy at a really, really critical time.

I want to make sure I understand a little bit more about what's happening. Because of Brexit, that means the UK is no longer part of the common agricultural policy and is now needing to reconstruct its agricultural policy structure. It sounds like the commission was brought in to do some of this work. I would like to understand what in particular challenges are facing the food and agriculture scene in the UK post Brexit.

I think that the first thing that we were able to do in the work of the commission was to start talking about food as a system. That was relatively unusual in the UK. One of our leading thinkers, Professor Tim Lang, used to say that the UK's food policy was basically leave it to Tesco, which is one of our big supermarkets. It was essentially left to private markets to determine the kind of food that we had on our plates. It was clear that that strategy was not working anymore. And given the really quite startling system changing implications of that particular vote, we were able to take a different perspective on food systems and start thinking about food as a system. We talked about, as it says on the tin, food and farming and the countryside, but we also talked about food and farming's relationship with climate, with nature, with health and wellbeing, and with equity and justice.

In bringing that more, if you like, systemic view into people's consciousnesses, we were able to demonstrate really how central food policy is to UK's economy, health and wellbeing of UK citizens. Perhaps in a way that had not been done with quite the same heft as before. Lots of people have been trying but hadn't quite landed center stage in policy terms. And we were able to show through our work and then our reports, the relationship between food and farming and diet-related ill health. Farming systems and the climate crisis. Farming systems and biodiversity loss and the nature crisis. And also, starting to reveal the inequities, the inequalities embedded in the food system when we start looking not just within our own borders in the UK, but beyond our borders to how the UK trades with the rest of the world.

Because countryside is one of the major themes, it's in the title of Food, Farming and Countryside Commission, and I've spent a little time in England and the countryside. And I'm from a rural area and the United States, and I'm interested to understand how you all are thinking about the needs or the challenges, or even the opportunities that the countryside faces in the UK.

One of the things that I realized when I started this job back in 2017 was that for many people in London, the countryside is just the gap on the map between the cities. They had very little understanding of the contribution of the rural economy, the importance of the rural economy, particularly the countryside's importance, criticality, even for tackling the climate crisis, tackling the nature crisis. It's there where a lot of the problems occur, but also where a lot of the solutions can be found too. And so, talking about the countryside, not as a kind of poor relation to the rest of the economy, but actually central to a version of the future that was able to be more resilient, more adaptive to whatever kind of scenarios might unfold. That felt like a pretty important thing for us to be doing. And when we were conducting our work in those early days, we did all the usual things that a commission might do. We did a literature review, we held workshops, we held all sorts of kind of formal research processes. But we also set out around the country, around the UK on a bicycle. My researchers set out around the UK on a bicycle. Because we wanted to do something pretty iconic to show the richness, the diversity, the variety, the political salience and the economic salience of the countryside to policy discussions in Westminster. I think one of our successes has been to bring those voices into policy decisions. And to give them much more gravity, I think, in policy considerations that often feel very distant in London.

How have they shaped the way you all have done the work at the FFCC? Are they altering or informing the work in different ways?

Yes. Absolutely. We work with citizens in a number of different ways. So that first moment, the kind of bicycle tour around the UK was if you like, a symbolic moment of connecting with people in their communities. Going out to where people are, letting them tell us in their terms, what mattered to them, what they cared about, what they were concerned about. But in a really kind of barefoot ethnographic way, I think, being able to hear directly from folk. But we also built long term relationships in three, if you like, sentinel parts of the country: in Devon, in Cambridgeshire, and in Cumbria. Different parts of the UK reflecting different kinds of priorities and different pressures in the countryside. Devon is a grassland community, it's very touristy. Cambridgeshire is one of the bread baskets of the country, but with huge pressures on housing and infrastructure. And Cumbria is the uplands, the high mountainous uplands that people understand as a holiday hotspot. But working in those places in depth over for five years now, we have been able to both test out policy ideas in, in real places, in real time. Our land use framework project is a case in point. In thinking about how we make better decisions about land, we worked with people for whom those decisions are incredibly material. It's about what happens in their communities, what happens around them. We were able to develop policy contributions based on testing different options, different possibilities with people in places. And of course, we were able then to bring forward their ideas, their thoughts, and their really practical activities to the view of government, to the view of policy makers and to businesses. It was a kind of reciprocal relationship, testing out ideas in communities, but also bringing community ideas into government, into policy makers. You know, demonstrating how people are already doing things, already doing really interesting and radical and progressive things, whether or not government is supporting them or not.

More recently, we've embarked on a very, very substantial project. It's called the Food Conversation and the Food Conversation is a project that was designed to really test out the answer to the question, so what do people really want from food? I wonder if you have the same experience in the United States, Norbert, but certainly in the UK, we hear over and over and over again, particularly from lobbyists, but often from government, that people don't really care about food. People just want cheap food. They just want convenient food. Nobody wants to be told what to eat. Nobody wants a nanny state. And those kind of toxic narratives, those devices were being used over and over again to limit government's appetite for policy intervention. And after this happened, again about two years ago, after the government commissioned its own national food strategy and then declined to respond in any meaningful way to it, I rather spat the dummy in in leadership terms and decided we were really going to have to test out this narrative, this way of framing food policy change. So, we set out 18 months ago, on the biggest civil society dialogue that the UK has ever seen. We conducted 12 citizens assemblies around the UK asking people directly, so what do we really want from food? In academic terms, it's kind of like a meta review, because what we've done is show citizens the kind of research that's been done over the last 10 or more years. The research has been done by experts in the UK and internationally that show the impacts of the food system on climate, on nature, on our health and wellbeing. And we've asked them what they think about the recommendations that those research reports have made. All of those recommendations that have been kind of discounted by governments because 'no one wants the nanny state.' You have to imagine my air quotes there. And of course, in conducting that conversation, we found really quite quickly that toxic narrative is not true at all. When you reveal to citizens the complexities and the interdependence of the food system with their health, with the state of their high streets, you know, what, what's being sold to them and how. When you explain how that impacts on farmers and growers, primary producers. When you explain how it impacts on communities all around the world, often very vulnerable communities around the world. When you explain how it impacts on the climate and nature, people are pretty, pretty shocked and pretty horrified.

And most interestingly, when you show people how the food system has become more commodified, more consolidated in fewer and fewer hands. More financialized by a small number of global agribusinesses who are continuing to make eye watering profits, while, for example, in the UK, our own health service is buckling under the strain of diet related ill health, obesity, heart disease and so on they are furious. They say, why don't we know and why doesn't anybody else do anything about this? And so that piece of work, well, this phase of it is coming to a conclusion. We've got, oh, 500,000 words worth of material generated by citizens contributions. And that culminates in a summit, the Citizens Food Summit in London on the 19th of November when we'll be sharing citizens perspectives. And indeed, business perspectives too, civil society organization perspectives. Because lots of businesses are lining up alongside citizens saying this needs to be different. We need to change this. And we're sharing those insights with policymakers. And the intention is to strengthen their arm in taking a proper systems view of food policy in the UK and starting to act as if food policy really matters. Because it does.

This is impressive work. This idea of listening to citizens and sharing with their government officials their views of the food system. In some ways. It's so basic you would thought this would be going on already. And yet we all know that this doesn't happen frequently. It's an exciting enterprise that you all have engaged. I would be interested to see what happens after the November gathering.

Very, very happy to share that with you. The way that we've designed it... you'll be familiar with citizens assemblies. They're usually national interventions. They bring people together from across the country. They happen over a period of weeks. They report and then, and then they finish. We've designed ours somewhat differently. We designed ours in places, so 12 around the country. Brought together citizens in those places, as well as the anchor institutions. Organizations that can actually get on and do stuff without waiting for government or big business to act. And so, we've been both listening to citizens, but we've also been doing a little bit of movement facilitation, if you like. We're helping to build food movements, along with our colleagues who are also doing this work in places around the country. And so already we're seeing citizens taking the opportunity to carry on talking to each other, to set up initiatives in their own community. To connect with the initiatives that already exist that they might not have known about. To talk to local policymakers and local leaders about how they can do things differently. So, it was really important to us to kind of learn from the successes and perhaps some of the failures of previous assemblies and dialogues to say, what needs to happen so that change can happen as a result of this, so that citizens efforts, citizens contributions, very generous contributions of their time and their insight actually make something happen.

You know what, I realize that this sounds very similar to the work of food policy councils here in the US. It's a similar sort of structure. But I'm interested, it's something you said earlier on, and I want to draw attention to this issue. I have my own experience that these efforts, lots of different folks come to the table with varying concerns and sometimes conflicting concerns. If you think about the economic gradient where there are people from higher income households and maybe lower income who are experiencing the food system differently. While they share a lot of concerns, there are some big differences. And I'm interested to hear how you all are dealing with that diversity of thought and experience.

Yeah. So, the way we selected our participants was through the sortition process. We sent out 120,000 invitations around the UK. We got a very high level of response rate to that. But from that number, we selected populations that really reflected their communities. And in some communities, we waited for the seldom heard voices. We wanted to make sure that we really pulled in those people who are less likely to be asked or invited or included in these sorts of initiatives. We built that, if you like, reflection of community in each of the assemblies around the country. We invested in quite a bit of context setting at the start. Helping people get to know each other, connect with each other, understand each other a bit, their own experiences and perspectives on the food system. And then getting people on the same page in terms of, you know, the context of food. What we found, and in fact the professional organizations, specialist organizations that have worked with us on this project have been really startled by it. The consistency of perspective across political backgrounds, educational backgrounds, socioeconomic backgrounds, protected characteristics, race, class, gender. The consistency of response to food systems issues is the highest that our professional advisors have ever seen. And, and that's, that's been really, really fascinating to me.

I think it is because, and this goes back to the reason why we wanted to do this work in the first place, very often we end up talking about big, abstracted issues. Even climate and nature can feel big and abstracted. And the political economy of food, very abstracted. When you come back to it, we all have a stake in food. We all have skin in that game. If you frame the conversation in the right way, everybody can participate. And like many things in life, actually, we all want the same things. We want a safe, secure, healthy life. We want to be able to live in a safe, secure, healthy environment for ourselves and for our families, our children, our loved ones. And of course, food is the very thing that connects us. You know, food is at the heart of our celebrations. You know, how we choose to be together when we gather in communities. And we do that so often over food. It's one of the very, very, very few things that connects us and we have a shared experience. So, whether or not you're poor or rich, you will celebrate with food. Whether you're poor or rich, you will want to nourish your children in the best way you possibly can. There are so many things that connect us.

Interestingly, and this was a kind of side benefit of this work, in a country which, I think, like yours, can feel incredibly polarized and at risk to populist politics that seeks to divide us over and over again. The conversations around food and food policy and how we might want food to be different in our communities, really united people. And it really showed people as being more thoughtful, more respectful, more insightful, more considered than very often we are led to believe right across the political divides. There's something very kind of visceral and you know heart centered about food that does help people connect.

Getting quickly then into the technical stuff. How do we make decisions about policies? We said to people here are all the policy ideas. There are hundreds. There are hundreds of policy ideas. We can group them together in categories, health, nature, farming, and so on. And we invited people to categorize them using a really simple taxonomy. Should government's business just do it? This is obvious, just do this thing. Should they test it? It needs a bit more research. We need to test this out a little bit more, in more detail. Or should we debate it? Is this actually quite complicated, indeed contested? And we need a better process to making some choices around this. People were able to look through those policy choices with some real thought and insight. And there's remarkable consistency between people about things that we just ought to get on and do. Things like formulating children's foods in schools. That there ought to be some really clear guidelines about the quality of food that's available for children in preschool and school. That doesn't exist at the moment. People don't understand why on earth that doesn't happen. For some big issues, like should we introduce universal basic income for farmers to make sure they have a level of income that doesn't make them vulnerable to, you know, price gouging by companies? People said, oh, that's quite complicated. We'd have to work out what that would look like, what impacts that would have on the rest of society. But it's an idea worth exploring further. So they explored everything from really, really basic stuff through to big economic issues that could be really quite transformative in a country like ours.

Bio

Sue Pritchard is the Chief Executive of the Food, Farming and Countryside Commission in the United Kingdom. Sue leads the organization in its mission to bring people together to act on the climate, nature and health crises, through fairer and more sustainable food systems, and a just transition for rural communities and the countryside. Sue’s background is in combined research and practice in leadership and organization development for systems change, working with leaders across public, private and not for profit organizations, especially on complex partnership projects. She is a Trustee of UK’s CoFarm Foundation and is an independent Governor at Royal Agricultural University. She lives on an organic farm in Wales where she and her family raise livestock and farm for conservation.

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Today, we're going to explore Daily Table, an innovative non profit grocery chain dedicated to providing fresh, convenient, and nutritious food affordable to everyone, even those on the Supplemental Nutrition Assistance Program, or SNAP. In today's economic climate, where rising food prices are impacting households across the country, the concept of a non profit grocery store seems to fill a real need. Our guest today is Daily Table CEO, Sasha Purpura, a software engineer who spent 15 years in the tech industry and product management and development roles.

Interview Summary

Sasha, it is such a pleasure to connect with you. I'm intrigued to hear more about where Daily Table is today because I too was a Daily Table shopper. So, let's begin just hearing about what Daily Table is and what's the driving mission of the organization.

Absolutely, Norbert. Simply what's driving the organization is the belief that everybody deserves access to healthy food. Daily Table is such a simple solution, but so incredibly innovative. It's a grocery store where everybody can afford healthy food. To me, seems like that should be there already. Unfortunately, it isn't.

Historically, the way we have addressed hunger in this country is food pantries. And food pantries play a critical role and they're very necessary. However, there's spaces designed for people with low income. To say you're low income, you can't afford food, come here. And we know that 40 percent of the people that qualify for food pantries won't go to a food pantry because of that stigma. And because they want agency. They want the dignity of providing for their families and choosing what they want to eat. So Daily Table creates that shopping experience.

People who don't use food pantries, they shop for themselves. And the sad reality is they have not been able to choose healthy food every day. They can't. It is not affordable. If you are lower on the income scale, you cannot afford to put fruits and vegetables on your table every day. Daily Table makes it possible for every person to afford to put fruits and vegetables on their table every day.

And we are a normal grocery store. Anybody can come in there. We welcome everyone. It is not set up for people with a low income. It is a shopping experience. It is bright and colorful. It is dignified, enjoyable. Let's go look at all this beautiful produce. Daily Table dedicates a third of its footprint in each store to produce. Think about any grocery store you go into. That is not the case. We are focused on healthy, beautiful, fresh food. So, it's produce. It's proteins.

And then finally, we have a commissary kitchen in our Dorchester store. It serves all of our stores, and we make healthy meals. A lot of people working two jobs cannot cook for themselves. Don't have the resources. And unfortunately, in many cases, turn to fast food, which isn't even that affordable these days. We make a chicken meal with a big chicken leg and 2 sides starting at $2.99. We have a large garden salad for $2.99. We have smoothies. We have soups that aren't extremely high in sodium. So, we provide healthy, tasty, prepared meals alongside fresh produce.

If you can cook it, it's the ingredients are there. If you can't cook it, we cook it for you. And so Daily Table, our mission and what we do every day, is ensure that healthy food is truly affordable to everybody.

This is really a useful way of hearing about what Daily Table is. As someone who used to live in Boston, I would visit the Dorchester store. And I remember all they asked is to tell us what zip code you're from and we would go shopping.

We don't even ask that anymore.

Oh, you don't even ask that anymore! That is awesome. And, you know, what's great it was easy to take my very young daughter at that time into the store and feel good about what we were getting. And my wife was like, can you believe these prices?

In a good way!

In a very good way. And so, it was always a positive experience. And it was great to know that there were people in that local community that were in the store. That were part of the staff. And it was a great place to visit. So, I'm glad to be able to connect with you on this. But I got to ask this question, how did a software engineer all of a sudden end up in a nonprofit grocery store? What happened? What drew you to this work?

Well, it wasn't all of a sudden, but it was definitely a path. I met my husband when we were working at Nokia. I was in product management at the time. And in 2005, he quit to start an organic farm. A dream he'd always had. Went to it full time, that's how he makes his living. And he'd always had a big garden and just been a food person and I learned through him. I'd work with him on the weekends and getting the farm started and go to farmer's markets with him. And I, I discovered food in a way I'd never really understood it. I fell in love with it. I fell in love with the way that food creates community. I mean, it is the center of community. It's how we show love. It's how we come together over holidays. But to work with my husband creating this really beautiful produce, healthy, and to share that and just, just at a farmer's market, see how people come together that don't know each other. And 'how do you use collard greens? Or what is this vegetable?' It was just life. It was just life and I wanted that. So, I quit in 2009. I worked with him on the farm for a couple of years while I went back to school just to expand my network and nonprofit and other things. And in 2012, I began as an executive director of another hunger relief organization. And what was amazing, what is amazing to me, whether it's at a food pantry or Daily Table or a farmer's market, it is the same experience. It is people coming together around food and sharing. And it is beautiful and it, it creates healthy communities. It's not just nourishing us physically, but that's critical. By the way, healthy food is the cheapest form of healthcare. If we would just invest in that. But it also nourishes a community. It's mental health. It's sitting around the table with your family. It's cooking. It's not being hungry. And so, to go from the one extreme of a local organic farm in a farmer's market that isn't cheap. You know, my husband isn't making money off of it. He's not getting rich, but the food, it takes a lot to grow food.

So, to go from that experience and bringing together people who can afford farmer's market prices and seeing that same experience in a food pantry or at Daily Table, it is, it's about food. It's not about money and it should be accessible to all. It is really amazing. I loved the two years on the farm and bringing access to local food to people. And to now do that to folks who otherwise simply couldn't get access to healthy food. It's, it's just an incredible honor to be a part of that.

Thank you for sharing that. And thank you for sharing part of your story. I'm interested to go back to Daily Table and understand how is it different than other nonprofit organizations, especially in the food justice space? Help us to appreciate that you gave us a bit of an idea when you were talking about comparing it to food pantries. But I'd like to hear sort of more of your thoughts on that.

Well, my thoughts are not so much are how are we different, but how do we fit into the emergency food system? One of the beautiful things... I'm in Cambridge, Massachusetts, Daily Table is at Cambridge and Boston and Salem. And I've worked now for 12 years in this field in Northeastern United States, Massachusetts. And what I've discovered is there is a network of food justice, hunger relief organizations. And we are an incredibly large community of people that care about the same thing and working together. So, we need a lot of different solutions. SNAP, as you mentioned, the supplemental nutrition access program, that is hunger relief, right? That lets people have access to purchasing food. Then there's Daily Table where you can use your SNAP benefits to buy produce. To buy very healthy food at very low prices. Then there's a food pantry for people that perhaps don't even have access to SNAP. They can go to a food pantry and access food, or people can shop at Daily Table and supplement what they're buying a Daily Table at a food pantry.

We work with an organization called the Boston Area Gleaners that uses volunteers to rescue food off of farms. And has their own farm now and grows some produce that we sell at Daily Table. We work within a network of different types of food justice organizations that are serving people in different ways and meeting them where they are. We work with Fresh Truck, which is a mobile market that goes into communities with a truck with fresh produce on it, right? So, all of these things are necessary. I would say Daily Table is absolutely critical to serving all of those people who are not comfortable getting free food. The last organization I worked for was called Food for Free, and it was wonderful, and it served hundreds of thousands of people. But there are hundreds of thousands of people that are not going to take food for free and Daily Table assists folks in that way.

Yeah. I am really appreciative of the way you've talked about this. And sometimes I get a sense that there is competition in this space. And what you're talking about is, no, we're actually all part of a large network and that we're serving different needs and that we are stronger together. Finding ways of collaborating and giving people options and in the community. I find this really encouraging. Thank you. I'm so excited to hear more about this and to think about what that means as we go beyond the Boston area. Beyond the Northeast. And talk about replication, but I don't want to get ahead of myself. I've got to ask. This can't be easy, I mean, to offer these products at the low prices that you do and the fact that they're all nutritionally oriented. And I'm interested to learn what are the challenges of providing and doing the work that you all do at Daily Table.

There are many, but they are luckily balanced by the joys of doing the work. One of the ongoing challenges is fundraising, right? We are a nonprofit. We work with local partners, and they give us deals in many cases. Little Leaf Lettuce, this incredible hydroponic lettuce grown out of Devons Massachusetts, ensures that we can have the absolute lowest cost little leaf at our stores every day. The same stuff you could buy at Whole Foods for twice the price. So, that's some of it, but we buy a lot of our food from a distributor, just like anybody else. And as we all know, there has been tremendous food inflation since the pandemic. And that has made our costs go through the roof. And we have not been able and not wanted to pass those costs onto our customers, so we are a nonprofit and we have to raise money. And that's that's part of why you feel like there may be competition, right? All of these nonprofits rely on the community. We rely on foundations. So, it is always a challenge for us to ensure we are continually investing in letting people know we're a nonprofit. That can be hard. We're a grocery store. We make two thirds of our revenue through store sales. That's incredible. Every time you shop there, you're giving to our organization. But we need to raise a third of our revenue through philanthropy. So that is an ongoing challenge. And more specifically, we have had this amazing program called Double Up Food Bucks. Which means people shopping with SNAP can get half off of produce. And it is incredible to see, as we launched that program, how much SNAP shoppers increase their produce spending. It just showed if food is affordable, people will buy it. If healthy food is affordable. Unfortunately, at the end of September, we lost funding for that program. And we had to pause it. We were able to keep it going in Cambridge, thanks to funding from the city of Cambridge. It has been devastating to our clients who have come to rely on not only low-cost vegetables, but being able to get twice as much as the dollar would normally get. Luckily, we did a GoFundMe, and we had tremendous response from people. And now the city of Boston is willing to step up and help us fund that. I'm hoping, fingers crossed, that that program relaunches in the next week or two. But that is another program that's going to require ongoing funding. And it's a challenge for every nonprofit, I think. I feel confident that if we get the word out about Daily Table, it's an exciting organization to support. And what's wonderful is you can support it by going there and getting great prices on healthy food.

I am encouraged by how you all are thinking about these challenges and how you're finding innovative ways of expanding the work that you're doing. And I got to say, when I was in Boston, I lived in Somerville. I was there at the grand opening of your second location. I didn't realize that you all have expanded.

Yes. Dorchester is 2015 and then Roxbury, which you just referenced and Nubian Square opened in 2018. Then in 2021, January, I remember I was there. It was in Cambridge, and I knew I knew the founding was happening, and I was at the ribbon cutting. We all had our masks on and we were standing 6 feet apart, but Central Square Cambridge opened. And then last year in September, we opened Salem, Massachusetts, which was up on the North Shore. Our first non urban store.

I mean, you clearly have figured out how to make this work. You're overcoming some of these challenges. But some challenges still exist because of the need to continue to fundraise. You know, I'm interested to know, where do you see Daily Table, the network of organizations, going into the future? And I've just got to ask, how are you thinking about expanding?

Sure. Some people don't know, Daily Table was founded by Doug Rauch. And Doug Rauch was the former president of Trader Joe's North America. And when Doug was at Trader Joe's, it was a small chain on the West Coast. And Joe, the CEO, asked Doug to head out to the East Coast and see if he could get a foothold for Trader Joe's here. And that's what he did. And now, as many people know, Trader Joe's is all over the country. And that is our dream of Daily Table. I mean, it is... it is needed in so many cities in Massachusetts. In every single state in this country, and in so many cities in every single one of those states. We have received outreach from throughout Massachusetts from California from Denver from Texas from Maine. And so, we absolutely believe that a Daily Table should exist everywhere across this country, deeply in Massachusetts and in other states as well. And our hope is in, you know, the not-too-distant future, to open a store outside of Massachusetts to show people this is not a Boston based thing. This is what can be a national solution. And then to over time start to expand throughout Massachusetts and throughout the country. Now, that requires funding as we know. But I think with the outpouring we've seen from different states and cities saying, we want this, we believe that it is possible to find that funding. And to really expand our network across the United States over the coming years and decades.

BIO

Sasha started her career as a Software Engineer and spent 15 years in the tech industry in Product Management and Management roles. In 2005, she helped her husband launch an organic farm and through that experience discovered a true passion for food and its ability to nourish not only one’s body and soul, but communities as a whole. Driven by this new passion, she left tech in 2009 and, after acquiring her MBA in Organizational Sustainability, went on to lead Food For Free. Over her 10 years as the head of the organization, she transformed it from a small, grass-roots program primarily serving Cambridge to a regional leader in food access. She has long admired Daily Table and was honored by the opportunity to join the organization as CEO in early 2024.

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On our podcast, we have often talked about the Supplemental Nutrition Assistance Program, or SNAP. In many of those conversations, we've talked about the benefits and eligibility, and ways to improve the work that SNAP does to help low-income families meet their food needs. In today's podcast, we're going to turn our attention to a particular challenge, and it's the SNAP skimming fraud. To help us understand this and the larger context of SNAP, we have the great pleasure of talking with Salaam Bhatti, who is the director of SNAP at the Food Research and Action Center, or FRAC.

Interview Summary

So, let's provide a little bit of level setting for our listeners. Can you tell us what role SNAP plays in the lives of individuals who are facing low income or food insecurity?

Yeah, Norbert, the problem with being in the richest, most powerful nation in world history is that we are facing a food and hunger crisis. We have the means, we have the resources to solve for it, but we haven't. For the record, the USDA, the United States Department of Agriculture, did a study last year. They do this study every year where they report food security in the country. In 2023, 86.5 percent of U. S. households were food secure. The remaining 13.5 percent, which is 18 million households, were food insecure. And this was an increase from 2022. So, 86.5 percent of food security is barely a B+. To be in the most powerful wealthiest nation in the world and we're barely getting a B+ in this space is unacceptable. And so, we saw some really interesting policies happen during the pandemic. We saw emergency allotments come in for the SNAP program, where all households received the maximum benefit amount for their households. And that, unfortunately, sunset. When that emergency allotment was in place, food insecurity-surprise, surprise-decreased. But not just that, we also saw Medicaid healthcare spending costs decrease as well. Because who would have thought that when people had food security, they didn't need to go to the emergency room because their blood sugar was low. So, we're experiencing a lot of challenges where we've seen the government show its hand that it can end poverty. It can end hunger. It just chooses not to.

We know that SNAP is an entitlement program. It's available to anyone who meets the eligibility requirements. But we know that everyone who's eligible doesn't participate in the SNAP program. Can you help us think about how more people can be enrolled who are eligible. And maybe we even need to think more broadly about what is eligibility? What are your thoughts about this?

In a given month these days, about 42 million people participate in SNAP. That's a lot of people. I would say that 42 million people are participating in it every day, but unfortunately, SNAP benefits do not last the whole month. By the third week of the month, people's SNAP benefits have been exhausted.

Now, taking a step back, in case the listeners don't know how SNAP benefits work, it's a, as you said, a government program. And it comes in the form of an electronic benefits transfer card, an EBT card. It looks like a credit card, looks like a debit card. But really, it's more like a hotel card key, because it doesn't have the security measures, which we can talk about later in the show. It doesn't have the security measures that a credit and a debit card have. It is essentially a glorified hotel key. It's got the magnetic stripe on the back, circa 20 years ago. Maybe 15. I'm dating myself. I don't know how long ago it was we were swiping the cards. But all you gotta do is you swipe the card and you type in your PIN. And then you can use it at the EBT retailer. That is in a nutshell how 40 million people are utilizing SNAP benefits every single month.

The program itself is also vital to retailers as well. We've seen that every dollar of SNAP benefits generates about $1.54 in economic activity during an economic downturn. So that means that when somebody is using their SNAP benefits at the grocery store, it's helping that grocery store keep the lights on. You know, employ the cashiers. And we need to employ cashiers, enough of this self-checkout stuff. It helps to pay the truck driver who's transporting the produce to the store. And it ultimately even helps pay the farmer for growing the crop. So, it's a great investment from the federal government into not just our households to help them put food on the table, but really into the whole local economy. And it is immediately used directly by the people and helps so many people.

Now so, to your question about how do we enroll more people? Well, luckily we are at a time where the USDA reports that in the fiscal year 2022, 88 percent of eligible individuals were participating in SNAP. And that is the highest participation rate we've seen since they started tracking this in the past 50 years. That's great. But again, it's just a B+ so we can do better. There is room to improve. In the study, it showed that older adults, those who are over 60, they're participating at lower rates with only 55 percent of eligible members in that age category participating. We also have so many military families and veterans who are eligible, but don't participate.

This SNAP gap is something that our partners are working throughout the states, throughout the entire country. We're working in partnership with a lot of federal agencies and partners as well. So, how do you ultimately close the SNAP gap? We're seeing a lot of targeted outreach. Seeing a lot of education efforts, but, you know, with 88 percent of eligible people participating, what's going on-on the local level? And unfortunately, Norbert, we've seen that state agencies which administer the SNAP program are unfortunately understaffed and they're underfunded. I used to be a state advocate at the Virginia Poverty Law Center. And when I was, hustling in the halls and lobbying for a million households with low income, I became friends with our social services agency because we had similar goals. We wanted to help households with low income. And we came to learn that the agency that we are relying on to administer the program was never getting their budget met by the legislative assembly. So, what we did was we got into partnership with them to advocate for their budget so that they could retain their staff, and so that the staff could do the job. That is something that we have to do across the states. Support these social service agencies in getting the funding so that they can have the staffing so that they can administer the programs in a timely way.

Unfortunately, I don't know if you've seen this but earlier this year, the USDA Secretary Vilsack sent out a letter to like 44 state agencies, including D. C. and Guam. Being very concerned about their timeliness issues because they're supposed to complete the application reviews and determine eligibility within 30 days. And that's for a normal SNAP application. You have seven days for expedited applications. And 44 of these agencies were not meeting the mark. That's bad for, in terms of deadlines, but even worse for the families experiencing the food insecurity. So that is a very layered answer. It's the seven-layer dip answer of how we increase participation. Well, we need more staff to, to help that out.

I hear that, and I'm really grateful for how you hit it at this point, and I want to draw a little more attention to it. While you talk about 88 percent participation, it looks different on a state-by-state level. Some states have a higher level of participation, other states don't. Do you think it's really the ability of those state agencies to provide that support, or do you think there are other factors that may be influencing the differential participation rates across states?

Yeah, so we saw a big retirement, the great resignation, that happened during the pandemic. There were so many state agency employees, you know, who were, who were doing the job because they were passionate about it. They were also at retirement age. So, we saw quite a resignation happen. Because it was incredibly difficult. It was traumatizing to be involved in this space. And so, they resigned, or they retired, or they moved on to somewhere else. The new workers came in and they learned the programs with the flexibilities that were provided during the pandemic. Now, they have to relearn the program because all those flexibilities are gone. So, we're seeing a lot of administrative burden taking place within these agencies.

I have a colleague, Carolyn Barnes, who's worked on this idea of administrative burden and the challenge of what's sometimes referred to as street level bureaucrats. The people who are on the ground who do the administration of these programs and the challenges that they face and the ways they engage folks. I appreciate hearing more about this. And I'm going to ask a potentially controversial question then. What if we took that responsibility out of the hands of state agencies and privatized that? What would that look like?

Oh, and people have tried that. Governments have tried that, and it's always resulted in net losses. Not only has it cost the states more, but it has also led to the participants not receiving their benefits, or receiving less than, or receiving an error of more than. So many errors have resulted, which has made the program and administration worse. Which is an interesting question because a lot of people don't know that there are skilled employees at the helm within the agencies that are working on these eligibility determinations. They're known as merit-based staff. And every now and then you'll see a Farm Bill, that's the piece of legislation that houses the SNAP program, it'll come in and they'll try to privatize parts of the program. In the guise of, 'Oh, we're just wanting to help the agencies out and get the benefits to the people.' But listen, the several states that have privatized their benefit programs have learned the hard way and they've done away with those privatization efforts.

Okay. I want to turn our attention to something that you hinted at, and we talked about at the top of the program. This idea of skimming or the SNAP skimming fraud. And this is not something that participants are doing. It's something that's happening negatively to participants. So, could you tell us a little bit more about this skimming issue?

You know, skimming is a very serious problem that has affected all types of consumers. It's a device that gets put on the point-of-sale system, like that thing that you insert your card into or swipe at the checkout. And it's indistinguishable from the actual point of sale system. You could have a trained eye and still not be able to tell that this point-of-sale system has been compromised.

So, what happens is when somebody uses a compromise point of sale system, their information, their card number, their pin is all taken. And within the same day, within an hour, you'll see the benefits are extracted. Usually in an entirely different state, and just the account balance is completely wiped out. The SNAP participant does not find out. If they don't check their account balance, they won't find out until the next time they're at the grocery store and they've done their, you know, 30 minutes of 45 minutes of shopping, with their kids in tow, and they've put everything on the conveyor belt and they're checking out and they swipe their card. And it says your payment is declined. And that is an awful harrowing situation that people are subjected to in the richest nation on the planet. They can't even use their government benefits to put food on the table. And then the process that currently exists to replace those stolen benefits is a lot of administrative burdens there as well. Where you have to you go home without the food, you fill out a piece of paper to say what happened, and then it takes weeks for you to get your benefits replaced. And God forbid that this happens to you more than twice in one year because the current resolution from Congress only allows two benefit replacements every year.

But I mean, Norbert the question might be, who's stealing all this stuff? And why aren't the states doing something about it? Or why isn't the SNAP participant doing more to protect themselves? What we have to understand is that there are federal authorities, the FBI, are looking into this. They are investigating this because tens of millions of government dollars have been stolen. Over 120,000 households have been affected. This is big. This is bigger than the SNAP participant. This is bigger than the state. This is bigger than the retailers. And so, there's a lot for the federal government to do not just in replacing the benefits. Because that's you know, you we have a hole in the boat and we can't throw money at the hole. We need to fix the hole. So, what are we looking at here? We're looking at the opportunity to Secure our cards, secure the EBT card, by moving to chip. So, that is the next big thing

You know what I appreciate out of this conversation is the experience of individuals who are using their SNAP benefits and they go to the store and the pain of discovering that their SNAP benefits have been expended. Not by them, but through some other means. I know the experience of having identity theft and, losing a credit card and not being able to do it. But I'm not in a situation where that means I'm not able to put food on my table. So, thank you for bringing our attention to the individual tragedy of that experience. And I think that's something important. But what you're also hinting at is that this is not some small-time incident. This is something much bigger. And of course, the federal government has a deep interest in trying to address this issue. And there needs to be some fix. And how this fix occurs also needs to be cognizant of the individual experience of low income individuals who are just struggling to make sure that they're able to solve this food problem.

Yeah, you were talking about identity theft and when identity theft happens in the private sector things are resolved pretty quickly. If your credit card is hacked, nowadays you can just go online and say dispute charge and everything's taken care of within 24 hours. But can you imagine like not getting food benefits, like your debit card, your bank account being emptied, and you don't get everything back for weeks. It's mind numbing. It's really awful to think about.

You've mentioned some technology fixes. And seems like they're pretty well known, the chip technology. Are there other fixes or in terms of technology or security systems that could help prevent this skimming challenge?

One of the other challenges we're facing with the skimming is that the replacement benefits are temporary, it's going to expire on December 20th of this year (2024). And this is an extension that happened after the original replacement benefits, which was just under two years. These short-term fixes, or these short-term replacement benefit strategies are not what we need. We really need a permanent replacement benefit because no matter how secure the card gets, criminals are just going to be creative, and they will attack every single type of card as they continue to do with chip cards. Because we're talking about skimming, there's also something called shimming. S H I M M I N G. And that's when the point-of-sale system isn't compromised from the top, but from within, where you insert the card. That's shimming. So, that's something that exists as well. Chip cards will go a long way to decreasing the benefit theft when chip cards rolled out in the private sector it reduced theft by like around 90 percent. We're hopeful and optimistic that similar patterns will emerge there. But that's of course not 100 percent. It's not AA+++ It's a reason for why permanent replacement benefits need to continue. When it comes to chip card benefits, your listeners might be like, wait, wait, wait, this is 2024. We still have cards that haven't gone chip? It's because there's so many layers in the financial sector of what's going on the back end of these cards. So thankfully there was this massive process known as the x9 process where the entire industry came together. All the card manufacturers, grocers, convenience stores, retailers, banks, us humble nonprofits, and we came in to talk about what needs to be done. And so, they finally released the standards just over a month ago. And now we have two states in the running California and Oklahoma to roll out chip cards in the new year. All eyes are on Cali and Oklahoma to see how it goes before, I guess other states are going to hop on. The chip card is going to be the next big thing in the SNAP benefits world.

Thank you for sharing this. I want to ask you one additional question about this technology issue. And it's related to a project I'm working on. It's the idea of online grocery shopping and the expansion of the SNAP benefits for online grocery shopping. And I'm wondering if there's any relationship between what you're seeing in skimming and the ability to use online grocery shopping. Or are these completely disconnected?

I haven't seen anything regarding theft online, it's all been physical. We are seeing some promising things coming out of online shopping, especially for people who are living in areas without food access. Once we can bridge that gap of getting fresh food, like the produce and meats and chicken and fish, to people who are far away from grocery stores, then we've found the magic solution. But it's a promising trend on the online delivery space.

Oh, that's awesome. I want to ask you just more generally about SNAP and where FRAC is right now. Where are you all thinking about in this space? And then what are ways that you can get just regular everyday people to help in the policy work of eliminating food insecurity?

For more than 50 years, FRAC has been working to improve health, nutrition, and the well-being of people who have been struggling with poverty related hunger in the United States. Now, we have made tremendous strides in the fight against hunger. We've played a critical role in expanding SNAP. We've secured increased benefits for households with low incomes through landmark legislation, litigation. But unfortunately our work is far from over and we are really trying to work ourselves out of jobs. We cannot do it alone. We really need all hands on deck, especially as we are seeing in this upcoming Farm Bill effort some cuts that are being suggested or offered to SNAP benefit. We really need all hands on deck to protect this program. To build a nation free from hunger we encourage your listeners to go to frac.org, frac.org. Sign up for our action network and urge your members of Congress to prioritize ending hunger in America. Now, I know that oftentimes we're not sure what we should be saying to our Congress members. Our action network tells you all the things and it helps you really quickly and easily customize templates. Send in your own messages to your members of Congress. And also learn about hunger in your state and the solutions that exist as well. So, what will it achieve for you at the end of the day? Your efforts will advance bold and equitable policy and program solutions. And provide technical assistance and training to thousands of anti hunger advocates across the country, because we're collecting your stories. And your stories help impact Congressmembers. It helps us win their hearts.

Bio

Salaam Bhatti joined FRAC in November 2023 as the SNAP Director. In this role, he works to strengthen SNAP access and benefit adequacy. Salaam works closely with the Interim President to develop, lead, and track annual work plans; set and meet unit goals; collaborate with other unit Directors to assist in achieving FRAC’s strategic plan goals; and expand the unit’s innovation and work. Salaam joined FRAC after working at the Virginia Poverty Law Center (VPLC). While at VPLC, he successfully lobbied to fully repeal the drug felon ban for SNAP and TANF, twice achieved record increases to TANF cash benefits, subsidized reduced-priced school meals, repealed the TANF family cap, ended lunch shaming policies in schools, and received a unanimous vote to expand SNAP for over 20,000 families. Salaam also helped develop a mobile-friendly, SNAP screening tool which is used by tens of thousands of people & multiple non-profits and has been rolled out to be available for all states and D.C. He received the Young Alumni Achievement Award from Albright College for his work in alleviating poverty and promoting Muslim-Jewish relations. Salaam also received the inaugural Stuart A. Freudberg Award for Regional Partnership for his work with Maryland and DC Hunger Solutions to address food insecurity across the metropolitan Washington area from the Metropolitan Washington Council of Governments. Salaam has a J.D. from Touro Law School, is barred in New York and Virginia, and received his Bachelors in Political Science and International Relations from Albright College (with a year abroad in the University of Aberdeen).

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For many years in talks that I gave, I showed a slide with an ingredient list from a food most people know. Just to see if the audience could guess what the food was. based on what it was made of. It was very hard for people to guess. A few people might come close, but very few people would guess. And it was pretty hard because the food contained 56 ingredients. This is in one food. And the ingredient list had chemical names, flavorings, stabilizers, and heaven knows what else. But 56 things in one, just one food in the food supply. Pretty amazing to think what kind of things we're bombarded with in foods we eat in our everyday lives. So, one key question is do we know what all this stuff does to us, either individually or in combination? So, how does ingredient 42 interact with ingredient 17? Even if we happen to know what they do individually, which we may not. And, who's looking out for the health of the population, and who has regulatory control over these things? Today we're joined by the author of a new article on this topic published in the American Journal of Public Health. Jennifer Pomeranz is an attorney and is Associate Professor of Public Health Policy and Management in the School of Global Public Health at New York University. The food, by the way, was a chocolate fudge Pop Tart.

Interview Summary

So, who has regulatory oversight with these things that are added to foods?

The FDA has the authority over all of those packaged foods. So, Pop Tarts, all of that type of packaged foods and the ingredients in there.

Can you explain the nature of their authority and the concept of GRAS and what that stands for?

Yes. So, there are two main ingredients in our food, but there is also color additives and other things that we didn't get to in our study. But the two main ingredients are called 'food additives' and then 'generally recognized as safe' or GRAS substances. And these are the two ingredients that are in all the processed foods. They're both complex substances, but they're regulated differently. GRAS is assumed to be safe. And food with GRAS substances is presumed to be safe as long as there's a generally agreement among scientists that it's safe, or if it's been in use in food since 1958. Food additives, on the other hand, are presumed to be unsafe. And so, foods that have food additives must have the food additive be approved for the condition of use. So actually, the FDA issues regulations on the food additives.

Is it true that the FDA authority covers lots of these chemical type things that get put in foods that we discussed? But also, things that occur naturally in some things like caffeine?

Yes. And so, caffeine is considered GRAS or generally recognized as safe. The FDA has a tolerance level for cola-type beverages for caffeine. It actually doesn't enforce that as you see, because we have energy drinks that far exceed that type of level. So, there's different types of GRAS substances. But they can be very complex substances that are actually not so different than food additives.

Who decides at the end of the day whether something's safe or not? You imagine this battalion of scientific experts that the FDA has on hand, or consults with, to decide whether something's safe or not. But how does it work?

Unfortunately, that's not exactly the case. When it comes to food additives, the industry must petition the FDA and provide evidence showing that it's safe. And the FDA promulgates a regulation saying that it agrees it's safe and it can be used for the things that it set forth in the regulation. For GRAS, there are two mechanisms. One is the industry can notify the FDA that it thinks something's safe. And then it actually goes through a similar transparent process where the FDA will evaluate the evidence submitted. Or, shockingly, the industry can actually decide that it's safe for themselves. And they don't have to notify the FDA. And they can add it to their food without the FDA or the public actually knowing. Now they might disclose this on a website or something, but it's actually not even required to be based on peer reviewed literature, which is actually one of the concerning aspects about this.

Concerning is polite language for what one might call shocking. So, in the case of some of these things that go into the food, the industry itself decides whether these things are safe. And in some cases, they have to at least tell the FDA that something they declare as safe is going into the food. But in some cases, they don't even have to do this.

Right. So, they only have to if they've determined that it's a food additive. But actually, the industry itself is deciding that it's a food additive versus GRAS. Once it made the decision, it's GRAS, it doesn't even have to notify the FDA that it considers it safe. If they do, they are supposed to rely on their own research saying that it's safe. But actually, there's some alarming parts about that as well. The other outside research that's not my own found that the panels of experts that they employ, 100 percent of the people on those panels have financial conflicts of interest. So, that's already worrisome.

They're receiving money from the food industry in some way.

Yes. To say that the ingredient is safe. Another scary part is that if they do notify the FDA and they're not happy with how the FDA is reacting to their GRAS notification, they can actually request a cease and desist. The FDA will issue a cease and desist letter, and then they can actually go to market with that ingredient.

Pretty amazing. Like loopholes that not only a truck can go through, but a train and everything else. That's really pretty remarkable. So one could say that the risk built into this system is hypothetical, and it works pretty well. But is that true? I mean, are there cases where things have gotten through that probably shouldn't have? Or is it just that we don't know?

I think there's a lot of unknowns. The Environmental Working Group does that research and they have identified things that they find to be concerning. A lot of it is that we actually don't know what we don't know, right? So even the FDA doesn't know what it doesn't know. And that is, is part of the concern, that you can't just identify this by looking at the nutrition facts label where they list ingredients. Sometimes they just use terms like spices, flavorings, colorings, chemical preservatives. But that could be masking an ingredient that has never been examined and for which It's unclear that it's actually safe.

I know there have been some policy efforts in places such as California to prohibit use of some of these things that have otherwise been considered safe by the FDA, or perhaps just by industry. Is that true that's happening more and more?

Yes, actually there has been. Because of the gap in the FDA's oversight, we are seeing states, and it's actually a pretty shocking situation, that California banned four ingredients that the FDA did not. And it's saying that those ingredients are not safe to be in food in California. And given what a huge market California is, the thinking is that the industry will have to change their ingredients across the nation. And frankly, they've already taken those ingredients out of the same foods in Europe, where those ingredients are not allowed.

So how much do you trust this self-policing by the industry?

To be honest, I'm quite concerned about it. The FDA has the authority to review substances post market, so after they're already in the ingredients. But we see that it can take years or even decades. In the case of, remember, partially hydrogenated oils, which were artificially produced trans-fat. It took decades for them to get that removed from the food supply, despite significant research showing that it had caused health harm. So, even when there is evidence of harm, it takes quite a long time for the FDA to remove it. And in the case of another ingredient recently where California banned it, then the FDA decided to ban it. So, it does worry me that even their post market authority is not being utilized to the extent that it should.

Let's think about what a good set of defaults might be and how this might actually play out in practice. If you'd assume these things that go into foods are not safe by default, then the question is what would it take to make sure they're safe before they're allowed in the food supply? And it would take toxicology studies, studies with lab animals perhaps, studies with humans. I don't know exactly how these things are tested, but one can imagine it's not an easy or a quick process. Nor probably an inexpensive one. But somebody would have to do it, and if government can't do it, you can't rely on industry to do it. I wonder if the default might be fewer things in the food supply and whether that might not be a pretty good thing?

I love that you said that because that's the conclusion I came to as well. Why do we need all these new ingredients? We already have ultra processed foods, which are by definition contain all these ingredients that we don't really know what they are. And why do we even need new ingredients? I think they could even put a moratorium on new ingredients and say, let's take a, take an analysis of what we've got in the food supply at this point. And to be honest, it would take Congress to act to change FDA's authority to give them more authority to do what you just suggested. And of course, resources, which would be personnel like you described.

So maybe that chocolate Pop Tart that has 56 ingredients could get by with 41 or 32 or 17. And you know, maybe we'd be just fine having it with fewer ingredients. One interesting thing that I've heard about, but I'm not an expert in because my background isn't law, is I know it's possible for outside parties to bring lawsuits against government for failing to execute its duties. Has there been any talk about possible lawsuits taking on the FDA for failing to protect the public's health with regard to these things?

Well, actually, there was a lawsuit already. These consumer protection organizations sued the FDA, arguing that they weren't protecting the public. And that they were actually ceding authority to the industry, which, they by definition are. But according to the law, because Congress didn't require them to review these ingredients pre market, the court found that the FDA did not violate the Food, Drug, and Cosmetic Act. And so, they were operating according to the law. But also, to your point, I could see other lawsuits would be possible about them not actually exercising their post market authority to protect the public. Those could be from private lawsuits or a state attorney's general. There are different ideas there.

So, what do you suggest going forward?

You know what? Don't eat the Pop Tart. I think you got to avoid the many truly ultra processed foods and go for the lower processing levels. It's kind of that original advice. If you can't understand the ingredient list, maybe pick something different. And there are options within the same categories, right? There are potato chips that have three ingredients and there's potato crisps that have something like 12. So there are different options in that way.

Bio

Professor Jennifer Pomeranz is a public health lawyer who researches policy and legal options to address the food environment, obesity, products that cause public harm, and social injustice that lead to health disparities. Prior to joining the NYU faculty, Professor Pomeranz was an Assistant Professor at the School of Public Health at Temple University and in the Center for Obesity Research and Education at Temple. She was previously the Director of Legal Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. She has also authored numerous peer-reviewed and law review journal articles and a book, Food Law for Public Health, published by Oxford University Press in 2016. Professor Pomeranz leads the Public Health Policy Research Lab and regularly teaches Public Health Law and Food Policy for Public Health.

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I don't know about you and your household, but in my home, we have a long history of opening the refrigerator and discovering pasta sauce or mayonnaise that we don't remember when it was put in the refrigerator, when we last opened it, and we're confused. We open the container; we smell it; we check out the date label. And if we're confused, we have a mantra: when in doubt, throw it out. But aren't those date labels supposed to help us make good decisions about whether or not a food product is safe? Currently, there is no federal regulation on what those labels should say. Best Buy, Use Buy, Sell Buy, or what have you. However, there is legislation in the Congress called the Food Date Labeling Act to help us address this issue. And today's guest, Regina Harmon, will help us explore this particular issue. She is the executive director of the Food Recovery Network, the largest student led movement fighting food waste and hunger in the United States.

Interview Summary

First, some of our listeners may not be familiar with the Food Recovery Network. Could you tell us more about the organization and what it hopes to accomplish?

Absolutely. Thank you so much. Food Recovery Network was started in 2011 by college students at the University of Maryland who saw a couple of things happening. They saw a lot of food waste on their college campus, and they also saw a lot of people who were experiencing hunger in their communities. And so, they thought, hey, instead of throwing this perfectly good food away, what we could do is package this food up and give it to those in our neighborhood that we know need some help. And that's how Food Recovery Network was started. They started at the University of Maryland, one dining hall, one carload of food. They started calling other friends that went to different colleges and universities across the United States. And over the last decade and some change, we've grown into, as you said, the largest movement of students who are fighting food waste and hunger. We have about 200 college campuses that have food recovery network chapters. We've recovered over 16 million pounds of food through the power of young people. And today we also help other sectors that would like to also do the right thing with their surplus food. We help farms, we help corporate events, large scale events, we help conferences. You name it, wherever there's surplus food, Food Recovery Network can help make sure that food doesn't go into landfill and helps feed those in need.

I would love to hear a little bit about who you are able to serve through the Recovered Food. Are you working with food banks? Are you working with the pantries directly? Tell me a little more about that connection.

It's a beautiful connection. We have about 400 nonprofits all over the United States. That directly receive the surplus food that we donate. We go to the sites where the food is. So again, in college dining halls, large scale events, you name it, and that food is packaged up safely. And then it's brought to what we call hunger fighting nonprofits. These are nonprofits on the front lines in all of our communities that are in some way feeding our neighbors in need. These are homeless shelters, soup kitchens, food banks. These are domestic violence shelters. These are afterschool programs, churches, anywhere that can also handle the food safely and then distribute it to our neighbors directly. So through that, we've been able to meet so many incredible people, and a lot of times volunteers themselves who work at these incredible locations that again, are just helping those who need support to make their ends meet.

Great. This is really important work. Thank you so much for the work that you all are doing. So, how does the Food Recovery Network activate to end food waste and make a positive impact on the environment?

There's a lot of things that are happening here. You know, millions of tons of food is wasted every single year. And I know we'll get into the Food Date Limiting Act in just a moment, but every part of our food system, there's food waste. On farm fields, during transportation, at supermarkets, in our own homes. And so, a lot of times, most of the time, the majority of the time, all of the food that is wasted is actually thrown into landfills. You know, we see those images of whole entire tractor trailer trucks of food being dumped into landfill. And that is the problem. The majority of food, much of which is still perfectly good to eat, perfectly good to consume, is being driven into landfill, where it then is covered up, it begins to rot, and this is where the environmental harm starts. The food rots, and it creates additional CO2 into our environment and other greenhouse gases that is really difficult for our environment to reabsorb because it's happening at such an increased rate. And that is directly causing what we now know as global warming.

Food all across the United States, all across the globe, is the third largest emitter of CO2 gases. And so that is the environmental issue that Food Recovery Network is addressing. It's directly harming our atmosphere. But then when we take that step back and we think about all the water it took to grow these plants, all the fuel it took to transport the food, all the fertilizer it took to put into the soil. All of those precious resources are also wasted, and we need to reclaim those resources year after year after year for food that ultimately we are going to throw away, have it cause harm by rotting and going into our atmosphere in the form of CO2 gas. So, it is a really disturbing cycle. Our mission is to recover surplus food to feed everyone who is hungry so that precious food isn't going into landfill unnecessarily and causing all of that environmental harm.

Yes, this is what I find really critical about the work that you all are doing because of the greenhouse gas emissions from decomposing food and landfills is really problematic, but I'm so grateful for the way you talked about how there are losses, if you will, all along the supply chain from on the farm to the final consumer. I remember even talking to a farmer in Virginia who said, it really breaks his heart to see food wasted. He put a lot of effort, his blood, sweat and tears into that production to see it wasted was just disappointing. And that's going beyond the environmental costs to just thinking about the value of someone's labor. I really appreciate what you all are trying to accomplish. But it sounds like you all are involved in the day-to-day work of preventing it from going into the landfill and trying to get into the hands of people. How is it that you all are involved in policy? I'd love to hear how you all are thinking about date labeling and the law that is in the Congress to try to address this challenge.

Thank you so much, Norbert, for that question, because, yes, we are here to feed people through recovering food and donating it and helping our neighbors and being in community with our neighbors. That absolutely must happen. There's 47 million people who are food insecure all across the United States. We all know somebody who is food insecure. We might not know it. But we do. 47 million people. So that act of not wasting our precious food and bringing it back further into community is vital.

And then at the same time, Food Recovery Network, we are involved in advocacy to begin to correct a system that allows for this food waste and food loss. At the policy level is where we can really begin to recapture all of this precious food that our incredible farmers across the United States are growing for all of us. So, we got involved with the Food Date Labeling Act several years ago, and it has, you know, come up in our Congress a few different times. And we see this as a beautiful way to help reduce confusion around why food is being wasted in the first place. And in particular at the consumer level - our homes. You know, 80 percent of households at some point, they're going to be confused because of a date label. Again, your story emphasized that so wonderfully because it's something that we've all experienced. About 80 percent of homes are having those same kinds of conversations. The majority of people do believe that date labels are already standardized, and lo and behold, they are not. And so, what we're trying to do, we're lending our voice to support the Food Date Labeling Act, so that we can begin to standardize these date labels. And then prevent millions of tons of food from going to waste in the future every single year unnecessarily.

This is the way that I can imagine doing the work that you all are doing, not just on the physical movement of food, but also thinking about the policies that can help support the work that you're doing. It takes sort of that broad spectrum of approaches to really affect this challenge. But I've got to ask, and I hear your passion. I hear your great concern. Can you help us understand why the urgency now? Why, why try to find a permanent solution to food waste today? What's the impetus?

You're absolutely right, Norbert. The time is now. We are getting many messages. I will speak from the perspective of our students. So, this is Gen Z, Gen X, Millennials, you know, young people that are on the front lines of this movement to say, we can no longer waste precious food. We were all born [00:10:00] into millions of people being food insecure. That's wrong. And we know that we can do something about that. We have the simple solution of at least redirecting our precious food to help those in need. So that urgency is now. People are hungry right now. And we have our chapters all across the United States that are doing a food recovery right now. At some point in the day, there's somebody who is doing the right thing to help say, I can help feed my neighbors in need. There's nothing more urgent than that.

We know all the hardships that come with being food insecure. And then when we think about our planet. That urgency is now. I tell people all the time if we can all get on board together in this wonderful community to say, we don't need to waste food any longer. We have the solutions to no longer throw away precious food, and we can begin to, as you said earlier, I love this. To keep that value of the food every single step in the process from seedling to going into our mouths. If we can keep the value of that food, we can really reduce food going into landfill unnecessarily. And then when we can begin to think about that as how we view food, you know, what other problems can we solve together to make our communities thrive for one another?

But in particular with the environment, the time is now. Our food waste is causing environmental harm. We can mitigate that environmental harm by stopping this dizzying, disturbing cycle of wasting food. We're wasting our potable water. We're wasting our fertilizer. We're wasting fuel, gasoline through transportation. And then this food is rotting and it is causing environmental harm, which is going into a larger, broader system of our storms are worse. Our storms are longer. They're starting earlier. They're ending later. They're in places that they weren't before. This is all part of. the environment that we can help to stem the tide of what we are experiencing as a species. So that's another reason why the immediacy is now. Let's not make this worse for the young folks in our lives. Let's not make this worse for the people who have yet to be born. We can do something now.

This podcast is co sponsored by the Recipes Food Waste Research Network project led by American University and funded by the National Science Foundation.

Bio

Regina Harmon has been the Executive Director of Food Recovery Network since 2015 and has been a pivotal voice in raising awareness and harnessing action to reduce food waste, end hunger, and positively impact the environment. She has been invited to share her insights with media outlets such as CNN and Al Jazeera and was recognized as one of the most influential leaders in the food industry by SELF magazine and Food Tank. Apart from her position at Food Recovery Network, Regina is also a board member of Food Tank and Earth Island Institute, serves on ReFED’s Advisory Council, and is a member of the Philadelphia artists' collaborative Pink Noise Projects. Regina emphasizes the need to address the racial disparities in the food system that disproportionately affect the health and economic outcomes of Black, Latinx/Latine, and Native American communities, highlighting the importance of working together to bring about change. Regina holds an MA in Literary and Cultural Studies from Carnegie Mellon University and a BA in English Literature from the University of Maine at Augusta.

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About two years ago, we released a podcast with Dr. Thomas Wadden of the University of Pennsylvania describing work on a new generation of medications to treat diabetes and obesity. They were really taking the field by storm. Since then, much more is known since many additional studies have been published and so many people have been using the drugs. So many, in fact, the market value of the Danish company, Novo Nordisk, one of the two major companies selling the drugs, has gone up. It is now greater than the entire budget of the country of Denmark. This single company is responsible for about half of Denmark's economic expansion this year. So, a lot of people are now taking the drugs and this is a great time for an update on the drugs. And we're fortunate to have two of the world's leading experts join us: Dr. Wadden, Professor of Psychology and Psychiatry at the University of Pennsylvania School of Medicine and the inaugural Albert J. Stunkard Professor of Psychiatry at Penn. Joining us as well as Dr. Robert Kushner, a physician and professor of medicine at Northwestern University and a pioneer in testing treatments for obesity.

Interview Summary

Tom, you and I were colleagues at Penn decades ago. And I got frustrated the treatments for obesity didn't work very well. People tended to regain the weight. And I turned my attention to prevention and policy. But you hung in there and I admired you for that patience and persistence. And Bob, the same for you. You worked on this tenacious problem for many years. But for both of you, your patience has been rewarded with what seems to me to be a seismic shift in the way obesity and diabetes can be treated. Tom, I'll begin with you. Is this as big of a deal as it seems to me?

Well, I think it is as big of a deal as it seems to you. These medications have had a huge impact on improving the treatment of type 2 diabetes, but particularly the management of obesity. With older medications, patients lost about 7 percent of their starting weight. If you weighed 200 pounds, you'd lose about 15 pounds. That was also true of our best diet and exercise programs. You would lose about 7 percent on those programs with rigorous effort. But with the new medications, patients are now losing about 15 to 20 percent of their starting body weight at approximately one year. And that's a 30-to-40-pound loss for a person who started at 200 pounds. And with these larger weight losses, we get larger improvements in health in terms of complications of obesity. So, to quote a good friend of mine, Bob Kushner, these medications have been a real game changer.

Thanks for putting that in perspective. I mean, we're talking about not just little incremental changes in what treatments can produce, which is what we've seen for years. But just orders of magnitude of change, which is really nice to see. So, Bob what are these medications that we're talking about? What are the names of the drugs and how do they work?

Well, Kelly, this transformation of obesity really came about by finding the target that is really highly effective for obesity. It's called the gut brain axis. And when it comes to the gut it's starting off with a naturally occurring gut hormone called GLP 1. I think everyone in the country's heard of GLP 1. It's released after we eat, and it helps the pancreas produce insulin, slows the stomach release of food, and reduces appetite. And that's where the obesity story comes in. So pharmaceutical companies have taken this hormone and synthesized it, something similar to GLP 1. It mimics the action of GLP 1. So, you could actually take it and give it back and have it injected so it augments or highlights this hormonal effect. Now, that same process of mimicking a hormone is used for another gut hormone called GIP that also reduces appetite. These two hormones are the backbone of the currently available medication.

There's two on the market. One is called Semaglutide. That's a GLP 1 analog. Trade name is Wegovy. Now, it's also marketed for diabetes. Tom talked about how it is used for diabetes and increases insulin. That trade name is Ozempic. That's also familiar with everyone around the country. The other one that combined GLP 1 and GIP, these two gut hormones, so it's a dual agonist, the trade name for obesity is called Zep Bound, and the same compound for diabetes is called Mounjaro. These are terms that are becoming familiar, I think, to everyone in the country.

Tom mentioned some about the, how much weight people lose on these drugs, but what sort of medical changes occur?

Just to reiterate what Tom said, I'll say it in another way. For Semaglutide one third of individuals are losing 20 percent of their body weight in these trials. For Tirzepatide, it even outpaces that. And I got a third of individuals losing a quarter of their body weight. These are unheard of weight losses.

And with these weight losses and these independent effects from weight, what we're seeing in the trials and in the clinic is that blood pressure goes down, blood sugar goes down, blood fats like triglyceride go down, inflammation in the body goes down, because we marked that with CRP, as well as improvement in quality of life, which we'll probably get to.

But really interesting stuff is coming out over the past year or two or so, that it is improving the function of people living with congestive heart failure, a particular form called a preserved ejection fraction. We're seeing improvements in sleep apnea. Think of all the people who are on these CPAP machines every night. We're seeing significant improvements in the symptoms of sleep apnea and the apneic events. And lastly, a SELECT trial came out, that's what it was called, came out last year. Which for the very first time, Kelly, found improvements in cardiovascular disease, like having a heart attack, stroke, or dying of cardiovascular disease in people living with obesity and already have cardiovascular disease. That's called secondary prevention. That, Tom, is the game changer.

Bob, I'd like to go back to Tom in a minute but let me ask you one clarifying question about what you just said. That's a remarkable array of biological medical benefits from these drugs. Just incredible. And the question is, are they all attributable to the weight loss or is there something else going on? Like if somebody lost equal amounts of weight by some other means, would these same changes be occurring?

Those studies are still going on. It's very good. We're thinking it's a dual effect. It's the profound amount of weight loss, as Tom said. Fifteen to 21 to even 25 percent of average body weight. That is driving a lot of the benefits. But there also appear to be additional effects or weight independent effects that are working outside of that weight. We're seeing improvements in kidney function, improvement in heart disease, blood clotting, inflammation. And those are likely due to the gut hormone effect independent of the weight itself. That still needs to be sorted out. That's called a mitigation analysis where we try to separate out the effects of these drugs. And that work is still underway.

Tom, one of the most vexing problems, over the decades that people have been working on treatments for obesity, has been long term results. And I'm curious about how long have people been followed on these drugs now? What are the results? And what was the picture before then? How do what we see now compared to what you saw before?

The study that Bob just mentioned, the SELECT trial followed people for four years on Semaglutide. And patients achieve their maximal weight loss at about one year and they lost 10 percent of their weight. And when they were followed up at four years still on treatment, they still maintained a 10 percent weight loss. That 10 percent is smaller than in most of the trials, where it was a 15 percent loss. But Dr. Tim Garvey showed that his patients in a smaller trial lost about 15 percent at one year and while still on medication kept off the full 15 percent.

I think part of the reason the weight loss in SELECT were smaller is because the study enrolled a lot of men. Men are losing less weight on this medication than women. But to your question about how these results compare to the results of earlier treatment, well with behavioral treatment, diet, and exercise back in the 70s beyond, people lost this 7 or 8 percent of weight. And then most people on average regain their weight over one to three years. And the same was true of medication. People often stopped these earlier medications after 6 to 12 months, in part because they're frustrated the losses weren't larger. Some people were also worried about the side effects. But the long and short is once you stop taking the medication, people would tend to regain their weight.

And some of this weight regain may be attributable to people returning to their prior eating and activity habits. But one of the things we've learned over the past 20 years is that part of the weight regain seems to be attributable to changes in the body's metabolism. And you know that when you lose weight, you're resting metabolic rate, which is the number of calories your body burns at rest to maintain basic bodily functions. Your resting metabolic rate decreases by 10 to 15 percent. But also, your energy expenditure, the calories you burn during exercise decreases. And that may decrease by as much as 20 to 30 percent. So, people are left having to really watch their calories very carefully because of their lower calorie requirements in order to keep off their lost body weight.

I think one thing these new drugs may do is to attenuate the drop both in resting metabolic rate and energy expenditure during physical activity. But the long and short of it is that if you stay on these new medications long term, you'll keep off your body weight. And you'll probably keep it off primarily because of improvements in your appetite, so you have less hunger. And as a result, you're eating less food.

I'd like to come back to that in a minute. But let me ask a question. If a person loses weight, and then their body starts putting biological pressure on them to regain, how come? You know, it's disadvantageous for their survival and their health to have the excess weight. Why would the body do that?

Well, our bodies evolved in an environment of food scarcity, and our physiology evolved to protect us against starvation. First, by allowing us to store body fat, a source of energy when food is not available. And second, the body's capacity to lower its metabolism, or the rate at which calories are burned to maintain these basic functions like body temperature and heart rate. That provided protection against food scarcity.

But Kelly, you have described better than anybody else that these ancient genes that regulate energy expenditure and metabolism are now a terrible mismatch for an environment in which food is plentiful, high in calories, and available 24 by 7. The body evolved to protect us from starvation, but not from eating past our calorie needs. And so, it's this mismatch between our evolution and our appetite and our body regulation in the current, what you have called toxic food environment, when you can eat just all the time.

I guess you could think about humans evolving over thousands of years and biology adapting to circumstances where food was uncertain and unpredictable. But this modern environment has happened really pretty rapidly and maybe evolution just hasn't had a chance to catch up. We're still existing with those ancient genes that are disadvantageous in this kind of environment.

Bob back to the drugs. What are the side effects of the drugs?

Kelly, they're primarily gastrointestinal. These are symptoms like nausea, diarrhea, constipation, heartburn, and vomiting. Not great, but they're generally considered mild to moderate, and temporary. And they primarily occur early during the first four to five months when the medications are slowly dose escalated. And we've learned, most importantly, how to mitigate or reduce those side effects to help people stay on the drug.

Examples would be your prescriber would slow the dose escalation. So. if you're having some nausea at a particular dose, we wait another month or two. The other, very importantly, is we have found that diet significantly impacts these side effects. When we counsel patients on these medications, along with that comes recommendations for dietary changes, such as reducing fatty food and greasy food. Reducing the amount of food you're consuming. Planning your meals in advance. Keeping well hydrated. And very importantly, do not go out for a celebration or go out to meals on the day that you inject or at least the first two days. Because you're not going to tolerate the drug very well.

We use that therapeutically. So, if you want to get control on the weekends, you may want to take your injection on a Friday. However, if weekends are your time out with friends and you want to socialize, don't take it on a Friday. Same thing comes with a personal trainer, by the way. If you're going to have a personal trainer on a Monday where he's going to overwork you, don't take the injection the day before. You'll likely be nauseated, you're not eating, you're not hydrating. So actually, there's a lot that goes into not only when to take the dose and how to take the dose, but how to take it to the best ability to tolerate it.

Two questions based on what you said. One is you talked about these are possible side effects, but how common are they? I mean, how many people suffer from these?

Well, the trials show about 25 to 45 percent or so of individuals actually say they have these symptoms. And again, we ask them mild, moderate, severe. Most of them are mild to moderate. Some of them linger. However, they really do peak during the dose escalation. So, working with your prescriber during that period of time closely, keeping contact with them on how to reduce those side effects and how you're doing out of medication is extremely important.

And the second thing I wanted to ask related to that is I've heard that there's a rare but serious potential side effect around the issue of stomach paralysis. Can you tell us something about that?

I mentioned earlier, Kelly, that these medications slow gastric emptying. That's pretty much in everybody. In some individuals who may be predisposed to this, they develop something called ileus, and that's the medical term for gastric paralysis. And that can happen in individuals, let's say who have a scleroderma, who have longstanding diabetes or other gastrointestinal problems where the stomach really stopped peristalsis. In other words, it's moving. That's typically presented by vomiting and really unable to move the food along. We really haven't seen much of that. We looked at the safety data in a SELECT trial that Tom mentioned, which was 17,000 individuals, about 8,000 or so in each group. We really did not see a significant increase in the ileus or what you're talking about in that patient population.

Okay, thanks. Tom had alluded to this before, Bob, but I wanted to ask you. How do you think about these medicines? If somebody takes them, and then they stop using the medicines and they gain the weight back. Is that a sign that the medicine works or doesn't work? And is this the kind of a chronic use drug like you might take for blood pressure or cholesterol?

That's a great way of setting up for that. And I like to frame it thinking of it as a chronic progressive disease, just like diabetes or hypertension. We know that when you have those conditions, asthma could be another one or inflammatory bowel disease, where you really take a medication long term to keep the disease or condition under control. And we are currently thinking of obesity as a chronic disease with dysfunctional appetite and fat that is deposited in other organs, causing medical problems and so on. If you think of it as a chronic disease, you would naturally start thinking of it, like others, that medication is used long term.

However, obesity appeared to be different. And working with patients, they still have this sense 'that's my fault, I know I can do it, I don't want to be on medication for the rest of my life for this.' So, we have our work cut out for us. One thing I can say from the trials, and Tom knows this because he was involved in them. If we suddenly stop the medication, that's how these trials were definitely done, either blindly or not blindly, you suddenly stop the medication, most, if not all of the participants in these trials start to regain weight. However, in a clinical practice, that is not how we work. We don't stop medication suddenly with patients. We go slowly. We down dose the medication. We may change to another medication. We may use intermittent therapy. So that is work that's currently under development. We don't know exactly how to counsel patients regarding long term use of the medications. I think we need to double down on lifestyle modification and counseling that I'm sure Tom is going to get into. This is really work ahead of us, how to maintain medication, who needs to be on it long term, and how do we actually manage patients.

Tom, you're the leading expert in the world on lifestyle change in the context of obesity management. I mean, thinking about what people do with their diet, their physical activity, what kind of thinking they have related to the weight loss. And you talked about that just a moment ago. Why can't one just count on the drugs to do their magic and not have to worry about these things?

Well, first, I think you can count on the drugs to do a large part of the magic. And you may be surprised to hear me say that. But with our former behavioral treatments of diet and exercise, we spent a lot of time trying to help people identify how many calories they were consuming. And they did that by recording their food intake either in paper and pencil or with an app. And the whole focus of treatment was trying to help people achieve a 500 calorie a day deficit. That took a lot of work. These medications, just by virtue of turning down your appetite and turning down your responsiveness to the food environment, take away the need for a lot of that work, which is a real blessing.

But the question that comes up is, okay, people are eating less food. But what are they eating? Do these medications help you eat a healthier diet with more fruits and vegetables, with lean protein? Do you migrate from a high fat, high sugar diet to a Mediterranean diet, or to a DASH like diet? And the answer is, we don't know. But obviously you would like people to migrate to a diet that's going to be healthier for you from a cardiovascular standpoint, from a cancer risk reduction standpoint.

One of the principal things that people need to do on these medications is to make sure they get plenty of protein. And so, guidance is that you should have about 1 gram of dietary protein for every kilogram of body weight. If you're somebody who weighs 100 kilograms, you should get 100 grams of protein. And what you're doing is giving people a lot of dietary protein to prevent the loss of bodily protein during rapid weight loss. You did a [00:20:00] lot of research with me back in the 80s on very low-calorie diets, and that was the underpinning of treatment. Give people a lot of dietary protein, prevent the loss of bodily protein.

The other side of the equation is just physical activity, and it's a very good question about whether these medications and the weight loss they induce will help people be more physically active. I think that they will. Nonetheless for most people, you need to plan an activity schedule where you adopt new activities, whether it's walking more or going to the gym. And one thing that could be particularly helpful is strength training, because strength training could mitigate some of the loss of muscle mass, which is likely to occur with these medications.

So, there's still plenty to learn about what is the optimal lifestyle program, but I think people, if they want to be at optimal health will increase their physical activity and eat a diet of fruits and vegetables, leaner protein, and less ultra processed foods.

Well, isn't it true that eating a healthy diet and being physically active have benefits beyond their impact on your ability to lose the weight? You're getting kind of this wonderful double benefit, aren't you?

I believe that is true. I think you're going to find that there are independent benefits of being physical activity upon your cardiovascular health. There are independent benefits of the food that you're eating in terms of reducing the risk of heart attack and of cancer, which has become such a hot topic. So, yes how you exercise and what you eat makes a difference, even if you're losing weight.

Well, plus there's probably the triple one, if you will, from the psychological benefit of doing those things, that you do those things, you feel virtuous, that helps you adhere better as you go forward, and these things all come together in a nice picture when they're working.

Tom, let's talk more about the psychology of these things. You being a psychologist, you've spent a lot of time doing research on this topic. And of course, you've got a lot of clinical experience with people. So as people are losing weight and using these drugs, what do they experience? And I'm thinking particularly about a study you published recently, and Bob was a coauthor on that study that addressed mental health outcomes. What do people experience and what did you find in that study?

I think the first things people experience is improvements in their physical function. That you do find as you've lost weight that you've got less pain in your knees, you've got more energy, it's easier to get up the stairs, it's easier to play with the children or the grandchildren. That goes a long way toward making people feel better in terms of their self-efficacy, their agency in the life. Big, big improvement there. And then, unquestionably, people when they're losing a lot of weight tend to feel better about their appearance in some cases. They're happy that they can buy what they consider to be more fashionable clothes. They get compliments from friends. So, all of those things are positive.

I'm not sure that weight loss is going to change your personality per se, or change your temperament, but it is going to give you these physical benefits and some psychological benefits with it. We were happy to find in the study you mentioned that was conducted with Bob that when people are taking these medications, they don't appear to be at an increased risk of developing symptoms of depression or symptoms of suicidal ideation. There were some initial reports of concern about that, but the analysis of the randomized trials that we conducted on Semaglutide show that there is no greater likelihood of developing depression or sadness or suicidal ideation on the medication versus the placebo. And then the FDA and the European Medicines Agency have done a full review of all post marketing reports. So, reports coming from doctors and the experience with their patients. And in looking at those data the FDA and the European Medicines Agency have said, we don't find a causal link between these medications and suicidal ideation.

With that said, it's still important that if you're somebody who's taking these medications and you start them, and all of a sudden you do feel depressed, or all of a sudden you do have thoughts like, maybe I'd be better off if I weren't alive any longer, you need to talk to your primary care doctor immediately. Because it is always possible somebody's having an idiosyncratic reaction to these medications. It's just as possible the person would have that reaction without being on a medication. You know, that, that can happen. People with overweight and obesity are at higher risk of depression and anxiety disorders. So, it's always going to be hard to tease apart what are the effects of a new medication versus what are just the effects of weight, excess weight, on your mood and wellbeing.

You know, you made me think of something as you were just speaking. Some people may experience negative effects during weight loss, but overall, the effects are highly positive and people are feeling good about themselves. They're able to do more things. They fit in better clothes. They're getting good feedback from their environment and people they know. And then, of course, there's all the medical benefit that makes people feel better, both psychologically and physically. Yet there's still such a strong tendency for people to regain weight after they've lost. And it just reinforces the fact that, the point that you made earlier, that there are biological processes at work that govern weight and tendency to regain. And there really is no shame in taking the drug. I mean, if you have high blood pressure, there's no shame in taking the drug. Or high cholesterol or anything else, because there's a biological process going on that puts you at risk. The same thing occurs here, so I hope the de-shaming, obesity in the first place, and diabetes, of course, and then the use of these medications in particular might help more people get the benefits that is available for them.

I recommend that people think about their weight as a biologically regulated event. Very much like your body temperature is a biologically regulated event, as is your blood pressure and your heart rate. And I will ask people to realize that there are genetic contributors to your body weight. just as there are to your height. If somebody says, I just feel so bad about being overweight I'll just talk with them about their family history of weight and see that it runs in the family. Then I'll talk to them about their height. Do you feel bad about being six feet tall, to a male? No, that's fine. Well, that that's not based upon your willpower. That's based upon your genes, which you received. And so, your weight, it's similarly based. And if we can use medications to help control weight, cholesterol, blood pressure, blood sugar, let's do that. It's just we live in a time where we're fortunate to have the ability to add medications to help people control health complications including weight.

Bob, there are several of the drugs available. How does one think about picking between them?

Well, you know, in an ideal medical encounter, the prescriber is going to take into consideration all the factors of prescribing a medication, like any other medication, diabetes, hypertension, you name the condition. Those are things like contraindication to use. What other medical problems does the patient have that may benefit the patient. Patient preferences, of course and side effects, safety, allergies, and then we have cost. And I'll tell you, Kelly, because of our current environment, it's this last factor, cost, that's the most dominant factor when it comes to prescribing medication.

I'll have a patient walk in my room, I'll look at the electronic medical record, body mass index, medical problems. I already know in my head what is going to be the most effective medication. That's what we're talking about today. Unfortunately, I then look at the patient insurance, which is also on the electronic medical record, and I see something like Medicaid or Medicare. I already know that it's not going to be covered. It is really quite unfortunate but ideally all these factors go into consideration. Patients often come in and say, I've heard about Ozempic am I a candidate for it, when can I get it? And unfortunately, it's not that simple, of course. And those are types of decisions the prescriber goes through in order to come to a decision, called shared decision making with the patient.

Bob, when I asked you the initial question about these drugs, you were mentioning the trade name drugs like Mounjaro and Ozempic and those are made by basically two big pharmaceutical companies, Novo Nordisk and Eli Lilly. But there are compounded versions of these that have hit the scene. Can you explain what that means and what are your thoughts about the use of those medications?

So compounding is actually pretty commonly done. It's been approved by the FDA for quite some time. I think most people are familiar with the idea of compounding pharmacies when you have a child that must take a tablet in a liquid form. The pharmacy may compound it to adapt to the child. Or you have an allergy to an ingredient so the pharmacy will compound that same active ingredient so you can take it safely. It's been approved for long periods of time. Anytime a drug is deemed in shortage by the FDA, but in high need by the public, compounding of that trade drug is allowed. And that's exactly what happened with both Semaglutide and Tirzepatide. And of course, that led to this compounding frenzy across the country with telehealth partnering up with different compounding pharmacies. It's basically making this active ingredient. They get a recipe elsewhere, they don't get it from the company, they get this recipe and then they make the drug or compound it themselves, and then they can sell it at a lower cost. I think it's been helpful for people to get the drug at a lower cost. However, buyer beware, because not all compounded pharmacies are the same. The FDA does not closely regulate these compounded pharmacies regarding quality assurance, best practice, and so forth. You have to know where that drug is coming from. Kelly, it's worth noting that just last week, ZepBound and Mounjaro came off the shortage list. You no longer can compound that and I just read in the New York Times today or yesterday that the industry that supports compounding pharmacies is suing the FDA to allow them to continue to compound it. I'm not sure where that's going to go. I mean, Eli Lilly has made this drug. However, Wegovy still is in shortage and that one is still allowed to be compounded.

Let's talk a little bit more about costs because this is such a big determinant of whether people use the drugs or not. Bob, you mentioned the high cost, but Tom, how much do the drugs cost and is there any way of predicting what Bob just mentioned with the FDA? If the compounded versions can't be used because there's no longer a shortage, will that decrease pressure on the companies to keep the main drug less expensive. I mean, how do you think that'll all work out? But I guess my main question is how much these things cost and what's covered by insurance?

Well first how much do the drugs cost? They cost too much. Semaglutide, known in retail as Wegovy, is $1,300 a month if you do not have insurance that covers it. I believe that Tirzepatide, known as ZepBound, is about $1,000 a month if you don't have insurance that covers that. Both these drugs sometimes have coupons that bring the price down. But still, if you're going to be looking at out of pocket costs of $600 or $700 or $800 a month. Very few people can afford that. The people who most need these medications are people often who are coming from lower incomes. So, in terms of just the future of having these medications be affordable to people, I would hope we're going to see that insurance companies are going to cover them more frequently. I'm really waiting to see if Medicare is going to set the example and say, yes, we will cover these medications for anybody with a BMI of 40 or a BMI of 35 with comorbidities. At this point, Medicare says, we will only pay for this drug if you have a history of heart attack and stroke, because we know the drug is going to improve your life expectancy. But if you don't have that history, you don't qualify. I hope we'll see that.

Medicaid actually does cover these medications in some states. It's a state-by-state variation. Short of that, I think we're going to have to have studies showing that people are on these medications for a long time, I mean, three to five years probably will be the window, that they do have a reduction in the expenses for other health expenditures. And as a result, insurers will see, yes, it makes sense to treat excess weight because I can save on the cost of type 2 diabetes or sleep apnea and the like. Some early studies I think that you brought to my attention say the drugs are not cost neutral in the short-term basis of one to two years. I think you're going to have to look longer term.

Then I think that there should be competition in the marketplace. As more drugs come online, the drug prices should come down because more will be available. There'll be greater production. Semaglutide, the first drug was $1,300. Zepbound, the second drug Tirzepatide, $1,000. Maybe the third drug will be $800. Maybe the fourth will be $500. And they'll put pressure on each other. But I don't know that to be a fact. That's just my hope.

Neither of you as an economist or, nor do you work with the companies that we're talking about. But you mentioned that the high cost puts them out of reach for almost everybody. Why does it make sense for the companies to charge so much then? I mean, wouldn't it make sense to cut the price in half or by two thirds? And then so many more people would use them that the company would up ahead in the long run. Explain that to me.

That's what you would think, for sure. And I think that what's happened right now is that is a shortage of these drugs. They cannot produce enough of them. Part of that is the manufacturing of the injector pens that are used to dispense the drug to yourself. I know that Novo Nordisk is building more factories to address this. I assume that Lilly will do the same thing. I hope that over time we will have a larger supply that will allow more people to get on the medication and I hope that the price would come down.

Of course, in the U. S. we pay the highest drug prices in the world. Fortunately, given some of the legislation passed, Medicare will be able to negotiate the prices of some of these drugs now. And I think they will negotiate on these drugs, and that would bring prices down across the board.

Boy, you know, the companies have to make some pretty interesting decisions, don't they? Because you've alluded to the fact that there are new drugs coming down the road. I'm assuming some of those might be developed and made by companies other than the two that we're talking about. So, so investing in a whole new plant to make more of these things when you've got these competitor drugs coming down the road are some interesting business issues. And that's not really the topic of what we're going to talk about, but it leads to my final question that I wanted to ask both of you. What do you think the future will bring? And what do you see in terms of the pipeline? What will people be doing a year from now or 2 or 5? And, you know, it's hard to have a crystal ball with this, but you two have been, you know, really pioneers and experts on this for many years. You better than anybody probably can answer this question. Bob, let me start with you. What do you think the future will bring?

Well, Kelly, I previously mentioned that we finally have this new therapeutic target called the gut brain axis that we didn't know about. And that has really ushered in a whole new range of potential medications. And we're really only at the beginning of this transformation. So not only do we have this GLP 1 and GIP, we have other gut hormones that are also effective not only for weight loss, but other beneficial effects in the body, which will become household names, probably called amylin and glucagon that joins GLP 1.

And we not only have these monotherapies like GLP 1 alone, we are now getting triagonists. So, we’ve got GIP, GLP 1, and glucagon together, which is even amplifying the effect even further. We are also developing oral forms of GLP 1 that in the future you could presumably take a tablet once a day, which will also help bring the cost down significantly and make it more available for individuals.

We also have a new generation of medications being developed which is muscle sparing. Tom talked about the importance of being strong and physical function. And with the loss of lean body mass, which occurs with any time you lose weight, you can also lose muscle mass. There's drugs that are also going in that direction.

But lastly, let me mention, Kelly, I spend a lot of my time in education. I think the exciting breakthroughs will not be meaningful to the patient unless the professional, the provider and the patient are able to have a nonjudgmental informative discussion during the encounter without stigma, without bias. Talk about the continuum of care available for you, someone living with obesity, and get the medications to the patient. Without that, medications over really sit on the shelf. And we have a lot of more work to do in that area.

You know, among the many reasons I admire the both of you is that you've, you've paid a lot of attention to that issue that you just mentioned. You know, what it's like to live with obesity and what people are experiencing and how the stigma and the discrimination can just have devastating consequences. The fact that you're sensitive to those issues and that you're pushing to de-stigmatize these conditions among the general public, but also health care professionals, is really going to be a valuable advance. Thank you for that sensitivity. Tom, what do you think? If you appear into the crystal ball? What does it look like?

I would have to agree with Bob that we're going to have so many different medications that we will be able to combine together that we're going to see that it's more than possible to achieve weight losses of 25 to 30 percent of initial body weight. Which is just astonishing to think that pharmaceuticals will be able to achieve what you achieve now with bariatric surgery. I think that it's just, just an extraordinary development. Just so pleased to be able to participate in the development of these drugs at this stage of career.

I still see a concern, though, about the stigmatization of weight loss medications. I think we're going to need an enormous dose of medical education to help doctors realize that obesity is a disease. It's a different disease than some of the illnesses that you treat because, yes, it is so influenced by the environment. And if we could change the environment, as you've argued so eloquently, we could control a lot of the cases of overweight and obesity. But we've been unable to control the environment. Now we're taking a course that we have medications to control it. And so, let's use those medications just as we use medications to treat diabetes. We could control diabetes if the food environment was better. A lot of medical education to get doctors on board to say, yes, this is a disease that deserves to be treated with medication they will share that with their patients. They will reassure their patients that the drugs are safe. And that they're going to be safe long term for you to take. And then I hope that society as a whole will pick up that message that, yes, obesity and overweight are diseases that deserve to be treated the same way we treat other chronic illnesses. That's a tall order, but I think we're moving in that direction.

BIOS

Robert Kushner is Professor of Medicine and Medical Education at Northwestern University Feinberg School of Medicine, and Director of the Center for Lifestyle Medicine in Chicago, IL, USA. After finishing a residency in Internal Medicine at Northwestern University, he went on to complete a post-graduate fellowship in Clinical Nutrition and earned a Master’s degree in Clinical Nutrition and Nutritional Biology from the University of Chicago. Dr. Kushner is past-President of The Obesity Society (TOS), the American Society for Parenteral and Enteral Nutrition (ASPEN), the American Board of Physician Nutrition Specialists (ABPNS), past-Chair of the American Board of Obesity Medicine (ABOM), and Co-Editor of Current Obesity Reports. He was awarded the ‘2016 Clinician-of-the-Year Award’ by The Obesity Society and John X. Thomas Best Teachers of Feinberg Award at Northwestern University Feinberg School of Medicine in 2017. Dr. Kushner has authored over 250 original articles, reviews, books and book chapters covering medical nutrition, medical nutrition education, and obesity, and is an internationally recognized expert on the care of patients who are overweight or obese. He is author/editor of multiple books including Dr. Kushner’s Personality Type Diet (St. Martin’s Griffin Press, 2003; iuniverse, 2008), Fitness Unleashed (Three Rivers Press, 2006), Counseling Overweight Adults: The Lifestyle Patterns Approach and Tool Kit (Academy of Nutrition and Dietetics, 2009) and editor of the American Medical Association’s (AMA) Assessment and Management of Adult Obesity: A Primer for Physicians (2003). Current books include Practical Manual of Clinical Obesity (Wiley-Blackwell, 2013), Treatment of the Obese Patient, 2nd Edition (Springer, 2014), Nutrition and Bariatric Surgery (CRC Press, 2015), Lifestyle Medicine: A Manual for Clinical Practice (Springer, 2016), and Obesity Medicine, Medical Clinics of North America (Elsevier, 2018). He is author of the upcoming book, Six Factors to Fit: Weight Loss that Works for You! (Academy of Nutrition and Dietetics, December, 2019).

Thomas A. Wadden is a clinical psychologist and educator who is known for his research on the treatment of obesity by methods that include lifestyle modification, pharmacotherapy, and bariatric surgery. He is the Albert J. Stunkard Professor of Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania and former director of the university's Center for Weight and Eating Disorders. He also is visiting professor of psychology at Haverford College. Wadden has published more than 550 peer-reviewed scientific papers and abstracts, as well as 7 edited books. Over the course of his career, he has served on expert panels for the National Institutes of Health, the Federal Trade Commission, the Department of Veterans Affairs, and the U.S. House of Representatives. His research has been recognized by awards from several organizations including the Association for the Advancement of Behavior Therapy and The Obesity Society. Wadden is a fellow of the Academy of Behavioral Medicine Research, the College of Physicians of Philadelphia, the Obesity Society, and Society of Behavioral Medicine. In 2015, the Obesity Society created the Thomas A. Wadden Award for Distinguished Mentorship, recognizing his education of scientists and practitioners in the field of obesity.

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For much of history, the word 'epidemic' applied to infectious diseases. Large numbers of cases of disease caused by organisms such as bacteria and viruses that spread through water, air, or other means, sometimes transmitted from person to person, or back and forth between people and animals. Then came epidemics of chronic diseases such as obesity, diabetes, heart disease - diseases occurring in very large numbers and created not by infectious agents, but by drivers in our day to day lives, such as a bad food environment. A new paper was just published in the PLOS global health literature that I found fascinating. It focuses on another use of the concept of epidemics: market driven epidemics. Let's find out what these are and find out a little bit more about their implications for our health and wellbeing. Our guests today are two of the authors of that paper. Dr. Jonathan Quick is a physician and expert on global health and epidemics. He is an adjunct professor at Duke University's Global Health Institute. Eszter Rimanyi joins us as well. She works on chronic disease and addiction epidemiology at Duke university.

Interview Summary

Access the PLOS article “Dynamics of combatting market-driven epidemics: Insights from U.S. reduction of cigarette, sugar, and prescription opioid consumption.”

So, Jono, let's start with you. Tell us what you mean by market driven epidemics.

The pattern is familiar to people. There is a product that that humans like and the business community says we can make a lot of money on this unmet need. And so they do that and they start selling a lot of it. And then people start noticing that this thing that the humans like is killing some of them. And so, the scientists do the public health. And then the business community says these scientists are going to kill the golden goose. They buy up other scientists and try to defend themselves. And then it goes on and on before we really bend the epidemic curves. This pattern of consumer products that have harmful effects, those products are major contributors to the root causes of at least a million deaths a year in the US, and over 20 million deaths worldwide.

So, to try to look at this from an epidemic point of view, we first established a case definition. Our definition of market driven epidemic is a significant increase in death, disability and other harmful effects on humans and human health and wellbeing. It's arising from a consumer product whose use has been accelerated by aggressive marketing. Whose harmful effects have been denied or otherwise minimized by producers. And for which effective mitigation is possible but actively opposed by producers.

So, we looked at the natural history of this, and we found five phases through which these epidemics pass. There's market development, either inventing a new product, developing a product like prescription opioids, or transforming an existing product like tobacco. Phase two is evidence of harm. First, there's suspicion, astute clinicians, whistleblowers, and then eventually proof of harm. Phase three is corporate resistance. Companies deny harm, seek to discredit accusers, commission counter science, manufacture doubt, mount legal challenges. All the while deaths and social upheaval and economic costs are mounting. And finally, our next phase four is mitigation. We get some regulatory efforts going, and there's a tipping point for the consumption and resulting deaths. And then finally, phase five of this is market adaptation. In a response to decreasing or threatened consumption, companies and consumers typically seek alternatives. Adaptations can be positive or negative. Some are healthier, some are equally or more harmful.

Thanks very much for that description. It really helps explain what the concept is all about. You chose three areas of focus. You could have chosen others, but you chose cigarettes, sugar, and prescription opioid use. Why those in particular?

We wanted to identify differences in these market driven epidemics in a few product categories. We wanted to look at distinctly different consumer experiences so we could see what worked and what didn't in terms of bending the epidemic curve. We picked nicotine delivery, food, and prescription medicine. And to choose within those categories we established five inclusion criteria. So, number one, the product had to have proven adverse health effects. Number two, there needed to be well documented histories of product development, marketing, mitigation efforts, and so forth. Number three, the product needed to meet the overall case definition. That is, companies knew they were doing harm, continued to do harm, and fought that harm. Number four, there needed to be long term data available for product consumption and associated impact. And number five, most important, we chose products for which mitigation efforts had already resulted in significant sustained reduction in product consumption. Based on these three criteria, cigarettes, sugar, and prescription opioids came out as the ones that we studied.

Thanks. I really appreciate that description. And when we get to the punchline in a minute, it's going to be interesting to see whether the behavior of the industry in this natural history that you talked about is similar, given that the substances are so different. We'll get to that in a minute. So Eszter, I'd like to turn to you. What kind of information did you pull together to write this paper?

I think I looked at over a thousand different documents. But there were two clear types that I interrogated to pull together all of our background data. The first category was publicly available data, so that could have been a clinical study, epidemiological study, advertisement by the company, CDC or other government reports, mortality data, etc. But then there was also a distinct different type of data that we really looked at and that was really useful for putting together these pictures of the natural history, which was internal documents. In some cases, these could have been leaked by an internal employee, which was the case with the so called 'brown documents' with tobacco. But it also came from sometimes court hearings or as a result of lawsuits that the companies had to release internal data. It was really interesting to compile together the different sides, of the outside look from CDC reports, and then the insider scoop from Purdue Pharma. So, it's a very well rounded, interesting way to find all this data.

I admire your effort. It's a big job to do a normal scientific review where you might have 50 papers and you were looking at things that were much harder to obtain and a vast number of things that are really quite different in character. Boy, congratulations for just reading all those things. Tell us what you found.

Gosh, so even though there's so many distinct differences between a lot of these epidemics, what we actually found was that there was a lot of narrative similarities. And because of that, we could really create this holistic, but also really well-fitting idea of market driven epidemics. A lot of the corporate strategies were either mirrored, imitated, or in some cases quite literally lifted over because of overlapping ownership between the companies.

One of the things that we really wanted to hammer into our article was that producers not only created their product, but they also manufactured doubt. Which means that they created, on purpose, public hesitancy around their product even when they internally knew that it was harmful to health. They wanted the public to be on the fence about what the health impact of their product was. There was a lot of different ways that they achieved that goal. Sometimes it was through showing propaganda films in high schools. Which I still can't believe that happened and then that was legal. But also in different ways, like co-opting science, paying scientists to publish articles in their favor. I know a really famous example of this that has now been public is that two Harvard researchers in cardiovascular disease published saying that sugar was not harmful to health. So, there's a lot of different ways that they achieved it, but the goals overall were very similar by all the companies.

You know, you mentioned overlapping ownership. And so, you might have been referring specifically to the ownership of the food companies by the tobacco companies.

Correct.

Because it happened a while ago, that's not something that was well known. But there's a fascinating history there about how the tobacco industry used its technology to maximize addiction and used that to develop food products and to change the DNA of the food companies in ways that still exist today, even though that ownership ended many years ago. I'm really glad you pointed that out.

Yeah, exactly. I think there's this shared idea that there's a turning point for companies. Where they know internally that their product is causing harm. And what really tips them over into becoming market driven epidemics is not actually coming out and saying that there's an issue with their product or not improving it. But you know really digging that information into the dirt and saying no we're going to protect our product and keep giving this out to the public despite the harms.

You know, maybe we can come back to this, but the fact that you're finding similarities between these areas suggests that there are contingencies that act on corporate executives that are similar no matter what they're selling. And that's helpful to know because in the future, you can predict what these companies will be doing because there are many more similarities than differences. Jono let me ask you this. You've talked about this appalling period of time between when there are known health consequences of use of some of these things and the time when meaningful action occurs to curb their consumption and to rein in the behavior of the companies. How long is this gap, and what explains it?

Kelly, this is one of the most fascinating things about this study. And it really highlights the importance of taking an epidemiologic approach. This is a behavioral epidemic, not a viral one. But it has so many characteristics. One of the key points is that is how important time is. And we see that in any epidemic curve when things start going exponential. If we take cigarettes, okay, the harms of cigarettes had long been suspected. But the first credible scientific publication was by a US physician, Isaac Adler, in a 400-page 1912 book where he first associated cigarettes with cancers. Fast forward over 40 years to British scientists Doll and Hill, and they did the epidemiology which definitively and convincingly links cigarette cancer with smoking deaths. So that gap was incredible and so that's one of the first examples. Once those articles were published, others followed the initial one. It took about a decade until the 1964 Surgeon General's report on smoking and health. And that was quickly followed by a series of federal actions. So, 1964, '63, '64 was the tipping point. Five decades after the initial suspicion.

For sugar, the journey from suspicion to compelling evidence was more complex. There was a big debate between researchers, clinicians, scientific journalists, that began in the '50s. A diabetologist from Britain John Yudkin, argued in the 1957 Lancet piece, it's sugar that's equal or larger than fats. An American physiologist, Enzo Keyes, says au contraire. He said it on the cover of Time Magazine. From 1950 to 2000, there was this debate back and forth. Finally, sugar consumption in the US peaked in '99 when a sugar wary group of researchers, journalists, and advocacy groups began becoming really vocal. And that was the tipping point. The actual compelling science, it came a few years after the preponderance of folks engaged said, no, it's sugar. You got to do something.

And finally, with prescription opioids: 1997, rural doctors Art Van Zee and another fellow, alerted Purdue Pharma, the producer of OxyContin, about rising overdoses. A year later, there was a publication that said the sustained release version of OxyContin, which was a hydrocodone that was sustained release, that they first tried it with morphine, and they had evidence from there that the sustained release drugs were a problem. And again, it was over a decade later that mounting prescription opioid deaths in the US convinced CDC to declare an epidemic of [00:14:00] opioid prescribing. This gap, if you look at it, to summarize, for cigarettes, the journey from credible suspicion of harm to consumption tipping point, five decades. Sugar, four decades. Prescription opioids, fourteen years. But the key thing is that the power of collective action, because today, only one in eight Americans smoke, and it was nearly 50 percent at the peak. The US consumption of sugar, which increased by 30 pounds between the year 1950 and the year 2000, when all this debate was going on. We picked up an extra 30 pounds of sugar consumption per person per year, but within two decades, that was cut back. We gave back 15 pounds of that. And now prescription opioids have gone back to a medically defendable level, having risen to 8 to 10 times that in the peak of the prescription opioid epidemic.

Hearing you talk about that, it's nice that there's sometimes light at the end of the tunnel. But boy, it's a long tunnel. And that you can count the, the number of deaths during that tunnel period of time in the millions. It's just unspeakable how much damage, preventable damage gets caused. Now, and I'd like to, when I come back to wind up this podcast, I'd like to ask each of you, what do you think might be done to help narrow that or shrink that time gap and to prevent these long delays and to help address these corporate determinants of health. But before I get there, Eszter, you know, I'd like to follow up on the conversation we had earlier. You know where it's clear that sugar and tobacco and opioids are all quite different substances, but the companies, the natural history of these things looks quite similar. And you mentioned in particular the industry attempt to plant doubt. To create doubt in the minds of people about the stories they were hearing of the dangers of these things, whether they were true or not. And were there other things that the industry was doing during that time that you noticed might have similarities across these areas?

Oh my gosh, so many. I have to go through all the examples in my head and make sure that I have a very crisp message out of all of them One of the ones that is interestingly being employed today in a very different epidemic with firearms and guns, is this idea of whose choice is the consumer product in its use. And today there's a lot of ideas that were initially created by tobacco, and then used by food, that are currently being used by gun lobbyists talking about individual freedoms. So with some of the previous market driven epidemics, like tobacco and prescription opioids, it's a way easier argument to make that the individual at some level does not choose to use the product. Maybe in the beginning, the first couple uses were their individual choice, but then there's on purpose, a really strong withdrawal response in the body and socially. The individual kind of had to continue using the product. But some of those ideas are being used today with firearms. The idea that somebody has the liberty to use this product or to purchase this product, which undoubtedly causes harm. You know, it's probably not really good for public health if this argument exists. And, in the cases with firearms, which I think is a little bit ironic and sad, a lot of the people that buy guns for their own self-defense actually experience those guns turned around and used on them, usually by the perpetrators of aggression. These ideas of individual freedoms usually backfire to the people that are consuming the products. It's interesting to me that a lot of these ideas were initially created for very different products, but are being used in the current day.

So interesting to hear you say that because here we have yet another area where there are similarities with the firearms. And the companion argument to that idea that it's your personal liberty to use these things is the argument that there's overreach by government, big brother, things like that. When government wants to, you know.

Yeah.

It's so interesting.

So one point on that. The market economy was never meant to be a free for all. Because the reality is that the market economy has brought billions of people out of poverty and saved more lives than most health interventions. But the problem is, as I said, it wasn't meant to be a free for all. And it depends on having good consumer information and when companies are distorting it, they're basically taking away the informed choice, which is critical. The other part of it is, when they are purposely engineering their products for maximal addictiveness, which is done with clicks and social media, and was done purposefully with the nicotine content in cigarettes, then you don't have a real informed choice. The freedom of choice. You've had your brain pleasure center hijacked by, by purposely addictive products.

Right, and you didn't mention food, but there's another example of substances that are created to hijack the reward pathway in the brain.

Absolutely.

I'd like to ask each of you, what in the heck can we do about this? I mean, you've pointed out a massive problem. Where the number of lives that are sacrificed because of corporate behavior, just enormous numbers. What can we do about it? Jono, I will start with you. And, you know, you've written this very highly regarded book called The End of Epidemics. And you've talked about things like bending epidemic curves and accelerating shifts. But tell us more. What do you think can be done in the case of these market driven epidemics like we're talking about?

Well, I think it's important to realize that both kinds of epidemics, viral and behavioral, are communicable. Both involve a lot of rumor, blame, uncertainty. And as we've talked about both cause deaths in the thousands or millions. And we haven't talked so much about the significant social disruption, and the cost. Trillions of dollars in economic losses and additional health burdens. So let me focus on four kinds of key actors because when it comes down to it, it's groups that that really start acting against these things. The first is the research community and its funders. You won't be surprised given the time it takes to get the evidence because what's clear is without clear evidence of product associated harm, we're not going to move the political agendas. We're not going to get public support for epidemic curves. So, we have really good researchers working in these areas. They need to guard against groupthink. That's what happened with our salt sugar 50 years of chaos discussion. And conflict of interest because companies do try to undermine the database.

The second is the funders of research, foundations and all, and national health services need to have an early warning system and an annual research roadmap in this area. I think Eszter will probably talk about the importance of public health leaders, because she's looked a lot at that. Another community though is the different civil society groups that are active. Because there's Mothers Against Drunk Driving, there's the Sandy Hook group on gun shooting, and there are a variety of interest groups. But what we realize is that there are lots of different strategies for how you move decision makers and all. So, more information sharing from those groups, civil society groups and all across. And finally, companies. It's actually in their interest to be more forthcoming earlier on. With tobacco, with prescription opioids, and now with baby powder, with talc, what we're seeing is companies at risk of bankruptcy paying billions of dollars. And if their CEOs aren't looking at that, then their board needs to be.

Can I ask you a quick question about that? When the chickens come home to roost, and those bad things befall a company, you know, really seriously damaging lawsuits, or the possibility that perhaps sometime the executives will go to jail for corporate malfeasance. You know, the behavior that caused all the millions of deaths occurred 15 CEOs before them. So, if you're a CEO and you know you have a certain shelf life as CEO, you want to maximize profit during that time. And by the time anything happens negatively to the company, you're on vacation, you're retired, or you're gone. So how do you deal with that?

Here's the thing, it's having criminal and civil liability that can go back to the individuals involved. From a different sector, an example. The German executive who was head of Volkswagen over a decade ago when they cheated on their environmental issues. He's been criminally charged today, a decade later. And I think that sort of personal accountability, it'll be hard to get, but that's the kind of thing that will make CEOs and their boards, if their boards also become responsible for hiding information in a way that it resulted in deaths. I think that, unfortunately, that kind of hammer, although it's going to be hard to get, that's probably what's needed.

Okay, that makes good sense to me, and I'm glad I asked you that question. And I appreciate the answer. Eszter, anything you'd like to add to what Jono said about what could be done.

Yes. One of the amazing things about market driven epidemics was when we were creating the paper, we created a table of all the different types of actors that could have very successful mitigation. And that table actually ended up being cut from the paper because it was so long that the editor said that it might distract from the rest of the paper. But that's actually a very positive message because there are so many actors that can have positive change, I'm going to highlight a couple of them because I think there's a few things here that are fairly good core messages that we can take away.

One of the ones is the need for a trusted public health authoritative voice. I think nowadays there's a lot of commotion over how much we trust the government. And how much we trust, for example, the head of the CDC and the types of data they're talking about in terms of public health. But in the past, when we had a very trusted public health voice, that was really crucial in getting consumers to change their behavior. For example, in the 1964 Surgeon General's report, seemingly overnight changed people's behavior. Before then, smoking was a common, everyday social event. And after that, people started viewing it as a deadly, bad habit that some people had. And that type of change was really hard to get in the modern day. When we were talking about public health crises that were viral. So, I think one of the things that we really need to get again in the modern day is this trust between the people and public health voices so that when we have such good forthcoming information those statements actually mean something. So much so that the consumers change their behavior.

Another thing is with us individuals who maybe aren't part of public health, we actually play a pretty big role in how much other people consume these different products. I remember when I was researching cigarettes in particular and the intersection with social media. I think if somebody under 18 saw a peer smoking and posted that to Instagram, that doubled their likelihood of trying out smoking for the first time. You have to be really careful with how you show yourself in the presence of others, and online too with a new digital age. Because you might tip the scale in somebody trying out a product for the first time. Which then if it has a very strong withdrawal effect, you know that person might have to might feel that they have to continue using that product to avoid withdrawal. I think as an individual, you can be more mindful about if you have a certain product use that you don't want others to also pick up, to maybe not do it or not show it as much so that other people aren't interested in doing that.

Okay, the last really positive message I have is that I think as my generation gets into higher positions of power, even within corporations, I think Gen Z and Gen Alpha and other young people have the sense of responsibility for others and for the planet. And I think if there was a young person in power in a corporation and saw that oh no this product that we've had is now there's evidence that's harmful. I think there would be more accountability and more of a want to do something that's good for the planet and for people. I'm hopeful that, maybe 50, 60 years ago, if people were more in favor of kind of brushing things under the rug, then maybe the young generation won't be as into those ideas. And we'll actually want to be accountable and do what's right.

BIOS

Jonathan D. Quick, MD, MPH (“Jono”) is adjunct Professor of Global Health at the Duke Global Health Institute, where he teaches global health policy, serves on foundation grant advisory boards, and mentors students. Dr. Quick’s current research and writing focuses on market-driven epidemics, from tobacco to opioids to social media. He is also Affiliated Faculty in Global Health Equity, Brigham and Women’s Hospital/Global Health & Social Medicine, Harvard Medical School. Dr. Quick is the author of The End of Epidemics: The Looming Threat to Humanity and How to Stop It (Australian, Italian, Korean, South Asia, U.K. and U.S. 2018/2020/2021 editions), creator of MDS-3: Managing Access to Medicines and Health Technologies and an author of The Financial Times Guide to Executive Health, Preventive Stress Management in Organizations, as well as more than 100 other books, chapters, and articles in leading medical journals.

Eszter Rimanyi is a chronic disease epidemiologist working with Dr. Jonathan D. Quick at the Duke Global Health Institute. Her research interest centers around Market-Driven Epidemics, including tobacco, sugar, opioids, and breastmilk substitute/infant formula. She is currently working on applying the market-driven epidemics approach to new epidemics, such as social media and firearms. Rimanyi has authored scientific papers in journals such as PloS Global Public Health and MDPI.

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In 2021, American University and 15 partner institutions across the U. S. launched the Multiscale RECIPES Research Network with the goal of transforming our wasted food system into a sustainable and resilient one. Food loss and waste is a complex problem spanning societal issues such as food insecurity and food recovery, sustainable farming, food packaging and transportation, food marketing, sales and consumer preferences, family dynamics, and corporate profits, among others. A fascinating part of the RECIPES Network vision is a purposeful focus on convergence, making the research process more effective and creative in designing solutions to big problems such as these. In a recent article in the journal Ecology and Society, team members evaluated how well the network's intentional convergence efforts have worked thus far.

Interview Summary

Norbert Wilson - It is my great pleasure to welcome my colleague, Amanda Wood, who is a research scientist at the World Food Policy Center.

Amanda Wood - Thank you, Norbert. I'm looking forward to this discussion today. Our guests come from the University of Illinois Institute of Technology Food Systems Action Lab. Weslynne Ashton is a professor of environmental management and sustainability at Illinois Tech and co directs the Food Systems Action Lab. Azra Sungu is a design researcher and strategist at the Food Systems Action Lab, who just defended her doctoral dissertation. So, our biggest congratulations to Dr. Sungu. Thank you so much for being here today. So first, I want to start by saying the RECIPES Network has gone about their work a little bit differently than most traditional academic projects by taking a convergence approach. Weslynne, would you talk about what convergence is in research, and why is this approach useful for tackling complex societal challenges like food waste?

Weslynne Ashton - Convergence is an approach that really tries to integrate the best of many different disciplines. The way that they see, approach, and tackle problems. And tries to integrate them in a really holistic way, right? Like, we often operate in silos and universities and this is a way of trying to get out of that. But more than working side by side on the same topics, it really tries to pull ways of working and ways of knowing across these different disciplines. For the topic of food waste, which as Norbert described is incredibly complex, right? There are so many different dimensions. They're scientific, natural science, social science, anthropological, political science. So, there are these technical aspects, economic aspects, social aspects, as well as cultural and spiritual aspects that we really don't talk about that often. And so, a convergence approach tries to say, how can we bring together the way all of these different disciplines approach understanding and developing solutions so that the solutions we develop can be more holistic. And more likely to take hold because they are considering these different perspectives.

Amanda - A lot of individuals might not see food waste as this complex challenge. They throw their leftovers in the bin and that's food waste to them. But as you say, challenges of food waste and food loss extend all the way across the food system. So, we definitely need that more holistic approach. Thanks for that bigger picture. Norbert, over to you.

Norbert - Azra, I'd like to turn it over to you and ask you a question about design. And I've got to say, this is the first project that I've ever worked on where I've worked with design scholars. And so, I'm excited for you to share with our audience what actually is design. And how do you see design fitting in the context of the work that we've been doing?

Azra Sungu - Thank you. Yes, it's been very exciting for me to part of such a transdisciplinary group as well. And probably in over 12 years of design education that I got, that was the most frequent question. Like my family and everyone that's asking, like, what is it that you do actually? So, I think it's really important that we clarify that because design in this context is a little bit different than the design of products and services.

In a way, we could say that it carries similar principles, but in recent years, design has been gaining visibility as a creative and collaborative problem-solving approach. So, some of the key mindsets, methods, and processes of design have been distilled into more accessible toolkits that allow more people from various backgrounds and expertise to get together and collaboratively explore problems of different kinds and approach them in more creative ways. So, we can say that, yeah, this adaptation of design found applications in different fields, such as entrepreneurship. We see that picking up in education or even apply to issues related to social justice. And I would say that what makes it different from other problem-solving approaches is that it centers a deep understanding of humans, their needs, their interactions, their behaviors in every step of the process. So, from framing the problem to testing out the solutions. And in design, we combine this human centered approach with a hands-on process where we iteratively explore a solution by making things and experimenting in a more open-ended way, rather than like planning everything and applying the solution at the end.

So, in the context of convergence, I think of convergence as a collaborative search for ways for reshaping the systems that we live in. And if I pick back on what Weslynne just said, yeah, the design can help ground this search in the real lives of people so that the solutions we envision can be adopted and also actualized by people who are driving this change on the ground. So, it can support a more action oriented approach to knowledge production.

But another role of design, which we speak more of in the paper, is designing the conditions for this form of collaborative research and knowledge production. Designing the spaces where people can build relations to build really confidence to think outside of the box. And I see it as giving people the tools and processes to tap into their collective creativity. And that you can't really get out of a toolkit. That's a deeper and relational process.

Norbert - Thank you for sharing that. And I am really pleased that we've had the opportunity to not only work with you all, but folks at MIKA to think about design in this network. And can you give us an example of how you all were able to use design to help us work better together, to move us closer to convergence?

Azra – Yes. I guess in the first two year of the RECIPES where we explored design's role in the context of convergence, it's applied more to the second part of design's role that I mentioned earlier. So, creating the conditions for convergence to happen. And I think we're in the process of shifting to applying design to the solutions and like this iterative process itself.

I would say that there are five components that we identified in our investigation. And I always like to joke that like, we can't just throw people in a room and expect them to collaborate and come up with results. And let's remember RECIPES as a network started during the pandemic. We didn't even get a room to be together in until two years later. So, in this context, a key role of design was really convening people and connecting them to build that capacity and trust in each other to collaborate. And like trust one another to jump into a very open ended and ambiguous form of inquiry. Because this is what happens when we tackle such complex challenges as wasted food. And the other role is perhaps, yeah, in this exploration giving a shared vision to people to move towards. And enticing possibilities in this vision that may not be in our immediate horizon. So again, like how we think outside of the box and envision possibilities that may not seem evident. But that might be the root of more transformative change.

And the third role is probably one that relates to storytelling and visualizing. So, as we gather a group of people with such mixed disciplinary expertise and mixed personal backgrounds, we don't necessarily talk the same language. Even if you're approaching the same problem. So even when we talk about wasted food, it might seem so evident, but we might focus on completely different sides of it. And yeah, we have like mathematicians, chemists, engineers, social scientists in the same room. And when we're collaborating with such mixed group of expertise, design can create the interfaces, the visual language for us to be able to speak of the same thing and communicate ideas. But also, like foster flow and dissemination of ideas between these different conversations by telling the stories and capturing the ideas and really distilling them in a more relatable and accessible way. Because God knows we have a lot of meetings, and somebody needs like shepherd those conversations.

And the last ones are probably like making and prototyping. Which I think is very, very core to design practice, right? We just materialize things, whether it's in a visual format or whether it's like really getting hands on and making something that we got a taste of in our first network meeting that was in person.

I think one process where this manifested really beautifully was the creation of guiding principles and community norms that was a very collaborative and co-creative process where Network members really shaped how they would like to work together and create together and set the conditions for that. So, in this process, designers collaborated with other researchers in the network to set these workshops to gather different perspectives and ideas of network members on what it means to be in a good collaborative research environment. And this was a very iterative process. We created multiple drafts, materialized this, and brought that back to the network and gathered input and feedback. So, it was I think along a process of over a year, it was taking shape. And at the end we had this artifact that was co-created with people from various areas of expertise and had everyone's input that helped lay the groundwork for a more authentic and genuine collaboration.

Norbert - I want to pick up on one thing you said, Azra. Yes, there were a lot of meetings. So many meetings. But they were really important for us to figure out how to work. But one of the things I found really challenging being a part of the network and as I interacted with the design process is I wasn't comfortable with the storytelling. I wasn't comfortable with this sort of new way of being because it wasn't the way I was trained, right? But over time, I found it sort of expansive. And I love there was a conversation we had before we started our recording, this idea of being my whole self in the process. Of being my whole self in the project. And I, I really have enjoyed, and I will use the word 'enjoyed' working with this network because I'm fully myself in many of these settings. So, I want to thank you all for helping us do that and opening up new ways to work with other people beyond the network.

Azra - Thank you. Yes. And a question I think that they ask very often when hiring designers is like, are you comfortable with uncertainty and ambiguity? And I always like to say, no. Like nobody's really comfortable with uncertainty and ambiguity. But I think it's really about building the confidence to jump into that together. And that happens by building trust. It's not just about producing knowledge and transferring that between one another, but how do we approach this in a more relational way? And I think that's the transformative shift that's happening with a more convergent approach to research. Great. Thank you.

Amanda - Sounds like it was a transformative experience for many involved. Good to hear. Weslynne, let me shift back to you so we can dig into some of the results of the paper. In your view, how did the integration of design really enable the network's convergent approach? And is there anything that didn't quite work?

Weslynne - Yes, so Azra's pointed out to several things that the design team did. I would add that we had a dedicated design team, right? That was really important because there was this group who that one would help to facilitate these meetings, right? And get people to come in, structure exercises to get people to talk to each other. Create whiteboards where people could, you know, say what they're thinking, whether that's in a larger group or in a smaller group. And then behind the scenes, they would distill and synthesize all these whiteboards from all the breakout groups into something that was actionable, right? And I think like, that's really one of the powers of design. It's not just talk, right? It's how do we take this talk, take people's ideas, and synthesize them into something that we can create actions around, right? So, the example that Azra gave of the guiding principles and community norms, you know, looked like several brainstorming sessions and breakout groups where people had a document, a kernel to react to. And weigh in on what are the values and the principles that they thought were important for us to have in this network to guide how we worked, not only with each other, but also with external partners. And to iterate, right, iterate on those prototypes and bring something back to the group that, that we can hold up and say, yeah, this is something that, you know, like we all agree to at least for now, right? In a year we might learn something else and want to come back to this and change it. But having that dedicated team was really important.

I'd say another thing that convergence puts forward is the importance of integrating the next generation of scientists, of researchers, into practice. And so, I think one of the things that we did well in the structure of the network. So, we were structured in different thematic clusters. But there was a student cluster where all the students from all of the disciplines came together, including the design students. And it turned out that the design students gave some training to the other students in design methods in facilitation. And that actually I think is perhaps one of the most beautiful examples of convergence in the network. So that the students were able to understand each other's work in a much deeper way. And think about how they might use design in this work.

So, what design did well, and reiterating on what Azra said, it's really creating these enabling conditions, right? For people to feel comfortable, to show up as their whole selves. To make it okay to take a risk and say something crazy, something out of the box. Because someone would be able to synthesize that into a hole later on.

I think there were perhaps like a couple instances, like within some of these thematic clusters where we had initially thought, okay, we're going to put a designer in each of these clusters and use that as a way to integrate some design thinking into each of these groups. But there were some of the groups that were like really so highly technical and so highly focused that it was hard for the designer, who does not have that technical background, to get a toehold in that group. And so, where we kind of merged is that we had our co-design cluster as the primary place where people who we're designers or we're curious about design could come to learn. And then can take that back to the groups that they were working in. Rather than trying to plug design into every single one of the clusters.

Amanda - I really appreciate these insights, especially underscoring the importance of having specific roles to help facilitate. I think, often as researchers when you're applying for grants, either the funder doesn't allow you to apply for a facilitator role, or you think, oh, we have too many important other researchers that we need to fund. And I think this project was a great example that, I think Azra said it before, collaboration doesn't just happen when you throw people in a room. And this project really highlighted the value of having those design experts in the group. Helping everyone along on that journey. I hope that these learnings can go out to both funders and other research groups. But I'd like to ask both of you a question now. In the paper, you write that the pairing of convergence and design is a natural fit, but not necessarily a seamless one. What kind of tensions or challenges did the Network face when using design to foster convergence? And Weslynne, let's start with you.

Weslynne - One of the important tensions, I think, is on this role of a designer, right? So, often when designers show up in spaces, it's as a graphic designer. So, someone who's visualizing the process making illustrations. It's as a facilitator, right? So, someone who's structuring the conversation to be more productive, to help people be more collaborative. And the tension that we see is that that's not the only role of design, right? Design research in and of itself is an important research area that adds value to projects, right? And whether that is using a human centered design research approach, right? Where we're plugging in designers into a research project. For example, to learn about how employees are behaving, right? And if we wanted to change a particular food waste prevention strategy in grocery stores, we need to engage the employees to understand their perspectives, right? So, designers help to integrate that approach as a research method. And so, you know, this tension here is that we can have some designers working as facilitators of this network convergence, but we also need designers as researchers who are contributing to the research questions and research methods that we're trying to converge in the process.

I'll say one more and then I'll pass to Azra to, to see what she would add. This is a National Science Foundation funded project, right? And there is an inherent tension that the type of research that NSF tends to fund is very STEM focused, right? So, it's science, technology, engineering, math. And there is social science, but certainly, you know, like, we have a dominance of science and technology as the predominant set of disciplines in this group. And so that means that the social scientists, the designers are kind of at the fringes. And one of our challenges was to really create a space where all of these different disciplines have the ability to come in on an equal footing. I'm sure Azra would like to add a couple more.

Azra - Yeah, thank you. I could build up on what you just said about like how design's role is understood. Yeah, when I was first talking about design, I talked about how toolkits made it more accessible. Like processes of human centered design and design thinking to be learned and adopted by people who are non-designers, and really gain more visibility to design. It was a blessing, but also a barrier for people to understand broader expertise of design, right? Like what, what we learned in 12 years of school cannot necessarily be translated to toolkits. And there is in the design field itself, over the past decade, there has been different branches that are emerging that are specifically dealing with the complex issues that we try to tackle through convergence research. So, we have specific areas of expertise. Like, systemic design, who tries to use design processes to understand systemic dynamics and patterns. We have transition design who tries to understand how long-term transition processes can be fostered in more creative and inclusive ways. Or we have life centered design that some of the researchers from MIKA are leading that are going beyond human centered design approach, but like saying, how can we center the life itself? How can we consider the needs of non-human beings in our design processes? And I think it's going to be a lot longer process for like these different areas of expertise of design to gain more visibility. But it's also, yeah, a mutual understanding that gets fostered as we work together.

And perhaps the second thing I could add, I've been talking a lot about unlearning and unmaking recently. And it's probably the stage that I met at the end of PhD journey, where I realized how much unlearning it took. And I think the same applies to convergence research, because here we are trying to cultivate a completely different way of working that goes beyond disciplinary boundaries, that goes beyond geographic boundaries that sometimes goes beyond like the hierarchies that we're used to in academia. And there are certain structures and mindsets that come from traditional scholarship that can get into way of such authentic collaboration and open-ended way of working, right? We work with a certain funding structure. We work with certain expectations of progress and success from academia. And that might conflict sometimes with like a very open-ended exploration and experimentation that might also include failure and not getting anywhere at the end. So, yeah, I think there are some structures and mindsets that we need to reevaluate. We want to cultivate a broader culture of convergence.

Amanda - Thank you. I have to admit as a researcher, I was probably one who did not appreciate all of the nuances of design. So, this has been a very enlightening conversation. But also, just the emphasis that this is going to take time. It's not necessarily that you get in your first convergent project and wow, you've now done the perfect model of convergence. You're learning as you go. As you said, sometimes failure is involved. And so, it's just the journey that you're on. Thank you so much for those reflections.

Norbert - Weslynne, I want to come back to you and just think about something that was already said. This idea of we can't just simplify design as a series of tools that you could just kind of pick up and put into something else. And appreciating the complexity, the richness of what design as a discipline is, I'm interested to know how do we best use design, recognizing that it's a huge area? How do we use it authentically to address issues like convergence in the research team? And I want to even push that a little bit further. I mean, because some of our listeners are not researchers. They're not part of research teams, but they're designing policy. They're designing or they're a part of policy efforts. I'd be interested to think about what design can offer to any sort of group of people coming together to solve complicated challenges.

Weslynne - I'm going to bring this into my teaching because I think like as a lecturer in a design school, one of the things that, that I emphasize in thinking about systems, thinking about how designers show up, is that there are many different types of expertise, right? So, there's our professional, educational expertise. There's the expertise of lived experiences. And it's often the case that we are biased in terms of one being more important than the other. And I tried to train my students to think about, like, what are their own biases and assumptions coming into situations. So that they can more authentically create space for different viewpoints and different ways of being.

So, if we're trying to map systems and map all of the forces that are important for not only understanding a problem, and not just kind of the symptom of the problem that we see, but the real patterns and structures that are the root cause of those problems. That we have to kind of create a space where people can feel more comfortable to really explore more of those, those root causes. I think in applying design and a convergent research context, and a policy solution development process, that designers can help to create the conditions, create a space, for people from different perspectives to come into that space and be comfortable bringing their knowledge, their ways of being, their ways of knowing into that context. And that's a skill, right? That is a facilitation skill to help people show up in, in that way. I think that there are also these tensions that we came across in this Network, in the course of doing this research, where, you know, we found that it's really important to create a space for reflexivity. So that it's not just about creating these outputs and it's not just about these tasks. But creating a space where people have the time to reflect on what's happening, well, what has happened, and how they can then integrate that back into their practice, right? There can be these cycles of convergence, but there's also a need for divergence, right? And giving people the space to express what they're interested in, do the types of work that they're most interested in. And then come back together to say, okay, how can we bring these things together? I see design as really helping to play an important role in reframing questions. In helping groups dig deeper and reach more robust understanding of the challenges that they face. And then help to make the solutions more actionable, right? And that's not just as a research output. It's not just as a research paper. But really having solutions that work for a diversity of people.

Norbert - I'm grateful for the way you've explained what design is. Both you and Azra have explained what design is and what it can do for us as members of society. And I just think about the current political and social moments that we're in and how design has a role to play in helping us, as you talked about, reframing problems, and finding solutions that benefit a broad swath of society. I didn't realize I was going to become an evangelist for designers. And I'm grateful for the work that you all are helping us think differently about how we do research or how we engage the larger community.

BIOS

Weslynne Ashton is a professor of environmental management and sustainability at Illinois Institute of Technology, with joint appointments at the Stuart School of Business and the Institute of Design. She is the co-director of the Food Systems Action Lab at Illinois Institute of Technology. Dr. Ashton is a sustainable systems scientist, whose research, teaching and practice are oriented around transitioning our socio-ecological systems towards sustainability and equity. She studies the adoption of socially and environmentally responsible strategies in business, and the role of innovation and entrepreneurship in addressing social and environmental challenges. Her research is grounded in industrial ecology and the circular economy. Her current work focuses on increasing sustainability and equity in urban food systems, and developing regenerative economies in post-industrial regions, newly industrializing countries and small island states.

Azra Sungu is a design researcher and strategist at the Illinois Institute of Technology ID Food Systems Action Lab. Her research focuses on narrative-focused approaches for cultivating radical transition imaginaries. Her work uses design to navigate complexity, surface patterns and discover new pathways. Dr. Sungu earned her doctorate from Illinois Institute of Technology.

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Now more than ever, it's important to challenge the world's food and beverage manufacturers to address nutrition issues like obesity and undernutrition. Today, we're going to discuss the 2024 Global Access to Nutrition Index, a very important ranking system that evaluates companies on their nutrition related policies, product portfolios, marketing practices, and engagement with stakeholders. The index is an accountability strategy produced by ATNI, the Access to Nutrition Initiative, a global nonprofit foundation seeking to drive market change for nutrition. Our guest today is Greg Garrett, Executive Director of ATNI.

Interview Summary

You know, I very much admire the work you and your colleagues have done on this index. It fills such an important need in the field and I'm eager to dive in and talk a little bit more about it. So, let's start with this. You know, we've all heard of the concept of social determinants of health and more recently, people have begun talking about corporate determinants of health. And your organization really is focused on corporate determinants of nutrition. Let's start with a question that kind of frames all this. What's the role of industry in nutrition, according to the way you're looking at things? And how does the Global Index shine a light on this topic?

Thanks for the question. We're working primarily quite downstream with large manufacturers and retailers. But we hope to affect change across the value chain by working with that group. Of course, when we talk about private sector in food, that's a very, very broad terminology that we're using. It could include farmers on the one hand, looking all the way upstream, all the way through to SMEs, aggregators, processors, manufacturers.

SMEs are what?

Small and medium enterprises, small and medium enterprises, local ones. All the way through to the multinational food and beverage manufacturers. But also catering organizations and restaurants. When we talk about business what we're trying to do is ensure that business cares about portability, and access to safe and nutritious food. And I think we can say pretty safely, based on the data which we'll talk about, that the health aspects of food are still not as, they're not at the forefront like they should be. Yet.

We'll dive in and talk a little bit more about what the index is and what it shows in a minute. But let's start with a kind of broader question. What is the role of diet and consumption of processed foods in influencing health?

Yes, so they say now one in five deaths are related to poor diet. It's arguably now the biggest risk factor related to global morbidity and mortality. We've seen in the last 20 years a slight slowing down of our efforts to combat malnutrition and undernutrition. Whereas we've seen over nutrition, obesity, really taking off. And that's not just in high income countries, but also low- and middle-income countries. So, you know, it might be too little good food and that can lead to at the extreme end of things wasting. It might be too little micronutrients, which can lead to all kinds of micronutrient deficiencies or hidden hunger that leads to many adverse outcomes. Including, for example, cognitive decline or reduced immune system. And then, in terms of diabetes and obesity, we're seeing that really skyrocket. Not only in countries where we have excessive food intake, but also in low- and middle-income countries where they have too much food with a lot of, say, empty calories. Not enough nutrients that are needed. In fact, the recent numbers that we've been working with, it looks like in the last 20 years, obesity rates have gone from about 7.9 percent to 15.9 percent. And by 2030, it might be that 20 percent of global population is considered obese if we don't mitigate that.

Right, and of course that number is many, many times higher in the developed countries. So, you've got a tough job. You talked about the complexity of the food industry going all the way to the farmers, to the big companies, and caterers even, and things. And a lot of different health outcomes are involved. How in the world do you construct an index from all that? Why don't you tell us what the Global Index is, and then some of what you found in the most recent report.

Yes, so the Global Index, we've been running it for 11 years since ATNI was founded. And it has gone through multiple iterations. This latest one was the biggest we've done and we tried to capture about a quarter of the world's market. So, what we did is we took the 30 largest food and beverage manufacturers by revenue. We looked at 52,000 of their products, and that's where we know the market share was about 23 percent global market share. We profiled the foods. We tried to understand their governance structures and how much nutrition features in the way they run their business. We tried to understand, for example, how they market the foods. Are they marketing them responsibly, according to the World Health Organization guidelines? Really dive deep. It's dozens and dozens of indicators where we ask lots of questions of the companies over a 10-month period. And, by doing that, we hope to understand how financially material is nutrition to these companies. We want to give something of use, not only for the companies, but to policymakers. Because we know there's a big role for policymakers to both incentivize the production and the marketing of healthy foods, but also disincentivize unhealthy foods. We want this to be useful for investors. So, we spend a lot of time, through collaborative engagements, working with the shareholders of these companies as well so that they can invest more responsibly in the food company. And then the other group that we hope to eventually work with are the consumer associations. The groups that would represent consumers so that they can put appropriate pressure on the demand side, you know. They can demand healthier food. It's not that we believe by running an index somehow companies are going to start doing everything right. No. We want to provide data and analysis to the sector so that all the stakeholders can use it to help influence change.

That makes perfect sense to have some data driven enterprise to figure out what's actually going on. Otherwise, you're just having to go on intuition. So, what did the most recent index find?

Right, so out of those 30 companies, what did we find? There's some good news. Let's start with the good news before we get into the bad news. There's maybe more bad news than good news. In aggregate, we're actually now seeing that 34 percent of the revenue derived from the products that we profiled, those 52,000 products, is based on healthier sales. Meaning 34 percent could be considered healthier foods. That doesn't sound great, maybe, but consider just 4 years ago when we ran this index, it was at 27%. So, there's some marginal increase and maybe if we can accelerate things, and that's what we're trying to do, it's our big strategic objective. We hope that by 2030, we could say that at least half of business' revenue is coming from healthier food options. There's a lot of changes that need to take place to get to that point, but some companies are doing it.

Also, we noticed a lot more companies are now starting to use a government endorsed nutrient profile model to define the healthiness of the food products, to measure and monitor the healthiness of their food portfolios, and then to disclose that. That's really good. It's the beginning. First step is measure, disclose. The second step would be put targets on that and actually start to get substantive change towards 2030.

But there was a lot of unfortunate news too. We had some backsliding from some of the major companies. For example, low- and middle-income countries actually had the lowest health score. What we think is happening, based on the data we looked at, is that if you're a low-income country, you're getting the lowest healthiness score of these products in your country. So, brand X would be slightly healthier in Europe, but less healthy in the low-income country. So there's a need for regulation there.

Can I stop and ask you a question about that? I've got a million questions just flying out of my head that I'm dying to ask. But what you reminded me of is the history of the tobacco industry. When the policies came into play, like very high taxes and banning smoking in public places in the developed countries, US specifically, the smoking rates went way down. But the companies made more money than ever because they just went outside the US. Especially the developing countries and were selling their products. So, it sounds like the food companies might be engaged in a similar enterprise. But why in these countries would they be pushing their least healthy foods so aggressively?

I'll start with the facts, because there's some speculation here. But the fact is, if you look at your own monitored data, the highest growth of the modern food retailers is in Africa. So, you've got, for example, 80 to 300 percent growth over the last 5 years in Africa of these modern food retail shops. And in Asia, that's, that's already happened. Still happening in some countries. So, you have enormous opportunity for packaged foods, right? Because that's usually what they're selling, these retailers. I think you have some aspiration going on there, too. I think there's consumers who aspire to have convenient foods. They're more affordable now as incomes increase in those settings. Now, regulation is definitely, in general, in those countries, not as mature as it might be in Europe when it comes to colorants, and taxing, say, sugar sweet beverages. So, what you've asked, I think there's some truth to it. I don't want to come out and say that that's exactly what's happening, but we ran the numbers and the healthiness score. So, we use a five-star rating system. The Health Star rating system, one to five. Anything 3.5 or above, we would consider healthier in a diet. 3.4 and below would be considered unhealthy. And the score in low-income countries was 1.8. And in middle to high income, it was 2.4. So, it's quite a, quite a big difference.

That's really very striking. You know, I guess if I'm a food company and I just want to maximize my profits, which of course companies are in business to do, then what I'm going to sell are the foods that people eat the most of. Those are the ones that are triggering the brain biology, the 'over consume'. And the ones that have the greatest shelf life and are easiest to produce and things like that. So, I'm going to make processed foods and push those into new markets as aggressively as I can. So, I'm not asking you to think through the corporate mindset about what's driving this. But it sounds like the data that you have, the end product of all these practices, would be consistent with thinking like that.

We like to think that there could be a role for healthier processed foods. But it has to be in moderation. So, what we looked at is the materiality of nutrition. Are companies actually able to have their business and have a healthier food portfolio? So, before we ran the global index, we did an assessment of this. And what we found is that if you're a mixed food company, and you decide to reformulate so that over time you have a healthier food portfolio, in fact, we found that their capital valuations and how they did on the market was slightly better. Not a lot. Than their say, less healthy counterparts. So, what we see is the beginning of a 'health is wealth' sort of narrative. And we hope that we can drive that forward. And of course, policy would help a lot. If policy would come out and say, let's tax the bad, subsidize the good. Then I think industry is going to fall in line. So, we're not sympathetic with industry because a lot of what's happening is not good. On the other hand, we're realists. And we know that these companies are not going away. And we need to make sure that what they offer is as healthy as it should be. And there's a role for everybody in that.

All right, that's such an interesting perspective. So, you talked about the global findings. What can you say about the US in particular?

What I'd like to do is actually refer to our 2022 US index. So, we did a deep dive just recently; October 2022, right after Biden's Nutrition Conference in DC. And, it wasn't really positive in the sense that we looked at 11 companies. The 11 biggest companies representing 170 billion revenues in the US. And 30 percent of all US food and beverage sales were based on healthier food options. Now, that was 4 years after we ran a 2018 US index. So, 2018, same thing, 30%. There's no change. It's still as unhealthy as ever. I think we need the US to come on board here because it is such a leader. A lot of these companies are headquartered in the US. So, we need to see that healthiness score go up in the US.

You know, it's interesting some of the things you mentioned companies might be doing outside the US would be helpful if they did take place in the US. Like front of package labeling would be one example of that. So that would be a place where American companies are behind the curve, and it would be helpful if they caught up. It'd be interesting to dissect the reasons for why they are. But it's interesting that they are. What are some of the things businesses are doing to improve nutrition outcomes? Let's talk maybe on the more positive side. Do you think there's progress overall? It sounds like it from the numbers that you're presenting. But are there signs also of backsliding? And what do you think some of the successes have been?

Yes, and I think we can get specific on a few. There's a company headquartered in Mexico, Grupo Bimbo. They rose up in the rankings six places between our 2021 Global Index and this one in 2024. They've been reformulating. They've been making their product portfolio healthier overall. It's about 50 percent now. I think some of that was their own initiative, but it was also prompted by a lot of Latin America's regulations, which is great. I think we can learn a lot from Latin America when it comes to front of pack labels and taxes. So, Group of Bimbo was a good success story. Arla, a Danish dairy company, they came out on top in the index in terms of marketing. So, they have basically said they're not going to market unhealthy foods to children under the age of 16. And they try to even go to 18, but it isn't quite being monitored across all digital platforms. And that's the next level is to take it to the digital platforms and monitor that.

And that was a bit disappointing in general, just to find that out of the 30 companies, not one is able to come out and say that they followed the WHO Guidelines on Responsible Marketing 100 percent. The latest index shows that nine out of the 30 companies now, or 30%, nine out of the 30 companies are now using a government endorsed nutrient profile model to define healthy, and then monitor that across their portfolios. And that's a lot of progress. There were only a handful doing that just four years ago. We would ask that all 30 use an NPM, a nutrient profile model, but nine is getting somewhere. So, we're seeing some progress.

Boy, if not a single company met the WHO Guidelines for Food Marketing it shows how tenacious those practices are. And how important they are to the company's bottom line to be able to protect that right to market to kids, vulnerable populations, to everybody really. So it really speaks to keeping that topic in the limelight because it's so important.

We'd like investors to come out and say they will only invest in companies that are moving towards a 2030 target of marketing response. Zeroing in on 1) responsible marketing and 2) the healthiness food product. Zero in on those two things make really clear what the metrics are to measure that.

So, you've mentioned several times, a very important, potentially very important group: shareholders. And you said that that's one of the stakeholders that you interact with. Are there signs out there of activist stakeholders? Shareholders that are putting pressure on the companies to change the way they do business.

Yes. So, institutional investors have the ability to talk directly to the board, right? And they have the power in many cases to remove the CEO. So, they're a powerful group, obviously, and we've worked with over 80 now. And had them work with us to understand what investing in a progressive food company would look like. It's making better and better decisions, continuous improvements on nutrition. We have 87, I think is the latest count, who have signed a declaration to invest like this in a food healthier business. They represent $21 trillion of assets under management. It's a very powerful group. Now are all 80 actively, like you mentioned activist shareholders, you know, pushing, say, for example, for resolution. No. Some are. And they're using our data for that. And we applaud any kind of action towards better nutrition, healthier foods, better marketing using our data. We, as ATNI, do not sign these shareholder resolutions. But we absolutely will make our data available as a public good so that they can be used by this powerful group to yeah, hold the companies to account and hopefully invest in the long term. That's what it comes down to. Because it's true that this will take time for the benefits to come to both business and to people, but it's worth it. And I think the longer-term investors get it. And that's why they're doing these shareholder resolutions and different other investor escalation strategy.

That strikes me as being pretty good news. Let's go down this road just a little bit further, talking about this, the shareholders. So, if the shareholders are starting to put, some at least, are putting pressure on the companies to go in a healthier direction, what do you think is motivating that? Do they see some big risk thing down the road that they're trying to anticipate and avoid? Is it policies that if the companies don't behave, governments might feel more emboldened to enact? Is it litigation that they see? What are they trying to avoid that's making them put pressure on the companies to move in these directions?

That's a great question. When we ran the materiality assessment on nutrition earlier this year, we interviewed many of the investors and it seemed to come down to three things. One, there is coming regulation. There's more and more evidence that when you regulate the food system and you regulate food industry, and you do it in a smart way through a two-tiered levy system, for example, on sugar sweetened beverages. You tax the company, not the consumer. It actually does work. You have a decrease in consumption of these beverages. So coming regulation. The other one is increasing consumer demand for healthier options. Now, that might not be happening yet everywhere. And I think it only really happens when people can afford to demand healthier foods, right? But it seems like it's a trend everywhere as incomes increase and people's knowledge and understanding of nutrition increases, they do want healthier options. So, I think investors see that coming. And the third one is healthcare bills. Now, the investors don't always pick that up. Although in the case of some of our insurance companies who we work with, like AXA, it does. But they see the big macroeconomic picture. And we were talking to one of the investors last week, and they said it's all about megatrends. For them it's about investing in the megatrends, and they see this as a mega trend. This, you know, growing obesity, the cost related to obesity, growing costs related to diabetes and all NCDs. And they don't want to be investing in that future. We need to be investing in a healthier future. I think those are the three things we're gathering from the investors.

So, Greg, there's sort of this jarring reality, it seems to me. And other people have written about this as well. That if the world becomes healthier with respect to its diet; let's just say you could wave a magic wand and obesity would go from its very high levels now to much lower levels or even zero. It means the world would be having to eat less food and the companies would be selling less food. And then you superimpose upon that another jarring reality that people simply buy more, eat more, of less healthy options. So, if a child sits down in front of a bowl of plain cornflakes, they're going to eat X amount. If that's sugar frosted flakes, they're going to eat, you know, 1.5 X or 2 X or whatever the number is. So, how can the companies try to make as much money as possible and be true to its shareholders and shareholders while at the same time, facing these realities.

That's a great question. It goes to the heart of what we're trying to do at ATNI. That's why we say we're transforming markets for nutrition. Because if we don't help support that underlying market change, then we won't get very far in a sustainable way. You mentioned calories and over consumption. And that, of course, is part of the problem, but I think it's equally fair to say not all calories are treated the same and we need to look at the ingredients going into these food products to begin with. You know, why is sugar or any kind of corn derivative such an attractive cheap ingredient to put into food? And so bad for people if it's not eaten with anything else, if it's just an empty carb, for example. It's because of the subsidies, the billions of dollars of subsidies going into sugar around the world. In the United States, a very large subsidy going to the corn industry. And so, corn is then turned into many types of derivatives, many different types of ingredients that go into our foods. So, that's one thing. I think the other is that there's a big role for food policy to level the playing field. We hear this all the time from our industry partners, and we tend to agree. You know if two or three of the 30 companies that we just indexed stick their neck out and do something good, it’ll work for two or three years until the other 27 start to undercut them. And if they're somehow making, you know, better money, bigger profits, more market share it's going to be very tempting for the three that made the good decisions to go back to what they were doing before. We have to change the market structure and end the perverse market incentives.

Makes sense. One final question. What can policymakers do?

I think we've touched on it a little bit. There's the fiscal policy space, which we're very excited about at ATNI. There are over 100 jurisdictions now that have put in place some kind of sugar sweetened beverage tax. But why not expand that take it to any kind of product which is too high in sugar, right? And again, make it like a proper levy on the company and not the consumer. Because that's where the evidence is that it works. Subsidies, you know, there's very few countries which are subsidizing healthier foods. Instead, you're seeing subsidies, as we just mentioned, going to the wrong kind of product. So that's one. And here's a new one: environmental, social, and governance investing metrics. As countries start to mandate the disclosure requirements for publicly listed companies, why not include two nutrition metrics? One on marketing, one on healthiness, so that every food company is mandated to disclose information on these things. That would be a real innovative way for policymakers to help regulate things. And front of pack labeling. You mentioned it yourself earlier. We would agree clear front of pack labels. So, the consumers know what's healthy and what's not.

BIO

Greg S Garrett is the Executive Director of ATNI (Access to Nutrition Initiative), a global foundation supporting market change for nutrition. Greg has held several leadership roles over the past twenty years, including serving on the Global Executive Team of the Drugs for Neglected Diseases initiative (DNDi), directing Abt Global’s health reform in Kyrgyzstan and leading strategy at ThinkWell, a global health organization. During his eight years with the Global Alliance for Improved Nutrition (GAIN), Greg served as Director of Food Fortification and Director of Policy & Financing during which time he established a multi-million-dollar financing facility and managed a portfolio that reached one billion people with fortified foods. Greg serves on the Global Nutrition Report’s Stakeholder Group and is a member of the Blended Finance TaskForce. He holds a BA and an MSc in International Development from the University of Bath, UK.

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The U. S. is the largest importer of aquatic foods, which includes fresh and saltwater fish, crustaceans, mollusks, and aquatic plants served in restaurants and homes. A critical piece of this global market is the cold chain, keeping these foods chilled or frozen during storage and transport to market. With 44 percent of aquatic foods sold live or fresh globally, the percentage of fresh over frozen aquatic foods creates an extra logistical cold chain challenge. What's more, most aquatic foods become, well, fishy from cold chain disruptions, which can cause perceived food safety concerns, potentially resulting in food getting tossed into the bin. Until recently, research to understand just how much aquatic food gets wasted or lost has been spotty. However, in a recent Nature Food article, researchers argue that aquatic food loss and waste in the United States is actually half of earlier estimates. And that's good news that we'll explore today. This interview is part of an ongoing exploration of food loss and waste.

This episode is co-hosted by environmental economist, Martin Smith at Duke University's Nicholas School of the Environment.

Interview Summary

Martin Smith - So I'm really pleased to introduce our guests for today. First up from University of Florida, a natural resource economist, Frank Asche. Frank is a long-time collaborator of mine and a good friend. And he's also one of the world's leading experts in seafood markets and trade. And honestly, Frank has taught me just about everything I know about aquaculture.

Also today, we have Dave Love from the Johns Hopkins Center for a Livable Future. Dave is someone whose work I'm also very familiar with and is a leading expert in food systems and sustainability. And recently in my classes, I have often said out loud to some student questions that I don't know the answers to. I'll bet Dave Love knows the answer to that question.

Norbert Wilson - So Dave, let's begin with you. Why was it important to develop better estimates and methods of aquatic food waste in the US? Why did your team pursue this research question?

Dave Love - Great question. So, the US government has a goal of cutting food waste in half by 2030. And if you want to know how much you need to cut, you really need to go out and measure. And that's one of the areas of food waste that we really don't know a lot about for many different types of foods. We know the production data. We know how much is produced. We have a pretty good sense of what's consumed, whether that's in an economic sense of being consumed or actually eaten. But we really don't know how much is wasted. And groups come to the table with different numbers, different estimates, and they, they make their way into reports, into national guidelines. But for seafood in particular, the estimates haven't been refreshed in a while. So, it was about time to do that. And this study aimed to tackle that issue from all the stages of the supply chain, from production to consumption, looked at different forms of seafood and among the top 10 species. So, we rolled those species estimates and stage estimates into a national number. So yeah, that that's, that's why we did it. And we were really surprised at what we found.

Norbert - Well, what surprised you?

Dave - Well, earlier estimates were that about half of seafood was lost or wasted in the US and that came from UN Food and Agriculture Organization data. And when we actually crunched the numbers for the US supply, we thought it was more like 22.7 percent is wasted. So, a lot less than the FAO estimate. Which means we're doing a good job in some areas, but there's also room for improvement in others.

Martin - So, Frank, maybe you could tell us a little bit more about the key takeaways from this Nature food paper are?

Frank Asche - It's really that it's important to recognize that we are consuming a lot of different species and they have very, very different characteristics. For instance, the filler yield of a salmon is about 65 percent while for a cod it is about 40%. That makes your starting point really important. Moreover, this thing of looking at the whole supply chain is important because there are different ways to organize it, and there are a lot of potential uses for what food is sometimes wasted. And to look into what different types of producers are actually doing. What different companies that are operating these cold chains that Norbert spoke about are doing. And what they are doing when these things break apart. Kind of, there's all these people in the supply chain that may help us, and some of them do. Some of them aren't very good at it. But it's really nice to find that there are best practices that can really help us a lot of people take the trouble to figure that out and follow that up.

Martin - That's really interesting. And it makes me wonder with all this heterogeneity that you're describing, are large producers better positioned to manage or, or reduce food waste than small producers? Or is it the other way around?

Frank - Oh, I'm a good researcher. So it depends.

Martin - It depends. Of course it depends. It depends!

Frank - If we're going to say anything general then, in wealthy countries, large producers are better. In poor countries, small producers are better. In the sense that when labor cost is low, and food is relatively expensive people are much more willing to eat a fish that is not the best quality. While, if you're a small-scale producer in a wealthy country where labor is really scarce, you tend to focus on your main production process, which is the fillet. While if you become a big producer, then the quantities that potentially gets weighed that become so large that they actually are a useful raw material for new products. And we see big producers developing new products that it doesn't make sense for smaller producers to look at.

You've all eaten your hamburgers. One of the more popular products in recent years is different kinds of seafood burgers. And they are great because they are trimmings and cutoffs and slices that doesn't fit well into that fillet that you're normally thinking about when you're consuming a chunk of fish.

Martin - Yeah, and I think many seafood consumers have had that experience of being at the fish counter and saying, 'Oh, I only want this much,' and they put too much in there and like take a little off. And then you start to ask yourself the question, who's going to eat that little, little bit that gets sliced off. That's really interesting and enlightening. I had another question for Frank. Before we go back over to Norbert. So, in this paper, you describe different points along the food supply chain where the seafood might be lost or wasted. Can you talk a little bit more about that in different points in the supply chain and why there are some of these differences between species? You mentioned the sort of, yield of salmon and cod for a filet being a little different. And so, I'd like you to talk a little more about why different species might, might get different rates of loss.

Frank - I think it starts with this thing here that for most seafood species, there's a choice part that is sort of your preferred chunk of meat. Most species it's a filet, but for a mussel, you eat everything that is within the shell. But it's different. But even for all those species, kind of, there are shrimps with small heads, there are shrimps with big heads, there are fish that gives you really good fillet yield, fish that doesn't. There are fish where there's a lot of useful meat that, say, the head or in the tail, that normally doesn't make it to a store, but it's useful if somebody chooses to use it. And then you have the quality issues. If a fish, say, falls to the floor during the production process, what do you do with that? And, yeah, that's one of those things we learned that in Vietnam, they will give it to a worker, and they will eat it. And Norwegian salmon, they will typically put it into some kind of acid where they use it to make animal foods. Small scale producers will just throw it into the bin. Other producers have good systems which, within the right hygienic control systems, are using what they can and not what they cannot. In general, producers have been getting better, but producers are still one of the key points in the chain. The companies from the producer of the raw fish to the consumer is generally pretty good. And there's fairly little waste in transportation and processing and so on. Then there's a bit more waste in the store. One of the cool little episodes I learned during this project was that one of the biggest items of food loss for fish in US grocery stores were people buying shrimp for the salad, and then deciding that they didn't want the salad anyway, and they are putting it in a shelf somewhere else.

But you and I are the biggest problems. That is, what do we do with what we do not eat when we come home? What do we do with this portion that we put out of the freezer, and we didn't eat all of it. And we are pretty bad when we go to a restaurant too. And too often we don't eat our full portion. We may wrap it, but, but do we actually eat it the next day? In general, we do not.

Norbert - Dave, I have a question. I recognize you as a sustainability expert. So how does understanding the pinch points for aquatic food losses and waste help households, the food industry and, and policymakers?

Dave - Seafood is one of the most expensive proteins. If you go to the grocery store, it's going to be, you know, $9, $10 up to $15 or $20 a pound. And really, consumers don't have that amount of money to throw out. If they're going to buy it, it's in their best interest to eat it. So, we're looking at ways that the seafood industry can package and sell products that are going to help consumers, you know, stretch that dollar. One of the ways is through frozen seafood. Selling prepackaged individual units frozen. And, through this project, I've started to buy a lot more of that type of type of seafood. And you can also buy it now for other kinds of meats. And you just, whatever you want to prepare probably that, that next night you, you know, cut out the packaging, put it in the fridge and a little bowl in case from food safety standpoint in case it leaks. And then you don’t want to leave it on the counter overnight or leave it out for a couple hours.

But so, there are ways that you can package products that perceive what consumers are going to ask for. And you can still get that freshness in seafood, even if it's frozen. Because a lot of frozen seafood is frozen on board the vessel. It's frozen sooner than it actually would be if it was processed in a processing plant. So, you know, I think it's kind of a win-win. We've been exploring cook from frozen as a not just food waste, but also for other angles of sustainability. Because of course when there's waste is also the embodied energy and the embodied water and all the things that go into making that food. And when it gets to the consumer, it's got a lot more of those steps involved.

Norbert - Thanks, Dave. I will say from some of my own research looking at package size, and package configuration that smaller, more readily used products are less likely to be wasted. I can appreciate that kind of innovation in seafood products could also be beneficial. And my family, we're big users of frozen seafood, and the quality is good. So, these are really helpful ways of thinking about how we as consumers can make adjustments to our behavior that can actually mitigate some of the food waste that you all observed. And so, because of this research, what new insights do you have about loss along the supply chain for aquaculture versus wild capture fisheries?

Dave - That's a really good question. I can speak to the production stage. That's one of the areas we looked at where you see the most amount of food loss - at the production stage anyway. But we sort of split it out as the fisheries losses were either discards or bycatch. And from aquaculture, people had not really estimated what food loss looked like in aquaculture. But we looked at disease and mortality as a cause of food loss. We asked farmers, what's your typical mortality rate when you're raising shrimp or salmon or tilapia? We got back their mortality rate, we did some modeling, some estimation and found out when a certain percent of that harvest dies. Not just when they're babies, but when they die close to the harvest period, we'd count that as, as food waste. Because there are ways to control disease in aquaculture. You know, it's not going to be zero. There are always going to be some animals that die. But, if you do control disease, you can cut down on some of this kind of perceived food waste in the process. So, we counted those two things differently.

I would think a good example would be Alaska sockeye salmon. Over the last 10 or 15 years, they've instituted a lot of new methods for reducing damage to fish when they're captured. For example, now you get incentives as a fisherman to put down rubber mats. So, when the fish come off nets, they don't hit the boat hard, they'll hit a rubber mat. Their incentive is to bleed the fish, which helps with quality. And of course, to ice them when they're caught. You know, a lot of the catch of sockeye salmon in the '80s - '90s, didn't necessarily get refrigerated after it was caught. It went to a canning line. And folks eating canned salmon, they couldn't tell the difference. But as the salmon industry in Alaska transitioned to more of a value-based fishery, they increase the quality, increase the percentage of fillets compared to canned. I think a lot of these things go hand in hand with value. As you decrease food waste, increase food quality, you can sell it for more. I think that's a nice transition point for a lot of farms and producers to think about.

Martin - Since we're on salmon, I have a quick follow up on that. I noticed in the paper there is some differences in the rate of food waste for wild caught sockeye and for farmed Atlantic salmon. And in my mind, I immediately went to, well is that because most of that wild caught sockeye is ending up frozen? Maybe it's sold at the fresh counter, but it's been previously frozen. That's certainly my experience as a seafood consumer. And most of that farmed Atlantic salmon is actually sold directly as fresh and never frozen. And so, I'm wondering how much of that is a driver or how much it's really the disease thing?

Dave - It's probably a little bit of both. At the retail stage, if you're going to a grocery store and you're looking at that fresh display case, the rate of waste there is somewhere between five and 10 percent of what's in that display case. It’s going to end up in the garbage. They want to just have a nice presentation, have a lot of different products laid out there and they don't all get purchased. Some grocery stores will prepare that and sell it on a hot bar. Others, their principle is we just want to provide the freshest thing and they are okay with a little bit of waste. For canned and frozen seafood, the rate is more like 1%. And as Frank alluded to, sometimes people pick up a frozen item and they get to the checkout counter and they go, you know, I didn't really want to buy that. And they might slip it into you know, another aisle where it shouldn't be. That middle of the chain, there's not a lot of waste that we saw. You know, wholesalers and distributors, that's their job to deliver food and they really do a good job of it. And then at the upstream stage, the production stage, there's a big range in waste. And it depends on the product forms and at what point is the fish cut and frozen.

Martin - So, I have a question for both of you now, maybe changing topics a little bit. So, reducing food waste, food loss and waste, is an important element of environmental sustainability. I think we all agree on that. And that's particularly in response to climate change. We know that Greenhouse gas emissions associated with our food system are a major contributor to climate change. I'm wondering, sort of looking ahead, what role do you see seafood in general playing in a future in which we might price carbon emissions. We might actually make it costly to buy products that have a lot of that embodied greenhouse gas emissions in it.

Frank - Yeah, pretty well actually. But it depends a little bit on what's your current diet. If it has lots of red meat, seafood is going to do really well because red meat in general have significantly higher carbon emissions. If you're a vegetarian, maybe not that much. So, in the bigger scheme of things, seafood looks pretty good in the category of animal proteins, largely together with chicken. The difference between most seafoods and chicken is not too big. And of course, there's a little bit of variation within the seafood. They of course have a problem though in that nature produces a limited quantity of them. And if the amount completely takes off, there's no way you can increase the supply. So, then it must be aquaculture. And then you are more than slightly better or approximately chicken.

Dave - And I'd say you know, if you want to learn more about this topic, stay tuned. We've got a paper coming out about that. It should be out fall 2024 or early 2025. Similar to the waste piece, we've done the energy footprint, the greenhouse gas footprint, and the water footprint of all the products you see in the Nature Food paper. And we're really excited to share this finding soon.

Martin - That sounds really exciting and I can't wait to see it.

Norbert - I'm curious about your thoughts on how trade incentives or restrictions could be used to remote access to aquatic foods in addition to climate resilience of the food system? Frank, could you give us your thoughts?

Frank - Oh, there's a short answer to that or a complicated answer. So, the short is, of course, you can do like you're done with some other challenges. You also have dolphin-safe tuna and turtle-safe shrimp and so on. And you could basically make it hard to enter the market for people with bad practices. And you can make it easier to enter the market for producers with good practices. But if you go to the more complicated thingy, and particularly if you are also interacting with domestic supply chains, then we do know really well that eating beef is a real environmental challenge. But I still cannot see a world, at least within the foreseeable future, where US policy is going to sort of suggest that we're going to import more seafood so that we can produce less beef. And when you get to all those complicated interactions, yes, you can use trade policies to advance some agendas. But they are certainly going to run into some others, and it's a challenge when there's so large heterogeneity when it comes to what do you think a good food system is.

Norbert - Dave, what about you?

Dave - Well, I sort of come at this from a different angle. You're thinking about local; you know. What's the value of local food and local and regional food systems? And so, in principle, I'd like to suggest that to people to buy their food from regional markets. Because of the connection to place and that's really important. Once you have that connection to place, then you start to value the environment where it comes from. You get a little bit closer tied to the labor market and the folks who grow and produce that food. So, I like to kind of come at it from that perspective. Invariably we're going to have some internationally traded seafood. Right now, 70 percent of seafood is imported. But I think looking at opportunities to support your local and regional fisheries, and your local and regional aquaculture, I think there's a lot of merits to that. Some of them could be climate arguments. And there's lots of other good arguments for it as well.

Frank - I agree with that, but I really think that you should have the caveat that producing your seafood, or really any food under good microclimatic conditions, with good soils or water for that product, gives you food with a much smaller footprint than what you have necessarily locally. And particularly if you're producing something that doesn't really belong that well locally. And it's also really important that, except if you fly your food by air the carbon footprint of transports is tiny.

Dave - Yes, that was, that was one thing we found. With air cargo be really careful. You want to buy live seafood or fresh seafood that's air freighted, that's going to be a big piece of the carbon footprint. And really for consumers, an easy way to chip away at their environmental impact is to cut out stuff that's flown in fresh. But, you know, that flies in the face of what restaurants and grocery stores are trying to sell, which is 'the freshest.' ‘We're going to give you never frozen super fresh.’ So there's a bit of a disconnect there. And I think unlocking that is going to be getting into some of these chefs' minds and talking to them about - you know fresh is important, but how do you want to spin this in a way that you can have it fresh today, but you also can have it fresh in the future. Not just today, but a few generations down the road when it is possible to fly in food from all over the world that have that perfect plate. And you know, this is something that we need to engage with lots of different people on.

Martin - It sounds a little bit like you're suggesting a, a world in which we, we seek to consume fresh local, and frozen global. In the sense that, that you cut down all those, those transportation, greenhouse gas emissions, if you're doing frozen seafood, and you can exploit that sort of natural comparative advantages of different places to farm and different places to catch seafood with those global markets. But, but for the real fresh stuff, there might be some benefits to eating locally, including those, those greenhouse gas emissions.

Dave - When we looked at the trade from Asia, 99 percent comes by container ship. You know, almost nothing's being flown in. And then when you look at closer markets to the US. What was Europe... it was maybe closer to 50 /50 for flown versus shipped by water. And yes, I think South America was similar. I guess the closer you get to the US market, you know, there's that incentive to kind of fly it in and get the price premium. There's definitely a reason to do it, but it does come with a part of the carbon footprint, you know. It's, it's maybe a quarter, maybe a third, you know?

Frank - But as Marty alluded to, as long as there's no cost associated with the carbon footprint as is the case now, nobody will really care. It's first when you actually have a system where there's a price to it that you would expect to see any real change.

Dave - Yes. And, we did some work, sort of a spinoff to this. We looked at the US seafood industry and then they become more carbon neutral. We teased that out for a couple of different sectors: farmed catfish in Alabama and wild caught salmon. And there are steps that producers and fishers can do, but a lot of it's going to have to depend on their local utility. What's the energy mix of the utility? Because that utility energy mix is what feeds the plant. It feeds the energy going to a catfish farm. And they use a lot of electricity, but they don't have a big say in what the Mississippi Electric Cooperative or Alabama Electric Cooperative chooses as its energy mix. So, I think there's, it's really a 360 issue that when you start trying to unpack energy and climate, it goes well beyond the seafood sector really quickly. So, we can be a voice. But it's going to take a lot of people to make systematic change.

Martin - Great. So, I had one final question to ask each of you. And that's really about what's next? And I know we have this other paper that's coming out to look deeply into the life cycle of the different species featured in your food waste paper. But I'm wondering specifically what's next on seafood waste and, and what kinds of things will affect what kinds of policy changes might be on the horizon, what kinds of things will affect change, short of, I guess, what we've already talked about. Which is some, you know, sweeping carbon legislation that, that prices carbon. But short of that, what other kinds of things are going to affect change and what else do we need to know? Let's start with you, Dave, and then then we'll go to Frank.

Dave - I think we sort of laid out the big picture. The estimates for the US supply for different production stages. But I think we really need to drill down into case studies where folks, us and, and colleagues, I know Ronnie Neff is exploring this with you Norbert, but really drill down into case studies that try out some of these ideas that we have. Some of the innovations being implemented and see how they work and maybe scale up the best ones.

Frank - Right. And beyond that is like companies are doing what companies always have been done at all stages in supply chain. As long as new technology makes it profitable for them to be more sustainable, they're going to be more sustainable. So, there's going to be a lot of new packaging and new ways of chilling and so on that will help. But at the end of the day, the biggest challenge is you and I as consumers, and what we both buy. Because that determines what products is going to be on offer. And then how we treat them after we have purchased them.

This podcast is co-sponsored by the Recipes Food Waste Research Network Project, led by American University and funded by the National Science Foundation.

BIOS

Dave Love is a Research Professor at the Johns Hopkins Center for a Livable Future. Dave’s work focuses on aquaculture and fisheries and the environmental, social, health and food system issues related to those industries. He also engages in a wide range of food-related topics including food waste, veterinary drugs and drug residues in foods, antimicrobial resistance, and CAFO worker and community health. In 2012 he founded a research and teaching farm at the Cylburn Arboretum in Baltimore and oversaw the facility from 2012 to 2015. The farm is now called the Food System Lab and is a place where students of all ages learn about urban agriculture. The Food System Lab is a member of the Farm Alliance of Baltimore and sells produce at the Waverly Farmers Market. Prior to joining Johns Hopkins Dave was a postdoctoral fellow with Dr. Kara Nelson, working at the interface of engineering and microbiology, in the Department of Civil and Environmental Engineering at the University of California Berkeley.

Frank Asche is a professor of natural resource economics at the University of Florida School of Forest, Fisheries, and Geomatic Sciences. He is a natural resource economist with a research focus on seafood markets, production of seafood from fisheries and aquaculture and the sustainability of these production processes. Frank is president of the International Association of Aquaculture Economics and Management (IAAEM), editor for Aquaculture Economics and Management and associate editor for Marine Resource Economics. He was also a member of the team that developed the Fish Price Index of the United Nation's Food and Agricultural Organization (FAO).​

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If you feel like your grocery budget just doesn't buy you as much as it once did, you're not alone. According to U. S. Bureau of Labor Statistics, food prices rose 11. 4 percent last year alone - the highest annual increase in 23 years. The ongoing pinch at the grocery store has been in the news of a lot of media outlets, such as The Wall Street Journal, The New York Times, Times Magazine, Forbes, and so many others. Our guest today, food economics and policy professor David Ortega from Michigan State, is going to walk us through the food price inflation phenomenon.

Interview Summary

We've been hearing a lot about food price inflation. Can you tell us how food prices have changed over the last four to five years, and how that compares to the recent past?

Definitely. So, I think it's always really important to define what food inflation is so that we're all on the same page. We hear this word a lot and we've been hearing it for a number of years now. Inflation is the rate of increase in prices over a period of time - so how fast prices are changing or increasing in a given period. The time frame here is very, very important. Now, compared to last year, food prices are only up 2.1%. And this is for all food, which includes food at home and food away from home. Now groceries, food at home, are up 0.9% compared to last year. And menu prices at restaurants, or food away from home, are only 4.0% higher. Now if you're listening to this, you're probably thinking, ‘well, how can this be given how expensive things are at the grocery store?’ And that's because you are likely thinking about how food prices have changed since the start of the pandemic, right? So, over the past five years, food prices have increased around 26%. And so that's the cumulative effect of inflation that we're all very familiar with at the grocery store.

Wow. You talked about the recent past, and in particular, about the time since COVID. How has this looked historically if you take a longer time frame?

Yes, so if we look at a few years before COVID, food prices generally increase around 2% or so, year over year. Now in the summer of 2022, we experienced double digit increases in food prices. More than 11%, year over year. And that was the highest rate of increase in around 40 years, since the late 1970s and early '80s. So now that's a significant spike and departure from what we would consider to be normal. But the rate of increase has come down to almost pre pandemic levels, which is really great news. But remember the rate of inflation is the rate of increase, so because that rate has come down, it doesn't mean that prices are decreasing necessarily.

They're just not growing as fast as they were before.

Correct.

I have some ideas, but I really want to hear you talk about it. What has led to this significant increase in the last four and a half years or so?

It's really been a convergence of factors. It's not just one particular thing, but really all these factors coming together and sort of compounding on each other. We saw increases in labor costs, and then as we go through the timeline, we had Russia's invasion of Ukraine in February of 2022. And that really sent commodity prices surging for things like wheat, other grains, as well as vegetable oils. And it wasn't just the invasion alone, but we had countries responding with export restrictions on things like palm oil that really just exacerbated the situation. We also have the impacts of climate change. The summer of 2022, and for a few years leading up to then, there was this mega drought in the West and the plain states that affected anything from lettuce prices to the price of meat. Something that we're experiencing to this day. We also have the bird flu outbreak, now the largest outbreak in U. S. history. Egg prices have been through a bit of a roller coaster ride, and we've been hearing a lot about increases in egg prices. That's primarily due to the high path avian influenza outbreak, or the bird flu outbreak.

Now, those are all what I would consider, for the most part, to be supply side factors. But we also have demand factors at play. And that is, that when we look at consumer spending on food, especially over the past two to three years, it's been much higher compared to before the pandemic. Even when you adjust for inflation. Now, this is likely attributed to households. Some of them accumulated savings. We had the fiscal stimulus payments from the government that injected cash into the economy. For a period of time, some households, we could splurge at the grocery store. We've seen, and the data from USDA shows, that consumer spending on food both at home and away from home is much higher in recent years than prior to COVID. So again, it's a combination of both supply side and demand side factors that have contributed to the significant rise in food prices.

This is a really important point that it's not a single factor, but it's this mix of things, which also makes it really difficult to talk about how to disentangle it. And I definitely want to hit on that. But before we get there, I want to know what has the impact of these significant price increases on consumers been?

The first thing that I want to point out is that food price inflation doesn't impact everyone the same. It's really low-income households that are hurt the most by these price increases. And that's because they spend a higher share of their income on food. When we look at the poorest 20% of American households, they're spending over a third of their income on food, compared to the average American household that spends roughly 10 to 12%. Now, when we look at industry data, we see that as a result of inflationary pressures, individuals are making shorter and more frequent trips to the grocery store. They're doing more price comparisons. They're turning and buying more of the private labels, the store brands, that sell at a much more affordable price point. And they're buying fewer premium items. So less of the stocking up that we saw at the beginning of the pandemic. But this in turn can also fuel an increase in the price of those conventional or cheaper items. And that's something that I found in the research that I've done on egg and poultry prices. When prices increase, consumers switch to the cheaper, more conventional items. And that increase in relative demand can put upward pressure on prices. So, we've seen this also reflected in the way that consumers are shopping for food and the prices that they're seeing.

I think this is really critical for us to appreciate that while it is an often talked about issue, price inflation, and it does hurt lots of people, but appreciating that lower income folks are facing this at a much harder way is important. And, having spent time working with the charitable food sector and understanding the experiences of the individuals there, you're regularly hearing people talk about the high price of food and how they're trying to navigate it. And the role that these food pantries can play in helping meet that need, but it just still it's a grind. It becomes really challenging.

Yeah.

Recent economic data actually shows that food price inflation is moderating. So, it's not as hot as it once was. But consumers are still experiencing sticker shock at the grocery store. What's going on here?

So, coming back to the earlier part of the conversation, people are really feeling the cumulative effects of inflation. And again, that's why I find it very important to define inflation as the rate of increase in food prices. Well, the average consumer at the grocery store shopper, they don't really care about the rate of increase. They care about the price level, right? When you see that eggs are $3-4 a dozen that's going to catch your attention. When we look at the last 4, 4.5 years, food prices are up 25%. That's a significant increase.

Now, another reason for this disconnect in terms of what the economic data is telling us and how consumers feel about food price inflation, is the nature of food prices in our interactions with them. We see food prices on a weekly if not more frequent basis. We know when prices are going up. We encounter food prices, we go grocery shopping, much more frequently than we get a haircut or we buy a plane ticket. We see these prices rise. Now, it's also important, coming back to this discussion on the percent increase versus the price level, a 2% increase today is a higher dollar amount than it was a year ago, and certainly 5 years ago. Because the base has increased. It's not just in the consumer psychology. It's when we look at the price level and the increase. Prices are increasing more in terms of a dollar amount today than they were in the past. And so because of this, in many ways, the grocery store has really emerged as the face of inflation here in this country. And it really has impacted just about everybody over the past four or five years.

As someone who hasn't had a haircut in probably 10 years, I really do know that prices have changed fairly quickly when it comes to food. But I don't know what's happening at the haircut. But I really appreciate this. And, but I think the thing that a lot of people struggle with in this conversation is, but inflation is coming down. We've just heard these reports and why aren't food prices going down? But you've made it clear. It was almost like we've reached this high level. It is hard for it to roll back. I mean, we don't expect prices to actually fall, do we?

When we look at specific items, right, it's not uncommon to see, say, the price of eggs decrease when we have a period of low bird flu activity. But by and large, when we look at food as a category, say groceries, there have been some periods in the recent past where food prices decreased, say, 1-2% year over year. But we shouldn't expect prices to decrease to the level that they were before COVID. And that's because the nature of prices. They generally increase from year to year. And that's a good thing as long as they are moderate increases. And as the data have been telling us for a couple of months now, we're looking at food price increases in the neighborhood of what they were prior to the start of the COVID 19 Pandemic.

This is helpful. And it kind of makes me think of something we were talking about earlier. And so I want to ask you this last question. There's been some conversation in policy circles about addressing this problem of food price inflation. What are your thoughts on how policy could be used to make a difference in this situation?

That's an excellent question. We're coming up on an election and there's been proposals on both sides floating around and I appreciate the focus on an issue that is affecting consumers. But we have to look at the policies and what economic theory can tell us about what's going to happen.

The first thing I'll say before I even get to that is that the President of the United States, policymakers, have very little control over food prices, especially in the short term. We really have to look at sort of the longer time horizon. How can we make our food system more resilient to future shocks? Investing in crops that are drought tolerance, right? That climate change is one of the factors that's going to be with us from here on out into the foreseeable future. We have to make those investments now so that we have a much more resilient food system in the future.

In terms of coming back to policies, we have to look at economic theory. There's been proposals to ban, say, a price gouging at the federal level. That's something that I think we have to look at very carefully because there could be some unintended consequences. This is just straight out of Econ 101. Other candidates have proposed tariffs across the board. We've seen what happened when we had the trade war with China back in 2018. It leads to even higher increases in food prices because food producers, food manufacturers, rely on inputs oftentimes from abroad. And so now they're facing higher prices, they're going to be passed on to the consumer. As we look at policies, I think it's really important to look carefully at what some of the outcomes may be so that we don't run into some unintended consequences.

BIO

David L. Ortega is a professor and the Noel W. Stuckman Chair in Food Economics and Policy at Michigan State University. His research program focuses on understanding consumer, producer, and agribusinesses decision-making to better inform food policies and marketing strategies. Dr. Ortega provides timely analysis of forces and events affecting the agricultural and food sectors. He has been called to provide expert testimony before federal and state agencies, including the U.S. Senate and House agriculture committees. He is a frequent contributor to food price inflation reporting at The New York Times and NPR, and is regularly interviewed by prominent media outlets, including ABC News, NBC News, PBS, USA Today, CNN, Forbes, Politico, The Wall Street Journal, Financial Times, Newsweek, and the Detroit Free Press, to name a few. Dr. Ortega earned his Ph.D. in Agricultural Economics from Purdue University.

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When we talk about problems with food insecurity and the food system, we tend to reference challenges at the national or international level. And of course, work at that level really needs to be done. But increasingly, there is a unique focus on regional food system strategies and right sizing solutions to best fit those unique characteristics of a particular locale. In today's podcast, we will talk with Rachel Sabella, director of No Kid Hungry New York. She leads the planning, implementation, and evaluation of the No Kid Hungry campaigns across the state of New York.

Interview Summary

Rachel, it is such a pleasure to have you with us on the show today. We've done several podcasts with No Kid Hungry staff in the past and discussed topics like your Summer EBT Playbook for state governments. I'm really interested to learn more about your work in the state of New York.

Thank you so much for having me, Norbert. We have been so lucky to have No Kid Hungry on here to share the stories. And I'm excited to give you some updates about what we've learned with Summer EBT, and to talk about how things look in New York these days.

So, can you help our listeners understand more about No Kid Hungry New York as an organization? What is your approach to addressing childhood hunger?

No Kid Hungry is a campaign of Share Our Strength. And I have the honor and privilege of representing the organization across the state of New York as we work to create solutions, to draw more attention and awareness, and to help connect more kids and families with meals. We believe that every kid needs three meals a day to grow up healthy, happy, and strong. But too many children, and I know we'll talk more about this, are missing those meals. We really take an approach of working directly with communities. I don't know the right answer for each community. But my job and really my privilege is to work with school districts, with elected officials, with community organizations to look for challenges and work together to overcome them and really change systems.

I can appreciate that local communities look very different and appreciate if you're talking about New York City versus upstate New York. Can you tell us a little bit about how you all think differently about the cities versus the more rural areas of New York State?

I appreciate that question. I think all of my colleagues can hear me say, we almost run two different campaigns in New York. Because the approach in New York City, where there is one school district in five boroughs, but a large concentration of students, the largest school district in the nation, versus the rest of the state, is different. But ultimately, the challenges are the same. How are we communicating with families? What solutions are out there that we can implement? We really focus on listening, sharing tools, sharing toolkits, thinking about, in some communities, what they need are materials translated in different languages, so families understand that SNAP benefits are available, or summer EBT benefits. Or as in other communities, it's how can families get to a centrally located place to pick up meals? We really spend our time learning and listening and sharing these programs so that they can find the solutions that work best.

This is wonderful. I grew up in Georgia, I should just note. And I grew up in rural Georgia versus Atlanta. And we always talked about two Georgias, the Atlanta region versus the rural areas. And I can appreciate just how different some of those challenges are. But you're right, the central issue of access to food is similar and how you address those issues will look different in those regions.

I want to span out and talk about some national data that just has come out. USDA has reported food insecurity rates in the U.S. and we saw that hunger actually increased. And we see that for childhood hunger, food insecurity in general, it has risen since the 2019 pandemic. Why is this happening for children?

It's a challenging time. I think something that came out of the pandemic was right away, people said, families are struggling with hunger. What can we do? The stories on the news. We saw it no matter where you were in the country, with the lines to pick up food. And we saw government responded very quickly. There were expanded SNAP benefits. There were no cost school meals provided to every child across the country. We saw pandemic EBT implemented. We also saw the expanded child tax credit. At a time when families were facing tremendous challenges, there was that support from the government. But many of those programs have now ended. And in these economically challenged times, incomes haven't changed. Some people are still dealing with an unemployment crisis. We hear a lot from families as well that they're underemployed. There may be a job, but it's not that same income. And without these expanded government programs, families are facing challenges.

How is this looking specifically in New York State? Are there specific challenges happening in the state?

I think so, and we have specific challenges in New York, but as we talked about earlier, I think we see every state is facing that. In New York State right now, hunger rose for child food insecurity. We're looking at one in five children in New York State. If we look at New York City, it's one in four children could face food insecurity this year. I often say that hunger hides in plain sight because I hear from people, well, they have a house. Well, with a set budget, they're paying to keep that roof over their heads, they're paying for their electricity bill, and what is the number that can shift in the budget, unfortunately? It's for food. We did a survey earlier this year, and four in five families in New York State found that it became harder to afford groceries. Their incomes just were not remaining at the same levels. And in those surveys, when we dig in a little bit, it was highest in rural communities and parents of school aged children. They are fighting hard for their families, but with all these economic challenges, as a society, we have to do more to help them.

Thank you for sharing those insights. And I remember early in the pandemic, some colleagues at Tufts and I did a qualitative study talking to families who were using little free pantries. Those ‘lending library boxes’ where people were putting food and one of the stories that we heard that kept coming up was. It was about price inflation, which was interesting because this was at the early part of the pandemic, and we did worry what happened to those families as inflation increased. And this was before some of those policies came into place about summer EBT and other food assistance programs. But now that those programs have gone away and inflation is starting to let up, but it's still a challenge for families. I really appreciate the way the campaign is thinking about these issues. You've already mentioned earlier that the No Kid Hungry team has worked on the summer EBT playbook as you prepared for a national launch of that program. Could you first just give us a brief overview of what the playbook is and then how has the rollout gone in New York State?

Even to take it back a step, Summer EBT was a new program launched this year. Every state was eligible to opt into this program, which provided a grocery benefit for eligible children and families. Before this, it was available in certain states that were part of a pilot, and No Kid Hungry had been advocating for this to be nationwide. We also knew that there was going to be a short amount of time for this program to launch. So, what we did was bring all our tools and resources together, our staff members, and we said, what do states need to implement? We partnered with organizations like Code for America, like APHSA, and to really see what is this? So, is it tools to get the word out about the program? Is it about implementation? Is it connecting states that face similar challenges to learn from each other? What the state agencies did this year to implement this program in year one, in about six months, was pretty unbelievable. And we also hope that as we're learning from this, we're going to see even more exciting changes in year two.

In terms of New York and summer EBT, we have been seeing so thrilled to see the uptake of the program, the outreach and awareness for summer EBT in New York. In August, Governor Hochul convened an event to celebrate the launch. We had members of Congress, we had No Kid Hungry, we had families there talking about this program. We heard from families how challenging the summer months have been and how this made that difference to get meals to kids.

We've been working with the New York City Council on doing trainings for staff members. So many people trust their local elected official’s office to get answers. How do I get a new card? How do I check my balance? We are learning a lot, we're seeing materials in different languages, and again, what we're excited to do is recap year one, and how do we learn more and make it even easier for families to access in year two?

This is amazing work, and I, I know it's really a challenge when folks, if you will, leave money on the table. And so, helping people connect to the resources that they have legal rights to is a critical role that you all are playing. What do you hope will happen as you learn from the playbook as it was applied in New York? What do you hope to share with other states in this process?

We want to show other states our best practices, what worked really well, what's something that we would tweak a little differently. We also want to make sure that those states that weren't able to opt in this year, because there were more than 10, I think about 15, that did not opt in. We want them to see what they can do and how they can use this program to connect kids with meals. But also, this money is reinvested in local communities. Families are using it at grocery stores, at local markets. In New York, we're really excited to see how they're using it at green markets, getting those fresh fruits and vegetables, supporting agriculture. This program while it addresses hunger, it's also an economic engine. And we want to make sure everybody understands that and are using those dollars in a valuable way.

I want to ask you a last question, and it's sort of a big question about child hunger. So, what is the outlook of child hunger in New York, and what gives you hope about addressing this challenge?

One of the things that gives me tremendous hope Is when we did our survey of New Yorkers, 93 percent of New Yorkers believe that solving childhood hunger should be a bipartisan issue. They don't see the politics of this in New York. We have seen that increasing the SNAP minimum benefit is a bipartisan solution. We have seen no cost school meals for all children has bipartisan support. I think we see New Yorkers recognize they want to make a difference. We get questions all the time. How can I help? We have media outlets sharing the deadlines, putting the updates out for families. We see elected officials in New York State that are paying attention to what's happening in their backyards and their local communities. And they want to make a difference. I hope that what we are seeing in New York translates into other states, translates to the federal level. There is an excitement right now around school meals, and we're hearing a different dialogue. It's something that people like you and I, we know the difference it makes, but I'm hearing from family, from friends, 'Rachel, I read this story on School Meals," tell me about this. My hope is the excitement, the enthusiasm and the interest really changes the conversation and helps us drive forward solutions that will ensure that someday there is no kid hungry.

BIO

Rachel Sabella has been a respected advocate, strategist and leader for nonprofit organizations for more than 20 years. She has been the Director of No Kid Hungry New York, a campaign of Share Our Strength, since 2018. In this role, Ms. Sabella works closely with stakeholders across New York State to ensure children have access to the nutrition they need to grow and thrive. She oversees grant-making, awareness building, programmatic and advocacy priorities for No Kid Hungry New York and manages relationships with state and local policymakers. Since March of 2020, she developed and oversaw a strategy to distribute more than $9 million in emergency grant funding to organizations across the state of New York and Puerto Rico to connect more kids and families to meals. She has led successful advocacy campaigns at both the city and state levels on issues including expanding access to school meal programs and SNAP in order to connect more New Yorkers with meals. Ms. Sabella also serves as a member of the NYS Council on Hunger and Food Policy and was appointed to Mayor-Elect Eric Adams’ transition team. Prior to this role, Ms. Sabella served as the Director of Government Relations and Policy for the Food Bank For New York City. During this time, she led advocacy campaigns to grow and strengthen resources for anti-hunger programs, which led to unprecedented support for food pantries and soup kitchens in New York City. Her advocacy efforts also led to the creation of 25 school-based pantries that distribute food, menstrual and hygiene products, and household cleaning supplies to families in need.

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In today's podcast, we're discussing Fast and Furious. But it's not the movie series starring Vin Diesel. Instead, the catchphrase describes rapidly increasing and somewhat confusing food system environmental impact reporting. Food firms, farmers, and governments all have a clear need for more quantitative environmental impact data in order to measure and understand factors such as carbon footprint, sustainable agricultural practices, and food supply chain processes. But there is no single standard for such reporting and different measurement methodologies make it difficult to assess progress. What's more, greater transparency regarding environmental impacts and food systems will affect trade and supply chains. Our guest today is Koen Deconinck from the Trade and Agricultural Directorate of the Organization for Economic Cooperation and Development, or OECD for short.

Interview Summary

You and your colleagues at the OECD recently published a paper called Fast and Furious: The Rise of Environmental Impact Reporting in Food Systems. Can you tell me a little bit about the paper?

Sure. A while ago we were talking to one of the world's experts on sustainability in food systems. He alerted us that there was a major change happening in how people think about sustainability in food systems. He told us in the past, it was thought of almost as a checklist, right? People would say, here's a list of practices that you should or shouldn't use. And then we'll come and confirm whether that's the case on your farm. Then you either get certified or you don't. And he said, you should pay attention because there's a big change underway. We're more and more moving towards actually quantifying things like what is your carbon footprint? What is your water footprint? And so on. He convinced us that this was actually a major change that was happening. Oddly enough, outside of the role of the practitioners, not that many people have been paying attention to it. That is why we wrote this paper.

This is a really important shift because just thinking about this in terms of economics, evaluating outputs versus the methods that you get to those outputs can have really significant implications for the various actors involved. So, this seems like a good move, but it seems also kind of complicated. I would love to hear your thoughts about that particular move. Why did you think, or why did you all realize this was a challenge and opportunity at the same?

That's a great question. It actually gets to the heart of what we're describing in the paper. Starting with the good news, we do think that this has an enormous potential to improve sustainability in food systems. Because we know from the scientific evidence that there are big differences between different kinds of food products in terms of their average environmental impact.

For example, beef tends to have more greenhouse gas emissions per kilogram of products relative to poultry and then definitely relative to plant based alternatives and so on. You can see these kinds of average differences. But then the data also shows that within each kind of product category, there's huge differences between different farmers.

And what you can do if you start quantifying those footprints is it actually unlocks different kinds of levers. The first lever, if you think about carbon footprints, which is maybe the most intuitive example. The first lever is people know the carbon footprint of different kinds of food products. They could shift their diets away from the products that have a higher footprint towards products that have a lower footprint. For example, less beef and more towards poultry or towards plant-based alternatives. That's one lever.

A second lever is that if you can also start to get even more precise and use data that is specific to each producer, not just an average, then also within each product category, people can start shifting towards the producers that have a lower environmental footprint. So, for example, people will still be drinking milk, but then they can shift towards milk producers that have a lower carbon footprint. And the third interesting lever that you can unlock is if you have that data at a supplier level. Suppliers could then say, well, I changed my practices. I changed my inputs. I've done things differently to reduce my impact. You actually can stimulate innovation by each individual farmer, each individual company in the supply chain to lower that impact. And that is something that you can do if you're quantifying those impacts, and that is very difficult or even impossible to do with this previous checklist-based approach. So that's one of the reasons why we're, we think that this has tremendous potential if we get it right.

That's right. Just saying that you're doing sustainable practices isn't sufficient. It's really critical to evaluate what kinds of greenhouse gas emissions or other environmentally problematic outcomes of that producer or firm is what really matters. But I have to ask you just how difficult, how realistic is it to be able to measure the environmental impact of every farm?

That's a really good question. And of course, if you think about agriculture compared to other sectors, one of the big challenges for agriculture is indeed that there's just so many producers, right? I talked to people who work in the steel industry, and they say that their industry is complicated, but there's basically only 1000 steel factories around the world. That's not that many. The latest evidence suggests that there's more than 600 million farmers worldwide. So clearly, we're talking about a completely different order of magnitude, order of complexity.

And the second difficulty is that when we talk about measurements, for a steel factory, in theory, you could put sensors in the chimney and sort of measure that. For agriculture, that's really not practical. Scientists would sometimes do that because, you know, otherwise it's hard to know what greenhouse gas emissions you have in agriculture. But it's clearly not something that you're going to do on 600 million farms.

So, what people do instead is, scientists would do the primary research. There are different ways of doing that, to try and estimate which kinds of practices have which kinds of environmental impacts. If you have a cow and it has this kind of diet, how much methane is it burping and how is it affected by differences in the kinds of feed that you give the animal and whether it's inside or outside and so on. And then based on that very detailed research, that then gets simplified into a simpler model, a simpler tool, so that the farmer can plug in some key performance indicators from their farm. I can say ‘I have these many cows, this is the feed rations that I'm giving to them. These are the kinds of manure management options that I have.’ And then that tool is a simplified tool that basically gives you an estimate of those emissions. And once you have a tool like that, of course, the challenge is already a lot easier. Because then, if your tool is user friendly and you can sort of focus on just a couple of key parameters that farmers would know, then, of course, you can scale it up. And there are actual examples like that. In Ireland, there is a scheme called Origin Green, which is an initiative by the Irish government to promote exports of Irish Agri food products. They cover something like 90 percent of all the beef and dairy farms in the country. And as part of the initiative, they do the audits anyway, but as part of that initiative, they also quantify the carbon footprint. They basically have farm level data for 90 percent of the farmers. New Zealand similarly has had a big campaign called Know Your Numbers, where they've convinced farmers to use these kinds of calculation tools to get a good insight on how much the emissions are on their farm.

So, it is definitely not straightforward. But at the same time, we do see that it is actually happening. It is actually feasible.

Thank you for sharing that. This is really impressive work that's happening in the European context and in New Zealand. I have to ask, how challenging is this for small or medium sized producers? I mean, both in a European or Northern context, but particularly when we start thinking about the fact that Agri food chains are global and, and so there can be production practices in the Southern countries that would be of concern. How do you think about this in this context?

It is a really important issue. And actually, we've been here before. If you go back something like 20 years ago, and I think you actually did some research on this yourself back in the days, Norbert. There was a big increase in food safety standards, food quality standards. And these were not necessarily public standards. It was quite often retailers who started to impose that on their suppliers. And we did have all those concerns, right? Because on the one hand, it was making food safer and higher quality for consumers. But on the other hand, there was this risk that it would actually exclude, especially the poor producers, the small and medium sized enterprises from those supply chains. There's been a lot of research about that and it turns out that in the end, it was more nuanced than what people feared initially. But of course, we definitely have the same concern now. And there's a few elements to it. One is simply the difficulty of actually quantifying those things. I mentioned a few of these calculation tools and a few of these initiatives. So far, most of the investment in these things has been in high income countries. And even if you look at the underlying science, most of the research has happened in richer countries. So, if you go to tropical agriculture, we even have less scientific evidence that you would use to build a simplified tool like that. Then there's, of course, the challenge of actually getting farmers to use that. So, governments in developing countries typically don't have the same kind of capacity that the government of New Zealand, or the government of Ireland has to help farmers do that. So, there's definitely a role there for development cooperation, technical assistance, things like that.

But there's also another concern, which is that one of the important drivers of the environmental impacts of food products is actually your productivity. There are many parts of the food system where your environmental impacts might be roughly the same, no matter whether you are actually very productive or not. So, if you have the type of variety of rice or wheat that you're using that just has relatively low yields, then, of course, you divide the total environmental impact by a smaller number. So, automatically, your relative impact is bigger. And typically, that is what we find in the Global South. So, typically, the producers there will have much lower productivity levels. And studies do find that they tend to have higher environmental impacts, all else equal. So even if they were able to quantify it, there is actually an additional risk that then they would still get excluded.

What that means is that this rise of quantified environmental impact reporting is something that we need to pay close attention to. And development corporation agencies and everybody else should be thinking hard about how we are going to make sure that producers in the Global South are not only able to quantify, but also able to improve those environmental impacts. For example, through sustainable productivity growth.

This is really helpful. And thank you for sharing that. And you're right. I did think about these issues. I was influenced rather by the experience of increasing food safety standards. I would say one of the differences that we saw with food safety standards was how safe can food be? I mean, we want our food to be extremely safe, but there are always these tradeoffs. With environmental impacts, I think it feels a little different. And I really appreciate the concern of the difference between these small and medium sized enterprises, particularly out of a developing country context. I've got to ask sort of a broader question. Why is all of this happening now? This increase of environmental sustainability measures, both in terms of the technical work and the demand. I mean, what's bringing all of this together?

It is actually a pretty interesting story because it appears that, the way we look at it, there's been some changes on the demand side and on the supply side, so to speak, right? So, there's this growing demand for more information. Consumers are increasingly conscious about these things, even though it's not clear yet if this really translates into their shopping behavior. Civil society organizations, of course, have long been asking for more information on that. Governments, in some cases, are also pushing for that. One clear example there is in the European Union. There is this new rule in the EU. It's called the Corporate Sustainability Reporting Directive. That's quite a mouthful. And one of the things it does is it requires all large companies to report not only their own emissions and the emissions from the energy that they're purchasing, but also their emissions upstream and downstream in their supply chain. People sometimes call this Scope Three Emissions. This has huge ramifications because it means that for the supermarkets, a large part of their Scope Three Emissions are the emissions from food. They would then probably ask the food manufacturers 'well, give us more information on your carbon footprints.' And in turn, for the food manufacturers, a large part of their carbon footprint comes upstream from the agricultural sector. So, everybody would be turning around and asking their supplier and all the way up the supply chain for more information. All the way, not only to the farmer, but even further up to the fertilizer companies and so on.

So, there's definitely this push on the demand side. And, I guess governments and citizens and civil society, those are sort of the usual suspects, so to speak. There's also unexpectedly a lot of pressure from investors. We see organizations of investors pushing hard for more transparency. Their logic is that sooner or later, stricter regulations on the environmental side are going to come. For some of the companies that we're currently investing in, we have no idea how hard that would hit them. So, those companies need to disclose more information because we as investors need to know how much money is at risk if we invest in a business that is, for example, linked to deforestation and things like that.

So, that's the demand side. But what is really interesting is that at the same time on the supply side, it's also becoming easier to actually provide that information compared to five or 10 years ago. Some of this is because people have been working in obscurity for a long time, trying to develop certain methods and databases. A lot of that work has been coming to fruition in just the last few years. For example, there's been development of new reporting standards, there's been development of new databases, there's been development of new methods, people are now using satellites and so on to try and quantify things like land use change, deforestation impacts and so on. A lot of these things are now converging and blending with each other. We do think that the combination of this greater demand and greater supply that is driving what we're seeing now. And of course, some of these initiatives are still at a relatively early stage. At the same time, I think the direction of travel is clear. So, we think that demand is not going to go down. It will keep getting easier to supply that information. We think that this is what explains this fast increase that we're seeing.

This is really intriguing, and it makes me wonder how global value chains are going to be realigned. Going back to this idea of small and medium sized producers who may not be able to have the monitoring, or if you think of even larger firms who feel uncomfortable with having some outside agency evaluating the carbon emissions or other greenhouse gas emissions from their farm. I can imagine that this could realign value chains. Is this a fair assessment? Is this a concern?

I agree with you that this is something people should be looking at. At the moment, there's not yet any data on that. I don't think anybody has really researched that. We see in general that many researchers aren't really paying attention to this trend, which was actually one of the reasons we wrote this paper. But what you're describing is exactly one of the questions we have as well. There are a few ways that this could play out. You could imagine that if it's only some markets that are getting very interested in this kind of information, you might have a situation where companies in a producing country decide to just send the sustainable stuff to the countries that care about sustainability. But they keep producing the unsustainable stuff for all the other markets. In that case, the total impact for the environment might actually be limited. But there could also be other cases where companies think, well, since a large part of our customer base is asking for more sustainability, we might as well make everything sustainable just to be on the safe side. You might have other cases where companies start working backwards because they want to make sure that what they are selling is sustainable. So, you might actually have situations where a retailer starts working with suppliers or where a food manufacturer starts working with suppliers to make sure that their production is sustainable.

This is again something that we have seen in the wake of these food safety standards about 20 years ago. This was a really surprising development and there was a lot of investment from other companies in the supply chain to help farmers start meeting these stricter food safety standards. So, one possibility is that something like that might happen for environmental sustainability as well. At the moment, these are all really just hypotheses. And so I really hope people will start to investigate this more seriously, because I think it is very important also for policymakers to understand what has happened.

I'm really appreciative of you making the point that there is just a great deal of uncertainty in this space and that there is a need for researchers to explore this issue. And I agree the food safety concerns of 20 or so years ago is a good example. But I think there are going to be some differences and I'll be intrigued to see how that plays out. I am interested to understand, are there any risks besides the ones that we've kind of touched on, any other risks or downsides to this movement that we're seeing?

Yes, there are actually. Because the story I told so far was maybe a little bit on the optimistic side. I was explaining how it's becoming easier to supply the information in part because we now have better reporting standards. That is one part of the story. That's sort of the glass half full view of it.

The glass half empty view is that actually, at the same time, there's also a fragmentation. There are also many different initiatives, and this is why we call it fast and furious. So, there's lots of different initiatives that are competing for attention. And you do end up with situations where you might have different ways of calculating certain environmental impact. Different ways of reporting it. And then it's not necessarily clear when somebody is reporting something what exactly they were using as methods. And so that poses an enormous risk, because if every supermarket or every country starts coming up with its own way of doing things, its own way of reporting, then the end result is just going to be confusion and frustration and transaction costs. And then the benefits for the environment won't even be there.

So, it is really important if you want this to go well, that people get together, stakeholders, governments, researchers, to get together and try to align as much as possible on common reporting standards, common methodologies, etc. So that it's clear for everybody that the data that we're looking at is comparable. This is important, and I can imagine if we think about international accords on addressing climate change and how it takes a lot of effort to get agreement on those, you can imagine that when we're talking about these kinds of measures and getting concordance on that, there could be some real challenges.

We've already touched on this, but I'm interested to know, are there other policy implications of the work that this paper is doing? Is there something we should be paying attention to?

Well, one idea that I hope people would start taking seriously is I want people to start thinking in timelines and cycles. And let me explain what I mean by that. There's a lot of different initiatives out there. And you can even start to see a little bit of a hierarchy, how different things, some of these standards are building on other standards. Some of these databases are then in turn using some of those other standards. There's a kind of a logic that is emerging there. One of the problems that happens now is that it's not really clear when all of these elements are going to get updated. So, suddenly one of those standards might get updated and then now all of these other standards that build on that or those databases that build on that are suddenly no longer consistent with that original standard. And then there's some confusion and then it's not really clear whether the data you are using is actually still consistent with the original standard. One idea that I'm advocating for is that people should all explicitly define a certain iteration cycle where they say, look, every four years, for example, or every three years, every five years, we are going to review the standard. We'll give everybody 12 months of warning, and we'll have a stakeholder process, and we'll have a scientific process behind that so it's clear for everybody what we're changing and why. But this way, you know well in advance when each of these building blocks is going to get updated. Then that would make it a lot easier for everybody to make sure that what they're doing is aligned with those standards. And an additional benefit of doing it like that, I think, is these things are moving so fast and there's still so much new science and new technology coming in, that we have to keep the possibility open to keep improving and updating those methods and those standards as well. If you announce in advance that we'll do this on a three year cycle or a four year cycle or whatever it may be, I think that could help us strike a balance between the need for that flexibility, but at the same time that need for stability. Because of course, if things keep changing all the time, then you're never quite sure whether the numbers you're looking at make sense or can be compared. I think that idea would be very helpful. And that will probably require quite a bit of coordination between all the different stakeholders who work in that space. And I think that would be a very good thing to do.

BIO

Koen Deconinck is an economist in the Trade and Agriculture Directorate of the OECD (Organization for Economic Co-operation and Development) in Paris. He was lead author of the OECD report “Making Better Policies for Food Systems” (2021) and has worked on market concentration, seed markets, evidence gaps, resilience, and environmental impacts of food systems. He holds a PhD in Economics from the University of Leuven and has published research in the American Journal of Agricultural Economics, the European Review of Agricultural Economics, Food Policy, and Business History, among others. He currently works on measurement of carbon footprints and other environmental impacts of food.

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Today's podcast is a gastronomic treat. I'm talking with Chef William Dissen, James Beard Award-winning chef and owner of the restaurant, The Marketplace, located in Asheville, North Carolina. William is the founder of four award winning restaurants and draws inspiration from traveling the world, creating dishes that tell a story, surprising guests with inventive food preservation techniques, and bringing classic dishes with explosive flavors to life. He published a debut cookbook in 2024 titled Thoughtful Cooking - Recipes Rooted in the New South. Food and Wine Magazine recognized it as the best spring cookbook and praised how he takes readers on a culinary journey organized by the four seasons of Appalachia's most sought-after ingredients. William also enjoys the fame of being the first and only chef to beat Gordon Ramsay in a cook off on NatGeo TV’s Gordon Ramsay Uncharted Smoky Mountains.

Interview Summary

Will, you were early to the farm to table local foods concept. Some years ago, when I dined at your restaurant, the Marketplace, I liked the philosophy, not to mention the food, would you please tell us what led you down this road?

You know, I'm originally from West Virginia, from the Appalachian Mountains, and my grandparents were, were farmers that lived in very rural parts of the state. I grew up in suburbia in the capital of Charleston, West Virginia, but spent a lot of my weekends on their farm. And they very much lived the Appalachian mentality and culture of farming, of putting things up for the year. You know, they canned and pickled and preserved and fermented and dehydrated, and they foraged and they had honeybees to pollinate their garden. They irrigated with fresh spring water and things that I think now in 2024, hipster DIY trends that people are saying they're doing in bigger cities. But these are things my grandparents were doing to sustain themselves. And I'd say that those ideas and ideals imprinted upon me about not just sustainability and how to treat the earth, but also about how to make food delicious because great food starts fresh.

And from this initial exposure to food customs of your youth what led you to being a chef?

You know I think in those hot sweaty August days, as they say up in the holler of my grandparents’ farm, we'd sit in the front porch and shuck corn and string beans. I really kind of kindled a love affair with food. One of my first jobs I had, I was a newspaper delivery boy and shortly after that I was, you know, trying to hustle to make some more money. And I ended up washing dishes at a local country club. And I think a very similar story for a lot of chefs, one day the garde manger cook or the salad and sandwich cook called out. And the chef said can you make sandwiches and salads? And I thought, sure, I can do that. And haven't really looked back since.

You've been a chef at many fine restaurants in major cities. What led you to Asheville, North Carolina in particular?

After I left West Virginia, I lived all over the place. I was in New York and California and South Carolina and ended up back here where I'm now in Asheville where I have my restaurant, The Marketplace. And one of the things that really stood out to me was the really beautiful region. National Geographic has voted it time and time again as one of the most biodiverse places on the planet. It's actually a temperate rainforest. There are species of wild edible greens and medicinal greens. There are species of lizards and snakes and things that you only find here in this region. It's not just beautiful. It's also a really thriving ecosystem.

Terms like intentional, mindful, and in your case, thoughtful - it's in the title of your book - can be applied to cooking and eating. What does it mean to you?

I'd say in general, it's going back to what I mentioned about my grandparents. And really focusing on being present but also planning ahead. I feel like in this day and age, we're so connected to computers and phones and social media that we've kind of got disconnected from our food system. People say, well, you know, technology is driving the world and we need to be logged in to be able to stay relevant. And I don't disagree with that, but I feel as our society is doing that, we are losing touch with nature. And if you go back one generation, two generations and ask anyone, their grandparents, I'm sure grew a garden. Or were farmers, and they probably went through acts of preservation because there weren't Whole Foods in every corner. It wasn't Amazon delivery. They had to plan ahead, and to be in touch with the time of year enables them to sustain themselves and their families. And certainly, we're fortunate now in 2024 to not have to think that way all the time, but I do think there's a lot of value into being a little more thoughtful about the world around us.

And I think that's really what I want to try to show people with my book, Thoughtful Cooking, is that connecting yourself to the food system enables us to connect ourselves to the environment. Enables to connect ourselves to our local economy, to our community, and to be reconnected with those that make our food. And I think that's an important thing that a lot of us are missing in this day and age.

Please tell us more. What does thoughtful cooking look like in action?

I think thoughtful cooking is kind of multifaceted, right? I think it's being aware of what's in season. Here we are in August and in the Carolinas. What's in season this time of year, right? We have tomatoes and peppers and corn and okra, and we have all these different things that are uniquely delicious and in season. But it's a conversation when I talk about local food and talk about sustainability. I ask people, it's a very cliche question: when would you like to eat a tomato? July? August? Or January, February. And people say, 'Oh, well, of course, July or August. That's when the tomatoes are delicious and they're bright in color and they're ripe and they're juicy and sweet.' And I think those are the things that we're not being as thoughtful about nowadays. About where our food comes from and why things are in season.

So, I think that's one aspect of it. Another aspect of it is it's just taking the time to be mindful of the world around us. I think we're all moving so fast that I want people to be able to slow down and enjoy cooking. Cooking as a father of two, running many businesses, I joke with my kids it feels like a chopped competition in my kitchen. Some days when I open the fridge and I've got 30 minutes to make dinner for a couple hangry kids. But also taking the time to enjoy cooking. I think there's something to be said about slow food and taking the time to cook in your kitchen, open a bottle of wine, turn the music up. Actually connect with people around you rather than just staring and scrolling on your phone. I think it's a way to really bring people together.

And then the other, the other facet of it is, thoughtful cooking is that the way we choose to eat really creates an opportunity to vote with our forks. That there's a lot of advocacy and sustainability you can do just in taking the time to think about where your food comes from.

I can so relate to what you're saying. Not too far from where I live in Durham, North Carolina, there's an unbelievably wonderful farmers market. The state farmers market in Raleigh, which I imagine you've been at, been to one time or another. But what a pleasure it is to go there when the strawberries are just coming into season and then the blueberries and then the peaches and then the apples. Not to mention all the vegetables. And we just this weekend had guests and made a corn and tomato salad with all these wonderful things that were there. It just felt that there's something special about making it when you've gone to buy the ingredients from a farmer who grew them. And you're right, everything, every part of the experience is better doing that. How in the restaurant do you try to accomplish getting people closer to the food and more thoughtful about it?

At our flagship restaurant, The Marketplace in Asheville, the whole premise is local food sustainability. I really like to show that we can create a sustainable business that can last the test of time. And I think we have, as we're celebrating our 45th year this year in 2024. But for me it's taken the time to meet the makers. The artisans who are making cheeses or types of charcuterie. Dairy farmers, vegetable farmers, livestock farmers, fishermen. And taking the time to talk to them about what they do to be a little more thoughtful and inquisitive about how we're eating. Doesn't necessarily mean that we're all eating healthy food all the time, right? But understanding how they're taking care of it.

As you really dive into the food system, there's a lot of things that if you look at what's happening behind the scenes in some of these big, bigger commercial commodity farms - you may not like about people are being treated that are growing the livestock or the vegetables. About how they're treading on the environment in a non-sustainable way. And then also, what's going into the product that's going into your body? Are they putting hormones on or different types of spray or whatnot, you know, to cut the chemicals that could affect your body in the long run.

And I know I'm not a crazy health nut, but I want to make sure that, when I'm eating clean, I feel good. And I think a lot of it too I was very fortunate after I did undergraduate studies at West Virginia university, I went on to the culinary Institute of America for culinary degree. And I took a wine course there. It really imprinted on me about viticulture with how they grow grapes. They study this thing called a Brix level, which is the sugar level in a grape. They use this fancy electronic device called a mass spectrometer that measures the sugar content in a grape. And so, the vintners go around their farms, and test the grapes as they are approaching ripeness. They wait to pull them off the vine until the grapes reach that perfect ripeness because the grapes are higher in sugar. They're naturally sweeter. They're going to ferment into more delicious wine, but every fruit and vegetables has a Brix level. So if we're able to really be in touch with, with nature, with the time of year, when vegetables and fruits are ripe, they're naturally going to taste better. The vegetables are going to be bright in color heavy for their size because they're naturally ripe and sweet and they're just going to taste better. I don't know about you, but that doesn't necessarily make me feel like I'm a health nut. But it makes me feel like I'm in search of great flavor.

Well, it shows how much you appreciate good food and how important good food can be for the way we feel about ourselves. Obviously for the environment and things. You know, I've often thought it would be a wonderful experience to go to a restaurant and have a meal, but before the meal, be able to interact with the farmer. The farmer comes in and talks about whatever she or he has contributed to that particular meal and how the food was created and what their relationship is to the land and whatever practices they use. You get those things outside of a restaurant. But I've always thought it'd be really interesting in a restaurant to do that kind of thing. Maybe that's something you've already done.

We've definitely hosted a number of farm dinners. I actually have one coming up. There's a group out of Santa Cruz, California called Outstanding in the Field. This will be our eighth dinner we've done with them over the years. But we will do a white tablecloth dinner in the middle of a farm field for 200 people and cook over a wood fire. And you know, the hogs and the sheep are grazing the pasture beside it. And the vegetable garden is in other pasture over. And for a lot of people, they've never stepped foot on a farm. And it's a really transcending experience.

I think the answer to this is pretty obviously yes. But it seems like today's youth, like I think about students that I teach in college, are so much more interested in the story of their food than people were just a generation or two ago. But I think I, when I grew up, all we cared about was that we had food. And the, you know, the better it tasted, which basically meant how much it was processed and how much sugar and things it had in it. That was really about all we knew. But now people are asking a whole different level of questions about where their food came from. Do you see opportunities for working with children to help maximize that?

I do, yes. There's an organization that I've been on the board for a long time locally called the Appalachian Sustainable Agriculture Project. They have a subsidiary called Growing Minds Program. And it works to put healthy local food into schools and to teach children about the opportunity to healthy and eat fresh. I think it's a great thing.

I do a lot of food advocacy work as well on Capitol Hill where I go and lobby for different food policy. I've done that at Capitol Hill, you know, and internationally as well. I helped create the Chef's Manifesto for the UN's World Food Policy. And I spoke at a number of conferences around the world about it. But it starts with children, right? If we're able to teach them about eating healthy and eating local, it's going to be something that's ingrained in them forever.

And about local food, I feel like a lot of people say, 'Oh, well, shopping at the farmers market, like that's only for the 1%.' And I feel like I find a lot of great deals in the market. But a lot of farmers markets nowadays, because of different food policy and food advocacy, they have things even with SNAP benefits that they'll do two for one. So, you can really get some great deals at the market as well.

You mentioned you've done some advocacy activity in Washington arguing for certain policies, what kind of policies have you been involved with?

Given that we're in a presidential election year, I always like to tell people I don't really like politics very much, but I really like policy. Because policy is where you can take action and make change. I've done a lot of advocacy work advocating for things like the Magnuson Stevens Act, which provides federal fishery management and sustainability ratings for different species of seafood. I, also worked on the Childhood Nutrition Reauthorization Act, which was to add more funds to school lunches for children. Farm bill. Gosh, I've done so many different things. It's good to get out there. Our politicians get bombarded with different bills and lobbying groups all the time. But I think when they see somebody like myself, I’m a chef, I'm an employer, business owner, real estate owner, it's different than maybe your standard blue suit lobbyists. A lot of times take the time to listen. And many of them come in and eat at our restaurants. So, it's an opportunity to really try to direct change and hopefully when they go to vote for these various bills, they think about the opportunity that they've had to meet with constituents like myself. And hopefully they remember to do the right thing when they place their vote.

You also show how many ways there are to interact with the food system. And ways to try to make improvements, and the scope of your activity is really pretty impressive. So, let's loop back to your book. In your book, you talk about, again in the title, you talk about the New South. What is the New South?

I think a lot of people think of Southern food as shrimp and grits and gumbo and very heavy, rich country cooking. There's a lot of African American influence from the days of slavery. And recipes, ingredients that were brought over during slavery from West Africa, and traditions that arose in Southern cooking from those times. Like everywhere else in the world, the South is evolving and it's one of the most popular places for people to move to within our country, the United States. And we're starting to see this evolution of Southern food, right? It's not just this kind of typical stick to your ribs, Southern cooking anymore. We're starting to see other cultures come in. There's Indian culture, African American culture, Asian cultures that are coming in and they're taking these traditions of Southern food and local food, but then adding their flavors to it. And to me, it's a really exciting time because I’m biased, I love Southern food. I love shrimp and grits. I love these different dishes that are so wonderful. But I love when somebody comes in and they take a recipe, and they add their own touch to it and they tweak it. Because to me, that's, that's adding to our heritage as Southerners. And so, for me, recipes rooted in the New South is this evolution that we're, we're taking Southern food on.

If you wouldn't mind, give us some examples of some of the recipes that are in your book?

I have a number of dishes that I think are really exciting. One of my favorites: I have a red wine braised beef short rib. Serving that with a chili cumin sauce and then a blue cheese and green apple coleslaw. So, it's kind of taking this idea of, you know, of beef and coleslaw, but kind of adding in some other flavors from other cultures. You know, like within that there's a lot of kind of Hispanic flavors as well.

I loved looking through the recipes in your book. And I don't think there was one that I looked at where I wasn't surprised by some ingredient that I didn't expect. Or putting things together in unique ways. The book strikes me as being highly creative. I can just imagine how much work was involved in putting that book together and how long it took. It must sort of be the culmination of a lifetime of work, so congratulations for doing that.

Well, thank you. I think as I mentioned before about the other work I do outside the restaurant. I didn't just want to write a Marketplace restaurant cookbook. I wanted to write a cookbook that talks about, you know, the power of food and the philosophy behind it. But then also have some delicious and creative recipes in there that can be inspiring to folks as well.

BIO

William Stark Dissen is a renowned chef, author, culinary diplomat, restaurateur, and early pioneer of the farm-to-table movement in Asheville, North Carolina, and surrounding regions. His titles also include Seafood Watch Ambassador to The Monterey Bay Aquarium in California, and Official Ambassador for Le Creuset and Mountain Valley Spring Water. Named Fortune Magazine’s “Green Chef of the Year” two years in a row, William’s endeavors in sustainable food and dining, coupled with his passion for foraging and fly-fishing, often take him from the kitchen, into the mountain streams and peaks of the Southeastern, United States, Appalachian region, and beyond. William’s efforts to uplift the principles of food sustainability in his restaurant and network of vendors and suppliers, has not gone unnoticed. It caught the eye of Celebrity Chef Gordon Ramsay, who featured Asheville on NatGeo TV’s, “Gordon Ramsay: Uncharted, Smoky Mountains.” The hour-long episode featured William touring Ramsay through the forest and rivers of Western North Carolina and concluded with the two chefs competing in a peer-reviewed cook-off. William beat Ramsay for the first and only time in the show’s three seasons. Through this experience, Gordon Ramsay named William, “The Most Sustainable Chef on the Planet!”

A career in the culinary arts led Dissen to become an advocate for food policy on Capitol Hill starting in 2010, where he’s lobbied to Congress about the importance of passing legislation, such as The Farm Bill, The Childhood Nutrition Reauthorization Act, and The Magnuson-Stevens Fishery Conservation and Management Act. The Barack Obama administration lauded William as a “White House Champion of Change for Sustainable Seafood” for his work to create healthier oceans. He also serves in the American Chefs Corps in the U.S. State Department, which sees him traveling around the world to promote American food culture and sustainability practices.

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Join Kelly Brownell in a conversation with Michael Dimock, Executive Director of Roots of Change, about transforming food systems through innovative policies. Discover how Roots of Change collaborates with various stakeholders to create nutrition incentive programs and support sustainable agriculture, focusing on community-first approaches. Learn about pioneering projects, insights into policy influence, and the future of agricultural practices. This episode provides an optimistic view of the evolving food system landscape and the potential for significant positive change.

Interview Summary

Why don't we begin by you explaining what Roots of Change does. What's the mission and role of the organization?

Yes. We were originally founded by a group of philanthropic foundations that were very interested in food system change but had not seen much success in years. So we were really designed to be a catalyst to ignite the growth of what we would call the Good Food Movement. For 10 years, we were actually a philanthropic fund investing in different projects that built the power of the food movement. And then implemented projects that would catalyze change. That would show how you could scale change fairly rapidly by building collaboration. So that's really what we've been doing. And in 2013, the philanthropic fund ended, we'd spent down all the money. So we joined the Public Health Institute at that time because public health is such an incredibly important engine for food system change because the food system impacts public health so greatly. We've been since that time focused on policy change and implementing model demonstration projects.

Thanks for that explanation. You talked about catalyzing change for transforming the food system. What sort of changes have you emphasized?

We've been focused on a few key things. I would say that one of the most important for us has been healthy food access. And doing that through the creation of nutrition incentive programs. And the reason we're interested in that is, all the changes that we pursue are aimed to hit several different levers of change simultaneously. By building nutrition incentive programs, you help the small and midsize farmers who are supplying local grocery stores, the farmers markets, and at the same time, you're creating the funding for low-income families to actually purchase organic, regenerative, sustainable agriculture. From their local market. You get a lot of payoff for that kind of action.

You mentioned incentives. How do incentives fit into this?

There is a program, a federal program called the GUSNIP. Named after Gus Schumacher, who was Undersecretary at USDA during the Clinton years, and actually worked with us early on. And so that program is a pool of funding through the Farm Bill that is given as grants to either states or nonprofits that are creating these programs where a family comes in with their SNAP benefits, and their purchasing power is doubled. They're given matching dollars to buy fruits and vegetables from a farmer's market, a local store, grocery store. So it's an incentive to purchase fresh nutritious food. And so, we have worked on the original federal policy. We're one of the first demonstration projects to show how you do nutrition incentives working with folks in the upper Midwest and in the East. And then we created an analog. California also has a matching fund which helps us pull more money from the federal level. So, we can really get a big impact at the local level. And we built that California program as well. We've been really deep in nutrition incentives.

But we also work on farmer farmworker protections from heat. It's a big problem out here in the West. Increasing temperatures. We're working with different scientists, epidemiologists, and farmers to figure out best management practices or technologies that keep farmers cool. And then we also work on programs to provide incentives for ranchers to produce regenerative meat, that is grass-finished meat.

So, those are the three areas working in right now. But we're also just starting a project. I have a meeting today with the California Department of Food and Agriculture to develop a plan for mid and small-scale infrastructure for regional food systems in the state of California to be achieved by 2040.

One thing I really like about your approach is the lining up of incentives to produce food in a way that's better for both human health and the environment. Because so many incentives are lined up the other way. Obviously, the food industry wants to make as much money as they can, and that comes from highly processed foods that aren't very good for health. And then the same sort of incentives lines up for agriculture to do industrial forms of agriculture where you maximize the yield per acre. To turn that around is really going to be a major effort. One thing I like about your approach is that you're trying different things that can become models for what could be used in a very broad scale in terms of public policy. I really admire that and like what you're doing. Do you have an overall strategy for helping bring about change?

One of the things that we did in 2010-11 is we did a deep analysis of the food system and did a systems dynamic map of the entire food system. Working with leaders, Secretary of Agriculture for California, farmers - big size, small size, organic, conventional, with food justice folks. And we looked at where are the real intervention points. One of the things that we really realize is that, as you were pointing out, the current incentives are for industrialization, basically. And so, the question is, how do you actually change that? And policy is one important lever for doing that. So, we work a lot on trying to change the policy levers to create incentives for what we would call healthy and resilient agriculture.

Tell me more about how you go about doing that. I'd love to hear when you're done with that, how you go about doing that with policymakers.

Well, I'll jump right in on that. Let's look at what we did with nutrition incentives. So, working with Fair Food Network out of the upper Midwest, and Wholesome Wave out East, Roots of Change did a study. We created our own nutrition incentive programs using philanthropic dollars and some USDA kind of innovative dollars, and then we studied it for two years, what the impacts were. We wrote a report then, which went to Congress, to Debbie Stabenow in Minnesota, who was the Senator there who was on the ag committee. And she began writing a bill that would say, okay, let's provide incentives for people to buy healthy food that also helped the small farmers. So that switched the incentive from the big agricultural systems to the regional food system players. That was one way we did it.

The other thing that we did in California was we organized all the farmers markets to go to the State of California and say, look, if you provide this nutrition incentive program in California and analog, we'll pull down more dollars from the federal government. The California legislature said that's a great idea. They got on board. Which then helped the farmers markets to provide more funding because farmers markets are often stressed. Too many markets, so there's problems. Competition between markets. So, to provide a new market, which is low-income families who are using nutrition incentives and their SNAP dollars, that was really important for the farmer's market. Those farmer's markets became another big piece of our strategy. Our way of making change was just to build collaborations, large collaborations of people.

We work with many other nonprofits and farming groups in California to approach the legislature and over the last three years we've gotten $1.3 billion dollars in investments from the state of California into sustainable agriculture and food justice. Because we're able to build these large collaborations who convince the legislators who really care about votes that there's enough people out there want to see this happen. And we have just placed a billion-dollar request on the next bond, which will be in the next election, November. This November there's the climate bond. It's called a climate bond for the State of California. Ten billion dollars, one billion of that will be dedicated to nutrition, nutritional health, farm workers, and sustainable agriculture.

So, in all ways, it's about getting enough voices. So, if you look at what we're really trying to do, we're trying to build the power of what we would call the Good Food Movement.

Best of luck with that billion-dollar request. I really hope that goes through. You know, in the beginning of your response to my last question, you talked about a report that you did in concert with other organizations around the country and how that became influential in the policy process. Very often, some of the people in my orbit, scientists, wonder how they can help with this kind of thing and how they can do work that makes a difference. And I've often thought that speaking with people in the policy and advocacy world, like you, turns up some really interesting questions they could help address, if they knew what those questions were. But they often aren't having those conversations because they're mainly speaking to other scientists. That's one of the reasons why I so much like having people who approach things like you do on this podcast series. Scientists aren't our only listeners, but they're among them, and it's nice to give them ideas about how they can connect their work with what's going on out there on the ground in terms of policymaking. So, you emphasize putting people in communities first. What does that mean? And how does that play out in the work you do?

It's a great segue from what you were just saying about the need to combine community voices with nonprofits and scientists, academics, and people who are good at research and who are good at analysis. Back to this idea of nutrition incentives that really grew out of what community groups were doing. The IRC (the International Rescue Committee) works with immigrants from Africa, primarily at that time who were coming into San Diego. And they were farmers, mostly. They were escaping violence, war, in their countries. And they came to San Diego and the IRC worked with them to create a farmer's market, and a farm - a community farm. And those folks were the ones that were saying, this program works. And this is a really good way to solve many problems at once. So, we were hearing from community members and the nonprofit that had created this model. So, it was a way of us understanding what was actually working on the ground. So that's one example.

I can also say that in 2017, 2019 and 2020, we had terrible fires here in California. We also had all that followed with COVID in 2020. We were working with the University of California at Davis. Tom Tomich, who at that time was with the Ag Sustainability Institute at UC Davis. And we were doing research on how do you deal with climate change as small farmers? And what we realized is there was this moment in time when all of these things that have been piling up were impacting the ability to get meat. You'll remember that meat disappeared from shelves for a while because all the big plants that process meat in the Midwest were shut down due to COVID. So, what we did is then went out and we interviewed ranchers up and down the State of California, and we asked them, what do you need? And are you interested in finishing animals for grass-fed markets? Are you interested in building local markets? We got a lot of feedback that led to a white paper that Roots of Change published with the University of California at Davis and put out to the world. Which led to us getting a grant to actually take some of the suggestions and the recommendations we had gotten from the producers about what to do. What's that led to now? We have built a relationship with the University of California: ten campuses, five medical systems. They have committed to buy regenerative regional meat from the State of California. That grew out of a white paper, which was fed information by the ranchers on the ground, analyzed by academics and nonprofits, and delivered in a system that's now gotten the university to make a commitment. So, it's another example of just how you can mix all these great parties to get some sustainable change at a large scale?

Now that leads me pretty nicely to what my next question. And it has to do with what's needed going forward and how do these things occur in more places in a bigger way than the places they are now. Now you mentioned, for example, the regenerative agriculture pledge that got made by the University of California system. That's a big enterprise. There are a lot of people that get touched by that system. So, that's a pretty impressive example of taking an idea that might've been smaller to begin with and then became bigger. Going forward, what kind of things are going to be needed to make that kind of thing happen more often?

That's a really good question. Kelly, I think that one of it is communication. I mean, perhaps some somebody will hear this and reach out to us and say, how'd you do that? And then we'll say, well…and they'll tell us what they did and we'll learn from them. One of the things I'm really interested in, always been interested in, and one of the things that Roots of Change is focused on is trying to convene people to share information. Because you build partnerships when you share information. And those partnerships can become the engines for getting the policy makers or the corporations to change their modalities. How they're doing things. Because they realize, hey, the writing is on the wall. This has to happen. We need to figure out how to get there. And sometimes it's complex to get there because the food system is very complex.

So, I would say that one of the things I'm really looking forward to is more cross collaboration. You know, we're living in the season of elections. We're hearing it on the news all the time. And the thing that drives the policy makers is whether or not they're going to be elected or reelected. And so, the more that we can convince them that there is a large majority of the public that wants to see these fundamental changes in the food system. We will have their support. We've seen it in California. We are getting incredible support from our Secretary of Agriculture, our governor, and our Secretary of Natural Resources. They work together to create things on the ground. I would say that the Tom Vilsack and Biden did a lot for regenerative agriculture, working on two big projects that have been funded by the USDA that will touch a thousand ranchers of bison and beef to get them to learn about, adapt, adopt, and then build new markets for their products. So that's an important piece. The other is the marketplace and companies want to sell their products. So, the more that consumers become discerning and what they're purchasing, the better off we're going to be. So, we have a podcast like you do. And what we're trying to do is just educate people about the connections between what they're doing and what the farmers and ranchers out there who are trying to do good work with the land and with health and with their workers. We just try to promote this idea of making good decisions about what they purchase.

Tell us a little bit more about your podcast, which is called Flipping the Table. Tell us more about what you're trying to accomplish and the kind of people that you speak with.

Well, it's similar to yours in a certain way, I would say. Because what I'm doing is interviewing the people that are doing the kinds of projects that we think are scaling change or could scale change. Or people who have a depth of understanding. So, the regenerative meat world, we've done a lot in the last few years. Talking to Nicolette Hahn Nyman, who wrote a couple of books about the meat system, with a great rancher up in Northern California, who advises other ranchers on how to finish their animals on grass in California in a dry environment. I just, today we dropped a podcast with Cole Mannix from the Old Salt Co op in Montana about the ranchers he's pulled together. The co op he's built that has a slaughter plant, restaurants, a meat shop, and has an online thing. And then they do a big, they do a big annual event in the summer during the solstice. So, you know, we're just trying to get voices who, like you are, who are, who are modeling and educating the public around what is happening. How much is actually happening. I've been in this world for 30 years almost, and I have to say, I have never been more optimistic about the scale of change, the accelerating speed of change, and the possibilities that lay ahead.

BIO

Michael Dimock is an organizer and thought leader on food and farming systems and heads Roots of Change (ROC) a project of the Public Health Institute. ROC develops and campaigns for smart, incentive-based food and farm policies that position agriculture and food enterprises as solutions to critical challenges of the 21st century. Since 2006, Michael has been spawning and leading education and policy campaigns, community dialogues and creative engagements with government and corporate leaders to advance regenerative food and farm policies and practices that make agriculture and food enterprises solutions to critical public health challenges of the 21st century. His leadership has helped create one new law and funding program at the federal level and three new California laws that included two new funding programs and five successful budget requests. He began his career in 1989 as a sales executive in Europe for agribusiness and in 1992 founded Ag Innovations Network to provide strategic planning for companies and governments seeking healthier food and agriculture. In 1996, he founded Slow Food Russian River and, from 2002 to 2007, he was Chairman of Slow Food USA and a member of Slow Food International’s board of directors. Michael’s love for agriculture and food systems grew from experiences on a 13,000-acre cattle ranch in Santa Clara County in his youth and a development project with Himalayan subsistence farmers in Nepal in 1979. He is the host of the podcast Flipping the Table featuring honest conversations about food, farms and the future.

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Study after study has shown that consumption of sugar sweetened beverages poses clear health risk. So how have the big soda companies, Coke and Pepsi in particular, reacted to this news and to public health policies that have aimed to restrict their business dealings like marketing, labeling, and even taxes? A fascinating and important part of this history has been told in a new book by Dr. Susan Greenhalgh called Soda Science: Making the World Safe for Coca Cola. Dr. Greenhalgh is the John King and Wilma Cannon Fairbank Professor of Chinese Society Emerita at Harvard University. But hold on, what in the heck does China have to do all this? Well, we're about to find out. This will be a very interesting discussion.

Interview Summary

Let's begin by setting the context for your book, again, on soda science. Back in 2015, the New York Times published a major expose, written by Anahat O'Connor, and a critique of what was called the Global Energy Balance Network (GEBN), that was funded by Coca Cola. Could you explain what this network was?

Sure. The GEBN was an international network of researchers that argued that the energy balance framework is the best approach for addressing the obesity epidemic. So that simple framework calls for balancing the energy in the number of calories consumed through eating with a number of calories burned through moving to achieve a healthy weight. While that sounds neutral in practice, in the early 2000s, Coke and the food industry at large, adopted energy balance as their motto. It had several advantages. One is under the banner of "energy balance," the industry and the scientists working with it could say that people could eat whatever they wanted and then exercise it off. Unfortunately, that doesn't work for most people. Second, in practice, the energy balance slogan was used to promote exercise as the priority solution. What the research shows about energy is that exercise helps, but the primary answer to the obesity issue is to eat fewer unhealthy foods. Now the third advantage to the energy balance framework is that talking about energy balance meant the companies and the GEBN didn't need to mention soda taxes, or other legislative and regulatory measures, that worked but that might hurt the industry.

So, in my book, I call this body of ideas adopted by the GEBN and the food industry “Soda Science.” That's short for Soda Defense Science - a science created not so much to understand obesity, as to defend the profits of the soda industry.

Okay, that all makes sense, and I totally agree with your interpretation of the science that food intake is much more important in the obesity epidemic, in particular, than physical activity. It's not that activity is unimportant, but to divert attention away from the dietary part of it is really a public health misdeed. But one can obviously see the benefit to the industry for making that diversion. So, in that 2015 article, it was highly critical of the conflicts of interest that had been created by the soda industry paying prominent scientists. What benefits did the company reap from making these payments and what happened after that article got published?

The GEBN was the product of the 15 years that came before it, of gradually building up this soda science. The GEBN itself lasted only about a year, but during that 15-year period, the industry benefited by having fewer people, fewer specialists, fewer countries talking about soda taxes. But what happened after the GEBN was outed in the New York Times in late 2015 was Coca Cola was absolutely mortified. The revelation that the company had paid for industry-friendly science was just incredibly embarrassing. So, under absolutely withering criticism from scientists and the public, Coke stopped funding the GEBN, which of course led to its collapse. The company also took a major turn in its approach to obesity. Vowing to no longer single-handedly fund scientific research, and by publishing a long so-called transparency list of all the individuals and organizations it had funded over the last 15 years.

So, those things helped, but Coke's reputation remains tarnished to this day. But meanwhile, as for the academic scientists behind the GEBN, they saw things differently. They continued to maintain that their science had not been affected by the 20 million dollars that Coke had promised to support their network. Of the four researchers who led the GEBN effort, two stepped down and found wonderful jobs elsewhere. They both have leadership positions in different universities. One retired and the fourth continues to work in his previous position. So, there was no single, discernible impact on these debates within the academy.

I know some of the individuals involved. And by the way, I know a good bit of information available to understand what this network was doing came from Freedom of Information requests that various parties made. And your book contains transcripts from emails and things like that, that these various scientists were sharing with the industry. The content of those is extremely interesting and very telling. And the result, it's sort of this good-old-boy-back-slapping-network of people who were kind of winking - let's go get the people that don't like us. It's just interesting. My impression is that some pretty negative consequences befell at least two of those academics afterwards. You know, there was a lot of embarrassment. One basically, I think, had to leave the job he had. Another, suffered some real penalties in his academic life. And so, it wasn't outcome free, or it wasn't penalty free for these scientists at the end of the day. But I do think that your basic point is well made. That lots of people take lots of money from lots of industries on lots of topics. Not just on food, but you know energy and environment and all kinds of things. And very rarely do they pay any kind of a penalty. It only took this investigative report by the New York Times to shed special light on how pernicious this particular one was. But let me ask you a question, and then I kind of have my own thoughts about it. Why don't you think anything more happened to the people that got caught? I don't know if caught is the right word. But at least that they're taking industry money and their favorable science for industry got exposed. Why don't you think more happened about that?

The scientists themselves were deeply convinced that they hadn't done anything wrong. They were convinced that their science was not affected by all the money that they had taken from Coke, and the scientific nonprofit working for the industry, over all those years. I think there's a significant fraction of folks in the public health field, or at least in the obesity research field, who think the same thing. There's just a lot of support for them. As I see it, the two people who lost their original jobs have bounced back. I haven't done a survey of the field to ask people what they feel about these researchers, but they did pretty well given what they did.

The reason I think that they're convinced that they didn't do anything wrong is they have these practices, I call them “doing ethics,” to assure the world and themselves that their scientific integrity is intact. And one of the practices that these guys used was to constantly say, "This problem of obesity epidemic, it's huge. We have to include the food industry as our partner." And then when you go there, food industry begins to have a huge voice and there's very little you can do to effectively restrain it.

You know, it's an interesting way to think about it and consistent with the way I've thought about it over the years. I've done some writing on this topic and it seems to me that scientists have, not all scientists by all means, but a few select ones, get sought out by industry. And then this blind spot ensues where if you ask these scientists sort of, in general, does research get tainted or affected by industry money? They'll say yes. But if you ask does YOUR research get tainted by it? They'll say no. ‘Oh, no, I'm above that. I can be objective We have to change from within.’ There's a whole series of rationalizations for taking the money. But do they ever stop and ask, why is industry investing this money? And industry is not stupid. They wouldn't be paying you $50,000 as a consultant, or putting you on boards, or flying you around the world, or funding your research if there was no return from it. And the research on it is absolutely clear. Industry-funded research typically finds industry favorable results. So, all that's been documented. But the scientists who want to get involved with industry and take the money don't kind of interpret it that way. Like ‘I can take money but be free of the temptations to bias the work I do.’

May I just interject something here? I think that they believe it's a win-win prospect. Of course, Coke wants to emphasize exercise to make people forget about their sugar. But I've just dug long and hard into those emails, which none of the scientists ever thought would be read and used in scholarly accounts. But in the emails, the leader of the GEBN wanted to fund a major research project that he was promoting, and he's arguing all the reasons that Soda Science was good for Coca Cola. I suspect that he thought that Coke wasn't influencing him. Instead, he was influencing Coke. And in fact he was, but it doesn't matter where the influence comes from because in the end the science is affected.

You know, I've often asked myself, if there are negative consequences from this, the question is isn't there a police force out there looking after this kind of thing? And it's hard to know who that would be, because the scientists themselves have shown that enough of them are willing to take the money. And so the scientists aren't policing themselves sufficiently. Their institutions, the universities, tend not to do it because they're taking money from industry, too, in some way, generally. And their university's response to that is you have to disclose that you're taking money from industry. But there's research on disclosure, and that seems to make things worse rather than better. The journals that people publish their work in do the same thing. They make people disclose, but that doesn't have much impact. And professional associations have been investigated every which way by one of the same people who wrote that article in 2015, showing that they take money from industry. So, how can they police their members? So, it seems to me that the police have to be the press and people that do investigative scholarly work like you've done in this book. The book is pretty new. So, it's a little early to say what its impact is going to be. But let's hope that a lot of people read this book. And get more insight into how this works, how people feel when they're involved in this money taking, and what the ultimate impact might be.

So let's turn to one particular area of expertise you have. Let's talk about China. So almost all the criticism on industry-funded efforts like the Global Energy Balance Network have been focused on the U.S. But you follow the soda trail to China. So why did you do that and what's the significance of this inquiry?

Really significant. The GEBN was part of a much larger corporate project that was absolutely global in scope. So, from the vantage point of the industry, the U.S. has long been a declining market for soda. The important markets for sugary drinks are the large rapidly developing countries in the Global South. So that's where the industry is focusing its efforts to sell product, that is junk food and drinks. And to promote a corporate science and corporate policy that stresses exercise over dietary change in soda taxes.

So China. China has 1.4 billion people these days. One billion back in 1980 when Coke set up shop in China. China was the single biggest market for the soda companies. Coke was so keen to get into the China market that it started lobbying early. Actually the mid 1970s, when Mao Zedong was still alive. And in 1978, Coke became the very first Western company to set up shop in China as the country opened up for the first time in 30 years to the market, into the global economy.

And another advantage of the Global South, from the point of view of the food industries, is an attitude toward Western firms that's less critical than what you find in the U.S. In the U.S., huge companies are always under suspicion that they will promote corporate interests over socially valued goals. So those attitudes are much less prevalent in many countries in the Global South where big companies are often seen as agents of development, essential agents. In China, big Western companies were celebrated as sources of capital and advanced interests. So, nobody would suspect they were hurting the country. And the industry has lots of ways of dressing this up in a self-serving, positive way, by talking about developing emerging markets, investments in the developing world, and things like this. But it strikes me also as being stunningly similar to what the tobacco companies did when they got hammered in the United States. They simply moved outside the United States and tried to sell as many cigarettes as beyond our borders as they could. And a lot of these same sort of phenomenon take place. Does that seem true to you?

Absolutely. So let me ask what actually occurred in China. So, Coke sets its sights on China. It has this kind of process established that's trying to affect policy through connections with scientists. So, what actually took place in China? What was the impact on policies?

Well, to understand that, we need to know that the food industry had a magic weapon way back in the late 1970s. The food industry created an industry-funded scientific nonprofit based in DC that was global in scope. And whose job was to sponsor science that served industry needs. Its name was ILSI (International Life Sciences Institute). So, in China, the local branch of ILSI organized a series of major conferences and other activities designed to combat obesity. Over time, the proportion of these anti-obesity activities focusing on exercise rose dramatically, while the proportion focusing on diet sank.What this shows is that the food industry had tilted China's approach to obesity. ILSI China also played a major role in creating China's first and most important policies on obesity. The most important was the National Campaign for Healthy Lifestyles, ironically modeled after the patriotic health campaigns that Mao used to promote in his day. So, that healthy lifestyle campaign drew heavily on the Soda Science created by Coke, ILSI, and their academic friends. So, that ‘healthy lifestyle’ campaign prioritized exercise in a number of ways. Said nothing about sugar and soda. And it made the individual, not the government or industry, responsible for fixing the obesity problem. So, with this campaign, ILSI China had smuggled the policy favored by the food industry into China's policies.

That's an amazing history that you've documented. And it occurs to me that in the United States, we can celebrate public health victories, like the huge decline in cigarette smoking that occurred. And, the big decline that's occurred in sugared beverage consumption too. And those things are all good. But if this is like a balloon and you're just squeezing the end of it here, but it expands elsewhere in the world, the overall public health impact could be even worse than when you started, not better. And it sounds like the industry-funded front groups have been pretty responsible for making that happen.

Yes, they're incredibly effective. In my view, I really took apart ILSI, looking at it as an organizational sociologist. And I think it's just brilliantly designed to make academic-looking science that benefits industry. And to keep everything hidden from sight under that label nonprofit. It's really quite brilliant. They're not very happy with this project.

And the work that you've done, and the investigative journalists have done in the U. S., to expose these industry ties can have traction in the U. S. much more so in a country like China. So, it sounds like there's probably not much to put the brakes on this kind of thing in China. Is that right?

To tell the truth, there's a younger group of obesity experts, trained in the U.S., who now are based in China and have written major articles. There was a three-part series in The Lancet in 2021 on obesity in China. And they are on board with a critique of the food industry and working in every way they can to bring that to the attention of officials. But the government has a vested interest in the success of Coca Cola. I have to say that Coca Cola, and there's a huge state-owned enterprise called CoffCo, they now have a partnership called CoffCo Coca Cola, that runs the bottlers in 19 provinces, representing something like 60-70 percent of the Chinese population. So, the government has a vested interest in making sure Coca Cola remains happy.

Let's talk about that just a bit more. So, Susan, you'd think that the Chinese government would be in a conflicted position with this. On one hand, they want to financially benefit from Coca Cola prospering in their country. And I'm sure officials are benefiting individually from that kind of thing. But the country doesn't benefit because they certainly don't want high rates of diabetes and heart disease and obesity and other things that come from consumption of these products. How do you think that that plays out? Is it just that the short-term financial benefits are prevailing over the longer-term health consequences?

I think the government is highly conflicted. It has a number of policy, overarching policy themes, that it has been promoting ever since opening up in the late 70s and early 80s. One of those themes is marketization, growing the economy, advancing the technology in high end industries. And nothing can interfere with the achievement of that goal. China is known around the world for having very sophisticated environmental policies. But when push comes to shove, market goals prevail over environmental goals. I think the very same thing happens with health. It's just astonishing to see how market forces and market logics pervade the health sector. I did a separate piece of research, it's not in this book. But it shows that the major western food companies have been partnering with the Chinese government to carry out China's policies on chronic disease. And that means they're teaching the Chinese people basic notions of good nutrition. And what they're teaching them is not that soda is bad, is that, you know, it's that you can drink soda as long as you go ahead and exercise at all. I think there are major fundamental conflicts here at the level of profound party policy. I think this is going to be very hard to address.

I was going to say that's just a stunning observation. That part of the food nutrition education has been turned over to the food industry.

Absolutely. And you can, you can read about it in the Chinese media every year. They have, it's called Food Week or Nutrition Week, that's sponsored by the Chinese Nutrition Society, which is nominally independent. And they invite Western food companies to come in and sponsor a big project within that week. And of course they're very happy to do it.

Unbelievable.

And also, the policies that ILSI created that are very much pro industry, that was back in the 2000s. Those have now been built into central policy. So they continue to impact policy today.

So, a chapter of your book is entitled Doing Ethics, the Silent Scream. What do you mean by that?

Let me start with just a little bit of background. So, in China, the head of the ILSI branch operated as a virtual health ministry official. Kind of a de facto part of the government. So, no one could question what she did, part of the government, no questioning the government. As I just mentioned, most of the scientists I interviewed believed that Coke and other food and beverage companies were positive forces in China. They loved Coke's corporate social responsibility programs and had them all in their head and regaled me with these stories of schools in the rural areas supported by Coke. They thought everything was above board. They thought that ILSI's science was objective or disinterested. They couldn't imagine that Coke was supporting policies that benefited the corporate bottom line while harming the health of the Chinese people. Now, getting to that chapter, some very senior scientists, folks who had worked in the field before money came to dominate everything in China, they knew in their hearts that the food industry was corrupting China's science and policy. But it was very dangerous for them to talk about it. They certainly didn't volunteer those feelings to me. But when I began to ask really probing questions, they quietly acknowledged that yes, of course, corporate funding shapes the science. But the whole subject caused them just incredible angst. They couldn't talk about it. They certainly couldn't talk about it in public, and they couldn't do anything about it. And so, they issued a silent scream. And this is a really important part of the story of China. There really are voices of resistance, voices that see through the official line that everything's being done correctly. The readers of this book can hear that silent scream in that last chapter.

That's a pretty, pretty amazing story. Well, you know, it's heartening in a way that in a country like China, where the government controls so much of what day to day life is like, that there is some activity. At least some pushback, some resistance. So, let's hope ultimately that the objective science prevails. That the industry influence wanes, and the public health will be protected. So, speaking of chapters in your book, the last two chapters are titled, Soda Science Lives On. And then the final chapter, So What and What Now. Tell us more.

Oh sure, I'd love to. Soda Science Lives On: that's like the conclusion to the China part. I show how, even to this day, the provisions of Soda Science continue to shape China's policies on obesity and chronic disease more generally. In the last decade, President Xi Jinping has stressed the importance of including health in all policies, which is good. But a close look suggests that his signature policy package, that's called Healthy China 2030, bears the imprint of the Coca Cola company and -promotes ILSI's trademark exercise programs that omit soda taxes. And have a strong market orientation that makes individuals, again, not companies, not even the government, fundamentally responsible for maintaining a healthy weight through their healthy lifestyle choices. This, of course, neglects the importance of China's obesogenic environment and the impact of that environment on the choices available to individuals. So, this part of the book also introduces a group of next generation Chinese scientists who understand the threat posed by big food constantly lobbying the government to introduce policies to restrict its power.

I've talked about the impact on China, but I'm also very interested in the impact on America, especially American fitness culture. In the book's conclusion, what I do is I take the short history of Soda Science. And I place that in the context of the much larger history of the post-World War II history of American fitness culture. What I suggest is that Soda Science was instrumental in creating today's Fitbit wearing, step counting, exercise and obesity-obsessed culture that assumes that exercise by itself can take off pounds. That 10,000 steps a day is going to solve all my problems. It won't, but the idea is very much part of our everyday thinking about obesity. There's a lot of work to do.

As we all know, those big food companies are some of the wealthiest and most powerful forces in the world. Way richer than any of any fields of science in America. For critical scientists and social scientists, the effort to chip away at their power through the power of expose and documenting the truth often feels quite futile, time consuming and useless. But in fact, our work can make a difference. And I document this in the book. In the last few years, Coca Cola cut its ties with ILSI. That is big because Coca Cola was the founding company behind ILSI. Two other companies have also dropped ILSI. ILSI itself has also undergone a major reorganization and this is big - ILSI China has dissolved. It is no longer.

I'd like to think that the in-depth research of the social sciences has exposed what is really going on and left these corporate science organizations little choice but to close shop, or fundamentally change how they work. That's my secret dream. So this, this is progress, yes, but the food industry is still at it, for sure. Especially in the Global South. The industry is focusing its energies on defending junk food and drinks by opposing regulatory measures that have proven successful. You know, taxes, front of package warning labels, marketing restrictions and so on. So even in countries that have developed, often with the assistance of American researchers, really impressive chronic disease prevention programs, the industry has been moving aggressively to weaken, delay, or block them. Our work has just begun. And I really hope some listeners will be, will be encouraged to join the force of all of us working to expose and change how things are happening.

BIO

Susan Greenhalgh is John King and Wilma Cannon Fairbank Professor of Chinese Society Emerita in the Anthropology Department and Fairbank Center for Chinese Studies at Harvard University. A former Guggenheim fellow, she is a specialist in the social study of science, technology, and medicine, especially as these intersect with questions of policy, governance, and the state.

Her latest book, Soda Science: Making the World Safe for Coca-Cola (2024), uncovers the secret strategies by which Big Food, working with allies in academia, created an industry-friendly, “soda-defense” science of obesity that argued that the priority solution to the obesity epidemic is exercise, not dietary restraint, and that soda taxes are not necessary – views few experts accept. For 15 years the “soda scientists” were highly successful in promoting these ideas, eventually getting them built into Chinese policy, where they remain today. An earlier study of the American obesity epidemic, Fat-Talk Nation: The Human Costs of America’s War on Fat (2015), illuminates some of the unexpected consequences of the national panic over obesity for the bodies, lives, and selves of vulnerable young people. Under the Medical Gaze: Facts and Fictions of Chronic Pain (2001) presents a case study of iatrogenic injury, illustrating medicine’s power to define disease and the self, and manage relationships and lives, and sometime induce suffering.

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Join host Norbert Wilson and co-host Kerilyn Schewel in the latest episode of the Leading Voices in Food podcast as they dive deep into the world of small-scale fisheries with two distinguished guests: Nicole Franz from the Food and Agriculture Organization of the United Nations (FAO) and John Virdin from Duke University's Nicholas Institute for Energy, Environment, and Sustainability. Discover the significant role small-scale fisheries play in food security, economic development, and community livelihoods. Learn about the unique challenges these fisheries face, and how community-led climate adaptation alongside top-down national policies can help build resilience. This episode also highlights collaborative efforts between academia and organizations like FAO, painting a comprehensive picture of the state and future of small-scale fisheries.

Interview Summary

Kerilyn - So, Nicole, let's begin with you. Why is your work at the UN's Food and Agriculture Organization focused on small-scale fisheries and fishing communities? And could you share with us how they are different from fisheries more broadly? What's unique about them and their role in food production?

Nicole - Yes. Let me start with the latter question. And I think the first thing is to clarify actually what are small-scale fisheries, no? Because sometimes if you think about small-scale fisheries, what most people will have in mind is probably that of a man in a small boat fishing. But in reality, it's a sector that is much more diverse. There are, for example, women in Indonesia that are collecting clams by foot. Foot fishers. Or we have examples from small-scale fisheries that are fishing boats in Norway, which are comparably small, but if you compare them, for example, with how small-scale fishing looks in a place like Mozambique, it's a very different scale. But all of that, however, is comprised in what we understand as small-scale fisheries.

It is also important to understand that when we talk about small-scale fisheries in FAO, we don't only limit it to what is happening in the water, the harvesting part, but we also include what happens once the fish is out of the water. So, once it's processed, then, and when it's traded. So, so it's a whole supply chain that is connected to that small-scale fisheries production that we understand as being small-scale fisheries. And with Duke University, with John who is present here, and other colleagues and other colleagues from World Fish, we did a global study where we tried to estimate the global contributions of small-scale fisheries to sustainable development. And what we found was that at least 40 percent of the global catch is actually coming from inland and marine small-scale fisheries. And that's, that's enormous. That's a huge, huge amount. More important almost is that, that 90 percent of all the people that are employed in capture fisheries are in small-scale fisheries. And that is the human dimension of it. And that's why the community dimension is so important for the work. Because it is that big amount of people, 61 million people, that are employed in the value chains.

And in addition to that, we estimated that there are about 53 million people that are actually engaging in small-scale fisheries for subsistence. So, if we consider those people that are employed in small-scale fisheries, plus those that are engaging for subsistence, and all their household members, we're actually talking about close to 500 million people that depend at least partially on small-scale fisheries for their livelihoods.

We also looked at the economic dimensions of small-scale fisheries, and we found that the value from the first sale of small-scale fishery products amounts to 77 billion. So, these numbers are important. They show the importance of small-scale fisheries in terms of their production, but also in terms of the livelihood [00:05:00] dimension, in terms of the economic value that they generate.

And, last but not least, we also looked at the nutritional value from small-scale fisheries. And we estimated that the catch from small-scale fisheries would be able to supply almost 1 billion women globally with 50 percent of the recommended omega 3 fatty acid intake. So, I think with all of these numbers, hopefully, I can convey why the focus on small-scale fish is, in the context of food security and poverty eradication in particular, is of fundamental importance.

Kerilyn - Thanks, Nicole. That's really helpful to get a kind of global picture. If I could follow up to ask, what regions of the world are small-scale fisheries more common, or do economies rely on them? And in what regions do you see them disappearing? Are they common in countries like the US, for example?

Well, they're certainly more common in what is often considered as a Global South. In Asia in particular, we encountered the largest total numbers, absolute numbers, in terms of people involved in terms of production. But also in Africa, Latin America, the Caribbean. In the Pacific, obviously, they play a crucial role. They are more and more disappearing in the US, for example, in Europe. We see that it is a livelihood that is no longer very common. And one of the features we see there that it's an aging sector, it's a shrinking sector, for a number of reasons. But they still define the characteristic of certain areas where they really are part of the identity and of the local culture, even in the U.S. or in many, many places in Europe.

Norbert - Nicole, this is really fascinating. Thank you for sharing this broad overview of what's happening and who are small-scale fishers. What are some of the common challenges that these small-scale fishers and fisheries face? And what is FAO's response to those challenges?

Nicole - Well, where to start? There are so many challenges. I think one fundamental challenge that is common across all regions is securing access to fishing grounds. But not only to fishing grounds, but also to the coastal areas where operations, where they land the boats, where they, where the process of fish, where the fishing villages and communities are located. In many areas around the world, we see expansion of tourism, expansion of urban areas and coastal areas. The increase of other industries that are competing for the space now, and that are often stronger economically more visible than small-scale fisheries. So, the competition over space in those areas is quite an issue.

But there are also many challenges that are more outside of the fishing activity directly. For example, often small-scale fishing communities lack access to services. We had basic services such as education or health services, social protection. And in many cases, women are particularly disadvantaged in relation to access to these services. For example, women that are involved in harvesting or in processing of fish in small-scale fisheries, they often do not know where to leave their children while they are at work because there's no childcare facility in many of these villages. And there are 45 million women that are engaged in small-scale fisheries around the world.

Another set of challenges relates to the value chains and the markets. Often there's limited infrastructure to connect to markets. The processing and storage facilities are not adequate to bring the product to the market in a state that allows it to then fetch good prices and to benefit from the value chain. Often small-scale fishers and fish workers are also not well organized. So, they become more subject to power imbalances along the value chain where they have to be price takers. Now they have to accept what is offered. That also relates often to a lack of transparency in relation to market information. And of course, then we have another set of challenges that are coming from climate change that are becoming more and more important. And from other types of disasters also.

One thing that brings together all these challenges, or makes them worse, is often the lack of representative structures and also institutional structures that allow for participation in relevant decision making or management processes. So that small-scale fishers and fish workers don't even have an opportunity to flag their needs or to propose solutions. So, FAO has facilitated a process to develop Voluntary Guidelines for Securing Sustainable Small-scale Fisheries in the Context of Food security and Poverty Eradication. Quite a mouthful of a name. In short, we call them small-scale fisheries guidelines. In which all the major challenges in a way are compiled in one document together with guidance on how to address them. And these guidelines are the result of a participatory development process. So, they are really informed by the involvement of fishing communities from around the world, but also other stakeholders. And they have been agreed on and have been endorsed by the almost 200 members of the FAO. We are now working with countries, with the small-scale fishing communities around the world, with other partners, including Duke University, to help implement these small-scale fisheries guidelines.

Norbert - Oh, this is really fascinating and it's important work. I'm intrigued with the participatory process. How are small-scale fisher organizations involved in this? Are you working with different organizations? Or is this more individuals who are just interested in this issue coming to the fore?

This is through organizations at all levels. Be it at the national level where we are, for example, facilitating the formation of new women organizations in a number of African countries. Be it at the regional level, in particular in Africa, there are existing structures in the context of the African union, which has established so called non state actor platforms for fisheries and aquaculture, which we are supporting in order to bring their voice into the processes and to facilitate peer learning. And then there's a number of global social movements and producer organizations for small-scale fisheries that we are working with and using them as a facilitator to involve as many as possible. And gather as much insight that is coming from the membership of those organizations to then bring into global, regional, national processes from our side.

Norbert - This is really important to hear how different forms of governance and at different levels are playing a part in developing these guidelines. Thank you for sharing that, Nicole. I'd like to turn to you, John. You have more than 20 years of experience in studying and advising government policies to regulate human use of the oceans. With a particular focus on marine conservation practices. How has your thinking about marine conservation changed over the last 20 years?

John - Yeah, it's changed a bit. As you mentioned, my interest in work has been on ocean conservation and how it can alleviate poverty. A lot of times that has meant managing fisheries to address poverty. And I think in the past, that meant that I was really focused on what governments could do to increase the efficiency of fisheries. The economic efficiency. How do we increase incomes, how do you increase revenues for communities? All very important, but for all the reasons that Nicole mentioned, I spend a lot more time now thinking about the process rather than the outcomes, and thinking about what institutions are in place, or can be created, to help empower small-scale fishing communities to have much more of a voice in the decisions that affect them. In how the resources are used. How the space is used. And Nicole outlined really well a lot of the challenges that are facing communities from increased industrialization of ocean use to the squeeze from climate change and the effect on resources. And even the fact that climate change may be driving people to the oceans. I mean, as farms and agricultures maybe fail or face challenges, oceans are often open access, and can even be a sink for people to make a livelihood. And so, yet more pressures coming from outside these fisheries. How can fishers have a greater voice in making the decisions that impact them and safeguarding their livelihoods?

Norbert - Thank you for that. I'm interested in understanding how do these fisher folks, who are trying to organize and are organizing, how does that interact with sort of larger markets? I mean, I would imagine a number of these folks are catching fish and other seafood that goes into global markets. What's the interaction or challenges that may happen there?

John - As Nicole mentioned, because small-scale fisheries are so diverse you have markets in many places. These may be located near an urban center where you can have easy access. You can get fresh fish in a cooler and put it on a plane and off it goes to an export market. We found that, what may be surprised us, is a significant number of small-scale fishers are exporting in some cases. So, then that can be challenging because you might get higher prices, which is a good thing. But it might drive, for example, more fishing effort. It might drive higher levels of exploitation. It might change traditional practices, traditional rules for fisheries. It might really change how fishers organize in a given place. So, the access to export markets, even say an island setting, has kind of scrambled past fisheries management in some places and can be an outside force.

Kerilyn - John and Nicole, I want to ask you both a question now about painting a picture of these communities that you're working with. You both mentioned how diverse small-scale fisheries can be. I was wondering if you could just share what one community in particular looks like that you've worked with? What are the challenges that a particular community faces, or alternatively, where do you see things actually working well? So Nicole, could I ask you to respond first?

Nicole - I'm working more with global processes and the global level. So, through that, I have the privilege of working with representatives from many, many communities. So maybe what I can share is the feedback that I'm getting through that, in terms of the change that we can observe, and that is affecting fishing communities around the world. I think one thing that is being brought up as a concern by many is what I mentioned before. It's a process of aging in fishing communities and often a lack of capacity to retain young people in the sector. And that has different reasons. Now there are all of these challenges that small-scale fisheries have to face and that are difficult to overcome. So, that often drives people, in particular young men, to leave the communities. Or within the communities, to look for other alternative livelihoods now and not to take on the skills of fishermen or getting engaged in small-scale fisheries more broadly. So, in some cases, yes, it's not only other activities within the community, but really leaving the community and leaving in some cases also the country. What we see there is that sometimes people that have the skills, maybe still as a fisher, they have tried to fish. So, they have a knowledge of fishing. They emigrate out into other countries. And in some cases they are then hired into industrial fisheries where they work on industrial boats that go out fishing for longer periods of time. But where they at times end up in situations that can be called slave labor, basically, that are subject to serious violations of human rights. And that is in a way generated by this vulnerability to the poverty that is still there in those communities. The lack of being able to make a living, a decent work in the fishing community. So, that is something that we have seen is happening. We have also seen that in some cases, there's an involvement of fishers into say more illegal activities, be it in drug trafficking, be it also into the trafficking of people.

I'm thinking even about the Mediterranean. I'm working out of Italy, Rome. We have a lot of immigration from North African countries, for example, coming through that route. And oftentimes it happens that the transport of migrants is actually carried out by fishers and their boats because they have the skill to navigate the sea. And they make a better living by transporting illegal migrants than going fishing. So, those are some of the challenges we hear.

And the other one is there in relation to what is now a concept that is getting more and more traction. It's often known as the blue economy, which is, in a way, looking at the ocean as the last frontier for economic development. And that includes on the one hand, the expansion of previously existing industries, such as tourism. But also the expansion of newer sectors such as alternative energy production. Think wind parks now in coastal areas. So, what happens here is that in many cases, this adds again, additional pressure on the available maritime space. In the water and on the land. The expansion of marine aquaculture is another example. So, that also is something that we hear is becoming an issue for small-scale fishing communities to defend the space that they need to maintain their lifestyle.

Kerilyn - John, is there anything you'd like to add on this question of how fisheries are changing?

John - Very, very briefly. Taking the example in West Africa where I've spent some time over the years, you certainly have some communities there where it actually doesn't seem as if the fisheries are changing as much in the sense it's quite static and stagnant. And this could be caused by a lot of the reasons that Nicole mentioned, but the community, the economy, the fisheries aren't growing. People, young people may be leaving for a number of reasons, but it doesn't have to be that way either. I mean, there are positive examples. I was in Liberia last week, and there, from the numbers that the government has, small-scale fishing communities are growing. The number of fishers are growing. They've actually made a conscious effort to protect a certain area of the ocean just for small-scale fisheries. And to prohibit trawling and to give the communities more space to grow and operate in the 20 years since the conflict ended there. So, again, it doesn't have to be sort of stagnant or grinding on in some of these communities as they cope with competition for resources, for example, competition for space from others. Where they were given that space, in some cases in Liberia, they've grown. That may have its own challenges but.

Kerilyn - Interesting. In the back of my mind, when thinking about these communities and aging and migration of younger generations away from these livelihoods, you know, as someone who studies the relationship between migration and development, I think it's a common trend where, you know, as countries develop, young people leave traditional economic activities. They get more educated, they move to cities, they move abroad. To what degree is this somehow just part of these countries' development? Should we expect young people to be leaving them? And to what degree might we think differently about development in a way that would enable more young people to stay? And I think, John, you mentioned a really interesting point about how protecting the space For these small-scale fisheries to operate is one thing that seems to have kept people engaged in this livelihood. I'd be curious if there's other things that come up for you. Other ways of thinking about enhancing the capability to stay in small-scale fishing livelihoods.

John - Sure, and I'd be curious what Nicole's seeing from her perspective. I think, to some extent, it's a different question if small-scale fisheries are economically viable. And so, what I think Nicole and I are referring to in many cases is where for a lot of these external pressures upon them, they may not be as viable as they once were. And that has its own push on people, whereas where fishers are empowered, they have more of a voice in what happens to the fisheries and controlling those spaces and resources, and it can be more economically viable in these fisheries. That presents a different set of choices for young people then. So that's where we've really focused is: okay, what is the process by which small-scale fishing communities have their voices heard more, have much more of a say and much more power in the use of the fisheries, the use of the coastal areas, the things that affect those fisheries and their livelihoods? And then we can see what those choices might look like. But Nicole, I'm not sure if that's consistent with what you've seen in a number of places.

Nicole - Yes, and maybe to also rebalance a bleak picture I painted before. Like John said, there are obviously good examples. I think an important condition is probably a linkage to markets. Non-economic viability in many ways does play a role. And there are examples of how that can happen in different ways. For example, in Morocco, the country has made quite a significant investment to build a whole series of ports for small-scale fisheries. Specifically, along the entire coastline of Morocco where they are providing a port that is not just a landing site for small-scale fisheries, but it provides like a system of integrated services. There's an auction hall. So, the fish comes in, it's immediately kind of weighted. They get the information, the label for what they have brought in, then it goes into an auction that has set rules and everybody is tied to. But in that same area, for example, there's also a bank or there is an office that helps with the access to social protection services, for example. So, it's a whole integrated service center, and that really makes a difference to help make the sector more efficient. But at the same time, also really keep the tradition. So, it's not only economic efficiency, but by having all these different centers, it allows to maintain many people employed and to also maintain the characteristics of each of those different lending sites. That's one example. I was in Korea last year and there, they were doing something similar. They are reviving some of their traditional fishing villages where they are also investing in those fishing communities and providing them with funding to set up, for example, restaurants that are run directly by those involved in the fishery. Those are particular places that are close to cities. In my case, I was in Busan. So, it's very closely connected to the consumers now that come out there. They are focusing on certain products in these villages that they are famous for traditionally. They have little shops and they're starting e-commerce for some of the products. So, the way they package, and the label has become much, much wider than before. So again, that has revived a bit those communities. In Italy, it's a country that's famous for its food, you know. And they are in the region that's called the Amalfi coast. There's a tiny village and it's famous for the production of a value-added product made from tiny sardines that are fished by the small-scale fisheries boats. And they are processed in a very particular way. And there is like a label of geographic origin of this product, and it can only come from that village. And it has a high price and has it's like a high-end product, so to say. And in a way these are also approaches that provide dignity to this profession. And a sense of pride which is really important and should not be underestimated in also increasing the willingness, for example, of young people to be part of that and maintain the viability of the sector.

John – I’d like to just add, I think that's a really important point on the dignity and pride and the importance of these fisheries in so many places and cultures. I mean, I'll never forget talking to a minister of finance in one country and starting to try to make the economic case for supporting small-scale fisheries. He cut me off in about 30 seconds and started talking about growing up fishing in the village and going back home for vacations, and just the importance to the entire community of fishing to him and just how much it was a part of the fabric of the culture.

Kerilyn - I love that. That does seem so important and wonderful to hear those very specific examples that do give some hope. It's not just a bleak future.

Norbert - You know, it's great to hear how government policy is helping shape and reshape these fisheries in a way that allow for economic viability and also these are opportunities to connect communities to these traditions. And so, I find that really fascinating. I want to kind of push a little bit beyond that and bring back the idea of how to deal with climate that was mentioned earlier. And also change our focus from government policy to sort of what's happening within these small-scale fisheries and fishery organizations. So Nicole, a lot of your work focuses on building more inclusive policy processes and stakeholder engagement. And so, from your perspective, how does community-led climate adaptation, rather than top down adaptation agendas, lead to different outcomes?

Nicole - Well, I think one way that seems quite obvious, how community-led adaptation can lead to different outcomes is simply that in that case, the traditional and the indigenous knowledge that is within those communities will be considered much more strongly. And this is something that can be really critical to crafting solutions for that very site-specific context. Because the impact of the climate change can be very different in every region and every locality not due to that specific environment that it's encountering there. And holding the knowledge and being able to observe the changes and then adapt to them is something that certainly a community-based approach has an advantage over something that would be a coming from a more centralized top down, a little bit more one-size-fits-all approach. And this can then imply little things like, for example, if the water temperature changes, we see a change in the fish behavior. Now we see how certain stocks start to move to different environments and others are coming in. So, the communities obviously need to adapt to that. And they do that automatically. Now, if it changes, they adapt their gear, they adapt to the new species that is there. So, in many cases, there are solutions that are already happening, and adaptations that are already happening that may not carry that label, that name. But if you look at it, it is really what is happening, no? Or you can see in some cases, that for example, there are initiatives that are coming also spontaneously from the communities to replant mangrove forests, where you can observe that there is a rising seawater level that is threatening the communities and where they have their houses, where they have their daily lives. Now, you can see that through NGOs and often there is support projects for that. But you can also see it happening more spontaneously when communities observe that change. So, the top-down approaches often they lack that more nuanced, site-specific considerations in their approaches and the consideration of that specific knowledge.

On the other hand, it needs to be said though, that the top-down approaches can also play an important role. For example, countries develop their national adaptation plans. And those plans are usually, you know, developed at a higher level, at the central level. And often fisheries and aquaculture are not necessarily included in those plans. So that is something where the top-down level can play a very important role and really make a difference for small-scale fisheries by ensuring that fisheries and aquaculture are included in a sector. So, I guess that in the end, as always, it's not black and white. No, it's something that we need to take into account both of it and have any climate change adaptation approach to small-scale fisheries being grounded in both. And have a way to bridge the top down and the bottom-up approaches.

Norbert - I really like this idea of bridging between the top down and the bottom-up approaches, understanding the local knowledge that's there. I would imagine that's also knowledge that when used to make decisions makes it easier for people to stick with those decisions, because it's a part of their voice. It's who they are. And then the other side, it's critical to make sure that those plans are a part of a larger national move, because if the government is not involved, if those higher-level decision makers are not involved, they can easily overlook the needs of those communities. I really appreciate hearing that. I think sometimes we hear this tension. It needs to be one or the other. And you're making a really compelling point about how it has to be integrated. John, I'm really intrigued to see from your perspective. How do you see this top down versus bottom-up approach working in the work you've done?

John - I'll do what I typically do is echo and agree with Nicole, but just to give an example that I love. I teach this one in my classes. There's an old paper by Bob Johannes, a marine ecologist. And the standard practice in managing fisheries as government scientists is you count the fish, you then set limits for them, often from the top down. And his point was in the case of Indonesia, if you look at the reef fisheries that go through most of the communities, one tool to assess the fish stocks is to do a visual census. You swim transects along the reefs and you count the fish. So, he did a back of the envelope estimate and he said, well, if you're going to do that through all the reefs throughout Indonesia, it would probably be finished in about 400 years. And that would give you one snapshot. So, he's saying you can't do this. You have to rely on the local knowledge in these communities. I don't want to romanticize traditional knowledge too much, but I just can't imagine how policies would effectively support adaptation in these communities without building upon this traditional ecological knowledge.

Kerilyn - John, since coming to Duke from the World Bank, you've regularly collaborated with non-academic partners like the FAO as well as the UN environmental program. Can you tell us more about how your partnership with the FAO and your work with Nicole more specifically began?

John - Sure. I think more than anything, I got really lucky. But when I first came to Duke, I started working with a colleague, Professor Xavier Basurto at the Marine Lab, who I think is one of the world's leading scholars on how communities come together to manage common resources like fish stocks. We organized a workshop at Duke on small-scale fisheries. We got talking to Nicole, invited her and some of her colleagues at FAO to that workshop, together with others, to think about a way forward for small-scale fisheries for philanthropy. And I think from those conversations started to see the need to build a global evidence base on how important these fisheries are in society. And Nicole could probably say it better, but from there, she and colleagues said, you know, maybe you all could work with us. We're planning to do this study to build this evidence base and maybe we could collaborate. And I think we're very fortunate that Duke gives the space for that kind of engaged research and allows us to do it. I don't think we knew how long it would be when we started, Nicole. But over five years and 800 researchers later, we - Javier, Nicole, myself, and so many others - concluded with this global study that we hope does have a little bit clearer picture on the role of these fisheries in society.

Kerilyn - Nicole, from your side, what does an academic partner bring to the table? What's your motivation for partnering with someone like John or Duke University more specifically.

Well, I think as FAO, we like to call ourselves a knowledge organization, but we're not an academic institution. We don't conduct research ourselves, no? So, we need to partner around that. We work with the policy makers though. So, one of our roles, in a way, is to build that. To broker and improve the science policy interface. So, this is why collaboration with academia research for us is very important. And what we experienced in this particular collaboration with Duke University to produce this study called Illuminating Hidden Harvest, the Contributions of Small-scale Fisheries to Sustainable Development was really that first we realized we have a shared vision, shared objectives. And I think that's fundamental. Now, you need to make sure that you have the same values, how you approach these things. And in this case, it aligned very well that we really wanted to take in a way, a human-centered and multidimensional approach to look at small-scale fisheries. And then it was also very important to understand what every partner brings to the table, no? The different strengths that we have. And then based on that, define the roles and what everybody's doing in a project. And the added value for us was certainly the capacity from the Duke University side to help develop the method that we develop for the country case studies that we conducted in 58 countries. And not only to develop that method, but then we had a postdoc at Duke University for this project, who was actually then engaging with all of the people. People in these 58 countries. And, and she was. coaching them in that methodology, actually in three languages, which was quite amazing. It was very, very thorough. We could not have done that. And we had a lot of other students from Duke University that helped us once we had the data gathered. To then screen that data, harmonize that data, clean that data, obviously under the leadership of John, Xavier and other colleagues, no? So that was really something that was adding a lot of value and actually also helped us to get to know a lot of the students from Duke. And some of those then ended up also becoming consultants working with us more broadly on small-scale fisheries. So that was certainly great, great value for FAO as collaboration.

BIOS

Nicole Franz, Equitable Livelihoods Team Leader, Fisheries and Aquaculture Division, Food and Agriculture Organization of the UN. Nicole is a development economist with 18 years of experience in intergovernmental organizations. She holds a Master in International Cooperation and Project Design from University La Sapienza, Rome and a Master in Economic and Cultural Cooperation and Human Rights in the Mediterranean Region. From 2003 to 2008 she was a consultant for the Food and Agriculture Organization of the United Nations (FAO) and the International Fund for Agricultural Development (IFAD). In 2009-10 she was Fishery Planning Analyst at the Organization for Economic Cooperation and Development (OECD) in Paris, focusing on fisheries certification. Since 2011 she works for the FAO Fisheries and Aquaculture Division where she coordinates the implementation of the Voluntary Guidelines for Securing Sustainable Small-Scale Fisheries in the Context of Food Security and Poverty Eradication (SSF Guidelines) with a focus on inclusive policy processes and stakeholder empowerment. Since 2021 she leads the Equitable Livelihoods team.

John Virdin is director of the Oceans Program at the Duke University Nicholas Institute for Energy, Environment & Sustainability. He has a total of over twenty years’ experience in studying and advising government policies to regulate human use of the oceans, particularly marine conservation policies to reduce poverty throughout the tropics. His focus has been largely on managing fisheries for food and livelihoods, expanding to broader ocean-based economic development policies, coastal adaptation and more recently reducing ocean plastic pollution. He directs the Oceans Program at the Nicholas Institute for Energy, Environment & Sustainability, aiming to connect Duke University’s science and ideas to help policymakers solve ocean sustainability problems. He has collaborated in this effort with the United Nations Food and Agriculture Organization and the United Nations Environment Program, as well as regional organizations such as the Abidjan Convention secretariat, the Organization of Eastern Caribbean States, the Sub-Regional Fisheries Commission of West Africa and the Parties to the Nauru Agreement for tuna fisheries management in the Western Pacific. He co-created and teaches an introductory course for undergraduate students to understand the role of ocean policy in helping solve many of society’s most pressing development challenges on land. His work has been published in books, edited volumes and a number of professional journals, including Nature Ecology and Evolution, Ecosystem Services, Environment International, Fish and Fisheries and Marine Policy, as well as contributing to China Dialogue, The Conversation, the Economist Intelligence Unit, and The Hill.

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With food insecurity rising the world over, we cannot escape the reality that climate change is changing our food supply. This means people's livelihoods and lifestyles are changing too, particularly in developing countries. Join us on the Leading Voices in Food podcast as we discuss the rising impact of climate change on food security and livelihoods in Central America, specifically Honduras. Host Norbert Wilson, Director of the World Food Policy Center, along with co-host Sarah Bermeo, delve into the challenges and solutions with experts Marie-Soleil Turmel from Catholic Relief Services and Ana Andino from Duke University. Learn about the Dry Corridor, the effects of climate shocks, land restoration practices, and the role of international support in building community resilience.

Interview Summary

Sarah - Marie, some of your work with Catholic Relief Services engages with smallholder farmers in an area known as the Dry Corridor of Central America. Can you explain what the Dry Corridor is and provide some context about the food security situation in that area, and how much do residents depend on their own crops to provide food for their families?

Marie - So, the Dry Corridor of Central America refers to a region that stretches across the Pacific side of Guatemala, El Salvador, Honduras, and Nicaragua. The region has a long dry season and a rainy season when the crops are produced. In the last 10 years, this region has been characterized as one of the most vulnerable to climate change. Mainly due to prolonged dry spells in the growing season and more unpredictable rainfall patterns. This region is made up of many small holder farmers in the rural population. These are small hillside farms growing staple crops, maize or corn, and beans with relatively low yields. And most of the household consumption is coming from these farms, and they're selling any surplus that is produced in a good year. These are rain-fed production systems. So, the amount of food that the farms produced is directly tied to the amount of rainfall, making them extremely vulnerable to droughts and climate shocks. And also the region has a very high degree of soil degradation. It's estimated 70 percent of agricultural soil is in a state of severe degradation. This makes farms even more susceptible to climate shocks. So, this is a region that's already struggling with poverty. Close to 8 million people are living in a situation of food insecurity. And now with increasing climate shocks that are affecting crop yields, it's sending more people into a situation of food emergency and requiring food aid.

Norbert - Thank you, Marie, for providing that context. Ana, let's now turn to you. I understand that you've worked with the Honduran Ministry of Finance and the Inter American Development Bank on issues relating to economic development in Honduras. What do you view as some of the key development challenges facing the country?

Ana - So Honduras faces several challenges which have been dragged out for many years. And now some of them have even worsened, particularly since 2020 when we were hit by the pandemic and the storms Eta and Iota. It's tough to pinpoint just one or a few of them since it's a convergence of complex scenarios, but if I had to mention one - and going along with the conversation we're having today - I would mention intersection between climate change and economic vulnerability. As we heard Marie talking about the Dry Corridor, there are many rural communities that rely heavily on agriculture. But climate variability has made it even more difficult to maintain stable food production, affecting income and food insecurity. So, by mid-2023, about 25 percent of the population was suffering from food insecurity. Nationally, agriculture provides employment for approximately 30 percent of the country's workforce. And there's verification agriculture is also limited, which, this dependency constrains sustainable growth and resilience. Also, I cannot leave behind the access to basic services such as water and electricity. Of course, I'll include in this education, right? It is important, and it's not only a matter of access to them, but also the quality of their services.

Many households lack access to clean water. This impacts their daily life, but also their agricultural productivity. And even in the main cities, there is an inconsistent access to water and electricity, which affects livelihoods, but also small businesses to larger industries. Education is a no-brainer, since both access and quality remain a serious challenge. In this list, I would also like to add crime and violence, which remain high. And even though there has been an improvement in the last years, particularly reducing homicide rates, it still remains as one of the highest in Latin America. The situation is even worse when we look at femicide. Because Honduras is still one of the highest or has one of the highest rates of femicide in the region. That often goes along with high levels of impunity. And finally, we're almost getting there to my list of challenges, I would say that there is a lack of infrastructure, particularly in rural areas.

There is no reliable access to roads or markets, which affects a lot of smallholder farmers. This also affects connectivity for roads. It limits access to health care and education. And these all are challenges that compound together. And yeah, to finally wrap it up, it's that without institutions that can effectively implement policies and manage resources, it'll be hard to, to have development efforts and to see growth in the country.

Norbert - This sounds like a daunting set of challenges. And I realized that obviously in this conversation and the work that's going to happen later this week, we're not able to address all of those. But I would like to pull back and ask you both about issues around climate. And so, for the both of you, I'd be intrigued to understand this. Central America is believed to be highly susceptible to climate change, and Marie, you've already mentioned this. What are some of the key effects that climate change is having on the region? And I've heard you already talk about issues around availability of water. But how do these affect the livelihoods and particularly, how does this affect food security? So, Ana, let's begin with you.

Ana – So, as Marie mentioned, there are a lot of extreme weather events going around, such as prolonged droughts, intense rainfall, tropical storms. And these weather patterns have a direct and severe impact on agricultural productivity. Especially in regions where families rely a lot on subsistence farming. It becomes a challenge to plant, to harvest crops. This leads to a reduction in yields. Also, people have less income, referring to income losses, which in the end has a cascading effect on food insecurity and poverty. So basically, what happens is that families have less to sell, but also have less to eat.

If we transition to urban areas, climate change could cause floodings and damage to infrastructure, affecting severely industrial activity as well. This will disrupt the livelihoods of the people. In urban and rural areas, it exacerbates difficulties in accessing food, in accessing clean water, in accessing electricity. And just to give you an example, this happened back in 2020, right after Eta and Iota. We had long lasting effects, causing damage to agriculture, to livestock, to infrastructure. The effect on GDP was approximately eight to nine percent of GDP. And unsurprisingly, poverty rose 14 percentage points, which is a big increase. If you see national surveys going around, they have shown that people are having issues with getting access to food. And many people have also had to change their diet, leaving behind some proteins and introducing more carbohydrates or, or foods that are less expensive than proteins, right? And I would leave it there. Yeah.

Norbert - This is really important. Thank you for sharing that. Marie, what about you?

Marie - Ana really summed it up well, but I would add that it's really important to understand that that these farmers don't have crop insurance to fall back on like farmers in the U.S. So, we're seeing more frequent climate shocks, sometimes years in a row. Droughts and hurricanes. And farmers might be able to borrow seed or money, or to buy inputs to replant the next year, but after consecutive bad harvests, they run out of options and resources and really can't recover. And also keeping in mind that about 60 percent of the food in the region is coming from smallholder farms. And these climate shocks resulting in yield damage have implications for food prices and food security at the regional level, not just at the farm level, right?

Sarah - So, Ana and Marie, you do a very nice job laying out the multiple challenges that are facing in urban areas. Turning from that to thinking about adaptations or policy changes that could be successful, can you think of some that might help in decreasing the negative impacts of climate change on farmers, particularly in the Dry Corridor? And, have you seen evidence? Can you bring evidence from your previous work for this to think about pathways forward and whether or not those would be scalable to additional farmers.

Marie - So, a focus on land restoration and soil restoration is really key to building climate resilience. As I mentioned, these are areas with really highly degraded soils that are even more susceptible to these climate shocks. So, we're talking about managing the soil to manage water. And I just want to take a moment to explain why soil is so important for climate resilience. A healthy soil will capture and infiltrate more rainwater. These are rain fed systems, depending on every drop that falls. They store more water for plant production and also percolate more water down to recharge groundwater, which has an implication for water availability in the whole area.

In a degraded soil, like much of the agricultural land in the Dry Corridor and other parts of the world, soils have lost this function, and the rainwater runs off, it's not captured, it's not stored, and the resulting, the crops grown in that soil are much more susceptible to periods without rain, and there's overall less water availability. When soil and water resources are degraded, agricultural productivity is low, the families are susceptible to climate shocks, and this keeps them in a cycle of emergency and recovery and poverty. The good news is that the ability of soils to capture and store rainwater can be restored with good agricultural practices that build soil organic matter, protect, and protect the soils from erosion.

In Catholic Relief Services and in our programs, we call this Water Smart Agriculture Practices. In one of our programs from 2016 to 2020, we monitored a network of farms where we tested these practices with farmers on their farms and side by side plots comparing the water smart agriculture practices with conventional practices. Within that period, a very severe drought in 2018 hit. It affected the whole region and we found that these soils during a very severe drought could store up to 26 percent more moisture during this drought period. And on average yields were 39 percent higher. In a drought year, this can make the difference between a family producing enough food to still meet their household needs or being in an emergency situation and having to rely on food aid. And also, we found it in good years, yields were also much higher because of these good management practices. Meaning that farmers could produce and sell more surplus and improve their income savings. And this also contributes to greater overall resilience. And just to note also that these practices also sequester more carbon in agricultural systems, which also has climate mitigation impacts.

Now this alone, soil management alone, is not going to bring farmers out of poverty. We need to build on this foundation of good natural resource management with market access, diversification with more lucrative crops access to financing and, of course, increasing opportunities for women and youth. But all this needs to be built on this foundation of restoring soil and water resources so that we can be successful with these other types of development interventions. We're working to scale these practices in the Dry Corridor by working with a network of partners, including other local NGOs, government agencies. And one of the main limitations is that farmers have is gaining access to any type of agricultural extension services. So, we're really working to strengthen local extension. We're using a hybrid model that combines field training with digital extension tools and radio for mass communication to reach more people. And we know from some of our work and some of the work I'm doing with Sarah and Ana to look at the adoption of these practices, that when farmers do have access to extension services and training, they are in fact applying and adopting the practices.

Sarah - Thank you, Marie, for providing the detail about some of the programs that you're seeing and that the evidence, these are evidence-based practices that are actually making a difference for the farmers that you are working with. I want to turn to Ana now and shift the conversation just a little bit. You know, Marie was laying out potential ways to turn things around and ways that life could become better for farmers. But what do you see as some of the consequences of inaction if we don't keep on with these programs and if programs are not scaled up to help smallholder farmers and others in the region. What do you think will be the consequences of that for poverty and food security in Central America?

Ana - Sarah, that's a great question. Again, it's hard to give an exact answer on what would be the exact results of this. But there was this one thing that popped into my mind immediately, which is an accelerated flow of people migrating both within the region and towards the U.S. as well. Because people are seeking to escape these harsh living conditions, right? So, food insecurity will get worse, particularly in susceptible areas like the Dry Corridor where farmers are already struggling with this climate unpredictability. Rural families will also face greater challenges in meeting their basic nutritional needs. potentially leading to malnutrition and health crises. And even in urban areas, high prices and food shortage will disproportionately impact the most vulnerable communities, exacerbating inequality. Now, in addition to that, failing to act now will result in a greater cost in the future. And I believe another concerning consequence of inaction is the displacement of young people. And here I must add that right now Honduras has a demographic difference and we're not taking advantage of it. Many young individuals migrate in search of better opportunities, leading to the so-called brain drain. Or they even leave the country without any further motivation to help the country while they’re abroad. So, with insufficient opportunities for education, for employment, we are risking youth becoming trapped in cycles of poverty. We're losing people that are capable of helping the country, and this will undermine long term community development and stability.

Norbert - Ana, thanks so much for providing that context for the need for action and what consequences of inaction might be. You know, this has been a challenging conversation. We've talked about a number of things that are going wrong or where some of the challenges are. I actually want to turn the conversation to see some ways forward. And so, what are some of the positive changes that can take place? And, you know, Catholic Relief Services is doing some really important work. And I want to hear more about that. But I also want to hear about it in the context of what could happen if policy makers, government officials or decision makers in the international development institutions, if they changed policy or created new opportunities. What would you say are still some really pressing needs and where would you focus money and efforts to get the biggest impact or hope for the most people? Marie? Let's start with you.

Marie - I want to emphasize again just the importance of investing in land and soil restoration as a foundation, as a strategy to build climate resilience. Now, we really need programs that are also creating economic opportunities and developing markets for farmers, but this needs to be linked with land restoration initiatives in order to ensure resilience and the sustainability of these activities. You know, when land and soil is restored, these practices aren't just implemented, and they're not just implemented at the farm level, but like over whole landscapes. This improves productivity, but also water availability for households, urban areas, and other activities. So even programs that promote irrigation technologies as a solution for the Dry Corridor, which is really like a way forward also. These need to be linked with the land restoration activities because this water needs to come from somewhere. So, we need to ensure that we're protecting our water resources and ensuring the availability for these other activities, or else we won't be successful. And they also won't be sustainable.

We also really need to invest more in capacity-building aspects of our development programming. Not just focusing on asset replacement, which is necessary, but we need a good balance of investing in capacity building. This means farmers, agronomists, agricultural institutes to strengthen the extension systems and improving access to information around soil and climate, for improved decision making and management of these resources in order to also take action to reduce overall risk and climate risk in the area. So really building the capacity in the management practices that can in the long term reduce dependencies on external aid.

Norbert - Ana, what about you?

Ana- I think Marie summed up everything very well. But if I had to rephrase what she said in my own words, I would focus a lot on infrastructure development. Both physical and digital. This is essential. Investing in better roads, market access, but also digital connectivity would enable the population of farmers and entrepreneurs to reach bigger markets, fostering economic growth and development. And I'll also include improvements to infrastructure to be climate resilient and friendly to the environment. And going along to what she said about capacity development, I would also give focus on improving productive skills. Many companies in the region and especially in Honduras highlight the limited ability of the workforce to generate high value opportunities as a major constraint. So, concrete advances in competitiveness and innovation are needed in this sense. And I would wrap this wish list saying that for any policy to be considered if you want to talk to them to any government official or international organization, there has to be more focus and importance on inclusive policies. They have to engage local communities, they have to engage women, they have to engage youth in decision making processes. Basically, we want to ensure that these groups have voice in policy development.

Sarah - Great. Thanks Ana. I want to, you know, turn this attention now to thinking about research. So, Duke is an institution where research is one of our primary functions. And thinking broadly about the impacts of climate change on agriculture and food security, where do you see the biggest need for additional research? And maybe to think about in another way which research questions if they were answered could be transformative? And how might academic research and researchers partner with organizations like Catholic Relief Services and others doing work in the field in order to answer some of these questions about practical applications that could help on the ground? And Ana, let's begin with you.

Ana - Thank you for your question, Sarah. I would say our work with Catholic Relief Services has given us a lot of ideas on how we can improve in this sense. For instance, we need to understand how different technologies and practices performed in diverse kinds of conditions are crucial. What factors influence farmers’ adoption of one technology more than another, considering the heterogeneity of each farmer and each living condition. But I would also be interested in exploring how climate change impacts household dynamics and whether there is a shift in roles. Men and women, right? If there is an increase in women empowerment within the agricultural context once they're exposed to these new technologies. How they make the decision on what to eat, how much to eat, what to produce, what not to produce. And I would say also, and this is my Santa wish list of the things I want to research about as well is understanding their desire to migrate even under these improved conditions. Like even though we're giving them this technology, it's like what is actually keeping these farmers that we are helping stay and keep doing or producing what they're doing in involving improving with time.

Sarah - Marie, what about you?

Marie - Yes, so from the development organization perspective, collaborations with academic institutes can really provide an opportunity for us to go beyond the scope of the kind of monitoring and learning that we build into our development projects. And bring in different levels of expertise, and research methods. So definitely something that can be beneficial for our programming. I see two main areas that require more research and where, you know, collaborating with academic organizations or institutes could be, could be a benefit. The first is really around the whole biophysical type research on agricultural systems. Practices to accelerate land restoration, drought tolerant crops and varieties to improve resilience to climate and market shocks. And calibrating and applying different tools for decision making around soils and water resources. And then the other area is really research in development. So, what's the effectiveness of our different delivery methods of our programs, our extension models, and strategies for reaching and including women and youth. Understanding the scaling strategy and how we can reach more farmers. And also, translating these results and program impacts into policy recommendations. So really, research that informs our development strategy to ensure that programs are really leading to transformative, sustainable change and improvements in livelihoods and food security and resilience.

Norbert - I really do appreciate hearing this. As a researcher, it's, it's so easy to get, sort of, how do I get the next paper in a journal. But what you're talking about are research questions that really move the development efforts forward. That are, sort of, informed by what's happening on the ground to make sure that the work that you all are doing is the work that leads to the best outcomes for the largest number of people.

BIOS

Marie-Soleil Turmel is the Scientific Advisor for the Catholic Relief Services Water Smart Agriculture Platform in the Latin America and Caribbean Region. She is an Agronomist/Soil Scientist with 15 years of experience conducting research and extension to promote soil health, productivity, and climate resilience of smallholder farming systems in Latin America. Before joining CRS, she worked as a Research Scientist for the International Maize and Wheat Improvement Center (CIMMYT) and Bioversity International. Marie holds a Ph.D. in Soil Science from McGill University and an M.Sc. in Agronomy from the University of Manitoba.

Ana Andino is a PhD student in Public Policy with a concentration in Economics at Duke University’s Sanford School of Public Policy. Prior to joining Duke, Ana worked on development issues in Honduras with the Inter-American Development Bank and Honduran Ministry of Finance. She is now an integral part of the Duke team collaborating with Catholic Relief Services. Her research interests are in political economy, climate migration, food insecurity, and international development. She holds a Master of Science in local economic development from the London School of Economics.

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I’m Norbert Wilson, a professor of public policy at Duke university and director of the world food policy center. Now, I am an agricultural economist by training and today’s podcast, we will explore a creative and down-to-earth book titled Food Economics. Now stay with me, gentle listener. I already can sense the wave of anxiety, math anxiety, and discomfort with economics. but hear me out. To make the food system work for everyone, we must understand the economics of food, agricultural production, business decisions, consumer behavior, and of course, government policies. Tufts University Professor, economist William Masters, and Allegheny College economist and nutritionist Amelia Finaret, developed a wonderfully engaging textbook that is friendly for readers and learners who do not love math or who have a complicated relationship with economics.

Interview Summary So let’s start at the very beginning. Why did you write this book?

Will: Well, I’ll start. I love the subject. And I love the opportunity to work with Amelia on something. And we talked about taking the course that she was a Teaching Assistant for and making it into a textbook. And finally being able to do it has been revelatory. I’ve learned a lot, learned a lot from Amelia, learned a lot from the process of writing. The motivation really is because the topic is so compelling. As you said, food economics is crucial to whether people can afford to and do have the material requisites of wellbeing, as the original definition of economics put it. And so, food is this really distinctive, strange thing that’s, as I say, often hidden in plain sight. It’s something that many economists want to teach about, but don’t really know much about. And many people who work in food without economics would like to use some economics. So, putting the two together has been definitely a situation where two plus two is more than four. Putting the two together is something new and different.

Amelia: I think also that food is a very special type of good. And so, when we’re talking about economics we talk a lot about goods and services. And food is a special type of good in that you have to have it to live. And we also really found during the process of writing the book, as Will talked about, more and more examples that many of the fundamental lessons of economics can be learned with examples from the food system. So, we think that using a topic like food, which really resonates with a lot of our students, is a great way to teach econ and it can get them more excited than learning about widgets.

I am really intrigued by this, and I want to pick up on this idea that food is special and that is something I think is a critical part of what you all are doing. But I also heard something new in this idea of using food as a pathway into economics. So, as you know, folks react really strongly to economics because of math or a disdain for capitalism or other issues. Why do you want people to understand the economics of food?

Amelia: So food is something that all of us make choices about multiple times a day. And there’s very few other things, maybe about our time management overall, that we make choices about so frequently. But food is one of those things that we make choices about multiple times every day, all of us. And that’s whether it’s about producing the food, doing something else to the food or consuming the food. And economics fundamentally is about understanding and analyzing those choices and those behaviors. So, people, of course, are going to be confused sometimes about how to make those choices. And that’s one of the biggest and most important discussions in public health: how do we encourage folks to make better food choices? People are also just very confused because there’s so much different information floating around. So, what we wanted to do is to provide an economics perspective of food choice because economics is really great at analyzing choices. And this, of course, helps people connect what’s something that’s personal to them, which is making those kind of frequent food decisions. Even if they’re not thinking about it, they really are thinking like an economist frequently about food multiple times every day. And then connecting it to this discipline of economics to understand the formal logic of how we analyze those choices.

Will: And I would add the opportunity that we’ve had in teaching economics to people who didn’t like economics, chose not to do it, and wanted to do public health nutrition instead. For me, at Tufts in the Friedman School, and also with students from agriculture – I taught previously at Purdue students who didn’t like economics because they wanted to work in agriculture – I really want to demystify a lot of what became a kind of high jargon of fancy language. For example, in economics, people would speak of an individual “optimizing.” And we just don’t say that. Instead what we say is people are doing the best they can with what they have, and often it’s the least bad of their options. Similarly, economists talk about an equilibrium, but it’s not a “nice” thing. It’s just a prediction of a model of an explanation. So, much of our task here, I think, is to demystify economics for students, but also to help economists find a better language because economists use that off putting technical jargon way too much to talk to each other. And that really harms our ability to communicate with people who, as you said, might have a disdain for the outcome, for example. They don’t like the way capitalism is turning out and they want the vocabulary to change it. And we hope the book can provide that.

I really appreciate this. Picking up particularly on Amelia’s comment, I remember as a student at the University of Georgia, I had an amazing intro to agricultural economics teacher. His name is Joseph Broder. And he got me excited about this idea of how people make choices. And we were talking about it in the food and Ag space, and I just started to see that happen everywhere. I realized that this was a powerful tool to help me understand the choices that people were making and the choices that maybe they wanted to make but couldn’t because they were facing different constraints. So, I really appreciate this effort of what you all are trying to do in this text. That raises the question of who do you really want to read this text? I mean, who was your target audience and why those individuals?

Will: So, the number one audience is instructors, to make it easy for them to teach this material. Someone who comes from economics, works on some other topic, can teach a course in food economics just by picking up the book. A student who is assigned the book can get an explanation that is perhaps richer in detail with more examples. And then we also provide a lot of data analysis in the book that a student can read on their own. But I honestly believe that quite a few general readers can find it attractive to just pick it up and flip through it. When I wanted to learn about general nutrition, just vitamins, minerals, reading a nutrition textbook was actually great. And I hope that this textbook is something that people can just pick up and flip through. You can, because it’s open access, you can just search for a word in the book, and you can flip around and see what catches your eye. And I hope people find that experience interesting and enlightening and useful.

Amelia: And I think the book could be used by students, undergraduate and graduate students, and their instructors for all different kinds of courses that intersect with the food system. So, not just straight up economics courses, but also courses on the food system, maybe even on sustainable agriculture, on public health nutrition. And I think that, you know, for those courses, certain chapters could be selected and used in a course. So, we hope that people can use it really as flexibly as they want. Yeah, and then we also think that for economists who never learned about the food system, that it might benefit them as well, because we really do give a complete picture of what the food system is, what it looks like with all kinds of data. And they maybe haven’t thought about, you know, economists know econ, of course, but they maybe haven’t thought about the food system and how it’s kind of a unique sector. And this I think would help them really to formalize that for themselves too.

This is helpful. I’m going to bring up a different group of people who I think could be interested in this text. How do you see someone going into a department or ministry of agriculture or food or development agency, seeing policy differently based on the work of this text?

Amelia: In terms of the policy aspects of the book, the material in each chapter can intersect with different types of food policies. So, for anyone who works at a ministry of health or a ministry of agriculture who’s developing food policy, they might use the book to see, “okay, well, what am I going to be able to tell qualitatively? What will happen if this policy is implemented?” Of course, if they want to understand something about quantitative change, they would need to gather data and do some statistics and econometrics. But if they want to make a sketch of “okay, well, if I implement this policy, here’s what I can expect qualitatively to happen to prices and quantities and imports and exports.” They can definitely do that using the material from this book. I think that it might also help because it spans everything from production to consumption and health, it will allow policymakers to really see those connections between those aspects of the food system. So not just consumers, and not even just consumers and farmers, but also thinking about input markets and food manufacturing and processing, as well as retail. I think that it gives that kind of that whole picture of the food system, which could be really helpful to those policy makers.

Will: Another aspect of ‘whole picture’ thinking that we tried to instill in the second half of the book is just showing a lot of data. And in particular, zooming way out so that we show all of the data. We believe, I think with pretty good evidence, that when people choose a case study, choose a narrative, choose an example, there’s a lot of selection effect there. And when you zoom way out, as we do in the second half of the book to show scatter plots and line graphs, I think policy makers will see whatever decision they’re making in that quantitative context. They’ll get the qualitative insight that Amelia just described, plus the overall context. And that will really guide decisions, we hope, towards a more mindful and well-informed kinds of choices.

Now, that’s I think really powerful. And there’s something else that’s unique about this text is, you mention it, it’s open access. And so that’s really different for a textbook. And because it’s open access, that means it’s free for everyone. So as an economist, I have to ask, what does that mean? How do you make it free for everyone? So why did you choose that approach? And then this book also does something else a little differently. It doesn’t use extensive citations or footnotes and references. What was your thinking in that approach?

Will: Great question. I’ll talk about the open access and Amelia can talk about the structure and the tone, the voice. Open access was an opportunity that the Bill and Melinda Gates Foundation provided because of their support for the Agriculture Nutrition Health Academy that I’ve been privileged to be a founder of, to create a community of researchers. The Gates Foundation does support open access fees that are quite high. For this book, it’s $20,000, but the grant was willing to pay that. The total royalties that Amelia and I might’ve earned is very small compared to the effort in writing the book. And so, we really wanted to take advantage of that grant to have people be able to just click on the link and read the book. It takes all the delay and the challenge and the difficulty our and makes access seamless as well as free. So, it’s not just low cost, but also low time transaction difficulty. You can put it on any device and refresh. You know pick it up on your phone, pick it up on any laptop at any time. And that makes a big difference, we hope.

Amelia: Yes, the lower the barriers are for students to read the better for sure. And in terms of the structure of the book and having kind of the sprinkling of sources within the narrative text, what we really wanted was to create kind of a just a seamless narrative. So, we didn’t want readers to have to flip to the end to see about where the sources were. But we kind of describe key thinkers, key economists, and also experts in other fields whose work has really influenced economics within the narrative text. And so, we feel that this kind of helps it flow better. And we also put all the data citations right next to the figure so that you can click out to that source and see the data yourself when the data are updated. You know, students and readers could make their own charts with that same data. So, for the data visualizations, all the citations are right there, ready to go. And then for anything else that you might include normally as a reference, it’s all woven into the narrative. We also have a handbook chapter that has more than 300 citations for the health side of the literature. So people can use that if they want a guide to published papers that are individual studies.

Great. This sounds like a wonderful opportunity and really a unique way of contributing to both the educational component, but also sort of this idea of outreach of what university professors do. So it sounds almost like more of a public service than I would think we would normally look at a textbook. I gotta ask this question, because you start and you end with a poem about kiwis. Not the small animal or the people from New Zealand, but little furry fruit. So why do you do this? What are you trying to tell us through this poem?

Amelia: I mean, I think first is just to demonstrate that economics can be really fun. And also that the food system can be kind of confusing. Right? And that’s right in the title of the poem. Why are kiwis so cheap? This was Will’s poem. I’m going to let him talk about other reasons why you wanted to put it at the beginning and then at the end.

Will: Yeah, the question came from a journalist asking why are Kiwis so cheap because they come from the other side of the world, right? And when I first got the question, I thought it was a kind of a silly question. And I didn’t want to answer pedantically. And I had just written a sort of doggerel poem for my brother’s birthday. I had like doggerel poetry on the brain and I was thought – I could just write a fun little poem. So, there you go.

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When you hear university dining, you likely have images in your mind of college students with trays and hand waiting in a line for a meal in a dining hall. You may even think of a food court or a trendy food hall in the cool part of town. But there is so much more happening behind the scenes. Today we will learn about Menus of Change University Research Collaborative, MCURC for short, which is a nationwide network of colleges and universities using campus dining halls as living laboratories for behavior change. The Collaborative's goals are to move people towards healthier, more sustainable and delicious foods using evidence-based research, education and innovation. Our guest today is the Collaborative's co-founder and co-director, Stanford University's Sophie Egan.

Interview Summary

I'd like you to tell our listeners a little bit more about the Menus of Change University Research Collaborative. What is it and how does it actually work?

The Menus of Change University Research Collaborative was co-founded by the Culinary Institute of America and Stanford University, two divisions there, the Stanford Prevention Research Center and the School of Medicine, and Residential and Dining Enterprises. And that should tell you something is different in our vision, which is that first and foremost, we wanted to break down silos that exist on campuses between experts in food who work in academic realms. So, researchers, faculty who may be studying food, either from one certain discipline or ideally some cases transdisciplinarily, and those who actually feed students, the experts in the dining programs on campus. And Stanford was a good place to co-found this because of this great partnership that already existed between the dining program and between Dr. Christopher Gardner at the School of Medicine. But that model has actually now been replicated. We are at 70 plus institutions, not only across the U.S., but actually increasingly internationally.

In addition to fostering that collaboration and breaking down those silos on a given campus, we really wanted to foster collaboration between universities to take what we consider kind of a plug-and-play research protocol. You know, a given design of a study that, as you said, uses campus dining halls as living laboratories and actually replicate research. So that's what we've done. It's been incredibly fun to be part of it from the beginning, and it's been incredibly exciting and impactful because of the approach that we take. We really democratize even what it means to be a researcher, to be involved in research. We have involvement in the collaborative and in research projects from students, faculty, of course, who are critical in their expertise, but also executive chefs, nutrition and sustainability experts. And many other research collaborators who are mission aligned organizations like EAT and REFED and Food for Climate League, who bring their own kind of comparable expertise. And we all work together to shape these living lab studies and then to test those at multiple sites to see if this a more generalizable effect? Or is that something just those west coast schools work for? Or is this only something that, you know, more elite schools where students of a certain demographic really respond?

But that's also the beauty is the diversity of the institutions that we have. Geographically, public private, small and large. And we're really brought together by the kind of common language of what's also in our name, Menus of Change. And these are these principles of optimizing both human and planetary health through the food on our plates.

And for us really, especially through students, changing that trajectory and cultivating the long term wellbeing of all people in the planet, one student, one meal at a time.

Wow. This sounds like a really amazing program. And I love the fact that you're working across different types of universities across the U.S. and even outside. And it does make me believe that the findings that you have are applicable in a broader setting than if one institution does it. I can appreciate the power of the Collaborative. I want to know a little bit more about the impact of the collaborative. What has it been up to this point and in what ways have you seen this collaborative generate new ideas or new research findings?

Yes. So, we've got about six peer reviewed publications under our belt with more on the way. Our latest is called the University Procurement and Planetary Health Study led by Dr. Jackie Bertoldo, who was at the Johns Hopkins University and also Stanford Food Institute. But we have a number of academic publications also in the works. And then importantly, we actually have produced 13 operational publications and reports. So, what that illustrates is that we've come to realize that those that are collaborating have different currencies. Publishing in a peer reviewed journal, that's what motivates academic researchers, right? That's what's going to enable them to invest time and resources. Fundamentally, this is primarily something that people do, in their free time, right? It's a volunteer-based network of over 300 members. But if they're going to work on a project, it has to have some value to their own work. But what has value to those in dining operations is implementable, real, tangible strategies, recommendations, and guidelines that translate 'these are the findings of a certain study into what do you want me to do about it? How do you want me to change my menu, sourcing, the design of the dining hall, the choice architecture, right? The food environment itself. How do you want me to change something in the operational setup?' Maybe, if it has to do with food waste. All of these resources are on our website. We also have three really exciting new projects in the pipeline.

So that's our research and publication impact to date. But I should say that importantly, it's much more meaningful to us who take those resources and acts upon them. We know that universities are unique places to conduct research, but our research is not aimed only at the campus dining sector. It's actually offered open source to inform and shape the entire food service industry. We have been thrilled, for example, one of our kind of flagship publications called the Edgy Veggies Toolkit has been implemented and adopted by some of the largest food service companies in the world. Think of Sodexo, Aramark, Compass, who are phenomenal members of the collaborative. Think of corporate dining programs, hospitals, hotels, elsewhere. K 12 environments. And that's, to us, the most important kind of reach is to know that those toolkits, those resources.

Edgy Veggies was about how you could simply change the way you describe vegetable-based dishes on a menu, to use more taste focused language, to increase the appeal. We actually demonstrated you can measurably increase selection and consumption of vegetables. So, you can imagine that has applications in public health in countless settings. Even those of us trying to feed our kids. Hey, if I call tonight's broccoli, you know, zesty orange broccoli versus just broccoli, maybe my kid will eat more of it, right? So, it has applications in countless different contexts.

Another really big area for us is our collective purchasing power. So, we learned at some point that it's not only that these organizations, the institutions that are part of the collaborative are brought together by a desire to co create research, but it's really that alignment on healthy, sustainable, plant forward future for the food service industry. And so we've actually created this collective impact initiative where it's our combined purchasing power. We've now measurably reduced our combined food-related greenhouse gas emissions. By 24 percent just between 2019 and 2022, and that's across 30 institutions, 90 million pounds of food. I mean, this is a huge outcome for us, and we're not stopping there. We had a goal to reduce by 25 percent by 2030, and now reaching that, we're A, enhancing the target to a 40 percent reduction by 2030. But importantly, we're actually measuring now the uptick in diet quality. So, because human health is equally important to that sustainability part, that University Procurement for Planetary Health study that I mentioned, we're actually able to see that if we are aligning our procurement, meaning what do we buy in the total pounds of an institution and then in the aggregate, right? How plant forward, how healthy and sustainable is that kind of portfolio, that total mix of foods that we're purchasing? And we can actually really increase the diet quality and that kind of average health profile at the same time. So, getting that data layer is really key. And it's the kind of area of impact that has so much momentum and will only continue into the future.

Also, lastly, just to say our student engagement numbers have really grown, and that's critically important because educating and cultivating the next generation of food systems leaders. is also core to our work. We have our MCRC Fellows program and that has really grown to have about 30 fellows from a number of institutions all around the country. That's another great way that anyone interested can get involved in. Students are a reason for being. So, it's key that they see these ways to make an impact through their work as well.

I am really impressed with the improvements in lowering greenhouse gas emissions or improving sustainability of the dining facilities. How actually did you all do that? I mean, it sounds like you're asking people to report and through that reporting, you see reduction? Can you explain?

Coming soon is our 2.0 learnings report that will answer that exact question, but we do have a 2020 version. We call it the early learnings report that shares what it sounds, you know, the early learnings of what works, what doesn't. But what I can tell you can have been kind of the big keys to that success. First, collective target setting. We have been able to welcome institutions that really don't necessarily have the political support, the kind of stakeholder buy in, to make a big public commitment. Some schools do, some institutions do, and that's great. And others, they can sort of take cover, so to speak, in contributing to something where, you know. Their pace of change may be different. And so, it's really kind of contributing to something larger than only their institution, but also having the comfort that it's going to be fits and starts. It may not be linear. It may not be all forward. It might be a little bit backward in terms of the progress trajectory. So that's been really key to having a real diversity of schools where it's not only those that are at the very leading edge. And it's in again, places that aren't as comfortable coming out with a big splashy public wedge.

The other big thing that's been key is that we have created a very streamlined framework for data collection. Instead of kind of saying you must submit your data for every single item you've ever purchased, we've on a smaller subset of food categories, where it's easier for them to track, we've created a streamlined and standardized template for them to submit the data, and we also provide individualized reports back to that university. It's confidential. They are the only one who gets it. And that's very motivating because a lot of institutions don't have that resource or that expertise to conduct that analysis to track their emissions year over year. It's almost like getting kind of a free consultancy. But it's what creates that reciprocity where we need their data. We need their collective contribution to the collective effort. And they're getting something out of it because they do have to take the time to find the data and to submit it to us. And then the other thing I think has really been key is, and this was kind of the core concept of collective impact, is continuously iterating. Every year we're listening to those involved in tweaking, you know, how we're asking for the data, how frequently we used to ask for it twice a year, and now it's annually, for example. So always kind of iterating, testing and iterating to make the processes mutually beneficial as possible. And then also keeping the door open for those other institutions to join. It's kind of a cohort effect where we have some institutions that have been part of it from the beginning and others that have only been submitting data for a year and everyone is playing a role.

Great. Thank you for sharing that. I want to ask you a little bit more about your other work that you're doing because you're the co-director of the collaborative. You're also the co-director of the Stanford Food Institute. Can you tell our listeners more about that institute and what you're working on there?

The Stanford Food Institute was founded by our visionary leader, Dr. Shirley Everett, who's Senior Vice Provost for Residential Dining Enterprises at Stanford. And she really had this vision to bring together an entire community of people to shape a better future of food for the benefit of all humanity and, and really embracing how much food is happening on the Stanford campus. To have the Stanford Food Institute be really this hub and this home for what belovedly we say at Stanford, it's a very decentralized place. There's a ton of entrepreneurial spirit and that's fantastic and should be, but often we don't know what everyone else is doing. So, it's a great opportunity for the Stanford Food Institute to be that magnet and say, come one, come all, whatever student led group, research project, course, event, you know, we want to work with you.

So, in practice, what we really do is we work across research, education and innovation to bring together that community and work on this better future. We have a really strong focus on racial equity in the food system, as well as bold climate action. Those are kind of some cross-cutting themes.

Our R&DE (research, development, education) core values that have to do with excellence and students first, sustainability, health, deliciousness. All of those things are kind of foundational at the same time. So we actually collaborate with faculty in all seven schools, which is for me super fun because I get to learn about the business dimensions of food and the psychology and social sciences. We have the new Stanford Doerr School of Sustainability that is a very active partner. We have phenomenal partners in the School of Medicine. And when possible, of course, we bring them all together.

One really phenomenal culmination of all of those different research efforts is we host something called the Stanford Food Institute Food Systems Symposium, where every year, I like to explain it as a food systems science fair. It's a kind of exhibition style showcase. Researchers get really creative with how they show their work. We had over a hundred researchers at our latest symposium. And it demonstrates that real diversity of disciplines and topics that, that touch food because that's what's so exciting about food. It touches all parts of society. That's one big example. And then we have a number of community partnerships in the Bay Area. One is with the nonprofit Farms to Grow and we're really committed long term to helping support black farmers, not only in California, but sharing our model for increasing supplier diversity and equitable supply chains with other institutions. So those are just two examples, but it's really such a pleasure and an honor to lead the Stanford Food Institute. And as you can likely gather, it's really quite complimentary to the menus of change university research collaborative as well.

I am really excited to learn about this symposium. And I got to say, I've worked in land grant institutions before, and I studied at land grant institutions. And so it's interesting to hear of a school like Stanford that is not a land grant. That doesn't have a tradition of agriculture in a narrowly defined sense engaging in this work. I mean, how is it that you're able to find that many people? You said a hundred folks were working on different projects related to the food system. Is it just happening, and people don't necessarily know that it's happening and you're able to bring them together? What's going on there?

That's a good question. I don't have a scientific answer. I have a hunch. Anecdotal evidence. We're talking about research here. So, I’ve got to be clear on my methods for answering. I'll tell you, Norbert, so before I was in this role, one of the things I did was I taught a class at Stanford in the School of Design that was all about food systems careers. And it was essentially a stopgap because there was so much interest from undergraduate students in careers in food systems. But they didn't know what on earth they were going to do to make money, to make a living. How were they going to tell their parents I'm going to use all this money you spent on my degree to do what exactly? There also was just not a clear sense of even what the role types were. What's out there? What's possible? How can I make a difference? And so that class that we co-taught for several years. And I say that because that was just an interesting signal of how many students were interested, sort of, you know, poking at the edges. But a lot of them, to be honest, I call it off ramping. They didn't see the path. They just went the path that was more clear cut. They went to law school or they went to med school. And then they said, ‘well, I'll just like cook at home as a side hobby instead. Because maybe my passion for food doesn't need to be my career.’ And so I think what we're really doing with the Food Institute, and there's a number of other kind of similar initiatives, is trying to say, let's try to, you know, address this in a more root cause kind of way. We have something now called the Stanford Food Systems Community, which is just a list serve. And in the fall, we host an event right at the beginning of the year where it's, it's kind of a, again, a come one, come all. We come to the farm, the actual farm at Stanford and have a pizza party and get to know all the different events and things on campus.

I think to me, it's, it's a groundswell that's happening nationwide. So, I'm also an author and I've spoken for my books at a lot of universities. And I will often get asked to speak to the career services department. They'll ask me, can you talk about careers in food systems? I've seen this groundswell of interest from students. And then I think a lot of faculty also are really seeing how maybe they study law or a certain dimension. But its kind of either like backs into food or stumbles upon food, maybe. You know, we don't have, like you're saying, we don't have a department in nutrition. I mean, we don't have a specifically food kind of academic framework. But it's more those inherent intersectionalities with food where it's almost in, I think, inescapable to faculty. And then it's really kind of bolstered by how many students are expressing interest. It's something I'm really excited to see where we're in conversations with faculty to do even more to just make students aware of how many classes there are. Because I think sometimes that is the challenge that it's there, but they just don't know how to access it.

Right. Thank you for sharing that. And I got to say, I've been taking notes, so I may follow up with you some more later. You've been working with campus food leaders for over a decade now. And you talked about that even in, I guess, in referencing the class as well. What is it about colleges and universities that excite you when it comes to making positive changes in the food system? And you've given me a little bit about that. I'm intrigued to see what else are you seeing?

You know, it's surprising. It's the longest I've done something, like a certain one specific role is, is co leading this collaborative. Because I actually co-founded it when I was with the Culinary Institute of America on the other side of the partnership. And I think I have just a deep appreciation, and maybe I like to describe myself as an I realist, idealist mixed with a realist. A realistic view of the potential for universities to be change agents in society. Does it mean they always use that potential? No, but it's there. It's everything from the incubators of new knowledge. They're where new ideas emerge, right? I remember when I first went to the University of Bologna, and it's been there for a thousand years. That's just incredible, right? But it's also a place of growth and expanding your mind for students. Many of these higher education institutions are what's been referred to as anchor institutions. They are huge employers in a region. They are huge thought leaders in a region. They're places of opportunity for all kinds of different things. Whether it's collaborations with private sector and industry, whether it's international kind of tourism and exposure, I mean, so many different possibilities there. And I think the other big thing is that, and I should just say on the anchor institution point, it's the, all that purchasing power too, that I mentioned right there. Very streamlined, fairly agile decision making. I'm sure someone on the podcast is going to say, you think Higher Ed is agile, you know. There's bureaucracy, I know, but I just mean compared to some other food service companies or industries where it's really hard to make changes within campus dining, in particular, you do have a fairly sizable, you know, amount of purchasing power that can have fairly quick, they can be early adopters and they're known as early adopters. The food service industry really looks at what's campus dining doing. That's the tip of the spear. That's a signal of the trends to come. That's a signal of what are going to be the new norms.

And the last thing is that we really embrace the fact that students in college, this is this unique period of identity formation. They're figuring out their relationships to food. What is the role that food is going to play in their lives? What do they value? How does that get reflected through food? How does that make them feel? How do they perform academically, physically, et cetera? And of course, for community and belonging, coming together, breaking bread, et cetera. We really love this stat where we've seen that in a given year, we have 4 million meals across the collaborative. But it's not just the meals that these students eat when they're on our campuses. It's the billions of meals they will go on to consume in their collective lifetimes, and when they go on to be decision makers and parents and in the other future realms. And again, that shaping formative opportunity. There are many reasons, I guess, that I've been motivated and I think the potential is still just tremendous. I'm excited for all that's ahead.

This is great. And I love the idea and the recognition that this is this formative time for students. That their taste, which may have been shaped, of course, from home, but are being transformed in the dining halls. The place where they're learning to step out and make decisions about food in a way that they couldn't even in high school. I really appreciate this idea and this opportunity. And I appreciate the sort of seriousness that you take at approaching this issue. I have to say, as someone who's related to or connected to a policy center, I am intrigued to think about what kind of policy initiatives, federal, state, even university, do you see coming out of the work of the collaborative?

Well, you know, it's really exciting when there is, again, I mentioned that our schools are both public and private, right? So, policy has so many opportunities to kind of shape, again, that social or political will that the decision makers administrators, dining directors may have to pursue something. So, you know, the University of California has been part of the collaborative, most of their campuses have been part for a very long time. And it just is a good example, I think to me, where in that state, there is so much support from the governor's office for farm to fork, local procurement, direct procurement, supplier diversity, regenerative agriculture, climate friendly and plant forward meals in public schools, in K 12. It's that sort of enabling environment, I think, that policy can create and also learn from. So, if it sees constellation of institutions, making a bold move or all aligning on the same kind of, you know, targets or metrics, that can give them the wind at their backs to pass something that maybe applies to all publicly run institutions. Or all food vendors in their state.

For example, I would love to see more policy efforts on data and reporting. As I shared with you about collective impact, we're really proud of what we've done, but this is all voluntary, right? We're just choosing to measure this and hold ourselves accountable and keep striving. But I think at some point if it becomes required, you could have more resources in these institutions being brought to do that hard work that is required. I mean, it's not only, you know, sharing with us, but then it's analyzing your menu. What were the strategies that led to that biggest reduction? How did the student feedback go? Working with suppliers is a huge area that Stanford's really excited to have begun, but it takes time. It's, and we need more support, more capacity to do that.

I could envision that if there were more requirements kind of coming from policy for some of that tracking and disclosing. And an example that gives me reason to think that's possible is again in California. Something called SB 1383 requires Institutions like ours and all others to disclose their food donation amounts. And I think that's a really interesting example again of measuring something. Bring a measurement requirement from policy to something that maybe everyone's already been doing because it was just best practice, or something that they wanted to know for themselves again that more voluntary. I think there's a lot of opportunities to do more of that. And I would love to see more of those state and regional policies, but also some of these kind of best practices emerge from some of these states and counties that become perhaps nationwide.

You know the old saying, if you don't measure it, you can't change it because you don't know. And I love the fact that the collaborative sees itself as a place to prototype, to figure out how do we collect these data. How do we make it less burdensome? Because if you can figure those things out, then I can imagine allowing others to replicate that. This is a great test bed for what policies could look like by the work that you all are doing, it sounds like.

And I think that's a really important point because I think the fear would be that policies get created in a vacuum, right? Where you just say, we're going to require you to disclose XYZ crazy detailed things that either an entity doesn't know how to get, can't get, or it costs them thousands and thousands of dollars to collect, or something along those lines. And so, really marrying feasibility, sort of what measurement tools exist how is the kind of dynamic between humans in your environments and those technology tools? I mean, food waste measurement right now is an area that we're really focusing on that because AI and there's a huge opportunity to kind of reduce the burden on staff. But so far, it's been difficult for pretty much every food service operation, including campuses, to get really high-quality food waste data. Even though they may have these tools. And it often has to do with how difficult, how much time it requires staff. I think it's really key that policymakers really, yeah, work with institutions like ours. We love to be, as you said, that kind of prototyping place to find the right balance of rigor and frequency and volume of data with, again, kind of labor and financial constraints and operational realities. And for us, it's also critically important to keep in mind the student experience. How do we not do so many research projects in a four walled space so that we forget this is their home. This is where students eat and live every day. It can't only be about us getting as much data as possible, of course. It's just really accounting for all those variables in the equation.

I appreciate this. And I swear, Sophie, we could talk forever. Let me ask you one last question. And I think this is a good place for us to come to an end. What are the different ways people can get involved in the Menus of Change University Research Collaborative?

Excellent. Well, please do. So first, the easiest thing is just check out our website. Everything that we create is open source. As I mentioned, it for sure can be applied in university settings, but it pretty much across the board can be applied in a number of other settings. Food service, for sure, but also there's a lot of, whether it's prepared foods at retails, other settings in general. Check out moccollaborative. org in particular, our resources and research. The other way is if you're affiliated with an institution, if you're an academic researcher, and you can get in touch with us to find out about. Or you can become what we call a member institution where dining services and at least one academic researcher are involved. Then you're actually part of all that data collection kind of effort. I think the other biggest area is if you have students who are interested, if once you become a member institution, as I mentioned, there's tons of opportunities to get involved in shaping research. But also in the educational side, which is through our MCRC student fellows program. So those would be some of the big ones, and we always love feedback, too. Tell us how you're utilizing the resources and how we can continue to identify gaps in the research agenda that we are uniquely positioned to help fill.

BIO

Sophie Egan, MPH is the Director of the Stanford Food Institute and Sustainable Food Systems at R&DE Stanford Dining, Hospitality & Auxiliaries, where she is Co-Founder and Co-Director of the Menus of Change University Research Collaborative. She is also the author of How to Be a Conscious Eater (Workman, 2020)—named one of Bon Appétit’s “Favorite New Books for Climate-Friendly Cooking and Life”—and the founder of Full Table Solutions, a consulting practice that’s a catalyst for food systems transformation. An internationally recognized leader at the intersection of food, health, and climate, Sophie is also a contributor to The New York Times Health section and Director of Strategy for Food for Climate League. Previously, Sophie served as the Director of Health and Sustainability Leadership/Editorial Director for The Culinary Institute of America’s Strategic Initiatives Group. Sophie’s writing has been featured in The Washington Post, TIME, Parents, The Wall Street Journal, Bon Appétit, WIRED, EatingWell, Edible San Francisco, FoodTank, and Sunset. She is a member of the Food System 6 Advisory Board, James Beard Foundation Sustainability Advisory Council, and the Food Tank Academic Working Group. She holds a BA with honors in history from Stanford University; an MPH with a focus on health and social behavior from UC Berkeley; and a certificate from the Harvard Executive Education in Sustainability Leadership program.

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Today we discuss a new and provocatively titled book written by Southwestern Law School professor Andrea Freeman, an expert on issues of race, food policy, and health from both legal and policy perspectives. The book's title, Ruin Their Crops on the Ground, the Politics of Food in the United States from the Trail of Tears to School Lunch, has been called the first and definitive history of the use of food in the United States law and politics as a weapon of conquest and control. Freeman argues that the U. S. food law and policy process has both created and maintained racial and social inequity. She documents governmental policies from colonization to slavery; to the commodities supplied to Native American reservations. She argues that the long-standing alliance between government and the food industry has produced racial health disparities to this day.

Interview Summary

Let's talk about the title of your book. What are you trying to communicate?

So 'ruin their crops on the ground' is a paraphrase of what George Washington ordered his troops to do, to try to displace Indigenous people and take over their land.

That's a pretty powerful image to think about that. So, in your book, you use the term food oppression. Can you explain what you mean?

Yes. So I originally started writing about food oppression as the alliance between corporations, the food and agricultural industries, and the government that [00:02:00] create stark health disparities on a racial basis, sometimes gender and class. And as I've come through thinking about this over the years, I'm also using it to describe the way that food has always been used as a tool of subordination by the U.S. Government in history.

An interaction between the industry and government isn't inherently oppressive. How does it come to be that way? I mean, it could be good, good for the public, it could be bad, but why does it, how does it become oppressive?​

Yeah, I agree that the problem with the food industry is that the desire to make profits is in conflict with the nutritional needs of people that the U.S., Government programs focus on nutrition are supposed to be serving.

Let's go back to some of the earlier times. You've written about the role that food played in slavery. Could you explain?

Absolutely. So, enslavers were very careful about the portions and the type of food that they gave to people. the people that they enslaved. And they would write pamphlets and advise each other. Hoping to find a balance to give enslaved people enough food to be able to work and be alive, but not enough to give them the energy to revolt or perform acts of resistance that they inevitably did. And then food was used to create hierarchies within enslaved peoples. It was used to, I don't know, take away pleasure, really, from life to oppress people in so many ways. And so, not just from the content of the food, but even the way that food was delivered. So, instead of eating on plates, food might be poured into a pig trough or scattered on the ground, right? There are so many ways that enslavers used food to try to degrade and subordinate people through either the portions or the content or the delivery.

Food is such a fundamental and kind of elementary form of reinforcement. You could imagine it being used to punish particular individuals and reward others.

Absolutely. And the law backed up the way that enslavers used food. And even when enslaved people wanted to grow their own food, and perhaps sell it to gain some advantage, the law prevented that. Enslavers might just take over those gardens. Steal the food. Use it for their own purposes. That was all perfectly legal. And the law tried to protect other enslavers from having enslaved people come and steal their food by having some laws in place that said, you must give adequate provisions, which looked like something that might protect enslaved people, but in fact was only to protect other enslavers.

Going back to the title of your book, it makes reference to the Trail of Tears. And people have highly varying levels of knowledge of what the Trail of Tears refers to. In North Carolina, it's a really important and tragic part of the state's history for the native individuals living in the western part of the state. But could you tell us more about how food figured into this, what it was and how food figured in?

Of course. So the United States wanted the land that Indigenous people were living on. And they designated a part of the country that covers Oklahoma and some states around there and called it the Indian Country or Indian Territory. And to try to force indigenous people to move to that land and to make a journey across the country that was so dangerous, and ended up killing maybe half of the people who made that journey, they destroyed the food sources of people. They had no choice at all. They were starving. They either had to go or die there with no food. And food played into the promises that were made by the United States government of rations that would be given along the way and when people arrived. However, in reality, the rations were gone by the time many people arrived. Or they were bad meat or they were just inedible. And so, they caused not only people to move, but then once they arrived, caused many more deaths. Either along the way or once they were there. A lot of it was unfamiliar food that couldn't be cooked or digested. Food played a major role in the Trail of Tears and what happened both before and after that journey.

And the quality of the land for agriculture that they were forced to settle on was part of the picture too, wasn't it?

Yes. Some of it was good and some of it was absolutely terrible. And people were given no choice about where they were going to end up.

Let's fast forward to more current times. The U. S. Department of Agriculture has created several very important nutrition programs with the stated aim of improving nutrition. But you've raised some concerns. Please tell us why?

Yes. If we just think about that journey that began with the Trail of Tears and with George Washington's order. And then the role that food rations have played in the relationship between the United States and Indigenous people. The rations that were first introduced in trying to force that move, then played a role in many elements of this policy. For example, rations were taken away if parents would not give up their children to the federal Indian boarding schools. They were taken away as a punishment if Indigenous people engage in their own cultural and kinship practices under the Code of Indian Offences.

And so, rations played a huge role, and they continue to do so. They have now transformed into what is the food distribution program for Indian reservations. Which is another system whereby the United States is providing food to Indigenous people who are living on reservations, do not have access to many food sources at all, and so, are in need of nutrition. But the contents of the food that are given out through this program don't reflect the needs of the people who are receiving it. They reflect the needs of the agricultural industries and the surpluses that the USDA is responsible for getting rid of because of federal subsidies through the Farm Bill.

You've written as well about food marketing. Tell us what your thoughts are on that?

Food marketing is so important because it really defines in our society who eats what. It tells us a story that is rife with racial stereotypes and kind of propaganda about food. And it also determines the food landscape in many ways. When I think about race and marketing, marketing first of food really just employed a lot of racist tropes. Because marketing was directed only to white people. And, you know, racism was something that sold. We've seen that change and become more subtle over the years to the present where we even see food marketing taking on anti-racism as a form of what's called woke washing, to try to gain consumer dollars by adopting a certain political position.

The issue of who is targeted by marketing is enormously interesting, complex, and highly important. I'm glad to see you addressing that in your book. Let me ask one final question before we wrap up. How is the U. S. Constitution involved in this?

I have a theory as a constitutional law professor that the way that the United States has dealt with food in a way that creates racially disparate outcomes violates both the 13th amendment and the 14th amendment. So, let me explain. The 13th Amendment says that anything that comes out of slavery as a vestige, or a badge or a marker of slavery is not allowed. And that means that policies that began back then, that continued today with discriminatory harm are prohibited under the13th Amendment. I talked a little bit about how during slavery food was used to oppress and subordinate. And that caused health problems. Very racially disparate health problems where enslaved people suffered from illnesses and conditions and deaths associated with food and malnutrition at much higher rates than white people. That was explained away by constitution and genetics, but that was all lies. In the present, we still have those disparities and they're still due to deliberate policies that create this oppression, the food oppression that I talked about in the beginning. The 13th amendment should not allow that kind of food discrimination in the same way that it doesn't allow housing discrimination. Now, under the 14th amendment, all people should be treated equally by the government. But what we have is food policy that treats people differently based on their race. In the case of the Food Distribution Program on Indian Reservations (FDPIR), that's quite clear. In some other cases, like public school lunches, you have to kind of take a step back to understand how there are racially disparate effects. But the same commodities that the USDA is responsible for getting rid of, that they do through the Indian reservation program are being sent to schools. And these are public schools where in many districts, there are many more Black, Latina, indigenous students than white students. For example, where I am in LA, that's 94 percent of the public-school population. And the government is using that program to get rid of very unhealthy food that is making kids who go to public schools sick. And that is unequal treatment under the law. It should violate the 14th Amendment.

You know, I'm not an expert on constitutional law, but this is the first time I've heard this argument made and it's really an interesting one. Do you think there would be a day when we would see legal action based on this theory?

I think it's possible. I don't think that legal action would be successful in our present moment of jurisprudence. But I think that framing is really important for people to think about and to understand what is happening. And I think that sometimes thinking about things as unconstitutional can provoke social action. Social movement. It can allow people to think about injustice in a certain way that creates resistance. So, I think it's important, even if we can't bring a case today, on that basis.

BIO

Andrea Freeman is a law professor at Southwestern Law School in Los Angeles. She is a national and international expert on the intersections between critical race theory and food policy, health, and consumer credit. She is the author of Ruin Their Crops on the Ground: The Politics of Food in the United States, from the Trail of Tears to School Lunch (Metropolitan 2024) and Skimmed: Breastfeeding, Race, and Injustice (Stanford University Press 2019), in addition to book chapters, law review articles, and op-eds. Skimmed is currently in development for a documentary with Topic Pictures. Her work has been featured in publications including the Washington Post, New Yorker, Los Angeles Times, Salon, Huffington Post, USA Today, The Root, Yahoo! News, The Atlantic, NPR Shots Blog, Pacific Standard, The Conversation, Medium, Atlanta Journal-Constitution, and National Library of Medicine, and she has done interviews with news outlets and programs including CBS News, PBS News Hour, The Takeaway, Here & Now, Point of Origin, Newstalk Irish National Radio, Heritage Radio Network, The Electorette, Hawaii Public Radio. She studied food inequality in the UK as the 2020-21 Fulbright King's College London U.S. Scholar.

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Empowering Women in AgriFood Tech: A Conversation with Amy Wu of From Farms to Incubators - In this episode of the Leading Voices in Food podcast, host Norbert Wilson speaks with Amy Wu, the creator and content director of From Farms to Incubators. Amy shares her inspiring journey in highlighting and supporting women, particularly women of color, in the agri-food tech industry. Learn about the origins of her groundbreaking documentary and book, her vision for a vibrant community of women innovators, and the crucial role of education, mentorship, and policy in advancing women's roles in this sector.

Interview Summary

I have a great set of questions for you. So, the first thing, could you just tell our listeners a little bit more about From Farms to Incubators?

Sure. From Farms to Incubators is a special initiative and project that tells the stories of women in this fast-growing field known as ag tech, sometimes interchangeably used as Agri food tech as well. The mission of it is really to get more women involved in ag tech through storytelling, through resources, and also through education and training. I also would describe it as a multimedia content platform. I actually came to this as a journalist and as a storyteller that uses storytelling to amplify the voices of women leaders and entrepreneurs in this field. It's also a documentary and a book and also a website where we archive their stories and their biographies as well.

Thanks for that overview, and you just talked about the book and the documentary From Farms to Incubators: women innovators revolutionizing how our food is grown, which uses storytelling to highlight women innovators and how women innovators in the Agri food tech are doing their best. But there's also a movement and the community and this multimedia platform. Why did you expand from the book and documentary into this larger network?

That's a really good question. Briefly, as some context, I kind of fell into this project. It was a bit of serendipity. I was a reporter in Salinas, California, which is the vegetable salad bowl of the world. Ag is a huge industry, a 10 billion industry. And I was covering government and agriculture. And I observed that there were not a lot of women at the helm of the table, whether it be at farms or also in this growing field of ag tech as well. So it started off as a documentary. I got a grant from the International Center for Journalists, and then ultimately I got another grant from the International Media Women's Foundation to do a short documentary to profile three women who are entrepreneurs in ag tech. It was great. It was at the time in 2016, which now was ages ago, I guess. It was really hard to find women in ag, in this field of ag tech, women creating the innovations to tackle some of the biggest challenges that farmers are facing, especially under climate change. So, it could have ended there because the documentary turned out to be very, very well received. It's screened at hundreds of places, and I would have panels and discussions and the women would look at each other like, 'my gosh, I didn't know there were other women doing this too. Can you connect us? We'd love to convene further.' And then educators, community leaders, agribusinesses, investors just didn't know they existed as well. So, what happened was the stories kind of multiplied and multiplied as the more that I collected them. And then I decided to put it into a book profiling about 30 women in this growing field.

And to answer your question, Norbert, why is it continuing is that I saw a real need for women to have a community, women in agriculture and innovation and food systems to have a community to connect with one another, to potentially build friendship, build collaboration, build partnership, creating a collective vision sometimes and a place for them. I didn't plan on it. So, I guess the storytelling connects them. We've also have resources like a database that connects them and the goal is really so that they can have a community where they can build more. They can either build out their own startups. They can build their careers, build their professions. And then it kind of grew more legs. Now we're also extending into the area of education and training to try to get younger women, young people, youth. To see that agriculture, hey, may not be traditionally sexy. I mean, tractors and overalls are still what a lot of people think about it, but there are so many other opportunities in the food system for young people as well, especially since we all have to eat. So, how are farmers going to be producing the food for 10 billion people in 2050, right? Who's going to produce the food? How are we going to do it? Especially under the auspices of climate change, the weather's getting crazier and crazier. That's sort of why it has expanded from the stories all the way to what it is today.

This is a great story and I would love to hear a little bit more about some of the women and their innovations. And if I may, I would like for you to actually even explain a little bit about what you mean by the ag food tech or Agri food tech as you're talking about these women.

Broadly defined, is any kind of innovation that makes it easier, frankly, for farmers to do their work, to grow more efficiently, and to also increase [00:06:00] their yield. I can give some examples of what innovation is. Blockchain addresses food safety, really. It traces everything from the seed to all the way on the shelf, right? So if there's any safety issues, it's used to trace back, where did that seed come from? Where was it grown? What field was it in? And that really helps everybody in the food systems a lot more, right? We have sensors connected with drones. I forgot to mention robotics as well, which is a fast-growing area of ag tech. Everything from self-driving tractors to laser scarecrows to another level of robots that are picking specific kinds of fruits and vegetables that's tackling labor challenges. I don't foresee that ag tech necessarily is a replacement by the way of people. It's actually offering more opportunities because we need people who are very knowledgeable that kind of innovation.

And then you also asked a bit about the stories of the women in ag tech, for example, in the film and in the book and so forth. Soil sampling is a fast-growing area of ag tech. There's the story that I have in the book and also in the movie of two young women who are Stanford PhD graduates. Who created a soil testing kit that makes it easy for farmers to just test their soil for diseases, for pests, and soil testing is traditionally, you know, very, very expensive for most farmers actually. Not easy for farmers to get access to it and to get the data, but the soil testing kit that they created makes it a lot easier for farmers, small farmers even, to access it. And why is that important is because the more knowledge, the more data that, and analytics that farmers can get, the more that they can make smart decisions about how much to fertilize, how much to irrigate.

And that connects with the yield and their success. You know, another company that I can think about, another amazing woman. I just like her story, the story of AgTools and the story of Martha Montoya, who was actually an award-winning cartoonist. And she doesn't come from agriculture at all, and that's actually something that I want to highlight is a lot of these women are not farmers and don't come from agriculture. But she was a award winning cartoonist. I believe she was also a librarian and she fell into the food industry, and saw a need for having more data, offering more data and analytics to farmers. She created a system a little bit like a Bloomberg for farmers, where they can get real time data immediately on their phones, on their watches, so that they can get second by second data to make decisions on specific crops.

Those are a couple of the stories that are in the book, but really what I want to highlight is that all of the innovation that they are creating addresses some of the biggest challenges that farmers are facing, whether it be labor issues,lack of water, some areas of our country are becoming more wet, others are becoming more dry, drones that are actually doing the irrigation now or drones taking photos to give more data to farmers as well on what is their land look like. You know, it could also be human resources related as well to manage staff. So mobile apps to manage staff on cattle farms. I mean, how big are the cattle farms sometimes, you know, 50,000 acres. So, it's really to save money and to create efficiency for farmers.

If farmers are able to do their work more efficiently, they're able to generate greater profits, but it also allows for food prices not to rise. This has really big implications. Thank you for sharing those stories. And I love hearing about some of the individuals, but here's the question. I mean, why focus on women? What's important about what women contribute to this? And also, why are you also considering race as an important lens in this sector?

Well, I would say, why not women? Because women have already been contributing to the global food system, whether in the production end or the decision makers at the head of the dinner table for thousands of thousands of years, arguably. So what I discovered is that their stories, their contributions, existing contributions were not being celebrated and were not being amplified. And I actually discovered that a lot of the women that I connected with were a bit shy about even telling their story and sharing it like kind of like, 'what is my contribution?' And I'm like, 'well, why aren't you sharing your story more?' So the goal of it really is to document and celebrate their contributions, but also to inspire. As I said, young women, next generation, all of us have daughters, nieces, granddaughters, you know, and then future generations to consider opportunities in a field where we need people. We need people who are smart and you don't have to be from a generation of farmers. You could be in science, engineering, technology, and math. You could just be passionate about it and you could be in the field. So that's the first aspect of it.

And in terms of the lens of gender and race, there are not enough women in terms of just the startups in ag tech right now, only 2 percent of the billions of dollars being invested in ag tech startups. Only 2 percent are going into women led companies. It is very, very little. It is a problem that is deep rooted. And it starts with [00:12:00] funding. One problem is where is the funding coming from. Venture capitalists, traditional avenues of funding, where it is traditionally male dominated. So, there are many studies that show that investors will invest in companies where they connect with those who are leading the companies, right? So similar gender, similar backgrounds, similar stories. So, we're really looking to have a paradigm shift and move the needle of sorts and say that if there are more investors, there are more board members who are from a diversity backgrounds, then there will be more funding for women and those who are traditionally not leading agriculture, not in the leadership positions, not in the decision-making roles, right? There is a problem. There is a, what is a grass ceiling, not just glass ceiling, but grass ceiling.

I hear you. I hear you. Now this is really fascinating. I know from colleagues who are in agriculture that there is this demand for more agricultural workers throughout the Agri food system. And if there is a demand, we're saying that our colleges that produce the potential workers aren't meeting those demands. One of the ways we can see that change is by having more women and more people of color join in. And so, this is a critical thing. And I would imagine also the experiences that people bring may be a critical part of coming up with new innovations. Diversity can do that. This is exciting that you're exploring this.

I love what you're saying Norbert. I know I wanted to touch upon that about what you just noted is that it's also to create a pipeline, right? Education training is just so critical. And it makes me so happy to see that there are more and more programs at universities and colleges that are addressing programs in food systems, in agriculture, and increasingly in ag tech. So, whether it be courses or programs or certificates or eventually minors and majors, developing the pipeline of talent is really important and having mentors and mentees, which is something that now we're working on. This fall we'll have launched a menteeship program for women and for young people interested in ag tech and the first collaborator is the UC Merced in California. So, thanks for bringing that up. We have a couple of young people ready at the starting gates. Really excited.

I will say just on a personal note, I was active in 4 H for most of my youth and that's the way I got involved in agriculture. So, touching or reaching out to folks in their youth is critical to get them excited and help them to make the connection so that they can do that work further. I'm glad to hear this work. In your view, what are some of the ongoing challenges and opportunities that women face in the ag tech sector or the Agri food sector? What are some of the things you're observing?

Well, a continued challenge is having a place at the table, meaning at the leadership and decision-making level. And actually, as I noted earlier, the access to funding and not just the money, but the access to resources, meaning could be legal operational. Just how to get their startups or get their ideas out there. One example that I'm seeing that's again positive is that there's a growing number of incubators and accelerators specifically in food tech or ag tech that are is actually looking for candidates who are women or who are from underrepresented communities. The first thing is that they have a great innovation, of course, but the next thing that the incubators and accelerators are looking for is to have a diversity of perspectives. And to have representation, so seeing a lot more of that, whether it be. Individual accelerators, or even once at the university, right? Universities and colleges and the governmental level.

The other challenge is access to farmers and connecting them with the farmers themselves. Cause farmers are very, very busy and that's highlighted and bolded. Increasingly just dealing with this chess game that's very hard to play with the weather, but also with their own resources. It's expensive being a farmer, equipment, labor. They don't often have the time, frankly, to beta test some of the innovations coming out. So how best to connect innovators with the farmers and to have them communicate with each other: like this is the innovation. This is how it's going to help your problem. Educating the farmers and allowing them to see that this is how it's going to address the problem that I have. So, the two are still kind of separate and access to each other is still, I would say, a major challenge. But right now, some of the solutions are, as I've noted, networking at conferences and convenings. Also, under the grant programs sometimes under the National Science Foundation or USDA, they are allowing more collaborative initiatives where you have educators, where you have policy, where you have the innovators, where you have the young people. Increasingly, seeing more and more of those kinds of projects and initiatives happen. So hopefully everybody will have a seat at the table and that would help women out a lot in the field as well.

Awesome. Thank you for sharing those. And I love the fact that you're looking at not just identifying issues, but also trying to find ways of connecting folks to help overcome those challenges that women and women of color are facing in the marketplace. And it's the connections that are really critical. I appreciate you highlighting that. So, what is your ideal vision?

Oh, one more thing I forgot to note is that in terms of connecting, there's also a database - a women in Agri food tech database, and I, and at least four or five other women in the field have been working on for at least four or five years now. We now have more than a thousand members. It's an open-source database where you can click on a form, put your name there and information takes a few minutes and then you're added to this database where the women can be connected to each other as well. So that's another resource.

Yeah. And I mean, even just having peer mentors, not just mentors who are above you and they've like solved all the problems, but having people to go along with you as you're developing and as they are developing can be a critical part. I know as an academic, that's important for me and has been important for me. And I can imagine the same is true in this space as well. So, I'm so grateful to hear about this work. Yeah. What is your ideal vision for women in Agri food tech in the next, say, five years? And how will the digital network for from farms to incubators play a role in achieving that goal or those goals?

So, my dream - it always starts, I think, in the dreaming phase and then connecting that with also resources along the way. But if I could wave my magic wand, I would say that. We would have a lot more women in leadership and thought decision making positions in ag tech to the point where maybe we won't even need something like From Farms to Incubators anymore because they'll be already equal. The stories will be out there. So, it might be questionable as to why we have a special subgroup or network for this now. How to get to that vision, I think is the three components of increasingly having more stories, and the women tell their stories at public outreach. You know, it could be at conferences, it could be in their own communities, sharing their story out to the community of farmers, of local government, of schools, local schools and colleges and universities, gardening clubs.

The second component is education and training, building a pipeline. A vision that I have is actually having a campus. A virtual, and also in-person campus where women, especially from women in underprivileged communities will have the opportunity to have training and to be connected with mentors and the rock stars in the ag tech and Agri food tech field. Where they will also be able to have a project and initiative and test it out and have something to add to their portfolio. To have classes and people who are teaching those courses as well, ultimately. And then also to just build up a hub of resources. Like I mentioned the database. I mentioned that we'd like to extend it to having resources where folks can easily access internships, fellowships, granteeships, where they can be connected to funding. If they need help with legal, HR, just all components of everything that's needed to have a successful organization.

And it doesn't have to just be their own startup. It could be a job database of where we have larger organizations and companies that are building up their own ag innovation or food innovation center as well. So that is the vision. It's a big vision. It's a big dream. So we're going to have to kind of break it down into components. But I think taking it step by step is the way to go kind of like climbing Everest or doing a long distance swim.

Yes, I can see where you're trying to go in this vision and I'm interested to know what, if any role policy could play and help advance that vision.

Yeah, so what role could policy play in advancing this vision? Currently, when it comes to diversity inclusion in the ag tech field or even in agriculture, there is somewhat a lack of policy in a way. But then also with individual organizations and corporations, obviously, there is the movement of diversity inclusion. But also, I think it's very much with the hiring practices with HR. I think it's up to individual organizations, whether they be small, larger ones, governmental, to look at their own hiring practices. To look at who they are, how are they crafting the language when they look for a job, when they look at their leadership team, are there ways to further diversify it and when it comes to, gender, ethnicities, people who come from a rural area, urban. I mean, we all come with, from a diversity of perspectives and stories. I think a lot of it will come down to hiring practices and advancing this vision and with the individuals who are already working at those organizations to be more thoughtful and conscious about giving those who don't have a place at the table, a place and a voice at the table, giving everybody a chance. Because we have some amazingly talented and knowledgeable people who just traditionally in agriculture don't have families and generations who come from an ag background. But they do come with so much that they could offer. I would say that those are a couple of examples of that as well. And maybe, more discussion about policy is really needed on a larger level when it comes to farmers, when it comes to government leaders, when it comes to innovation leaders as well. And when it comes to educators and schools. I think the more the merrier when it comes to bringing folks at the table to open it up for discussion on solutions.

I appreciate this. And, this idea of not just welcoming people so that they get in the door, but also creating change. Environments and spaces where people are actually welcomed once they're there. That it becomes a place where folks can be themselves and bring all of who they are to the work that they're doing. This is critical.

Yes, absolutely. I want to touch upon that. My own story is I don't have an agricultural background myself. But when I first , landed in a place like Salinas, very much sort of an outsider because I'm not from there anyway, but also not in agriculture and then being a woman and being, you know, a Chinese American woman too, you know, I, I did feel that there was a challenge to kind of break into certain circles and to be welcome. Even despite my passion and enthusiasm, there was a little bit like, 'what is she? Why? Why? What? She, she doesn't know anything.' But I felt like it was the people who in the beginning, it was just a couple of people who were like, 'Hey, this is somebody who really wants to tell the story of what we're doing. Give her a chance.' You know, having advocates, frontline advocates made a huge difference. So that's what I'm hoping for, more frontline advocates.

Amy, I want to pick up on a personal story out of this. I did my graduate training out at UC Davis, at University of California, Davis. And I worked on dairy policy, which I do not have a dairy background. And it was great to have a mentor who actually helped me. Who introduced me to a number of folks and working through extension and the California Department of Food and Ag. Folks made space for me, and they understood that I was interested in this particular policy and trying to understand what it meant. And I actually got to learn so much. It was because people just said, okay, we'll give you a try. And I did the best I could. I'm grateful for that. Creating these spaces is not hard. It's not impossible. It can be done. I'm really appreciative of your efforts to keep furthering that story.

I love that story. And indeed Norbert it's like what you said, creating the space and even, even in the beginning and just having a couple of folks just to make space. And then I think the space is going to grow from there.

I fully agree. I've got one last question for you. And it's, sort of related to the vision, but just also thinking long term. What impact do you hope your work will ultimately have on society.

I hope that my work will create a bit of a shift ultimately. I mean, that's a rather large goal, but it's not just myself. As this project has grown and extended and expanded. It's really a joint team effort. I mean, along this journey, I've met folks who are mission aligned. And they also see the value in this, and they believe in something similar. Whether it be that they contribute their story, whether it be that they help write the stories, whether it be that they come be a guest speaker, and they share their career, and then they end up connecting with the younger person, every person counts in this. In making a shift. And it might take generations to completely have a paradigm shift, but I think that just moving the needle a bit is ultimately the goal, certainly. And in terms of the bigger picture of things, I'm hoping that it will continue to spark a discussion and ongoing conversation about the importance and the value of bringing different voices and people who traditionally were not given a space at the table when it comes to the food systems and agriculture. But who brings so much talent, so much to the table already. How we can make greater space for them as well, and how we can incorporate their talent and create a better food system for everybody. We all eat and we're looking at 10 billion people in 2050. So, looking at the people who are making those contributions and telling their stories and especially for those who traditionally have not had their voices told, I think is really, really important. I just keep the fire going, I guess.

BIO

Amy Wu is an award-winning writer for the women’s Ag and Agtech movement. She is the creator and chief content director of From Farms to Incubators, a multimedia platform that uses documentary, video, photography, and the written word to tell the stories of women leaders and innovators in Agtech. It has a mission of highlighting women in food, farming, and farmtech, especially women of color. From Farms to Incubators includes a documentary and a book that spotlights women leaders in Ag and Agtech. The documentary and stories have been screened and presented at SXSW and Techonomy. The initiative was awarded grants from the International Center for Journalists and International Women's Media Foundation's Howard G. Buffett Fund. Amy was named on Worth magazine’s “Groundbreakers 2020 list of 50 Women Changing the World” list. Since 2018 she has served as the communications manager at the Hudson Valley Farm Hub in Hurley NY where she runs the website, digital newsletter, and social media. Prior to starting From Farms to Incubators, Amy spent over two decades as an investigative reporter at media outlets including the USA Today Network where she reported on agriculture and Agtech for The Salinas Californian. She’s also worked at Time magazine, The Deal and contributed to The New York Times, The Huffington Post and The Wall Street Journal. She earned her bachelor’s degree in history from New York University, and master’s degree in journalism from Columbia University.

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In today's discussion, we will explore the application of debt relief to large investments in environmental sustainability, which can also support local development, including more resilient food systems. This is particularly timely, given the juxtaposition of enormous debt burdens with increasing environmental commitments by developing countries. Debt for relief swaps, such as financial forgiveness for cash strapped countries if they invest those funds to support global environmental goods, have been around since the 1980s. However, they haven't achieved their full economic or environmental potential, says Duke University Economic and Environmental Policy Professor Alex Pfaff. Smart reforms to improve debt relief programs can allow nations to help themselves and fulfill commitments to preserve the planet. Pfaff and colleagues described needed reforms in a recent analysis in a policy forum for the journal Science, also summarized in Foreign Policy magazine. His co-authors are sustainability expert Elizabeth Losos and conservation professor Stuart Pimm from Duke University. They note that global society has now learned lessons, not only from past debt for nature swaps, but also decades of evaluation of climate change of environmental and development policies.

Interview Summary

I have to say, having read particularly the Science piece, it is clear and it's very straightforward and accessible. But the other thing, it's hopeful. And I think in this moment of climate concerns, it's great to know that there's some ways to possibly move forward. I'd love to hear some more about this. If you don't mind, would you just describe a debt for nature swap? I gave a little bit, but I'd love to hear your consideration of it.

What you said is right. And I'll just agree with you first that we're definitely in a time when doing the right things could help a lot. One of my motivations is a little bit of fear in there, which is, if we don't take the opportunity we look back later and regret it. Which is one of the reasons why we're out there trying to bother people to do what we think would be more effective.

So, coming to the definition. A debt for nature swap, as you said is like it sounds. It's an agreement to forgive debt that countries owe on one condition - that they invest part of that money in some form of investment in nature. It's often been conservation. That was often thought of in terms of species or biodiversity at the time. But nowadays that would include thinking about storing carbon because of climate concerns, and then linking to your use of the term resilience in agriculture - for sure this also could be thinking about a climate adaptation.

Can you give us some examples of countries that have done this? What does this look like on the ground?

Yes, and the history, as you say, is that it started in the 1980s. And we really want to tip our cap to Tom Lovejoy who invented this at a time when, again, as you laid out, but it, at that time, was also true. There was huge amounts of debt and huge concerns about conservation, and it was a pretty simple idea. That it is a potential source of money to invest where the countries can help themselves, as you said, by getting rid of really quite crippling debt - tremendous amounts of interest are being paid on those debts - but also be helping the globe by investing in nature. So countries recently done, for instance, Ecuador has done a very big one recently. Belize has done one that's quite well spoken of. Those are different sized countries, different sized problems, which, as you can imagine from your own work, the institutions matter a lot. But there's been a long string and a long history of willingness to try. And I guess the last thing is that willingness started to go down when, as you summarized, it wasn't really working for the debtors who weren't really getting that much relief in their point of view for a lot of time bargaining. And it wasn't really working perhaps for nature. It wasn't having necessarily the impacts that one might have hoped. So, I think the question now is can we reform them? Because we do still have a big debt problem and we have some big nature problems.

Thank you for sharing that. And it's really fascinating to know that this is not a new idea. It's been around since the 80s. And this hope that I mentioned earlier suggests that there can be ways to make this debt for nature swap work better. I would love to understand what you want readers to take away from the reforms that you all suggest in the article.

Yes, and the punch line at the high level is it makes sense. It hasn't worked as done to first order. Of course, some things have worked. But simple reforms based on things that we have learned over the last few decades could make them work a lot better. So that's the high level. To get a little more detail the four things we say in those articles are the following. You gotta raise the scale. It has to be consequential relative to the scale of debt. Otherwise, it's not worth it for those countries. I think, and we think, and I'll give you the third condition in a moment, but I think for those countries also you have to emphasize local choice and sovereignty. Because there's a real sense of, geez, why are these conservation NGOs coming in telling us what to do in our country? I think there's clear gains to be had from letting local actors decide how to achieve global goals.

Now, the next thing you say is why if they are choosing, well how are they going to be oriented towards achieving global goals? So that's our third condition. You actually have clear measures of outcomes, and you only give relief conditional on measured improvements. That's a huge difference. That really has been more of a process bargain in the past. You will allocate some money to protected areas. Okay, that's fine, but there's actually a very famous fund which allocated money to Brazil. People have shown that Brazil just pulled the money out and spent it on other things that they were spending and just replaced it with the external money. So, then funding [for nature conservation] didn't go up. Or you could say, draw many new protected area circles on a map. Okay, but drawing things on a map doesn't really necessarily get you anything at all. And even defending a place that wasn't going to disappear doesn't get you anything because it wasn't going to disappear. So, there are many stories that in evaluations like I do of environment and development policy, we’ve seen a lot of things that sound sensible but don't really do that much in the end. Great, fine, here's a nice combination. We're going to measure the outcomes. But then you can do whatever you want, right? You can do whatever you want. If for you, you want to expand energy access, but you want to invest in renewable energy, great. A different country wants to stop using agriculture in a particular area and move it to another area, right? Another country wants to intensify agriculture and raise productivity even while leaving space for forests, and the knowledge, the preferences and the right to choose that I think and we think are naturally left with the countries in question who 1) has more information, and 2) are probably the right source of priorities for what matters locally, and if they don't find it interesting. These deals aren't going to happen again. You might then say, why are we just doing what they want? Because you're only giving relief when you measure actual global goals. Once you do that, once you switch to measuring outcomes, you should let people choose what's sensible for them.

Last thing, once you're measuring, as I've mentioned, there's a bunch of different goals you could imagine, right? If I get two NGOs, they don't even have the same goals for species. Forget climate change, forget climate adaptation. There are all these things that people would like to be helpful with. So take, for instance, a project that might save old forests. That probably helps with water quality downstream. It probably provides habitat for species, it definitely stores carbon, and when blocking rainfall that comes torrentially with climate change, it probably helps resilience and washing out of soil for agriculture. What's our last point? When you're counting outcomes, add together all the good ones, because then a project like forest gets points for all four of those. And you do this stuff that's efficient on multiple fronts instead of going left hand, right hand in an uncoordinated fashion. So those are our four suggestions.

That's really helpful. And having spent time with international trade and issues on regulations, one of the things that I've learned is permitting or allowing sovereignty and allowing nations to make decisions, one is politically important, but on the sort of economic side of it, there is something critical about countries knowing their own costs and own, if you will, demands. And allowing them to make those determinations is critical for an efficient and actually politically feasible approach. Is that a fair assessment?

I agree completely. You know agriculture much better than I do. But that description to me fits perfectly. You can come in and say you've got all sorts of good ideas. And even things that are good ideas won't go across because you came in and said them in an annoying way. And then, as you said, [local] folks have better information on what their costs are, better information on local benefits, they could probably design a locally incentive compatible version of what you thought you knew was good. It might have been kind of good but with the local information and interest, it becomes better and then thus more likely to happen. And that's better for the globe as well. I completely agree.

This is great. You've mentioned agriculture a couple of times, and I'd like to hear a little bit more about how you think debt for nature swaps can affect the food and agricultural systems in a country. Especially given the agricultural practices have some significant impacts on the environment and or can be affected by the environment, and particularly climate change.

Completely. Yes, I think it's because of that. Exactly. So, if I had to think of why this environmental resource paper is a fit in agriculture, it's because of what you said. That agriculture bumps up against the environment, so to speak, makes use of nutrients in the soil, sometimes involves the clearing of the land, and bumps up against the public. As climate changes, it really changes the ability to do agriculture in terms of temperature, rainfall, all those things. So, I think just for instance, if we go across all the World Bank labeled low-income countries of the world, the priority on climate adaptation under rainfall shifts versus climate expansion into forests, which could be replaced by climate intensification through more fertilizing and more pesticide use, so that agriculture takes less room but has higher yield. Those priorities are going to vary massively. I think agriculture is a fantastic sector, and it's not been a surprise that you said the things you did to think about the value of measuring the global goal and allowing the local choice.

In some places over fertilization is a huge problem. Not only do you not get more productivity, but you waste money, and you ruin water supply. Some places, pesticide use is an issue and is drifting across and killing plants and other fields. Some places, it's not. And who's the expert on that? Probably the local agricultural extension agents, right? And the local ag agency. So, to me, agriculture is a fantastic, illustrative sector. Not the only one, but an important one. Where the kind of things you said about the value of local information and choice come through in making a big financial swap like this potentially work for everybody.

Thanks for this example. It is great to hear this piece that did have a clear environmental focus, recognize that there is a place for the food system to be a part of that conversation. So, thank you for sharing that. You know, the debt for nature swap is a useful financial tool to support environmental causes, as I just said. And as an environmental economist, how do you use a market-based approach to address environmental challenges? And what, if any, drawbacks do you see to this approach?

In a way this is a form of market-based approach. I agree with you. It's certainly about prices and incentives. And looking around the world, I'm not sure if this is why I'm an economist, but I certainly do think people respond to incentives and that's important. That said and you said drawback. First, I'll just go with alternative to start. Prices are not the only thing people respond to, right? Institutions matter a huge deal. Even the set of opportunities that are available tend to be constructed in ways that are not price or market driven. You know, prices are wonderful. If you have a hundred identical firms and you're trying to figure out who has the lowest marginal cost of reducing carbon emissions. Fab, let them figure it out. Market will do well. Maybe not as fabulous in thinking about the distribution of rights locally between indigenous groups, small farmers, and large multinational corporations, right? Maybe that's not really a market price thing. And we might even get around to values. There are times when people don't really want to operate in a price space. And they're going to have to deal with incentives. But think about preexisting values on conservation, and when those are achieving the same goals as a price would, you don't have to try to wander in with a new market. I think that's fair as well.

I think of incentives as one super important tool. Far from the only one and somewhat in the spirit of our discussion of local knowledge. The right tool blend is an important part of the story as well.

Alex, I have to say, you've ventured in some spaces I'm really happy to hear you talk about. This idea of incorporating values and recognizing that the local knowledge matters - this is not something that we, as economists in our modeling world alone can solve the problem. It is going to take talking to people and learning their needs and learning even the bits about their culture to say what works for them in this moment. So, thank you for sharing that.

You're welcome for that.

In your analysis, in the team's analysis, you all argue for key reforms for debt for nature swaps. What other approaches would you consider to address these large environmental concerns?

I think ‘other’ but also complimentary. I'm in the sense that these are very high-level transfers, right? Here's a bunch of money. Please do something right. And as I said earlier, if we tell them what to do, we don't have a great track record. So, now we're going to maybe measure, right? One of our suggestions is to measure the outcomes. How are they going to get to those outcomes, right? So, there's a whole bunch of tools on the environment and the development policy side, which are also part of the source of learning over the last three or four decades. There's been a real push in a lot of fields, not necessarily to only be like medicine and do randomized control trials, etc., but there is some of that. But also just collect some data on what happened. Please try to figure out if when you do a policy, it actually achieves something.

Besides values, my meta story these days is we have to allow that learning is a good thing. There's a lot of people who seem to not want to even want to ask whether what they did worked because somehow, it's embarrassing. And I feel like we have to move as a world to the humility of learning by doing. And that's just what everybody does. And that means when I did something, half of them worked and half of them didn't. It's a really good idea to learn as fast as you can which ones didn't. So that's a super general speech, not quite to what you asked, but it applies to every tool I've ever known.

So, regarding protected areas - do they always have impact? No. I have a lot of work on that. Can we start to, over 30 years point, to where they have impact? Yes. Could we have measured outcomes? We could have, but we didn't back then. So, could we still use traditional tools like use a protected area, but look at past studies of when they had impact and start to see that it makes sense when they did and when they didn't? Yes. Same thing for payments for ecosystem services and any number of other tools.

BIO

Alexander Pfaff is a Professor of Public Policy, Economics and the Environment at Duke University. He studies how economic development interacts with natural resources and the environment. His focus is designing environment and development policies to support choices by individuals and groups that protect nature, reduce damaging environmental exposures, and improve livelihoods.

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We've recorded a series of podcasts on the microbiome and its wide ranging impacts. But boy is this a field that moves rapidly. As soon as you think you've covered much of the territory, along comes some new and exciting findings, and this is the case today. We're going to describe research done by our guest, Dr. Ibrahim Javed. He has done innovative work on links between the gut microbiome and the brain, particularly focused on Alzheimer's disease. Dr. Javed is an Enterprise Fellow and National Health and Medicine Research Council Emerging Leadership Fellow in Clinical and Health Sciences at the University of South Australia.

Interview Transcript

So let's begin, if you wouldn't mind, with an explanation from you about what the gut brain axis is and tell us how it's important.

Yep. Now we see a lot of, a lot of researchers around the globe building on investigations around the gut brain axis. But if we, if we investigate what this gut brain axis actually is, It's kind of like a bi-directional communication between two organs in our body, the gut and the brain. And when we particularly talk about gut, we have our stomach and our different portions of the intestine.

What we're actually interested in is the microbiome and all those small little things living inside the gut. There are around 100 trillion microbes in the gut, which is three times more than the number of cells in our body. So, we are kind of like more microbes than, than human cells. And they communicate with different organs in our body and how they communicate with the brain that we can describe it as a, as a gut brain axis. And then this whole gut brain axis thing was somehow kind of invisible to us. We were just looking at it as a fecal material or waste coming out of our body. But now we see a lot of importance to these gut microbes. They help us in a lot of daily things that we do. They shape our behavior, our response to stress, our immune system, and then how we respond to different medicines, and how we do our daily tasks. So, they have a lot of roles in that. They help us digest food, that's their main obvious function. But now we are more. getting more and more information about them, that how they are integrated with a lot of different things in our body. So, kind of like they are partners in our life.

That's a very, very nice explanation. Can you tell us about the importance of microbial diversity?

Yep. So microbial diversity, we can, we can refer to, to as a composition of all those bacteria, viruses, and fungi to some extent that, that live in, in our body. Digestive track and, and in a lot of other animals as well. And this diversity is very crucial in maintaining the gut health and on overall well-being of, of humans. And, and this microbiome whole thing is like, it is obviously associated with a lot of health benefits and, and how we develop disease, but it's also right from the beginning of life they help us in developing our brains. They help us mature the brain system and the immune system. Obviously, they help us in digesting food.

So, generally, we can actually divide them in two portions. One, we can call them a good gut bacterium. They help us with all these things. And then they are bad gut bacteria, which are kind of like kept within a within a bay. They are kept under control by this good gut bacteria with the help of the rest of our body. And in somehow in some conditions with the age or with the dietary habits or environmental factor or lifestyle, if they overcome and, and they take over the control in the gut, that's where the thing starts going haywire.

When I was growing up, microbes were a bad thing. You didn't want to have microbes. And now, now we hear that there are good microbes and now you're talking about the balance. There are still bad ones, but good ones. And the balance of those two was a really important thing. Let's talk about how bad bacteria find their way to the brain. How do they get access?

So, as we discussed, they are kept within the bay or kept under control by good bacteria and also by other different immune systems in the body. We have different checkpoints, like we have different barriers or three different compartments, the gut and the blood and the brain. And we have barriers that separate out these compartments and these barriers are very tightly controlled, very good health cells tightly integrated with each other and they police that whole things what need to go across and what does not need to go across what we need to stop it within that compartment. If we have adverse environmental factors, or poor dietary habits and these bad gut bacteria overcome, they produce a lot of different molecules to communicate with each other. And they produce a lot of different molecules to take over the good bacteria. And these molecules, they can get across those barriers, and specifically if they can get into the brain (that's what we are researching), they can do a lot of different bad things in the brain. They can do that by hijacking this gut brain axis. And this compartmental thing is one pathway that they can get from gut to the blood and then from the blood to the brain. But there is also a direct highway that connects gut to the brain and that's our enteric nervous system. These are specific nerves or neurons, for example, vagus nerve, they're quite famous. It's a direct link between the gut and brain. This nerve system helps us in a lot of different daily tasks without us even knowing about it, like digestion and heart rate and respiration, and emptying the stomach. And these are kind of like a pathway for bidirectional communication. So, a lot of molecules go up and down across these highways and the bad gut bacteria can actually hijack it and they can put their stuff into this highway and they can send it across the brain.

It's a very, very nice explanation you have of a very complicated process, and I find it absolutely fascinating. So, you've spoken about how bad bacteria can be opportunistic pathogens and can trigger problems or enhance the progression of existing problems. How does all that work?

So, we are investigating bad gut bacteria in connection with dementia and Alzheimer disease. We are specifically working on Pseudomonas aeruginosa and E. coli and they are quite common, like a lot of school kids. They know about these bacteria. They are quite commonly studied in high school microbiology.

So, these bacteria produce some molecules which help to make biofilms around them. They kind of build a castle around them to protect their colonies and for their own survival and they keep surviving then until they get an opportunity to expand their castles and build more biofilms. These molecules are quite similar in terms of their structure and in terms of how they communicate. With some proteins which are not related to bacteria anyhow, they are produced in the brain to do some normal stuff in the brain, but they also aggregate in Alzheimer disease using the same mechanism as the nature that these bacteria use for these proteins to make their biofilms.

Based on this common similarity, if they can somehow see each other, or if those gut bacteria can send those proteins or aggregate of those proteins across the brain through using those highways. They can induce the aggregation of those normal, naive, working, innocent proteins, which we have in our brain that have nothing to do with the bacteria. But if they can be accessed by those bacterial proteins, they go haywire and, and they trigger the onset of the disease, or if there is already going on, that they can actually accelerate that whole process. And this is a concept, actually, we have seen that concept before in prion disease, whereby eating infected food that have those prion particles, they can actually go from gut to the brain, and they can induce the normal prion protein in the brain to start making aggregates in a similar way.

Are there interventions that can stop the pathogenic bacteria from in the gut that might in turn affect the brain?

We should focus more on preventive measures. We can focus on maintaining a good diversity within the gut of having or supporting those good bacteria in that fight and keeping them healthy and alive as we age. Because as we age over the period of life, we keep losing those good bacteria. If we can have all those good things of exercise, balanced sleep, and more importantly, good food and a balanced variety of food. Then we have a lot of different varieties to support that variety of gut bacteria in the gut.

So that's, I think, the most important preventive measure to keep that balance intact. But of course, in the future as a therapeutic intervention, we are moving towards developing microbiome therapies where we can modulate those compositions. If that composition is not in a very good situation, we can actually modulate that by using probiotics and prebiotic dietary factors or some microbial compositions like yogurt and a lot of other foods. We can modulate that to inoculate those bacteria which are missing in the gut and, and try to achieve that balance and, and that balance will accelerate the effectiveness of the medicine which we are taking for any other disease.

The advice we've heard from some of our other guests is to eat a diet rich in fruits and vegetables. You know, consume things, you mentioned yogurt, kefir, kombucha, sauerkraut, and things like that. Sound like they're very good for enhancing the health of the microbiome. Is there anything else beyond that that might be relevant for the brain in particular?

For brain health, there are some antioxidant foods. For example, we have Curcumin, and some senolytic compounds. We cannot call them drugs because they are kind of like a food supplements. They are available in any pharmacy and super stores by a lot of different names. Mostly these are polyphenolic compounds. They are usually available in green tea and in green tea extracts. They are quite well known for their healthy and antioxidant and anti-inflammatory effects. Research around the globe has shown that there are good effects directly on the brain by these polyphenolic compounds. So, these are green tea extracts, quercetin and, and some other galectin compounds.

BIO

Dr Ibrahim Javed is currently an Enterprise Fellow (Senior Lecturer) and NHMRC Emerging Leadership Fellow at the Clinical and Health Sciences, University of South Australia. He is also an adjunct Senior Research Fellow at the Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland. He completed his doctoral studies at the Monash Institute of Pharmaceutical Sciences in 2020 and postdoctoral research at AIBN, The University of Queensland. He joined the University of South Australia in 2023 where he is now directing the laboratory of Gut-Brain Axis, Aging and Therapeutics. Research in Javed’s lab focuses on the gut-brain axis and its implications for aging and Dementia. His research team is working to unfold the specific role of bad/pathogenic gut bacteria in the aging paradigms and Dementia associated with Alzheimer’s and Parkinson’s diseases. His team has discovered and published the molecular details of how bad bacteria in the gut can trigger a younger onset (aged under 65) and accelerate Dementia and how the brain can develop Dementia when fighting with microbial biofilms in the gut – the infectious etiology of Dementia. With this research trajectory, his vision is to develop a multifaceted therapeutic intervention for aging-associated diseases and Dementia.

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Food companies market their products in a great many ways. Connecting their brands and products to sports and major sporting events is one such way and is drawing a lot of attention now. The reason is that the Summer Olympics are underway, which trains attention on the relationship between the International Olympic Committee and its longest running sponsor. Coca Cola has been a sponsor of every Olympics since 1928. So, it's intuitively obvious why sponsorships would be important to the Olympics because They get lots of money in the door and it's reliable.

It's been happening since 1928. But let's talk about why this relationship is so important to companies, Coca Cola in particular, and what the public health impact of that might be. Today's guest, Dr. Marie Bragg, has contributed some of the key studies on this topic. She is Assistant professor at the NYU Grossman School of Medicine, where she also serves as director of diversity initiatives. She holds an affiliate faculty appointment in the marketing department at the NYU Stern School of business; directs the NYU food environment and policy research coalition; and she's also a Food Leaders Fellow at the Aspen Institute.

Interview Summary

It's really nice to talk to you about this because it's an important issue and not a lot of science has been done on this over the years and you've contributed a lot of it. Let's talk about the issue of sports marketing and can you tell us a little bit more about what that is broadly and what's, what are some of the forms it takes?

You just mentioned one of the main areas of sports marketing with sports sponsorships. And so that's where a company like Coca Cola partners with an organization like the Olympics. And really is paying for the rights to have that famous Coca Cola logo or its products to appear at sporting events or in commercials that are involving the Olympics.

In terms of how much of it there is we know, for example, the world cup is one of the most watched sporting events in the world, along with things like the Olympics. The world cup, for example, has 5 million viewers. And so that's a lot of exposure for these brands, but it's not Sports sponsorship partnerships like that, there's athlete endorsements, and those dates back as far as to 1934, as one example, when baseball player Lou Gehrig first appeared on the box of Wheaties cereals.

There's a special place that athletes have always had in our society, and I think it comes through with these sorts of partnerships. But if we fast forward to today, our lab has even seen these kinds of partnerships appear in video games. And so, Nintendo had M&M's a race car game a few years back, and NFL Madden, which is a popular video game even has things like the Snickers player of the game appear within the video game, just like real NFL games. What this means is that these pictures of brands and products are peppered throughout kids experiences when they're playing video games. And then finally, if, and probably for anyone who's, been in a supermarket, when there's a major sporting event going on, like the Super Bowl or March Madness, it appears on products too in supermarkets.

It's peppered throughout our everyday experience in ways we might not always see or appreciate if we're not paying attention.

Marie, I like to do sports trivia with some friends of mine, and you've just given me a great question about Lou Gehrig and the Wheaties box in the 1930s. So that's a nice benefit of this podcast. So aside from that, why sports? I mean, companies could attach themselves to lots of different things, but why did they choose sports and why is that such a valuable connection for them?

One factor ties back into what we were saying about visibility. If there are millions of people watching a sport event, it means that there's a lot of time for brands to be able to have high visibility for whatever they're endorsing or sponsoring in that moment. On another level, I think on a deeper level, our society has a special relationship with sports and professional athletes.

Professional athletes are their own sort of unique category of celebrities that people love to follow and admire. That means that when a brand associates themselves with a sports organization like the Olympics or a professional athlete, they're buying into a special idea of what it means to be cool, to be fun, and to feel good about to feel good about the brand because when people are watching sports, they're excited.

If we think of other categories of life where there are maybe a high number of viewers to a specific televised event, like a presidential debate, that we don't see a lot of sponsorships around that. And maybe it doesn't evoke the same feelings that a sporting event does.

I'm expecting that this kind of relationship or attachments or symbolism of the sponsorship of sports might be especially powerful for children. I know if you ask kids what they want to be when they grow up, a lot of them will say they want to be a baseball player or basketball player, football player, something like that. Does that make sense?

I remember reading an article once that said, a dad was playing catch with his kid, and had spent all these hours with his kid working on pitching. And the dad made the point in the article, my kid doesn't want to grow up and be me as a baseball player. He wants to grow up and be ARod.

And so, this idea that we can spend all the time that we want with our kids and they still hold these celebrity athletes on such a pedestal is something that I think ties into why this is valuable for companies. It's kids who are engaged in sports or attending sporting events who are the next generation of consumers for these products. If they can get the attention and the brand loyalty of these children early on in these positive, exciting environments, it helps them secure the next generation of purchasers.

We'll talk about how important brand loyalty is in a minute, but let's talk about how valuable these connections are to the company. I guess one indication of that is how much a company like Coca Cola is willing to pay to be a sponsor of something like the Olympics. What kind of numbers do you know about in that context?

The companies don't usually disclose the exact numbers, but in 2008, NPR published an article that estimated that Coca Cola spent about 70 million to sponsor the Beijing Olympics. If we think about it, that's stunning given sponsoring an event is just one part of their massive advertising machine. More recently the Wall Street Journal estimated that Coca-Cola and a really large dairy company in China partnered and spent a combined, estimated $2 billion with a B, $2 billion for a 12-year Olympic sponsorship deal that will run through 2032. It's really incredible to think about that as just one slice of what they're doing, but with such a massive amount of money attached to it.

It really sort of begs the question what they are get out of it and what do they see as the value. I know there are branding opportunities, and again, we'll come back to that in a minute, but there's also sort of this goodwill part of it, isn't there. The Olympics are a great thing. No reason to question that. The fact that a company like Coca Cola would sponsor a good thing probably gives them a good company glow, doesn't it?

My colleague Bridget Kelly in Australia did a study on this topic of sort of the glow that sponsorship produces. In her study, she showed that about 68 percent of kids in the sample could remember the sports sponsor and thought the sponsors were cool and generous. And they wanted to sort of pay back the favor by purchasing the products of that sponsor. There is something really special to to that relationship in the minds of kids.

Wow. That's an impressive finding. So, speaking of findings, you've done some research on these sports sponsorships yourself. Can you tell us a little bit about what you've done and what you found?

Some of our work in this area has documented how food and beverage companies associate themselves with sports on the sponsorship side. Athletes and supermarkets with product partnerships. And in one of our studies that tied into sports sponsorships, we looked at the 10 major sports organizations that had a lot of viewers. So, things like the NFL, the NBA, and then we wanted to categorize what kinds of groupings, the sponsors belonged to an automotive brand. Ford motors was one of the largest categories. But food wasn't very far behind. We saw about 19 percent of sponsors were associated with food and beverage brands, and it was for mostly unhealthy items.

In the sports sponsorships, we're not. Seeing a lot of water being featured. It's a lot of sugary beverages you know, chips and things like that. We're not seeing much fresh fruit. And then when we did the same thing with athlete endorsements, one of the things that stood out about that study, which looked at a hundred athletes to get a sense of what are they endorsing and how healthy is this stuff and how much are people seeing it. The most striking finding for me from that study was that 93 percent of the beverages that were endorsed by professional athletes were sugary drinks. And we know that athletes need to drink a lot of water to sort of fuel themselves. And maybe sometimes they do need some sort of sports drinks for long workout days, but we saw a lot of sodas in the mix too and the other thing is that most kids don't need lots of sports drinks in their diet, but that's what is sort of being promoted through these through these endorsements, and so that really stood out to me about that study.

We also in a couple of these studies found that young people are often seeing more ads for this than adults. It's not even though it may be sort of targeting general audiences. A lot of times young people are really seeing a lot of these, including the forms of ads that pop up on YouTube because we know kids are really into social media. It's really across the board of all of our research. We find mostly unhealthy products being promoted through these partnerships with sports.

I remember back over the years that this issue comes up in the press occasionally and athletes get called out, specific athletes will sometimes get called out for promoting these kinds of foods. And, and I remember there being a couple of cases, although I don't remember the names of the athletes involved, where they've refused to do this kind of thing and they've made public statements about that. What's your recollection about that?

We were really excited one time with our athlete endorsement study that came out a couple of years later. Brita water filters issued a press release and I remember getting a lot of messages about it telling me to go and look at what was posted online. Brita had cited our study that most beverages promoted by athletes are sugary beverages.

And that's why we're so excited to partner with Steph Curry to promote Brita water filters. I framed that press release and shared it with all our team members who worked on those projects because it was an example of choosing a healthy beverage over some of these sugary drinks that are so commonly promoted.

So maybe there will come a day when LeBron James or athletes like that start advertising cucumbers or radishes or something.

And I wish cucumber producers had the same budgets as these sugary drink brands because it's really hard for some of the healthy stuff to compete with some of these major fast food and sugary drink companies.

For sure. Let's talk about the issue of branding, why a company like Coca Cola wants its brand image, that famous Coke logo out there in front of as many eyes as possible. Give me just a minute if you will. And I'd like to describe something that I've heard. Sort of observed over the years. It's my anecdotal impression that if you ask random people, are you a Coke or a Pepsi person? You'll get an immediate and definitive response. People know whether they're a Coke or a Pepsi person. But if you do research, you find that people can't very often tell the difference between Coke and Pepsi. And, going back as, as long as 1949, there are scientists who have done these kinds of studies on whether consumers can distinguish those two beverages, doing blind taste tests. A typical finding is that people aren't any more accurate than chance. And there was a fascinating brain scan study done much more recently, of course. When Coke and Pepsi were given to people and they didn't know which they were receiving, the brain scan showed similar brain activity for the two beverages, again, suggesting that people can't distinguish the difference. But when people knew they were drinking either Coke or Pepsi, there was a brain activity advantage. For Coca Cola, which of course is all about more marketing, bigger company, that kind of thing, I'm assuming. So based on this, it looked like Coke hadn't won the taste war, but the branding war. So why in the heck would people feel so strongly that they can tell the difference between these beverages when they probably can't?

Now my own two-bit theory on this is that no one wants to feel like they're a pawn of marketing. So, it'd be hard to admit that they favor one brand over another because then they would feel manipulated. They must believe in their own minds there's an objective difference. My theorizing aside, tell us about the power of a brand as opposed to a product and how the Olympics is such a golden opportunity for the Coca Cola brand.

When we think about a brand, it's really a combination of feelings, ideas, and the emotions that we tie into what it means to be part of that brand. And as people, and especially as young people, for let's say teenagers, they’re in an identity development stage where it's important for them to be adopting brands that are important to them, in part to distinguish themselves from their parents, to fit in with peers, and to start to have a sense of who they are as a person.

And one of the ways to do that is to associate with what you like for music, but another piece is brand. So, are you a Coca Cola or a Pepsi person? A Nike or Adidas person. That comes with all sorts of adjectives about what it means to be on one side or the other. When we think about Coca Cola as a brand linking up with the Olympics, it's an opportunity to potentially borrow, not only get their brand out there, but potentially borrow from the brand of the Olympics as well.

In our field, there's something called brand image transfer. This is the idea that when two companies or organizations partner together, the brand feelings we have about one might bleed over into the other and vice versa. It’s one of the things that's always fascinated me about this topic, and I'd love to hear your thoughts on it too, is this idea that the sports may have a sort of health piece to their brand identity. So, the Olympics have people at the peak of their, their sport. And my question has always been, what does that do to the way people feel about Coke in terms of its healthfulness? And is there some brand image transfer that's happening back and forth that's particularly beneficial for Coca Cola because of the health component?

You reminded me of something. Tell me if you think this is an interesting parallel. When I was a boy in public high school growing up in Indiana, I don't think there were any soft drink machines in my school, maybe one in the teacher's lounge or something that I never saw, of course, but there wasn't much. And then when my son, many decades later, was a student in a school, public high school in Connecticut, he and I walked around the school and counted the number of soft drink machines, and he was of course embarrassed to be walking around the school with his dad. But aside from that, I think we found something like 13 or 14 or 15 machines. I don't remember the exact number, but it was striking. And I've heard people speculate that the companies don't care that much about what's being sold in those machines because. It's not a huge profit center for them and they must split the profits with the school somehow, but it's all about the branding. And even the students who aren't buying anything from the machines walk past them probably many times a day. So, what's getting imprinted doesn't have much to do potentially with. A specific type of product, but it's just that company's main image. Does that make sense? And why those school sponsorships have been so important?

It does, and it's really, there's really an emphasis on wanting a sort of 360 level of involvement in young people's lives because if a brand can get themselves in front of kids at school, at a sporting event, in a movie, in a video game, on social media, they're immersing themselves in a way that allows the brand to keep itself top of mind.

And that's what starts to get people to be aware of it, build brand loyalty, reach for the product because it's, they, with so many ads, the ads are all competing for attention but being immersed in schools is just one aspect of that idea of having involvement in as many areas of kids’ lives as possible.

I think in addition to all the machines, there were tables outside that had. Coca Cola umbrellas, and then the football stadium had a scoreboard that had Coca Cola that featured prominently on it. It was like complete corporate capture. It was amazing how many exposures the typical student in that high school in Brantford, Connecticut would have had. And that's just in school. I mean, think about all the other things added to that. That's amazing, isn't it?

One of the things that interested me about this work was because when I played soccer and ran cross country and track as a kid, everything. There were so many instances where everything was sponsored. There were so many instances where unhealthy food products were linked with sport. So, we were the Snicker state champions of the state of Florida for soccer. I was a Wendy's high school nominee, not a winner. Let's be clear. And every brand. I have so many patches at home with fast food or sugary drink logos on them, right alongside.

And then probably not coincidentally, I remember when I was a young kid, and we were painting a piece of wood in the backyard. And I drew the Coca Cola logo with a soccer ball and a basketball next to it. Looking back, first, what an odd kid I must have been to draw Coca Cola’s logo, but to your point, I was really immersed in it and Coke was top of mind.

The kind of sports sponsorships that you talked about being exposed to when you were young. That kind of thing's happening outside the U.S. a lot too, isn't it?

It is. So, the sports sponsorship outside the U.S. – one of the big ones that comes to mind if McDonald’s sponsorship of the World Cup. We see a lot of international presence with brands, whether it’s through social media, and the way they sort of take local culture and tailor it to sports marketing. I remember being on a trip to Trinidad with my family. My mom's family is from Trinidad. And there was a Coca Cola bottling plant, I think it was. And alongside the perimeter was a painted fence and it had the Coca Cola logo and the Trinny flag and then a painting of a soccer ball and steel drums. So, there was this infusion of the culture alongside the Coca Cola logo. And that really, I think, accelerated my interest in understanding how these brands are capitalizing on the good feelings that people have towards their own culture.

It can be challenging to do anything about this and challenging, especially you regulate advertising in the U.S. because of protections provided for commercial speech through the first amendment. What can be done about the ads promoted through these unhealthy sports sponsorships?

One of the things I think we need more research on is the extent to which these kinds of ads might be contributing to a sort of misunderstanding about the health profiles of products. And so, I think that would help us better understand for kids, do they start to really think that some of these sugary drink products are healthier than water, for example.

That's just a random example but I think that will help us understand what's at stake when it comes to the impression that it's making on young people. And there's a little bit of work in this area, but more is needed. And then I think too about how as a society, there's policy regulations to it too, but that's very hard to do because of commercial speech protections. I will say one of our colleagues Nick Freudenberg has talked about how we should have an open mind with whether there's a possibility to move the needle on commercial speech protections. And so that's something I'd love to keep exploring with people on what that could look like it, and if it was possible to any extent.

And then the other thing that's always been on my mind is the idea that for some products being associated with and became a public relations liability. If we think about the way professional athletes used to endorse tobacco products and would be standing in their uniform with a cigarette in their mouth. Then that sort of became uncool. Not good for their brand. Not good for their look, and they moved away from it.

Will the same thing happen to sugary drinks and junk food partnerships. And I think sometimes we see glimmers of that. There was the famous video, years ago after a soccer game, when one of the world's most famous soccer players pushed away a sugary beverage and said agua in response. And it affected the market shares at that moment. I think there are instances like that, that we can think about in terms of getting some momentum behind the way athletes themselves identify with these products.

In that context, do you think parents could be an important advocacy voice? Let's just say that parents rose up and said to the local high school, we don't want Coca Cola stuff blasted all over our school. And they're pushing that. Coca Cola retains the right, because of the First Amendment to market its products, but local schools would have the right not to sign contracts and therefore deprive the company of those kind of marketing opportunities. Do you think parents might ever feel mobilized enough incensed enough to do something like that?

I think parents are a key factor in this issue of sports marketing to kids because companies care a lot about what parents think. Even though kids have a ton of pester power, where they nag their parents to purchase things, parents are also in many cases, especially for young kids, the gatekeepers of all these purchases. Companies know not to make parents too angry about something because of the risk of not purchasing their products. I think if parents got vocal about it, whether it's on social media or by getting involved in petitions that might be going around that's one way to get companies to start paying attention to these things because I think it getting them out of schools, for example, seems to me to be a common sense start to it and but many parents might not be thinking of this in the way, that how deeply it might be affecting their diet, their kids diets.

Bio

Dr. Marie Bragg is an Assistant Professor at the NYU Grossman School of Medicine where she also serves as the Director of Diversity Initiatives. She holds an affiliate faculty appointment in the Marketing Department at the NYU Stern School of Business, and directs the NYU Food Environment and Policy Research Coalition, which includes 56 faculty who study food and sustainability across 14 departments in 8 schools at NYU. Dr. Bragg’s research examines unhealthy food marketing practices that target youth and communities of color. Her current NIH-funded grants assess how advertising on social media affects the preferences and food choices of adolescents. Dr. Bragg is a Food Leaders Fellow at the Aspen Institute, and has testified on three public policies in New York City that aimed to create a healthier food environment. Since 2008, she has mentored more than 100 students, postdoctoral fellows, and junior faculty members. Dr. Bragg earned her PhD in clinical psychology from Yale University.

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Today we're talking about who has access to full-service supermarkets in America's cities, suburbs, small towns and rural communities. According to The Reinvestment Fund's "2023 Limited Supermarket Access Analysis Report," 8.5% of people in the US live in areas with limited access to full-service supermarkets. This means that families must travel further to get fresh foods, and it creates a barrier to adequate nutrition. This is the 10th year The Reinvestment Fund has published the "Supermarket Access Report," which provides data and context about grocery store access across the country. Here to discuss the latest figures is policy and analyst Michael Norton.

Interview Summary

This is a really interesting and kind of nuanced topic, so I'm happy we can talk about it in some detail. Why don't we just start off with kind of a broad question. What do we know now about areas of limited supermarket access in the US? Kelly, I think the big thing to take away at the very beginning is that the share of people living in places that would be considered low access is roughly the same as it's been over the past 10 years. We have about 8.5% of the population living in low-access areas across the country. That's pretty consistent to what it's been for over a decade. But what's important is that how low-access areas are distributed across the country varies quite a bit. And where they exist, the density of the populations where they exist, really informs the kinds of interventions that are available for addressing these needs. These vary considerably in different parts of the country and at different geographic scales. And what I mean by that is suburban areas, rural areas, and then some of the most remote areas across the country. So we do have a sort of consistent number or share of people. The actual number has gone up a little bit because the population has continued to increase. They become distributed in different ways that follow different kinds of development patterns, on the one hand. But then also places where you end up getting patterns of residential and racial segregation in more developed parts of the country.

It's so interesting. So, given that the average has stayed essentially the same over the 10 years you've been doing the reports, have there been pressures pulling in either direction that might have changed over the years? So, for example, are there pressures that are making access to full-service supermarkets less likely? Are they pulling out of some places, for example? And might that offset by some positive developments in other areas? So, while the average stays the same, the contours look different? I think the way to think about that is that we see a lot of expansion of low-access areas in the big metro areas that are expanding the fastest. So, the biggest increases in populations living with limited access are in big state in the South and out west in places like Arizona, Nevada, Texas, where you have these large metros that are growing at a really rapid rate. And the reason for that is that oftentimes residential development will show up before commercial development. So, in those kinds of places, food retail is trailing behind residential development. And probably those places are going to be well served by the time we update this analysis again in four or five years because of what those development patterns look like, right? So, when you're building more houses in more urban and remote areas, there's still folks who are first in buying out in those places. They're still going to have to go a long way to get their groceries for a few years until supermarket identifies this as a place where there's going to be enough demand for us to put one of our Krogers or Targets or Walmarts or what have you. But we've also seen, and this is more common in urban places, is the expansion of these low-access areas that have smaller populations, right? And so these are places with between 1,000 and 5,000 residents where folks are still having to go disproportionately far to get access to a full-service grocery store. Sometimes this is because stores have pulled out in these places because of limited demand, historically. And that limited demand is mostly because folks don't have as much income to spend on their groceries, right? And we see these little areas popping up within metro areas and even in some close-in suburbs and places across the country. And so you have sort of these bigger LSA areas, which have at least 5,000 residents on the outer edges of a lot of metros and in some within the cities, but mostly within the cities. It's these smaller, limited access, low population areas. And this differentiation of the type of low-access area is something that we introduced in this update to our analysis that previously wasn't available. It provided a really nice nuance to understanding what limited access to supermarkets looks like going forward, both within urban places, suburban places, and in some of these really remote parts of the country. So, based on this research, what does it tell us about the future of insecurity in the United States? I think what it really tells us is that it depends on where you live and what kind of community you live in and what that's going to look like. I think the ability to provide a little bit more nuance around who has access and when they have limited access, what about their community is going to inform the response to ensuring that folks are able to get what they need. In places where they are these traditional sorts of limited supermarket access areas where you have at least 5,000 people, they can become pretty good candidates for operating a full-service store, right? But when you think about urban parts of the country where you've had central business districts or neighborhoods sort of hollowing out in different places and local supermarket is closed, but there aren't enough people there living to support a full-service store, different kinds of interventions are required, right? And then in these really remote parts of the country where you don't have very many residents, but you have at least a thousand, but people are living a long way away from each other, how do you serve those places? Because some of them, these are very small towns, right? And there are people who have been living there and if the grocery store closed, then they have to drive 35-40 miles to the next town, right? That becomes a real challenge for their general way of life. I think really thinking about the future of food access and food insecurity in this country really has to have a geographic nuance to it in thinking about the appropriate responses that are going to meet the needs of people living in different parts of the country. So, how does your study inform investments do address food insecurity? Reinvestment Fund has a very active retail portfolio, both on our lending side, and Reinvestment Fund is also the national fund manager for USDA's Healthy Food Finance Initiative. These two avenues through which we make loans to increase access to fresh food and through USDA's HFFI program are opportunities to innovate. The USDA's Healthy Food Finance Initiative is both a grant-making and a lending program that is designed to identify innovative responses to access to fresh food in these different types of areas. So, we're able to use the results of these analyses to identify places where you can align the kinds of programs that people are proposing. Whether that's a small format store in a city where their primary supermarket has closed, whether it's a mobile market that is serving folks who live very far distances from their nearest food retailer, or whether it's setting up a aggregation site that is not just food retail but sometimes is attached to a healthcare center or a hospital where people are also making regular trips. These become opportunities for us to support innovative approaches and also try out different things. Once you start to get some information from successful programs that are coming out of the grant program, as they become investible and scalable at a store level when you become ready to take on debt to expand your operation or open a store in a place that typical operators aren't willing to go. So, let me ask you a question about the Healthy Food Financing Initiative. With politics being so partisan these days, is this a partisan issue as well, or is there bipartisan support for things like this? This is the good news part of access to fresh food. It really is a bipartisan issue. Healthy Food Finance Initiative was created under the Obama Administration, was expanded under the Trump Administration and has been expanded even more under the Biden Administration. Each subsequent farm bill has expanded the capital available for the Healthy Food Finance Initiative, with the goal to try and figure out how do we meet the food access needs of everybody in this country in a way that provides a signal to private market operators that they can be successful in these places. That really is a bit of good news, and I'm really happy to hear that. But I also wanted to ask you, are there options aside from full-service supermarkets to help address some of these matters you're discussing? Absolutely, absolutely. And these are things like smaller format stores, almost like a corner store but that operates like a healthy food market. And these are really appropriate in places where there are limited access, low population, and sort of filling in pockets inside urban communities and close-in suburbs. There are mobile market options that are popping up in different places. Food aggregation hubs that will be cited within the center of a low-access area where people can come to a central location and having purchased food online that shows up and then people can come and pick it up. There's expanding delivery options to more remote parts of the country. So, there is a wide diversity of models that are proliferating beyond just bricks and mortar traditional grocery stores. It's really the job of HFFI to seed these initiatives, identify the ones that are doing really well, and then work with the folks who created them and then others to scale them down the road into places that are not served by food retailers. I think you've helped answer the next question I was going to ask, which is how does this research help policy makers and practitioners think about addressing food insecurity in their community? There's a fair amount of tailoring that could go on where you're trying to meet the needs of a specific community. That's right. And I think one of the things that's important to keep in mind is the role that financial institutions like Reinvestment Fund play in making this possible. So, Reinvestment Fund is a community development financial institution, which is best understood as like a nonprofit bank. And these exist across the country and are more or less active in different markets, but they're really focused on working in a very deliberate, hands-on way with our borrowers to create access to fresh food in places where it's not going to be easy, right? Because if it was easy, all the big food retailers would be there, right? So, we have to be patient. You have to find someone who's willing to take a chance operating the store, to help them develop their business plan, help them identify all of the ins and outs that go with standing up a food retail business, and then work with them throughout the process of them sort of getting access to capital and making their business work. And that work is a lot more work than what is required to finance a new grocery store that is run by Target or run by Walmart, Krogers or something like that. This is a critical role that the CDFI industry is playing and increasingly recognized at the federal level as a resource for deploying public subsidies through the private market into the hands of operators who are going to make it work in places where traditional food retailers and capital just won't go. Let me ask a big-picture question. and this is a little complicated in my own mind. So, we're sort of defaulting in a way to the idea that full-service supermarkets providing access to such things for more people is a good outcome. And from a social justice point of view, it's unquestionably true that people who live in different sets of financial circumstances should still have access to things that people in better financial circumstances have. But in terms of nutritional outcome, having access to a full-service supermarket brings a lot more than just the healthy foods. And in today's modern full-service supermarket, the highly processed, less healthy options must outnumber the healthy ones 10 to 1, 20 to 1, 50 to 1? I have no idea what the number is, but it's enormous. And so, providing government support and financial incentives for a big store to come in is providing access to a lot more than healthy foods may have adverse nutritional outcomes rather than positive ones, unless you're just sort of agnostic about the type of food that people are getting access to, that any food is better than nothing if you have food insecurity. But I wonder how one might address that. And whether one could think about providing resources that were structured differently to encourage smaller stores, for example, that focus on more healthy options and fewer of the less healthy ones. And then you might get the social justice part addressed at the same time you're having a better nutritional outcome. Kelly, that's such a good question, and one that we wrangle with all the time. Because there is actually fairly limited evidence to suggest that access to fresh food is going to lead people to make healthier choices about what they consume. One of the sort of operating assumptions is that in the absence of access, you're not going to make healthy choices. And once there is at least access, the possibility for making healthier choices increases from, zero to something, whatever it is that is going to be motivating individuals how they go about making choices for the foods that they consume. And it is a very tricky relationship that folks in the food industry grapple with all the time as well in the medical profession. I think from a grant-making standpoint and a financing standpoint, Reinvestment Fund's position is always that whoever is receiving support through our programs or from our lending capital is offering a selection that meets what you would consider healthy food retail options, right? That there is an assortment of fresh fruits and vegetables, fresh produce, fresh meats and dairy, in that also with the understanding that almost all food retailers are also going to offer less healthy options. That is a constant tension within the field. And figuring out how to encourage behavioral change by consumers is sort of beyond the ability of HFFI to move. What we can do is ensure that the organizations and the individuals who we support are offering a variety of healthy options for the patrons that are coming into their locations.

BIO

Michael Norton, Ph.D., serves as Chief Policy Analyst at Reinvestment Fund, and supports all research related to Reinvestment Fund’s organizational goals and mission. In this role Dr. Norton works closely with a range partners, including small non-profit organizations, local and national philanthropies, private companies, colleges and universities, school districts, federal, state, and city governments and agencies. His work leverages nearly a decade of experience as researcher and project director to develop data driven solutions – solutions that meet the unique needs of Reinvestment Fund and our key stakeholders in the public and private sectors. Dr. Norton completed his doctoral studies in the Sociology Department at Temple University, where his research examined the relationship between secondary mortgage market activity and neighborhood change in the Philadelphia region at the turn of the 21st century. Prior to joining Reinvestment Fund in 2015, Dr. Norton served as a Senior Research Associate at Research for Action in Philadelphia. In this role, he led and co-led a range of mixed-methods evaluations of educational reform initiatives and policies at the local and state levels.

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Nonprofit organizations can play a very important role in building healthy communities by providing services that contribute to community stability, social mobility, public policy, and decision-making. Today we're speaking with Kathy Higgins, CEO of the Alliance for Healthier Generation. The Alliance is a nonprofit organization, a well-known one at that, that promotes healthy environments so that young people can achieve lifelong good health.

Interview Summary

Kathy, it's really wonderful to reconnect that you and I interacted some when you were in North Carolina and head of the Blue Cross and Blue Shield of North Carolina Foundation, and then you got called upon to be the CEO of the Alliance, a really interesting position. It's really wonderful to be able to talk to you again. Let's start maybe with a little bit of the history of the Alliance for a Healthier Generation. Can you tell us a bit about how it got started and over the years, how it's evolved? We've existed for almost 19 years now. We celebrate our 20-year anniversary next year. And we were started by two vital public health forces: the Clinton Foundation and President Clinton and also the American Heart Association. They came together 20 years ago and began discussing childhood obesity and what could a leading public health organization do to really work in systems change across the country at a local level. It is those two organizations that we look to as our founders and who helped us advance our work. It's a time flies story because it seems like just yesterday that the Alliance was created. There was a lot of excitement at the time for it, and over the work. It's done some really interesting things. So, in today's iteration of the Alliance, what are some of the main areas of focus? As I mentioned, we are a systems change organization. What we do is take a continuous improvement approach to advancing children's health. So, we are working typically in schools or after school time and certainly in communities to work on policy and practice change that are about promoting physical activity and healthy eating. And then addressing critical child health and adolescent health issues, which as we know, were exacerbated with the pandemic. Things like food access and social connectedness are just so important. Quality sleep, which our children are not getting enough of, or other things like vaping and tobacco sensation and on time vaccinations. Another thing that we know is that the pandemic had a dramatic impact on families and children on time vaccinations. So, this is the work that we do and working with the policy and practice change so that there there can be opportunity for healthy environments for the children. I think most everybody would probably agree that the targets that you're working on, healthy diet, physical activity, smoking, vaping habits and things like that are really important. But people might be a little less familiar with what you mean by addressing systems. Could you give some examples of what you mean by that? Right. What we know is that in United States, in fact, every public school must have a wellness policy and areas that need to be addressed. But what we'll do is work with the school in making sure that those policies are best suited for the families, the community, and the school, and what they want to do to support the health of children from a collaborative and supportive role. What we know is that we can create great change when that occurs. We work with more than 56,000 schools across the United States, and one of the things that we know is that our approach is really reflected in the America's Healthiest Schools recognition program each year. It's interesting to hear you talk about schools as an example of system change. And boy, working with 56,000 schools is pretty darn impressive. And it allows for out-sized influence of an organization like yours because if you can affect things like these school wellness policies and that gets multiplied across a ton of schools, it can really affect a lot of children. Exactly. We will work school to school, but we also work in districts and that allows us then to make even a bigger impact in the number of schools that we're reaching with these changes. It also brings the community together because then they're all operating under the same principles or the same focus areas of the work that they're committed to doing. What we do see is that we're able to assist them in implementing what are typically best practices in all sorts of topic areas. Whether it's strengthening the social emotional health and learning environment for the children, but also focusing on staff wellness. The whole notion, Kelly, of putting your oxygen mask on first before assisting others is something that has been incredibly important to us. We've certainly been very supported to do that work from a variety of funders. The other area that we've been able to make great strides in is this increasing of family and community engagement, which has been really significant for us. We've been honored to have Kohl's as a major supporter of our work. Their investment and then reinvestment and then once again, another reinvestment, really helped us engage with strategies that focused on increasing family wellbeing. So really then our three-legged stool becomes the school environment, the family environment, and the community environment, which we find is just really effective. So can we talk a little bit more about the community engagement and why is it important and how do you go about making it happen and what sort of impacts do you see it having? I think I may have mentioned already that we do use a continuous improvement model that we find is just really effective for when we're working in the school or school district level. It allows us to serve in a role of being a convener and bringing people together. What we know now is certainly after COVID that schools are no longer for walls of learning. They have a central role to the health of the community because of the services that they're providing or the services that families need them to provide. So, when we're working with a school, we're able to convene the right people that are in their community. They may be in the same zip code, they may be down the street, they may be across town. But they haven't come together around the same table to start to address issues that they may have prioritized that are impacting a host of things. It could be impacting attendance rates, it could be impacting academic achievement. And we're really able to work with them to dismantle the barriers to what would lead to success. To give a couple examples in North Carolina, in fact, we work in both Bertie and Roberson County and on vaccination adherence, and also making sure that the children that may have deferred their well-child visits or their age-appropriate vaccinations during COVID that we've worked with convening just as mentioned, the right players, the right people in the community to come together. And in both those counties we've been able to have nearly 250 students that are healthy back to school and fully vaccinated as they should be and that they deserve to be and as their families wanted them to be, but the time the resources just wasn't there or convenient enough to do. And so, this really has allowed the community to have a great win. It's a great example of just the importance of sitting down together, looking at the data and thinking about how we can all make a difference. Kathy, what you've reminded me of as you've been talking about this is that there's sort of a sweet spot that you've attained. If all you paid attention to were best practices, you'd say, well, okay, everything that works in these other places is going to work in your place, which of course might only be partially true. But if you only work locally, then you'd miss the opportunity to be learning what's happening elsewhere that might help you. And you're kind of at the intersection of these things, aren't you? Thank you for saying that. That's exactly where we sit - at that intersection. Sometimes we feel in a continuous improvement model that there's a no wrong door, so to speak. And so, when we're engaging with a school, school community, a community, or even a school district, that we're able to sit with them in proximity and talk through what are the issues that they're facing, where their children are most at risk, and what is it that they are working to prioritize. Because we also know that if we can move them through a process and achieve success and really answer the question, is anyone better off? So to really be outcomes focused. Then, what we know is that there are other opportunities for improvement that we can continue that work. Part of the success here is just pausing and celebrating what good work this community is doing together. This school is doing together. Tell us if you will, a little bit about how the work of the Alliance is funded, because I know you draw support from a number of quarters. You mentioned Kohl's, but overall how is the work funded? Thanks for asking. You know, one of the things I did mention to start with is the Clinton Foundation and President Clinton, specifically with his leadership supporting the health of children and families and the Heart Association. But the significant financial supporter and strategic supporter at the time was the Robert Wood Johnson Foundation. They really put significant resources behind the creation of Healthier Generation. But the other thing that they did is put their brightest minds and public health leadership behind the creation of why we would exist and what would be the pillars of our organization that would serve well to make a difference. So having a technology backbone, which allows us to have an action center. Meaning that any school, any teacher, any administrator, any parent can access our training and our tools for free. Through our website, we have marketing and communication that follow best practices for how to create change and how to communicate change to the audiences that we're reaching out to our subject matter expertise and then measurement and evaluation. And it's this ability that really attracted funders like Kaiser Permanente. While schools have been central to our work, this digital platform really allowed our action center to help and support this access of no cost assessment tools, trainings, resources. Kaiser Permanente has been a key supporter of our work since 2013. I mentioned Kohl's as well, as such a significant supporter allowing us to reach 10 million families since the inception of our work together with them. Del Monte Foods is another significant supportive of ours. They allow us to implement the America's Healthiest School Awards program. I would be lost if I didn't mention Mackenzie Scott. She wanted to invest in whole child health equity and we were identified as an organization that was worthy of her funding and definitely was the largest single gift from a philanthropist that we've ever received. So, we were so grateful for that, that call called. That's wonderful affirmation. No question. It's nice to hear you have such a broad base of funding because that's a sign that people are thinking you're doing things right. I'm not sure I'm in a the best position to be completely objective about this because over the years I've received funding from through Robert Wood Johnson Foundation for a number of projects. But it's amazing how often their imprint comes up when you talk about organizations that are doing creative work and you go back to the beginnings and Robert Wood Johnson was often there doing these things when nobody else was. And it's really wonderful to see the long-term consequence of that investment that they made. Well, let's talk about some new work you're doing in the schools. I know that a relatively new effort of the Alliance involves the expansion of resources in terms of a playbook in the schools. Can you explain what that's all about? Oh yes. This was really born out of the pandemic environment and our need and the schools need to know better guidance on the work that we can do to create healthier environments when so many demands are being put on us. We all know what happened to the food service staff of any school. They became the food service staff of the community during the COVID years. Kohl's wanted us to partner with selected communities across the country to implement what would be really a new family engagement strategy to support children's health and developing. What we call and refer to as our Healthy at Home playbook for schools to forge stronger relationships with families. We know that when schools and the families are working together and schools are understanding what families need, and families are able to be in a position to be heard and communicate what their needs are, that together they can really make a difference. We've been pretty excited the collection of resources. They're both in English and in Spanish on topics such as nutrition, staying active, mental wellbeing, social emotional health and stress and we've been pretty excited to have that implemented. I could see how you'd be excited about that. So, let me ask a final question. The word policy has come up several times. Is it part of the purview of the alliance to argue for policy changes? You mentioned schools. So, for example, would the Alliance be in a position to argue for tighter nutrition standards in schools or even something beyond the schools, like something dealing with food marketing directed at kids or front of package labeling or really anything like that? We stay out of the advocacy and lobbying lane, but we do focus on the small P policy change in schools so that we're helping schools manage their policies. But the area where we've had success is in creating a difference. We had a great partnership many years ago with McDonald's and worked with them on changes that they were committed to making in their healthy meals. And what we know is when McDonald's makes a big shift, so goes the market. Our body of work was the removing of sugary sodas from the menu board so that you would have to opt for that versus low fat milk or water and adding the sliced apples. I think that might be one of our hallmarks of the work that we've done over the years: sliced apples, carrot sticks, the GO-GURT that was being offered. And then removing either the higher sodium or higher fat items from the leaderboards so that they have to ask for them in order to have them as part of the Happy Meal. That was some significant work that we were able to do. And the other work we did in our early years was getting the three soda manufacturers, whether Pepsi and Coke and Dr. Pepper to agree to come together and remove sugar sodas from our public schools and replace it with a better price point of water. And it's something I know President Clinton is very proud of because I think a 90% of schools were on board with that work after about a three-year period. I think it really made a difference. Bio

Kathy Higgins, chief executive officer (CEO) of the Alliance for a Healthier Generation, is a national expert on health care and philanthropy, having previously served as the president and CEO of the Blue Cross and Blue Shield of North Carolina Foundation. Higgins leads Healthier Generation’s team of nearly 100 professional staff across the nation working to make the healthy choice the easy choice for all children. Prior to taking on the role of Healthier Generation CEO in January 2019, Higgins spent more than 30 years at Blue Cross Blue Shield of North Carolina, where her roles span leading public health engagement, corporate communications, community relations, and corporate affairs. In 2000, Higgins led the launch of the Blue Cross NC Foundation. As president and CEO of the Blue Cross NC Foundation, Higgins led unprecedented growth, including the strategic investment of more than $150 million into North Carolina communities through more than 1,000 grants to improve the health of vulnerable populations, support physical activity and nutrition programs, and help nonprofit groups improve their organizational capacity. Higgins was also a significant advocate in Blue Cross NC’s early adoption of Healthier Generation’s decade-long innovative insurance benefit program, designed to encourage clinicians to extend weight management and obesity prevention services to kids and families. Higgins holds a bachelor’s degree in education from West Virginia Wesleyan College and completed her master’s work in community health education from Virginia Tech. She currently resides in Raleigh, North Carolina and is the mother to twin boys.

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Is it possible to decarbonize agriculture and make the food system more resilient to climate change? Today, I'm speaking with agricultural policy expert Peter Lehner about his climate neutral agriculture ideas and the science, law and policy needed to achieve these ambitious goals. Lehner is an environmental lawyer at Earthjustice and directs the organization's Sustainable Food and Farming Program.

Transcript

How does agriculture impact the climate? And I guess as important as that question is why don't more people know about this?

It's unfortunate that more people don't know about it because Congress and other policy makers only really respond to public pressure. And there isn't enough public pressure now to address agriculture's contribution to climate change. Where does it come from? Most people think about climate change as a result of burning fossil fuels, coal and oil, and the release of carbon dioxide. And there's some of that in agriculture. Think about tractors and ventilation fans and electricity used for pumps for irrigation. But most of agriculture's contribution to climate change comes from other processes that are not in the fossil fuel or the power sector. Where are those? The first is nitrous oxide. Nitrous oxide is a greenhouse gas about 300 times more potent than carbon dioxide. And it comes because most farmers around the world and in the U.S. put about twice as much nitrogen fertilizer on their crops, on the land, as the plants can absorb. That extra nitrogen goes somewhere. Some of it goes off into the water. I'm sure your listeners have heard about harmful algae outbreaks or eutrophication of areas like the Chesapeake Bay and other bays where you just get too many nutrients and too much algae and very sick ecosystem. A lot of that nitrogen, though, also goes into the atmosphere as nitrous oxide. About 80% of nitrous oxide emissions in the U.S. come from agriculture. Excess fertilization of our hundreds of millions of acres of crop land.

Quick question. Why would, because the farmers have to pay money for this, why do they apply twice as much as the plants can absorb?

Great question. It's because of several different factors. Partly it is essentially technical or mechanical. A farmer may want to have the fertilizer on the land right at the spring when the crops are growing but the land may be a little muddy then. So they may have put it on in the fall, which is unfortunate because in the United States, in our temperate area, no plants are taking up fertilizers in the fall. Also, a plant is like you or me. They want to eat continually but a farmer may not want to apply fertilizer continuous. Every time you apply it, it takes tractor time and effort and it is more difficult. So they'll put a ton of fertilizer on at one point and then hope it lasts for a while, knowing that some of it will run off, but hopeful that some will remain to satisfy the plant. There's a lot of effort now to try to improve fertilizer application. To make sure it's applied in ways just the right amount at the right time. And perhaps with these what's called extended release fertilizers where you put it on and it will continue to release the nutrients to the plant over the next couple of weeks and not run off. But we have a long way to go.

Okay, thanks. I appreciate that discussion and I'm sorry I diverted you from the track you were on talking about the overall impact of agriculture on the climate.

I think what's so exciting about this area is that everyone cares about our food. We eat it three times a day or more and yet we know very little about where it comes from and its impacts on the world around us. It's wonderful to be talking about this. The second major source of climate change impact in agriculture is methane. Methane is another greenhouse gas much more powerful than carbon dioxide. About 30 times more powerful over a hundred years and about 85 times more powerful than carbon dioxide over 20 years. Which is I think the policy relevant time period that we're looking at because we're all trying to achieve climate stability by 2050. And where does methane come from? A little bit comes from rice, but the vast majority of it comes from cows and from manure. Cows are different than you and me. They can eat grass, and their stomachs are different, and release methane. Every time they breathe out, they are essentially breathing out this potent greenhouse gas methane. This is called enteric methane and it's the largest single source of methane in the United States. Bigger than the gas industry or the oil industry. The other major source of methane is manure. Our animals are raised in what are called concentrated animal feeding operations. They're not grazing bucolically on the pasture, they are crammed into buildings where there may be thousands, or tens of thousands, or even hundreds of thousands of these animals. Those hundreds of thousands of animals produce a vast amount of manure, whether it be say pigs in North Carolina or dairies in many States, or cattle or chicken. All our meat nowadays is grown in these concentrated areas where you get concentrated manure and that is often stored in these lagoons. These big pits of poop basically. And that, as it decomposes in this liquid environment, what's called anaerobically , releases a tremendous amount of methane. That's the second largest source of methane in the country after the cows belching. So you have nitrous oxide and you have methane. And then the third way agriculture contributes to climate change, which is different say than the fossil fuel sector, is by changing the land itself. Agriculture uses a tremendous amount of land. Think about it. When you go around, what do you see? You see agriculture uses about 62% of the contiguous United States; 800 million acres of land for grazing; or almost 400 million acres of land for cropland. Healthy land before it's been used for agriculture has a tremendous amount of carbon in the soil and in the plants. Just think about a forest with all the rich soil and the rich vegetation. When that is cleared to be a cornfield, all that carbon is lost and essentially it goes into the atmosphere as carbon dioxide. And that soil after that can't absorb any more carbon. Healthy soil is absorbing carbon all the time and most agricultural soils are not. So that release of carbon when you convert land to agriculture and that continuing inability to sequester carbon is another major way that agriculture contributes to climate change. So these three ways: nitrous oxide, methane and carbon from soil are all important contributors to climate change that don't really fit most people's model of what drives climate change - burning coal or oil and releasing carbon dioxide. But the bottom line is if we don't address agriculture's contribution to climate change, no matter how successful we are in reducing our fossil fuel use, we are very likely to face catastrophic climate change. Agriculture's contribution to climate change is so significant. Far more than the indicated by many figures. We can't achieve climate stability without addressing agriculture as well. Agriculture drives about a quarter or a third total green climate change.

Given how important this is, why don't people know more about it? And does industry play a role in that?

Industry plays a big role, as does politics. Industry - and by industry we mean the food industry. And you've covered this before. It's very concentrated industry where usually two or three or four firms control the market, whether it be for seeds or retail or beef or chicken or pesticides. It's a very, very concentrated industry with tremendous political power. They have done their best to ensure, first of all, the agriculture industry doesn't even have to report their greenhouse gas emissions. Every other industry has to report their greenhouse gas emissions. The big polluters have to report. On the other hand, agriculture was able to obtain a rider in Congress. That's an extra provision on a budget bill starting about a decade ago that prohibits EPA from requiring agricultural facilities to report greenhouse gas emissions. So unlike most areas, agriculture doesn't even have to report their emissions and industry certainly wants to keep it that way. Also, as I was explaining, agriculture contributes to climate change in a way that is different than what we normally think about. I think that added complexity has just meant it is harder for people to understand. And third, there's a tremendous amount of mythology in agriculture. People think or would like to think that their food comes from this nice family farm with a few animals and a few diversified crops on the hillside. And that in some sense was the reality 50 or 100 years ago, but now it's not the reality. While there's still lots of small farms like that by number, those produce very little of our food. Most of our food is produced in these gigantic animal factories that I mentioned earlier or in gigantic monoculture chemical-dependent agricultural operations. So, we have this disconnect between what is the mythology of agriculture and where our food comes from and the reality of it. People really don't want their myths disrupted.

Given the importance of these issues, what are some of the main ways that the impact of agriculture on climate can be changed?

That's another exciting part of this. That there's a lot of things that can be done to reduce the impact of agriculture's contribution to climate change. And we know this because there are a lot of producers who have piloted these programs, who've implemented these programs and these practices on their own operations to reduce the climate impact. And they've been successful. So these can be, for example, rotating crops instead of having the same crop year after year after year, which really depletes the soil. You can have different crops in different years and each crop puts a little different in the soil and takes a little different from the soil. As a result, very often you end up needing less artificial pesticide and fertilizer, both of which contribute to climate change. You can manage your animals different. You can manage your manure differently. For example, if manure is treated and handled dry, as opposed to in these wet manure lagoons, it produces very, very little methane. Instead of producing tremendous amounts of methane, it produces almost none. So, if we manage manure differently, we can significantly reduce methane emissions. And of course, there's what we think of as the demand side. In the same way that we think about LED light bulbs or more efficient cars as part of our energy transformation, we can use our land and food more efficiently. We waste a tremendous amount of food. Maybe 30-40% of the food we produce is wasted. That's crazy. It's all the effort and the greenhouse gases from producing the food are wasted if the food is wasted. Even worse, the food is dumped into a landfill for the most part where it releases more methane. And it's inefficient. We have a system that very heavily subsidizes meat production, but meat uses, particularly beef, a tremendous amount of land because cows need a lot of land the way their biology requires land and time. So we have almost 800 million or 700 million acres of land devoted to cattle grazing that could be storing carbon. Then it takes about 15 pounds of grain to get a pound of beef where people can eat the grain directly much more efficiently. So there's a lot of practices that we can do at every stage of the process to reduce the climate impact of agriculture. The challenge is that it's only on a couple percent of American cropland or very little portion of our food is produced that way.

So Peter, let me ask you a question about that very point you're on. We've recorded a series of podcasts on regenerative agriculture. Some of the most interesting podcasts we've done from my point of view. And they've included scientists who've studied it, policy people who look into it, but also farmers who have done this. I'm thinking particularly, well, three names pop into mind, but there are more. So Nancy Ranney, who ran a ranch in New Mexico for cattle, Gabe Brown, a regenerative farmer in North Dakota, and Will Harris from Georgia were all people we spoke to. I got the sense in each of those cases that these people were converting to this new model of farming because of what they cared about. It was their own passions that led them to do this and belief that a different system of agriculture was going to be important for the future. They were doing it for that reason, rather than any incentives from the government or policies that were encouraging, things like that. So there will be a small number of such people who would do it because they're passionate about it. I'm assuming that number will grow, but never fast enough to really do anything to scale like we really need it. So I'm ultimately you're going to need policies in place to ensure these things happen in more and more farms. Are there particular policies that are oriented this way that you think might be especially helpful?

Kelly, you are spot on. I know Nancy and Gabe and Will, and they're terrific. They are pioneers and they are showing that we know this works. We're not looking at ideas that might work. We are looking at practices that we know work because of what they and others like them have done. As you said, they're doing it because they believe it's the right thing. We'll get some farmers that way, but we need policy to move from 2% of American crop land to 92% of American crop land. So, how do we do that? One is the current farm bill is very important. The farm bill is the most important environmental law nobody's ever heard of. It dates back to the depression. It's renewed every five years. Congress is debating it right now. It was supposed to be renewed last year, but they couldn't get their act together. So they may or may not be able to reauthorize it this year. But the farm bill in one section provides a tremendous amount of money for nutrition assistance. And you've probably talked about that, what we call the Supplemental Nutrition Assistance Program. In another part of it, it provides tremendous amounts of subsidies to farmers, about $20 billion a year of subsidies to farmers. Right now, those subsidies really are not designed to encourage farmers to adopt the practices that you talked to Nancy or Gabe or Will about. These practices that I was talking about earlier and that sometimes are called regenerative, sometimes agroecological, organic farming is often a part of that. These $20 billion of subsidies though, could be redirected, reshaped somewhat and not necessarily radically, but reshaped and focused on encouraging farmers to adopt these practices that can help mitigate climate change. And importantly, the same practices, and as I'm sure the folks you've talked to said, also help them be more resilient to climate change. They can better help the producer better withstand floods and droughts and temperature extremes. So there is a tremendous upside from this. We are already spending $20 billion a year on farm subsidies. Let's start spending it more intelligently in a way that really addresses our needs.

Do you see signs that things are moving in that direction?

I wish I did. There are some signs that we're moving in the right direction. The Inflation Reduction Act, which Congress passed a couple of years ago, was the first time Congress ever linked agriculture and climate change. In the 2018 Farm Bill, there's no mention of climate change. And when we were working on that with members on the Hill, there was really no overt conversations about climate change. Fortunately, things have changed. So, a step forward is that we're talking about climate change. And in the Inflation Reduction Act, Congress provided $20 billion to go to programs that are established under the Farm Bill. So, 20 extra billion dollars to these Farm Bill conservation programs and required that that money be spent on practices that will reduce greenhouse gas emissions, essentially help us mitigate climate change. And that, again, was the first time Congress linked agriculture and climate change. Super important. Part of what's going on now on the Hill is a fight to ensure that money that the Inflation Reduction Act provided stays. There are those in Congress that would like to raid those funds and put them to other purposes, which we think would be a big step backwards. So that was really great opportunity. As to the Farm Bill money itself, there's definitely some conversations, particularly among the Democrats, to ensure that all of the Farm Bill programs are a bit more climate-focused. But we're far from consensus on that. So, we're making a bit of progress, but right now Congress is, I think it's fair to say, not at its most functional. And so the type of policy discussions we need, and an honest discussion of how can we help American farmers shift to practices that are better for them, for the communities, upwind and downwind and around them, better for climate change resilience and climate change mitigation. We're really not yet having that conversation as robustly as we need. Hopefully we'll be able to get to a place where the politics will allow us to have that. And frankly, this podcast and other conversations are really important to educating people so we can have that conversation.

When you're trying to make policy advances, having public support for it can be a real asset. Do you see signs that the public is becoming more aware of this, that they're urging their political leaders to move on this front?

For sure. The public is very much concerned about climate change. Every poll shows that. And people are concerned about it both as citizens and as consumers. So, if you follow the food marketing world, what you see is that many surveys show that consumers are very interested in the climate impact of their food choices. And far more than was the case a couple of years ago. And they want to know how can I buy food? How can I eat food that is climate friendly, that helps us stabilize the climate? And industry is responding to that. Now, some industry is responding to that by deceptive advertising. You may have seen that the New York Attorney General recently sued JBS, the world's largest beef company, for misleading statements about the climate-friendliness of their beef. So some companies are talking more than they're doing, but others are trying to respond to consumers' interest in more climate-friendly food. You see a growth in plant-based foods, plant-based milks, because plant-based foods have a much, much lower climate impact than meats, particularly beef. And so consumers are interested in that, and that market is responding. And I think you'll see more of that in governmental procurement as well. Governments that are trying to think about how can we, say New York City, reduce our climate footprint while a big part of a city's climate footprint is the food it purchases, say for New York City schools. And a city can take action by trying to buy lower climate impact foods. And that would be foods produced in a way that you've talked about with regenerative practices and also lower climate impact, such as more plant based. So, I think we're seeing a lot of progress on that for sure.

So Peter, related to this, what would you think about some kind of labeling system on food products that gives an environmental score, let's say?

I personally like the idea of labels. I'm not an expert by any stretch. I do remember that not too long ago, New York City required restaurants to label or have on the menus the calorie content of food. And that provision was later adopted by the Affordable Care Act and now is required of chain restaurants. And Trump tried to roll that back. So we litigated to try to preserve that and get that requirement reinstated in the Affordable Care Act successfully. And during that, I learned that labels really make a difference. Calorie labeling on menus does in fact help people make more informed choices and often better choices. And there's no question, again, I'm not an expert. You probably know much more, but for example, the added sugar labels make a difference and others. So I think as a whole, labels can make a big difference. Now, environmental footprint is a complicated multifaceted issue because something may create harm to water. It may create harm through toxic, say pesticide residue, or it may have a big climate footprint. How do you put all of that into a simple label? It's a complicated question. But I do think there's interest in having particularly climate, the climate impact food be identified on the label. And perhaps we will move in that direction.

Bio

Based in New York, Peter Lehner is the managing attorney of Earthjustice’s Sustainable Food & Farming Program, developing litigation, administrative, and legislative strategies to promote a more just and environmentally sound agricultural system and to reduce health, environmental, and climate harms from production of our food. Peter is one of the leading experts on the impact of agriculture on climate change and is the author of Farming for Our Future; the Science, Law, and Policy of Climate-Neutral Agriculture. From 2007–2015, Peter was the executive director of the Natural Resources Defense Council (NRDC) and the NRDC Action Fund. Among other new initiatives, Peter shaped a clean food program with food waste, antibiotic-free meat, regional food, and climate mitigation projects. From 1999–2006, Peter served as chief of the Environmental Protection Bureau of the New York State Attorney General’s office. He supervised all environmental litigation by and against the state. He developed innovative multi-state strategies targeting global warming and air pollution emissions from the nation’s largest electric utilities, spearheaded novel watershed enforcement programs, and led cases addressing invasive species, wildlife protection, and public health. Peter previously served at NRDC for five years directing the clean water program where he brought important attention to stormwater pollution. Before that, he created and led the environmental prosecution unit for New York City. Peter holds an AB in philosophy and mathematics from Harvard College and is an honors graduate of Columbia University Law School. Peter is on the boards of the Rainforest Alliance and Environmental Advocates of New York and a member of the American College of Environmental Lawyers. He helps manage two mid-sized farms and teaches a course on agriculture and environmental law at Columbia Law School.

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The first nutrition labels mandated by the Food and Drug Administration appeared on food packages in 1994. A key update occurred in 2016, informed by new science on the link between diet and chronic disease. Along the way, things like trans fats and added sugars were required, but all along, the labels have been laden with numbers and appear on the back or side of packages. There has long been interest in more succinct and consumer-friendly labeling systems that might appear on the front of packages. Such systems exist outside the US, but for political reasons and lobbying by the food industry, have been blocked in the United States. There's new hope, however, described in a recent opinion piece by Christina Roberto, Alyssa Moran, and Kelly Brownell in the Washington Post. Today, we welcome Dr. Christina Roberto, lead author of that piece. She is the Mitchell J. Blutt and Margot Krody Blutt Presidential Associate Professor of Health Policy in the School of Medicine at the University of Pennsylvania.

Interview Summary

This is a really important topic, and if the nation gets this right, it really could make a difference in the way people make product decisions as they're in the supermarket. So, let's talk first about the importance of labeling on the front of the package. Why is that important when all the information is somewhere else, namely on the side or the back?

I think there's a couple of key reasons why it's good to do front of packaging food labeling specifically. So, as you mentioned, it was a huge deal in 1994 to get this information mandated to be on food packaging to begin with, right? All of a sudden, there was much more transparency about what's in our food supply, but that being said, when you think about the nutrition facts label, it's pretty dense. There's a lot of percentages, there's a lot of numbers, there's a lot of information to process. And when people are actually in the supermarket shopping, they're making these split-second decisions, right? So, it's not to say that some consumers are turning it around and inspecting that packaging, but the reality is, for most people, it's a very habitual behavior. And so, we want to be in a place where that information is prominent, it's easily accessible, and it's easy to understand so that when you're making those snap judgements, they can be informed judgments.

So, you're not talking about taking what's on the back and just moving it to the front. You're talking about a different set of information and symbols that might be available?

That's right. Yeah. What front of package labeling is designed to do is just take some of the key bits of information that we know from science is going to be most important for consumers to base their nutritional decisions on. That's things like saturated fat, sodium, added sugars, right? And moving that to the front of the package and communicating about it in a very simple, clear way. So, no numbers, no percentages, just very straightforward language. And ideally some sort of icon, like an exclamation point, that would draw attention to that symbol and just quickly let consumers know that this product is high in those nutrients that you need to be concerned about and you need to try to limit.

Why is it an important time to be thinking about this issue in the US?

It's an important and it's an exciting time because the FDA right now is highly interested in actually moving forward on a policy that would require these types of front of package labels. And that hasn't been true, as you noted, for about a decade. But last year, the White House convened a very significant conference that hadn't happened in 50 years about nutrition, health, and hunger. And front of package labeling actually made it into their report in that conference as a key objective for this country in terms of a food policy that, under the Biden administration, they want to achieve. What we're seeing the FDA do now is actually undertake a series of research studies to try to understand what should this label look like, and how should it be designed to be consumer friendly. With the hope that actually we'll get a proposed rule on this potentially by June, and even if not by June. There's clear momentum that it looks like this is going to be happening in the near future.

In a few minutes, I'd like to ask you about what's taken place in other countries, but what's been the history of this in the US?

Front of package labeling really came to a head back in 2009. And it's actually quite a delight to share this with you, Kelly, because you and I were doing some research around it at the time. So, what played out then is a labeling system was introduced called Smart Choices. At its face, it seemed to make sense, right? It was going to be a check mark that was going to be put on products that were deemed to be healthy as a smart choice. So, a consumer could look at that and select something they wanted to eat that was relatively healthy. The reality is when that labeling system came out, it was on Fudgesicles and it was on Cookie Crisp cereal, and there was a lot of kind of concern about whether this type of labeling system was systematically problematic and was going to mislead consumers. And at that time, Kelly, I was a grad student at the Rudd Center and you really taught me quite a bit about how to make things happen and how to have a public health impact. Because we were quite concerned about that system, we actually did a study where we randomly sampled 100 products from Smart Choices and we applied an objective nutrition standard - an algorithm to score those products. What we found is that 64% of those Smart Choices products would not meet healthy by this objective nutrition standard. And so, you had the vision to reach out to the New York Times and alert the media to this. And we started to see a lot of kind of concerning reports in the media, like Smart Choices, what's going on? This doesn't seem very smart. We had done this little bit of science, and then at the Rudd Center, you had reached out to the attorney general of Connecticut at the time, Dick Blumenthal, who was quite interested in consumer protection issues and worked a lot on tobacco. And he took this up as a real public health champion to say this is concerning, we have some of this science, and he came out and threatened legal investigation into that program. What was so remarkable to see in that story, particularly for me as a grad student, was wow you can get these different actors coming together, right? Some of that media attention, science playing the role it needs to play, a public health champion who can really make a difference in the attorney general, and all of that can come together and this program literally halted, they stopped it. And I should say, that was a great public health victory. But immediately after that, the Institute of Medicine, so now the National Academy of Medicine, was charged with writing two reports on front of package labeling. And they came out with one that was focused on the nutrition criteria that should underlie a system like that, and one about the design of the label. And they had some great recommendations, very consistent with what you and I have seen in the science, right? It needs to be accessible, simple, easy to understand. Well, what ended up happening is not much. The industry at that point then released their voluntary labeling system that they call Facts Up Front, which is what we have to this day. And as you might imagine, it has percentages and it has grams and milligrams and it's confusing, and they can also highlight positive nutrients on there. So you can have a Cookie Crisp cereal that's also touting the amount of fiber, the amount of protein. And so that's really what we've been stuck with. It's now only over a decade later that we are at this moment where we're finally seeing this progress, and we're at a place where we might get a labeling system that does a really good job of communicating this information to the consumer.

I guess one sort of ironic form of evidence that such a system is likely to really help consumers make decisions is how hard the industry has fought against having such a system. And not to mention the science that exists suggesting that these things might be helpful. A lot of activity has occurred outside the US. Can you describe some of that?

Over 40 countries have front of package labeling systems. Now, some are mandatory, some are voluntary. The mandatory ones, as you might imagine, produce better effects. They range. And many of them are designed really well. So, let's take some of the best examples. Chile, for example, has warning labels that alert consumers to whether products are high in saturated fat, sugars, sodium, and calories, and those symbols are designed in a very intuitive way. They're stop sign shaped, so they really leverage the automatic associations consumers have. They're prominent, they're black, they stand out from the packaging. And these well-designed labels, we now have evidence from scientific evaluations that they're producing effects, right? They're leading consumers to purchase less of these unhealthy nutrients. They're also leading to some reformulation. And by that, I mean the industry is trying to figure out, 'well, can we lower the sodium, so we don't get one of those labels?' The other thing that I think is often overlooked with labeling but is so important is once you decide to label the food supply and you have an agreed upon system, that can support other policies. And that's what we see in Chile as well. Now all of a sudden, you can't market foods with these warning labels to kids, right? And you can't sell those foods with these warning labels to kids in schools. So, it really has even a broader impact than just the behavior change you see from the labeling, and so many other countries have followed suit. Mexico has a very similar labeling system. One thing that they've learned from Chile is, and this is a concern, that as the industry brings down the levels of sugar, for example, in foods in response to labeling, they're increasing the levels of non-sugar sweeteners, right? Things like Sucralose or Stevia or monk fruit, and so that's a worry. Mexico has, in addition, also labeled those non-sugar sweeteners on the food packaging. And then you see other examples. France has a really nice system. It's called Nutri-Score. Very intuitive. There are letter grades. I myself had the chance to go to France. I was trying to buy some turkey for my son. I don't speak a bit of French, and I'm standing in the supermarket and I just see the letter grade A and I think, oh, okay, I'll pick that one.

Great, great example.

Yes, very intuitive systems around the world.

So, are there studies showing which of these systems work and what sort of effects they have? And I know you've done additional work beyond what you mentioned earlier.

Absolutely, and there are a whole range of studies, whether they're randomized controlled trials, lab studies, or online experiments. And then the more compelling, convincing evidence, which comes from natural experiments that are done around the globe, or even research we have from stores that have voluntary implemented these labels and we can look at changes in sales data. And what all that boils down to is labeling will produce behavioral effects. They will get people to purchase healthier foods, they will get people to purchase less of the unhealthy foods. Labels inform consumers, which I think is kind of the first order goal, right? Like let's just make sure people understand what's in the food supply, and then we see this reformulation. And that's been true, even if you look back to trans fat labeling, like requiring trans fat on the labels was also associated with trans fat coming out of the food supply. So, I think we can feel really good and solid that labeling can help people make healthier choices. And as anyone who's worked on issues related to chronic diseases, we're going to need a suite of policies, right? Labels are never going to be the silver bullet. They're not designed to be, but it's a policy that makes a lot of sense. It's a very cost effective policy. It's not very expensive to do labeling, and it can help support many other policies that might produce bigger effects.

So, given the different options, the different kind of systems that have been proposed or are out there in use, do you have a sense of what ultimately might be the best system?

I think the FDA has some good options in front of them. Now, if I were to wave a magic wand, I would do warning labels. I would make them more similar to what's done in Chile, just because we have good evidence that warnings in particular, and these kinds of symbols like a stop sign, are probably going to be more effective at educating consumers and shaping behavior. Now, that being said, we have some unique legal challenges in the US for getting a system like that. The FDA is proposing, I think, a totally reasonable, science-based label that essentially would have what it's high in and then indicate whether it's high in added sugar or saturated fat or sodium. I would love to see that label also have some sort of icons, some eye-catching exclamation point or something like that, but that label is great, it's a great option. Let's compare it now to what the industry is pushing for, which is basically what we have now, facts upfront. And as I said earlier, this is a label that has percent daily values, that has grams, that has milligrams, that can highlight positive nutrients that are going to appear on unhealthy foods. I think when you look at those two options, it's just a no-brainer to go with this very simple, very straightforward, high-end label that lists the nutrients and let's put some sort of icon on it.

So are you optimistic about where things might go?

Well, I'm a glass half full kind of person. I would say yes, I try to be very optimistic, but I think there's reason to be. I think we have some good options on the table, FDA is moving forward, research is being done, scientists and others are highly engaged in this process and giving feedback to FDA. And so many other countries have done this. So yes, I am feeling optimistic.

So at the end of the day, a lot of this will come down to how much the FDA can resist pressure from the food industry.

Right, so many things in food policy do come down to that.

That's really true. So true. It's interesting, one of the things that you highlighted, but I'd like to even bring a little more attention to is the issue of the industry reformulating its products so that they don't have to show these negative labels. That's such a potentially powerful public health consequence of this, that it needs to be focused on even more. I'm hoping the valuations are being done of the impact of that on public health. Because you can make an argument, couldn't you, that if these labels don't affect the purchasing behavior of a single individual, they still could have enormous public health benefit just because of the reformulation, do you agree?

Oh, 100%. Yes, absolutely. I would even argue that we have very few mechanisms to hold industry accountable, and to me is just a fundamental right of consumers. Like they have the right to know, there needs to be transparency, and great that they are likely to produce behavior change and great that they are likely to make the industry reformulate, but I just feel like that there's so many reasons to do labeling that it just feels like an obvious policy to pursue.

Hopefully, any system that comes into place can be nimble as much as they can be in these government regulations to take into account new science that occurs. Like at some point, maybe a symbol that notes whether a product is ultra processed would be in order, or as you said, in France, I think it was, where they've labeled the addition of the artificial sweeteners. Was it France or was it another place?

Mexico. Yes.

That's right. Okay. Yeah, thanks for clearing that up. Something like that might enter the system, so having a system that can adjust to the science as it goes forward would be really important too.

Kelly, it's such an important point. I think part of any labeling strategy needs to be monitoring and evaluation, and particularly with the non-sugar substitutes. Like right now, we don't know, it's a very hard thing to track. It's only on the ingredient list. We can't quantify how much is in the food supply. And so I would love to see coupled with labeling some way that that gets disclosed so we can really monitor and ensure how that might be changing in the food supply over time and evaluate, to your point, what's happening in terms of reformulation.

As an aside, we've done a cluster of podcasts on the influence of these artificial sweeteners and the sugar substitutes and the available science on this, on what goes on in the brain, what happens to the microbiome, the impact of health overall is really concerning, so I totally agree with you that having that information disclosed could be really helpful.

Yes, 100%.

BIO

Christina A. Roberto, PhD is the Mitchell J. Blutt and Margo Krody Blutt Presidential Associate Professor of Health Policy at the Perelman School of Medicine at the University of Pennsylvania. She is also an Associate Director of the Center for Health Incentives and Behavioral Economics (CHIBE) at Penn. Dr. Roberto is a psychologist and epidemiologist who studies policies and interventions to promote healthy eating habits and help create a more equitable and just food system. In her work, she draws upon the fields of psychology, behavioral economics, epidemiology, and public health to answer research questions that provide policymakers and institutions with science-based guidance. Dr. Roberto earned a joint-PhD at Yale University in Clinical psychology and Chronic Disease Epidemiology. Dr. Roberto completed her clinical internship at the Yale School of Medicine and was a Robert Wood Johnson Foundation Health and Society Scholar at the Harvard T.H. Chan School of Public Health.

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Traditional clinical weight loss interventions can be costly, time consuming, and inaccessible to low-income populations and people without adequate health insurance. Today's guest, Dr. Gary Bennett, has developed an Interactive Obesity Treatment Approach, or iOTA for short, that represents a real advance in this area. Dr. Bennett is Professor of Psychology and Neuroscience, Medicine and Global Health at Duke University, where he is also Dean of Trinity College of Arts and Sciences.

Interview Summary

You know, in this time when people are talking about more expensive, and kind of more intrusive interventions, like the big weight loss drugs, it's nice to know that there may be alternatives that could be accessible to more people. Could we start off with you telling our listeners what the iOTA approach is and how it works? Sure. This is an approach for weight management. It's useful for weight loss or preventing weight gain or maintaining one's weight after you've lost weight. The idea here is that it's a technology that's designed to be highly accessible, and useful for a range of different types of populations. So, as you described, we have developed and tested this primarily for folks who are medically vulnerable, who are low income, who are racial, ethnic minority, who live in rural communities, and where we have traditionally had real difficulty reaching populations with effective weight loss tools. So, iOTA is a fully digital approach. It uses technologies smartphone apps, but it can also use text messaging, interactive voice response, those are like robocalls, automated telephone calls, websites. We've tested this on a wide range of different types of technology platforms, and we've tested it in a range of different types of populations all over the country and indeed even in other countries. So, give us some examples of what kind of information people might be receiving through these various forms of media. The underlying kind of technology, the underlying approach, I should say, for iOTA is actually reasonably simple. It operates from the perspective that creating weight loss is really about making an energy deficit. That is to say, helping people to consume fewer calories than they are expending. The realization we had years ago is that you can get there, you can create that calorie deficit in a whole host of different ways. Some people diet, some people try to get more active, there are limitations around that kind of approach. But fundamentally, you can also just get there by asking people to do some reasonably straightforward behaviors. Like not consuming sugary beverages, or consuming fewer chips, cookies and candies. Or changing the amount of red meat that they put on the plate. And, if you frame those things out as goals, then you can prescribe those goals to people in ways that make sense to them personally. The trick though is actually in the idea of personalizing those goals to the given individual. And that's where technology comes in and gets very helpful. The case is, if you have a large library of these goals, you'd want to try to provide these in a highly personalized way. That really are aligned with what people's needs are and noting that those needs may change over time. So, what we do with iOTA is deliver a very short survey. That survey then helps us to be able to look into our library of goals and pick the ones that are most useful for our users. We prescribe those goals, and then we ask folks to self-monitor those goals. Self-monitoring or tracking is an extraordinarily powerful part of behavior change science. And so, we ask them to track using one of our technologies: the chat bot or the text message or interactive voice response or the smartphone app. Every time that we receive data from one of our users, we give them highly personalized feedback that is designed around principles of behavior change science. And then over time we also give them support. We do support sometimes from a coach or sometimes from a layperson, sometimes it's even from a physician. And over time what we find is that this kind of an iOTA approach helps people to lose weight, prevent weight gain, have weight loss maintenance, but it also has a cascade of other types of effects, some of which we didn't really even anticipate producing. This reminds me of something that I've fought for years, that nutrition and weight control can get incredibly complicated and down on the weeds in a fascinating way from a academic point of view. But that you can get to the goal line with just a few simple things. You might be 80% to the goal line just by eating less junk food and eating more fruits and vegetables and getting mired in that last 20% becomes confusing. It sounds like that's exactly what you're doing. That you kind of picked some of the big things that people can do, establish goals around them, and then provide a behavioral path for getting to those goals. That's precisely our thinking. And the thing I'd add to that is part of the challenge in weight control is making those types of changes for long amount period of time that it takes to produce and sustain weight losses. One of the things we know is that any kind of behavior change, but particularly behavior change for weight control purposes just requires an extraordinary amount of engagement over a very, very long time. So, I'm fond of saying to our teams and to others I'm really much less concerned with strategies that produce weight changes at a month or two months. Because the real question for us is how do we create technologies that can support users as they enter the 10th month or the 12th month? Fundamentally, what we're really after here. It's not really weight loss, but it's really the changes in a whole range of health parameters. So cardiometabolic function, the indicators of the development of various cancers, diabetes parameters, those kinds of things. And it takes time and effort to produce those changes via the weight control, changes that we're hoping to produce with these technologies. What kind of results are you getting from this and does the iOTA program in fact make it easier for people to stay on track with their health goals? Yes, it's a really interesting set of findings over more than a half dozen trials in the last bunch of years. If I were to summarize, I'd say we get pretty modest weight losses relative to say, what you might get with a very intensive weight loss intervention or with a drug or certainly with surgery. But what's different is that those weight changes do tend to be sustained over time. So, they're modest, but they last. And the really interesting finding for us is that people stay very engaged with these technologies. On average, people tend to use new apps pretty feverishly in the first month after they downloaded, or they put it on their phone one way or another. And then most people, about 70% of the time, people move away from those apps, they disengage. When we look back about a year after people started using iOTA, it's very, very common for people to be engaged with our technologies 80-85% of the time. That is to say, they're still tracking their goals at about 80% fidelity after a year. That's really terrific. and it's one of the reasons I think that we're able to see sustained losses, even though those losses aren't very large. And again, my goal here is much less - this is a public health approach - I'm much less interested here in trying to produce large weight losses for cosmetic reasons and those kinds of things. This is really an effort to try to create a very highly disseminatable, inexpensive treatment that is accessible to large numbers of folks. In trials, we certainly have seen changes in blood pressure and various cardiometabolic parameters like lipids. Those changes tend to be larger in certain populations. When we tested this in China, we saw very, very large dips in lipids. And those too also do tend to be sustained. The biggest surprise for us over the years has been a relatively consistent set of findings that suggest that people have improved wellbeing on the backend of participating in one of these kinds of treatments. They tend to feel less stressed, have more energy, and have better quality of life. In fact, we've seen very, very large reductions in depressive symptoms in study after study. I'll just add tangentially that's notable for us in the populations in which we work, because these are not populations for whom weight is very closely tied with one's emotional state. That is to say, the patient populations in which we work tend to have more tolerance for heavier body weights compared to other populations. So, when we see weight loss in our trials, we don't often expect to see that accompanied by improvements in depressive symptoms. But we see it in study after study after study. So, we've been really pleased with this broad array of impacts that this technology seems to produce. It's nice to hear the positive results. And I also like your aspirations because a smaller weight loss, better maintained is a much better outcome than a larger weight loss regain, which is typically the case. And the fact that you're getting these corollary effects in other areas of life, like mental health and things like that is very impressive. Are there other stories you could tell from people that have been on the program that might be illustrative? Oh yes. What happens most often in our studies is that at some point one of our patients approaches me and says, "You know, I've tried everything. I've tried dieting, tried this app and that app and this is just so easy. I've been able to stick with it for a long time." That happens a lot. And it always, always pleases me greatly because at the end of the day we're really trying to create these technologies for real people to use over a very, very long period of time. I find that exciting. We've had a number of people over the years who have gotten off their hypertension medications or have had seen changes in their diabetes, their A1Cs as a measure of diabetes. And it's just really exciting because then it's one of the things that I think gets us up in the mornings to do this work. That is exciting. How has it been especially influential among people who otherwise have limited access to care? We really started this work because of a series of observations that I made early in my career when I started working in community health centers. Community health centers are often primary care units in many major metropolitan areas, and often in rural settings as well. Their primary intention is to serve patients who are medically vulnerable, and often patients who are poor. On those settings, the providers in those settings are just doing extraordinary work. And I started to spend time there and was trying to understand how we might think about situating this kind of technology and these kinds of public health style interventions within those care settings. And the observation I made over and over and over again was that, even in these care settings that are really designed to serve patients who have low income or come from limited income backgrounds, weight control and behavior change in general was just not the highest priority. These physicians are dealing with all manner of acute and chronic health crises. And they just didn't feel that managing a patient's weight was the best use of their limited clinical time and attention with patients. The challenge of that, of course, is that, for patients who have obesity, that can be a primary cause of many of the acute and chronic conditions that my physician colleagues were treating. And so what I began to observe was that patients who have the greatest need for comprehensive obesity care are often the least likely to receive it. And this is borne out by national data, which suggests that if you're a person from a medically vulnerable background and you have obesity, you're dramatically less likely to receive high quality care from the health system. And then there are a whole range of financial constraints that limit your ability to be able to acquire that care in the commercial market. And so there are really many, many people, really, tens of millions of folks out there without options. So, that's really why we started developing these tools. And I'm very pleased to say that the underlying approach that we develop with iOTA has been leveraged in a variety of weight control interventions that are being used in other places. The next frontier for us is to really think about how to disseminate this in a more widely accessible way. We've begun having conversations with metropolitan areas. Cities where health departments are thinking about doing these kinds of things. Some of these technologies have found their way into other systems. And increasingly as we have begun to test these approaches in clinical care settings, we certainly have seen ongoing use of these technologies in the community health centers where we originally came up with some of these ideas. So, much more work there to be done but I'm hopeful. Do you see a role for this approach in conjunction with or as a companion to the weight loss medications that are getting so much attention now? Yes, I do. One of the things that's notable about this generation of weight loss medications is that they do not have an indication that they should be accompanied with a behavior change intervention. So, the other way to say that is that most weight loss drugs that we've seen in years past have received FDA approval, contingent on their combination, their use, alongside a behavior change intervention. And the GLPs, the ones that are most recently emerged, don't have that indication. Nevertheless, we know a couple of things. One is that these are medications that are designed to be used for very long time in order for fat, weight loss to be sustained. And there are a number of people who increasingly are interested in transitioning off of these medications and beginning to engage weight control on their own. So, my sense is that technologies like iOTA can be very useful in helping people make those transitions off of drug. I think the technologies we've created can be very, very useful as an adjunct to try to help to maintain motivation for weight loss. And to think about addressing some of the related behaviors that can help people to experience an overall improvement in their health. So, becoming more physically active and making changes in stress and wellbeing as an adjunct to the weight loss that's being produced by the drugs. I have to tell you, I'm very, very concerned about the cost of these medications. I'm very pleased by their efficacy, but I'm extraordinarily concerned about their cost and their limited accessibility. I expect that will change. But during this period of time, I'm very concerned about the creation of additional disparities, patient's ability to seek really high-quality care. I'm glad you raised that point. So, where do you see the work going next with IOTA? Well, I see it going in two directions. One, we are thinking about dissemination. Where can you embed this kind of approach inexpensively in ways that allow the greatest number of users. The emergence of artificial intelligence technologies, notably the large language models, really help in that regard because they allow us to deliver that kind of core iOTA special sauce more flexibly in a range of different technologies. And even more inexpensively than we can do right now. iOTA is extremely cost effective and with AI delivery it could be even more so. And then the other path I see is really what you asked before. And it's how do we think about using these technologies as an adjunct to medication treatment, which I think will become even more common over the next couple of years. I hope that it becomes a more common approach that's used to treat the patients who have the highest risk of obesity and all of the chronic health conditions that travel along with it. Bio

Gary Bennett, a professor in the department of Psychology & Neuroscience who also holds appointments in Global Health, Medicine and Nursing, is the founding director of the Duke Digital Health Science Center. For 20 years, he has been studying how incorporating digital strategies into clinical treatment of obesity can improve health outcomes. His development of the Interactive Obesity Treatment Approach (iOTA) has been supported by over $20 million in grants from the National Institutes of Health.

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Fast food is part of American life. As much a part of our background as the sky and the clouds. But it wasn't always that way, and over the decades, the fast food landscape has changed in quite profound ways. Race is a key part of that picture. A landmark exploration of this has been published by today's guest, Dr. Naa Oyo Kwate. She is an Associate Professor in the Department of Africana Studies and the Department of Human Ecology at Rutgers University. Her book, recently published, is entitled White Burgers, Black Cash: Fast Food From Black Exclusion to Exploitation. The book has been received very positively by the field. And was recently named the best book in the field of urban affairs by the Urban Affairs Association.

Interview Summary

I was so happy to see your book because people have talked about the issue of race off and on in the field, but to see this kind of scholarly treatment of it like you provided has been really a welcome addition. Let me start with a general question. Let's begin with the fast food situation today and then rewind to where it began. Are there patterns to where fast food restaurants are located and who fast food is marketed to? Absolutely. There's quite a bit of research, and you just alluded to the work that's been done in the field. There's a lot of research that shows fast food is most dense in African American communities. Not every study has the same finding, but overall that's what the accumulated evidence shows. On the one hand you have the fact that Black communities are disproportionately saturated with these outlets. Then there's also the case that apart from the physical locations of the restaurants, fast food is strongly racialized as Black in terms of how it's portrayed to the public. It [Fast Food] relies on images of Blackness and Black cultural productions such as Black music for its marketing. These sometimes these veer into racial caricature as well. One of the things I talked about in the book briefly is the TV commercial character Annie who Popeye's introduced in 2009. They basically created this Black woman that Adweek at the time was calling "feisty," but it's really just this stereotypical idea of the sassy Black woman and she's in the kitchen frying up the chicken for Popeye's. And actually, some of the language that was used in those commercials really evokes the copy on late 19th century and Aunt Jemima pancake mix packaging. It's a really strong departure from fast food's early days, the way that fast food is now relying on Blackness as part of its core marketing constructs. I'm assuming that it follows from what you've been saying that the African American community has disproportionately been targeted with the marketing of these foods. Is that true of children within that community? Research shows that in terms of fast food marketing at the point of purchase. There's more - display advertising for example at restaurants that are in Black communities. And then there's also been research to show, not in terms of the outlets themselves, but in terms of TV programming that there tends to be more commercials for fast food and other unhealthy foods during shows that are targeting Black youth. How much of the patterning of the fast food restaurants is due to income or due to the amount of fast food consumption in these areas with many restaurants? Almost none of it really. It's not income and it's not the amount of fast food that people are consuming. In fact, one of the main studies that led me to start researching this book, because I was coming to it from public health where there was a lot of research around the disproportionality of fast food restaurants. We actually did a study in New York City, some colleagues and we published it in 2009, where we looked at how fast food was distributed across New York City's five boroughs. And restaurant density, we found, was due almost entirely to racial demographics. There's very little contribution from income. So, the percentage of Black residents was what was driving it. That was the biggest predictor of where fast food was located. It wasn't income, income made very little contribution and if you compared Black neighborhoods that were higher in income to those that were lower in income, they basically had about as much fast food exposure. Then if you compare them to white neighborhoods matched in income, Black neighborhoods still had more. So, it wasn't income, it was race. There are other areas that were high in fast food density like Midtown and downtown Manhattan where you have commercial and business districts, transportation hubs, tourist destinations. So, you expect fast food to be in these really dense and kind of busy commercial areas, but the only residential space that had comparable density were Black and brown neighborhoods. The assumption that many people have is that, okay, well if it's not income, then it's probably demand. So probably fast food is just dense in those neighborhoods because Black people eat so much fast food. But again, the data do not bear that out, not just in our study, but in others. And in fact, apart from the study we did specifically on fast food, we did another study where we looked at retail redlining for a number of different kinds of retail sectors. And again, demand is not what situates, you know, where stores are or are not. And then when I got to this project, just digging through the archives, you find that until the industry really went in on targeted advertising to increase the numbers of visits that Black people were making to fast food restaurants and the average check size that they were spending, Black consumers were mostly using fast food as a quick snack, it wasn't a primary place for meals. So it's really the case that the restaurants proceeded the demand and not the inverse. It is an absolutely fascinating picture. My guess is that what you've just said will probably come as a surprise to some people who are listening to this, not that fast food isn't dense in particular neighborhoods, but that it's particularly dense in neighborhoods by race just because people generally think that fast food is popular everywhere. So, let's talk about why this occurred and dive a little more deeply into what your book does and that's to provide a historical view on how and why this evolved. So, what did the early history look like and then what happened? So, the book traces what's basically a national story, but I focus particularly on certain cities like Chicago, New York and DC. But it's tracing how fast food changed racially and spatially from the early 1900's to the present. I break out that early history into what I call first and second-generation chains. So, they opened in urban and suburban areas respectively. The birth of the first generation fast food restaurants took place in what is termed the Nader of race relations in the US from the end of the Civil War to the 1930s. So, this is a time during which you see Plessy versus Ferguson, for example, ushering in legal segregation. Lynchings are at their worst. You have the destruction of Greenwood in Tulsa, Oklahoma. That's taking place and other notable incidents and forces that were undermining Black life at the time. It's during that context that the first generation restaurants are born. And so, these are burger chains like White Castle, that was the first actually big burger chain. People often assume it's McDonald's, but it's actually White Castle in 1921. And then there are knockoffs of White Castle, like White Tower and Little Tavern, which was an East coast brand. And then there were also other restaurants that were not burger chains, but more like hot shops was more of a sit-down restaurant. And then you had Horn and Hardart, the outlets where they had auto mats. So, you know, this was kind of high tech at the time, but you would go in and the food was behind little glass compartments and you would put in your requisite number of nickels and then take out your little plate of food. These were all the restaurants that I'm calling first generation restaurants. So, you had quite a bit of diversity in terms of what they were serving, but they were all in urban centers. They were not franchised. They were corporate owned outlets and most importantly everything about them was white, whether figuratively in terms of who dined and worked there or literally in the architecture and the design and the name like White Castle. That veneer of whiteness was doing two things. On the one hand, trying to offer the promise of pristine sanitary conditions because this is a time when food production was rife with concerns. And then also it's trying to promise a kind of unsullied social whiteness in the dining experience. So, first generation then leads to second generation fast food, which begins in the suburbs instead of the urban centers. Second generation fast food starts to grow in the early 1950s. These are the brand names that are most synonymous with fast food today: KFC, Burger King, McDonald's. So, for example, Ray Crock launches McDonald's as a franchise in the all white suburb of Des Plaines outside Chicago near O'Hare airport. And he set to fly over prospective sites looking for church steeples and schools, which to him were an indication of a middle class and stable community, but of course, racializing that as white. Because you could have Black neighborhoods with church steeples, but that was not where the restaurants were going. So, what ends up happening with second generation fast food is that it takes this theme of purity and shifts so that it's not just the purity of simple kind of fuel for the working man, but instead the purity of white domestic space. And where first-generation restaurants targeted working adults, the second went after families and children. Fast food then becomes more than just food - it's about fun. Those are the two key ways to think about the early history. One could obviously find many, many, many examples of different racial groups being excluded from the economic mainstream of the country. For example, areas of employment, and my guess is that being excluded from the marketing applied to consumer goods and lots of other things. But do you think there's something special about food in this context? Oh, that's a good question. It's interesting because fast food. It's food, but it's more than that the way that fast food initially excluded Black people. One of the things I talk about in the early part of the book is James Baldwin going to a restaurant and trying to order a burger and being rejected and facing discrimination. And the idea that it's not just that you can't get a burger, it's not the same thing as if you try to buy, I don't know, a ham sandwich or something. But like what burger means something more than that, right? It's bigger than a burger is Ella Baker said. Fast food is kind of like the closest thing we have to a national meal. It sort of occupies a special place in the heart of America and is symbolic of this quintessential all-American meal. And the notions of a good and simple life that we purportedly have in this country. So, it means more I think the way that fast food was positioned as something that was totally wrapped up in this exclusionary whiteness. Your book traces the long pathway that fast food traveled going from exclusion in the beginning and then later exploitation. Can you describe a couple of the key turning points? Well I would say that it wasn't like a light sort of got switched on that caused fast food to shift abruptly from utterly excluding Black people to then pursuing them full throttle the next day. It was quite a long and bumpy pathway and really American retailers in general have continually had to discover Black consumers and the fact that they exist over and over. And then sort of trying to think like, oh, how do we reach them? We don't understand them, like they're this enigma kind of thing. Fast food was doing the same kind of thing. There was both what the industry was doing and then there were also pull factors that were causing fast food to be drawn into Black communities as well. There are a lot of turning points, but I would say if you start fairly early in the history, a key one was after second generation fast food got going. Where suburban fast food right, is trying to position itself as this white utopia. But almost immediately that notion was fraught and unstable because concerns quickly arose around teenagers. They were money makers but they were also rowdy. Their behavior, hot rodding and goofing off in the parking lot and so on, was off-putting to the adult diners. So, it became this difficult kind of needle to thread of like how are we going to track this consumer segment that's foundational to the enterprise but do so under conditions that would keep them in line and not mess up the other potential revenue that we have going. As the kind of nuisance of fast foods became more pitched, municipalities began introducing ordinances to control fast food or even ban it. And that made the suburbs harder to get into or to maintain a foothold in. Corporations then start looking more at the cities that they were avoiding in the first place and the Black communities there that they had excluded. So that happens fairly early and then some other key turning points occur throughout the 1960s. Here we have urban renewal, you have urban rebellions taking place and during the late 1960s when these rebellions and uprisings were taking place, this is the time period when you get the first Black franchisees. Into the 1970s you have oil crises, then you have the burger and chicken wars as the industry called them in the 1980s. And this was referring to corporations battling each other for market share. So, all throughout the history there were different turning points that either accelerated the proliferation of fast food or sort of change the way the industry was looking at Black consumers and so on. Now in some discussions I've heard of this issue off and on over the years from people who have looked at the issue of targeted marketing who have talked about how there was a period of time and you made this clear, when Blacks were excluded from the marketing and they just weren't part of the overall picture of these restaurants. Then there was a movement for Blacks to be included more in the mainstream of American culture so that it was almost seen as an advance when they became included in the marketing. Black individuals were shown in the marketing and part of the iconic part of these restaurants. So that was seen as somewhat of a victory. What do you think of that? It's true and not true. I mean when fast food decided to finally start actually representing Black people in its marketing, I think that is important. I do think that the fact that they were finally making ads and conceiving of campaigns that saw Black people as part of the actual consumer base at which they were, yes, that that is important. But it's also the case that corporations are never doing anything for altruism. It's because they wanted to shore up their bottom line. So, for example, Burrell Advertising is the biggest African American ad shop based in Chicago. They get the McDonald's account and so they're the first ones to have a fast food restaurant account. They begin their campaign in 1971 and at that time, their advertising actually positioned Black families as regular people doing everything everybody else does and going to the restaurant and enjoying time together as a family and so on. And I think those kinds of images were important that they were creating them, but again, at the same time it was only the context in which Burrell got that account. The reasons why McDonald's was reaching out to Black consumers was because, again, in the early 1970s white suburbs were becoming more saturated, and McDonald's needing to expand. Then you have the oil crisis in which people are not driving as much, and Black people because of racism are centered in urban centers and not in the suburbs. So that makes a logical place for them to go and so on. So, it's not without its vexed context that those new advertising images and opportunities were taking place. Okay, thanks. I know that's a complicated topic, so I appreciate you addressing that. You know, something you mentioned just a few moments ago was that when Blacks started to become owners of franchises, can you expand on that a little bit and say what was the significance? Yes. First of all, cities were changing at that time. White residents were moving to the suburbs, multiple public and private policies were keeping the suburbs white and white residents were moving to white suburbs. So, Central City was changing, right? The neighborhoods that had been white before were now changing to become predominantly Black. And so, the fast food outlets that were located in those neighborhoods found their client base changing around them. And many of those operators, and indeed their corporate superiors, were uninterested in and uninformed about a Black consumer base at best and outwardly hostile at worst. You end up with as neighborhood racial transitions are taking place, white operators are now in communities they never meant to serve. Som as urban uprisings rack one city after another, Black franchisees are brought on kind of as a public face in these changing urban areas. The primary goal was to really have Black franchisees manage the racial risks that corporate was finding untenable. They realized that it wouldn't do to have white managers or franchise owners in these neighborhoods. So, they bring in Black franchisees to start making that transition. And then after fast food becomes more interested in trying to deliberately capture more Black spending, Black franchisees become even more important in that regard. For their part, the Black franchisees were seeking out fast food outlets as a financial instrument, right? This was a way to contest and break down unfair and pervasive exclusion from the country's resources. So, it was never about how much fast food we can possibly eat, right? Again, with the demand issue. So, Black franchisees are basically trying to get their part of the pie and then the federal government is heavily involved at this point because they start creating these different minority enterprise initiatives to grow Black small business. And so, it wasn't only the Black franchisees, but also Black franchisors who were starting their own chains. So, for example, former NFL Player Brady Keys started All Pro Chicken, as just one example. So, this idea of expanding fast food franchising to Black entrepreneurs who had been shut out on its face, seems like a laudable initiative. But again, it's like this is not just altruism and also the way that franchises were positioned in this kind of like you can get into business and do so in a way that's low risk because you know you don't have to start from scratch. You're buying into a thriving concern with name recognition and corporate support and all that. And all of that sounds good except you realize that in fact the franchisees are the ones who have to bear all the risk, not corporate. That's what the government was doing in terms of trying to put in all this money into franchising is really. It's like that's the response to the real life and death failures, for example, around policing, which was always at the heart of these uprisings. You have these real life and death concerns and then the government's responding with giving people access to fried chicken and burger outlets, which nobody was asking for really. Not only was the method problematic, but the execution as well. Just because Black people had more access to the franchises doesn't mean that the rest of the racism that was present, suddenly disappeared, right? The theoretical safety of a franchise didn't bear out in practice. Because of course they still couldn't get access to credit from lending institutions to launch their restaurants because they still didn't get support they needed from corporate, which in fact there are still lawsuits to this day by Black franchisees because the communities in which they're operating were still contending with deep inequality. All of that meant that that whole project was not likely to work very well. And you know, it's no surprise that it didn't. You mentioned chicken several times. In fact, there's a chapter in your book entitled Criminal Chickens. Can you tell us more? Yes, Criminal chicken is towards the end of the book. So, the book is organized in three parts. Part one is white utopias, part two is racial turnover, and part three is Black catastrophe. In each of those you see how Blackness is problematic, but in different ways. So Criminal Chicken is really dealing with the fact that by the 1990s, fast food had become pervasive in Black space and was thoroughly racialized as Black. And so, since fast food has saturated these neighborhoods, of course Black residents began to consume it more. With that, a program reigns down from the dominant society over Black people's alleged failure to control themselves and an assumed deviant predilection for unhealthy dietary behaviors, whether fast food, but also the same kind of discourse circulated around soul food. And the tenor of the discourse really raises W.E.B. DuBois's age-old question, which is how does it feel to be a problem? That was really the tenor of the conversation around fast food at that time. The chapters about the ways in which Black people's consumption was frequently characterized as deviant and interrogating the paradoxes around the symbolic meanings of fast food. Because like what we talked about earlier, Black people are basically being criticized for eating something that's supposedly at the heart of Americana. It's a kind of a no-win situation. On the one hand, certainly overseas, fast food continues to enjoy this kind of iconic status of America and American Burger and so on. Even within the country's borders it still retains some of that allure as something emblematic of American culture. But it's also now more fraught because, you know, we're in a moment where local and organic foods and so on are held in high esteem and fast food is the antithesis of that and it's industrial and mass produced and homogenized and has all these nutritional liabilities. So, basically, it's looking at the changing ideas around fast food and race and how that intersected with Black consumption. That's so interesting. I'd like to wrap up with a question, but I'd like to lead into that by reading two quotes from your book that I think are especially interesting. Here's the first. It is painfully logical that Black communities would first be excluded from a neighborhood resource when it was desirable and then become a repository once it was shunned. And then the second quote is this. The story of fast foods relationship to Black folks is a story about America itself. So, here's the question, are there ways that you can think of that fast food and food systems could be reconceptualized to help address issues of justice and equity? I would say that addressing justice inequity in food systems of which fast food is a part, is really about dealing with the other systems that govern our daily lives. Meaning, it's not an issue of trying to fix fast food, right? So, that is a discreet industry it behaves more equitably with communities because what it has done over the history that I trace in the book is it's not so unique in its practices and it also can't have taken the trajectory it did without intersecting with other institutional concerns. So, for example, housing is instructive because you know, of course you can't exploitatively target Black consumers unless residential segregation exists to concentrate them in space. And to do that, obviously you need a lot of different institutional policies and practices at play to produce that. And in a similar way, housing went from exclusion in the form of rank discrimination, resource hoarding, redlining, the denial of mortgages, all of that, to exploitation in the form of subprime lending. And Keeanga-Yamahtta Taylor talks about predatory inclusion and I type that in the book because I think it's also a useful way to think about fast food as well. So, if you're thinking about equity in food systems, then you have to think about why is it that resources including food, but also beyond food, in this country are distributed the way that they are. And I think you can't get at the issues of justice that play out for fast food or injustice without addressing the key issues that reverberate through it. And so that's false scarcities that are created by capitalism, the racism that undergirds urban policies around land use, around segregation, deeply ingrained ideas in the American psyche about race and but also about other things. So, for me really, reconceptualizing fast food is really reconceptualizing how we live in America.

Bio

Naa Oyo A. Kwate is Associate Professor, jointly appointed in the Department of Africana Studies and the Department of Human Ecology at Rutgers. A psychologist by training, she has wide ranging interests in racial inequality and African American health. Her research has centered primarily on the ways in which urban built environments reflect racial inequalities in the United States, and how racism directly and indirectly affects African American health. Kwate’s research has been funded by grants from the National Institutes of Health and the Robert Wood Johnson Foundation, and by fellowships from the Smithsonian Institution, among others. Prior to her first major book, White Burgers, Black Cash: Fast Food from Black Exclusion to Exploitation, she published the short work Burgers in Blackface: Anti-Black Restaurants Then and Now, which examines restaurants that deploy unapologetically racist logos, themes, and architecture; and edited The Street: A Photographic Field Guide to American Inequality, a visual taxonomy of inequality using Camden, NJ as a case study. Kwate has been a National Endowment for the Humanities Fellow at the Newberry Library, and has received fellowships from the Smithsonian Institution, the European Institutes for Advanced Studies, and elsewhere. She is currently writing a book investigating the impact of corner liquor stores in Black communities from 1950 to date.

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A growing number of research studies show that the cognitive and brain development of low-income children differs from that of children in higher income families. For any family, that is a concerning statement. Today's podcast features a project called Baby's First Years, a multi-year effort to test the connections between poverty reduction and brain development among very young children. Here to talk about what the study has revealed so far is Dr. Lisa Gennetian from Duke University's Sanford School of Public Policy, and Dr. Sarah Halpern-Meekin from the La Follette School of Public Affairs at the University of Wisconsin, Madison.

Transcript

Sarah, let's start with you. What is the Baby's First Years study?

Sarah - So the Baby's First Years study is a study of how having additional income matters for children's development and for family life in families that had incomes around the federal poverty line when they had a child. And so, it includes two main components. The first is a randomized control trial that tests the effects of families receiving either a large or a small monthly cash gift each month, families get either $333 or $20 each month on a debit card from the time their child was born until just after the child's sixth birthday. Lisa and our colleagues, Katherine Magnuson, Kimberly Noble, Greg Duncan, Hiro Yoshikawa, and Nathan Fox lead this part of the study. They've been following mothers and children from a thousand families over the past six years. The other part of the study is a qualitative study in which we do in-depth interviews with a subset of those families because we want to learn more about how they think, about making financial decisions, the values and dreams for their children that guide their parenting and how they think about their money they're getting from Baby's First Years each month. This study is complex and would require time to observe change. Can you tell me about the length of time your team has been doing this intervention? Sarah - So the first families started the study in 2018. Lisa - One thing that's unique about this intervention is its length. As Sarah mentioned, it's starts at the time of birth and it's monthly. And families will be receiving this cash for 76 months. So, they'll be receiving it through the first six years of their child's life. Thank you for that detail. Lisa, what is the landscape for food programs and assistance in the United States, particularly for families with infants and young children? Lisa - There are two major programs that are federally funded in the US that are particularly targeted for families with infants and children. One of them is called the Women, Infant, and Children's Program, or WIC for short. The WIC program, let's see, in 2022, served about 6.3 million participants, but it provides a mix of core nutritional needs, breastfeeding support, information and referrals. And the second big safety net program in the US around food is called SNAP, Supplemental Nutrition Assistance Program. This one's broader and has served over 40 million people in 2022. And together both these programs have been pretty core to providing food and nutritional support to families, including those with young children. Thanks for that context. So now, how does the cash gift intervention differ from, or fit with other food assistance programs that these families may participate in? Lisa - The thing that cash can add above and beyond that, so thinking about how this Baby's First Year study might help supplement resources is in two ways. One is thinking about how money that might have been spent on the foods that are provided by these programs are now being taken care of through these food subsidies. One direct way that the BFY cash money can help is by increasing those net resources available for other types of food or for other things in the household. It's a real compliment to these what we call in kind or conditioned kind of food subsidy programs. The second is that there are no conditions. And so, what WIC and SNAP provide, which is really formative and really important for a lot of families, is also has some real parameters on what could be purchased. And so having extra cash means sort more flexibility around direct food resources. And that's actually something we start to see a little bit in the Baby's First Year study. Wow, Lisa, thank you for that. Given that these are means-tested programs, the cash infusion from Baby's First Year's project could influence participants' eligibility for other programs, right? How did you deal with that? Lisa - Oh yes, it's a really great question. Thanks for asking that. For the purposes of this study, we, for several years, worked closely with all layers of government, federal, state, and local to think hard about how to protect the families receiving this cash gift from losing eligibility for these other programs because as you say, right, we're increasing their income implicitly through this cash gift. And so, we did that through some administrative rulings, meaning states agreed that the families would be exempt and to the states, we had legislation passed to protect these families from their eligibility being affected by receipt of the cash gift. We did that as comprehensively as possible. There are some exceptions, but we think that it's been pretty effective kind of strategy we use to ensure that families, when they get this cash gift, that they're not mechanically losing eligibility for these other programs. So, the way to think about this cash and supplementing people's lives and supplementing and accompanying everything else, is also helping how families might think about access to these other programs and choices around that in ways that they might not have had before. That sounds like a large undertaking, and it took extensive planning to get to that point. I imagine you wouldn't want families to lose their benefits because they participated in this study. Sarah, I want to come back to you. What are families’ experiences with Baby's First Year and with government-provided food assistance programs in the United States? Sarah - So families in both gift groups are appreciative of having extra money every month. That's even more so the case for those in the high gift group mothers not surprisingly, some mothers in Baby's First Year struggle to make ends meet, for others, even if they can cover their bills every month, having just that little bit extra breathing room is pretty welcome. Like Lisa was talking about across the country, in Baby's First Years, the vast majority of families have experience with food assistance programs, either currently or in the past. It's pretty rare for them not to, relatively speaking, while families often receive WIC, that's the Women, Infants and Children program that Lisa mentioned, when they have babies, many stop getting WIC after their babies turn one, despite the fact that they remain income eligible for that. Most families also receive some benefits from SNAP. And in some qualitative work that I did with my colleagues, Carolyn Barnes and Jill Hoiding, we heard from families about how they thought about engaging with the WIC program. They thought about the value of the benefits they could get from doing so, but also the costs of doing that, like how hard it is to make it to appointments, to fill out the paperwork to use those benefits once you're at the grocery store. And they weighed those costs and benefits as their children grew up when they were thinking about whether or not to pursue those benefits. So Lisa, what are you learning from the Baby's First Year study about where and how families and children are getting food? Lisa - So Sarah has talked about the richness of speaking to moms directly at holistic types of interviews. Alongside that, we've annually been going back and speaking to mothers and collecting information about them and their children. And part of our, so these are our annual surveys, they are in or near the children's birthdate, and we ask them a bunch of questions about how life is going, about their spending, what's happening with income and employment and childcare, their own health, their mental health. One of the areas that we focus on is around food. And one of those food items is called a food security scale. This is a six item, a USDA-approved scale. It asks questions like not having enough money to buy food, questions about hunger, questions about eating balanced meals. It includes a set of items that we would call pretty subjective. For example, the question on balanced meals, but also less subjective. Is there literally enough money to buy enough food for the household? And so, we're learning some really interesting things. First, we're learning that there is very high connection to this food safety net that we were just talking about. So, far majority of the families are connected either to WIC or the food assistance program called SNAP. And that's pretty consistent. Sarah just talked about a little bit of the drop off of WIC, but we certainly see consistent connections to SNAP, all the way through the first three years of the child's life. We see that generally as sort of a kind of good news story. So, these are families who are eligible for these programs, their family's drawn from four very different dates and sites. They're very diverse in their racial ethnic composition and whether they've been born or not in the US in terms of the moms. The fact that there is very high connection to a food safety net system while raising young children, we think is a really positive signal of the food safety net system potentially working pretty well. And then we're not seeing big differences between the high cash gift group and the low cash gift group on this food security measure. In fact, we're seeing pretty high food security amongst these families with very young children on the scale. That doesn't mean that any one of these items, we're not seeing high reports of things like scarcity. So even though the families are very low in food insecurity, we do see that about a third of them are reporting some kind of food scarcity. So, 31% report that the food they bought did not last and they sometimes often didn't have money to get more. For example, we're also hearing from families, they're relying on free meals from non-federal sources. We haven't talked yet about the importance of the faith-based kind of system and support and informal networks in providing food. We ask families this when their children were about three years old, and roughly 10% report some receipt of free meals from other sources. We are inevitably also seeing, as you might expect, some variation across these sites. So that's sort of a hint on what we're seeing around food security and connections to the safety net. We also ask about spending, and we're not seeing overall differences in how much money is being spent on food with one very interesting exception. That's on money, on food spent eating out. We don't ask a whole bunch of information about nutrition, but when the children were toddlers, moms do report, who are receiving the high cash gift, they do report higher consumption of fruits and vegetables among their toddlers. It is a very sort of unique and narrow question, but positive, so more fruits and vegetables and not more of other things like salty treats, flavored drinks, sodas, sugary sweets. And we're looking forward to continuing to follow up on items of nutrition when the children are four. This is fascinating, and I'm so grateful that your team is paying attention to these families' experiences and engagement with the social safety net and the charitable food sector. Sarah, we often understand food, particularly healthy food, as a way to deliver nutrition that promotes health and development. Of course, food provides much more than nutrition. What, if anything, are you learning from the study about the social meaning of food and what it represents to families? Sarah - I really appreciate this question because it's something we've been looking at and thinking about a lot in our research, in the research other people have done before, and in our own study we really hear a lot about the role that food plays in families, beyond nutrition. In so many cultures, food plays a really core role in social time and in family time. This can be things like turning family movie night into something a little more special by microwaving popcorn. It can be having special mom and me time with mom taking a child out to go get a cake pop at a coffee shop. It can be eating a meal at a sit-down restaurant to celebrate a special occasion, a child's middle school graduation, for some of these purchases, you can't use food assistance. And so having cash on hand is really essential to engaging in these kinds of special rituals and family time. Like your question implies, it turns our attention to the role that food plays in family bonding and in socializing. We really want to think about the multiple roles that food serves in our lives and how having this kind of extra income on hand for families who are often income constrained, can change these opportunities for those special family times around food.

Bios

Dr. Lisa Gennetian is an applied economist, Professor of Public Policy, and the Pritzker Professor of Early Learning Policy Studies at Duke University’s Sanford School of Public Policy. Drawing on perspectives from the behavioral sciences, psychology, and child development, her research focuses on the economics of child development, specifically child poverty, parent engagement and decision making, and policy and social investment considerations.

Dr. Sarah Halpern-Meekin is Vaughn Bascom Professor of Children, Family, and Community in the School of Human Ecology and the La Follette School of Public Affairs at the University of Wisconsin-Madison. She is also an affiliate of the Institute for Research on Poverty. She is a sociologist whose research focuses on family, adolescence, social policy and the welfare state, class and inequality, and qualitative methods. Her current research includes examining the role of parents’ churning (on-again/off-again) relationships in family life, exploring the experiences and financial decision-making of mothers who are receiving monthly unconditional cash gifts, and understanding how rural men make ends meet, spend their time, and make meaning while disconnected from the formal labor force.

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Today's podcast is a story of one man's personal journey to making a difference by building communities. Zach Wyatt grew up caretaking an old 300-acre farm in Virginia. He went to college and ended up working in mortgage lending. And then something changed for Zack, and that's where the story gets interesting. He now leads the Carolina Farm Trust, working to strengthen local food systems in the Carolinas. The trust cultivates urban farm networks, farm apprenticeships, supports local farmers in purchasing equipment or land, making informed-decisions, and more.

Interview Summary I'd like to understand a little bit more, why did you want to start the Carolina Farm Trust? Well, with a lot of things, it was just kind of by accident and circumstance. And I would say subconsciously I had agriculture in my bones, ever since I was a kid growing up in agriculture in Northern Virginia. It just kind of seeps in. We [The Family] still have that little arm reached out to being a part the DC metro area. Growing up in an urban-rural environment kind of planted, I think, a lot of the seeds in the work that was going to transpire so many decades later. But it really just kind of came down to a life event. I had a partnership that just ended in one day, which was a huge blow to us financially. We had to get on EBT and Snap and went through that process. And I was really soul searching and figuring out what were the next steps for me. Looking back on it, I think I was really grasping on to how do I do anything, to kind of just do something. I got back into reading about our food system and farms and started meeting some farmers. And once you start talking to farmers in a real way and understanding what our food system truly is, it's horrifying. It kind of came down to seeing this visual metaphor of a meteorite heading toward us every day, and either sticking your head in the sand or doing something. Circumstance just led to this next event and next event, and the next event. And eight years later, here we are. What I hear from you is this story of resiliency and it seems like that's something you also see in the food system or a need for that is that a fair assessment?

Absolutely. We just take food in agriculture for granted. And over the last 80 to 90 years, we've really given our entire means of survival pretty much away. Most people don't really look at food and agriculture and how it spins every major decision on Earth. Every social problem we typically have, every health issue we have, if you follow it all the way down to where that problem started, you go all the way back to the dirt. So, to kind of look at resilience and what do we mean by that and more importantly, building regional resilience in a global economy: I think getting supply chains a whole lot shorter, focusing on soil health and nutrition density and our farming community, is where we really have to start. I'm starting to get a sense of the big picture of the farm trust. What is the driving mission of your work? I think you're hitting on some of that, but I'd like to hear more. I'd say the vision is very clearly about building regional resilience and then using food and agriculture as a primary driver. The four main pillars we have are health and nutrition, upward mobility and equity, sustainability, and climate change. Our four action-on-the-ground pillars are first, building an urban farm network and to get people to understand where our food comes from. Why is that important? We do really need to push urban centers to be more responsible for where our food comes from and playing a role in that. Second, our farm apprentice program, workforce development. You know, the average age of our farming community right now is a little over 60. Where is this next generation of farmers coming from? Where is the land coming from? So, it is not only kind of a labor force for us, you know, but how do we make sure every community garden, every school garden is thriving? How do we create teams that can go help our rural farming community with different projects or step in when someone gets sick or an emergency? Third, when we think of food as health, what does that really mean? If we're talking about food as medicine, in my opinion, we've already missed the boat. We got to talk about food as health, we got to talk about prevention. How do community health workers get out in communities covering geographic locations, really understanding what those needs are and how do we create systems to go meet them where they are. And then our fourth pillar is our distribution platform, which is really there to give a profitable revenue stream to our farming community. How do we use economics to really push them to start their regenerative farming journey? And then how internally to create supply chains that not only can work with consumers, you know, up and down the socioeconomic ladder, but how do we make sure we can build supply chains for larger institutions to be able to participate in a local food economy because the infrastructure is just not there. I was struck by your earlier comment of if you get down to the, if you will, root cause of any problem, and forgive the pun, it seems like it's in the dirt. Right? And I'd like to hear you explain a little bit more about what you believe is what's wrong with the food system as it is today. And I got a sense it's about the lack of being local, but I want to hear it in your words and how does this guide your actions now?

Well, it's just evolution. I mean we always try to get better. We wanted to make food cheaper, so we went from hundreds of farms and rapid consolidation over the years. We have processed and now ultra-processed food, and we have to deal with slavery and reconstruction and everything that kind of came with it with such as sharecropping from a social standpoint. We're looking at nutrition density and in average produce and protein sources we're almost 30 to 6% less than what it was 100 years ago. We're looking at climate change, sustainability. Where does that come from? Look at the carbon footprint, our agriculture industry puts on the planet, look at the massive consolidation of looking at if the world gets 40% of its grain from Ukraine, and then having different political and social issues come up. I include inflation spikes. We're looking at carbon sequestration, we're looking at no-till, we're looking at all these big environmental and all these sustainability and allergies and cancers. And so, where does all that come from? It comes from our environment. Looking through all of this, you can very much see parallels of how our food system started to consolidate and get more aggregated with all the other problems I just mentioned. And if you look at 1930, 1940, and then going from there, you can very much see kind of a parallel with a lot of the challenges that we face. So, I think we really spent a lot of time trying to kind of cherry pick among all these really big problems. We're trying to cherry pick smaller problems because they seem a little bit more manageable, but we really have to go rethink the system as a whole. And that's really, really hard to do. What we're really trying to push forward is how do we just look at a region, because I really feel like you have to do this from a regional perspective. How do we get a regional model to work, really go rebuild all that infrastructure, get, buy-in, understanding what the data's telling us, and then we can replicate that going forward to really other regions around the world. This is very helpful and I appreciate the way you approach that question. Seeing that there are these large global issues and there are structural challenges when we talk about agriculture - and you're working in the region, my understanding, you're out of West Charlotte - and there's a distribution center. Can you tell us a little bit more about what you're doing in West Charlotte, especially through this distribution center? It became very clear that our farming community needed a market. Farmer's markets are tough. As consumers, some of us love them, some of us don't pay attention to them. But for our farming community, farmer's markets are really hard. And from a wholesale standpoint, it's very hard for Carolina farmers to compete with Mexico, California, Florida. How do you compete regionally on a global market? So, we had a distribution model planned for a while and in my head, I wanted it to be in West Charlotte and it needed to be near I-85. We wanted it to be in a community because this kind of distribution facility would be an employment place and we would have a real retail concept. We wanted a meat processing butchery component. So, it was kind of putting a lot of pie in the sky visions into one parcel. But one of our strategic advisors in 2021 was at coffee, talking to a friend about Carolina Farm Trust and kind of what our needs were. One of them said, "Oh, my family has this warehouse," So we took a look at it, and it met every criterion we could have dreamed of. The only thing that was different was that I was thinking in my head we would want like 100,000, 200,000 square feet and this one was 25,000 square feet. But the moment I looked at it, I realized this is the exact size or the range that we need because of the community impact. We want more of these not one or two, you know, that are gathered around. This being in the community was such a key factor to it. So, with our wholesale operation, our commercial kitchen, the retail, the event space, the meat processing butchery component of it all, we really could start to see this framework of getting kind of an independent food system together. So, we're working on phase one, which is our wholesale operation and our 3000 square foot commercial which should come online, you know, in the next six weeks. And then we're just waiting on permitting for phase two and fundraising on phase two to get that activated. It's a really cool project and we're really excited to see it to come to fruition here in the next few weeks. This is really fascinating. You know, I haven't asked this, but I'm intrigued. Tell me a little bit about the farmers that you work with. What kinds of produce or crops are they or animals are they producing? I mean, how are you developing those relationships?

Over the course of the years we've met a lot of different farmers and we grow everything that we can grow here in the Carolinas. We're talking greens and obviously tomatoes and melons and corn. We're working with our grain farmers who are growing wheat for us and grinding flour that we're actually getting into a hotel right now in Uptown Charlotte, which is really exciting. Cattle, pork, lamb. And really looking to create markets for our farming community in any way that we can. So right now, Michael Bowling, our general manager of CFT Market, which is the name of our distribution facility, he and his team are going all over the state and finding arms that we've never heard of and getting recommendations and compiling our list. A big part of what we're trying to put together is how we can take the burden on some things like transportation, because it's such a margin killer, and such a challenge for our farming communities. How do we get amazing produce from the east, you know, into Charlotte and the West, into Charlotte. So, we're working on getting a fleet of vehicles right now to do that. So, it's really just trying to find all of the barriers that our farming community faces, and then how do we create the infrastructure systems. I want to end by asking sort of what are your hopes? Like what is the long game? Where do you see your work and the work of those who will follow you? Where does it lead? Well, I think you have to be very naive to think this way. And sometimes, being naive isn't a bad thing because if you do too much research, then you think your way out of doing what you should be doing. So really, the long game is trying to change the entire industry. But it's so much more than that because our food and Ag is health. It IS our health industry, you know, and obviously it's our food industry. But it's also going to play a huge role in saving not our planet for the planet's sake but saving the planet for our sake. You know, it's just critical. So, I mean, really we're wanting to really follow in Netflix footsteps. Netflix came in and changed the entire entertainment industry relatively quickly. We're looking at automotive legacy manufacturers that weren't getting electric vehicles fast enough. So, Tesla came in and disrupted that. Now suddenly, everybody's moving in that direction. So really at our core, we want to take market share and drive our industry partners to focus more on this work. That is really the long game. For us, it's how do we build the foundation? I know I'm never really going to see it, but how do we build this foundation for the next generation of leadership to really get it going on what we've been able to build in this short time. Bio

Zack Wyatt is the President/CEO of Carolina Farm Trust. Zack grew up tending to a 300-acre dairy farm in northern Virginia. After graduating from Coastal Carolina University in 2003 with a degree in Business Administration, he worked in home mortgage lending and IT. Zack’s passion for bringing the community together over food, his understanding of the importance of equitable food access, and his drive to improve local food systems led him to develop Carolina Farm Trust in 2015.

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If people knew how much food they threw away each week, would they change their food-wasting ways? That's a question scientists explore in the 2023 State of Food Waste in America report. The research goal was to understand why and how households waste food, and what would motivate them to prevent food waste. In today's podcast, we'll talk with MITRE scientists Laura Leets and Grace Mika, members of a team who developed and launched the MITRE Food Waste Tracker app. This is a first of its kind app for households to log information about discarded food and learn ways to save money by reducing food waste. The Food Waste in America study team includes the Gallup Survey Company, researchers from the Ohio State University, the Harvard Law and Policy Clinic, ReFED, the Natural Resources Defense Council, and the World Wildlife Fund.

Interview Summary

Laura, let's begin with you. Can you give us a quick overview of why MITRE focused on measuring food waste at the household level and the behaviors? Laura - In a general sense, Norbert, we know the United States waste 30 to 40% of our food, yet we do not know how much is wasted at the household level. We know that waste occurs along the entire farm to table supply chain, like approximately 15% with farms, 15% at manufacturing, about 20% at stores and restaurants and about 50% in the household. So, given that half the waste happens at the household level, it's important to measure it. If you can measure it, you can do something about it. Up to this point, people have not had an easy way to estimate their amount of food waste. So, to address this gap, not only did we develop a new way to measure household food waste and Grace will share more about that, but we also provided a baseline measurement of American household food waste. I would like to really dig in a little bit more. How much food do American households waste, and do you have a sense of what kinds of foods people are wasting? Laura - Let me start with the amount first. We found that the average American household wastes somewhere from 3 to 4.5 pounds per week. And there's two ways to measure household food waste. The first is you can focus on the edible or uneaten food. And with this measure, American households waste about on average three pounds per week. Second, you can add inedible food. So, that's your food scraps, your eggshells. And if you take edible plus inedible food together, then the American households wastes on average about 4.5 pounds per week. Let me give your listeners a couple analogies to understand that impact of that 3 to 4.5 pounds of household food waste. So, let's say we combine our own household food waste with everyone else's. The crop waste is large enough to cover the states of California and New York. From a personal perspective, imagine before every meal you scrape off 40% of the food on your plate. If you imagine that in each meal, you're going to start to understand that the current food waste is massive, and we're all contributing to it. So that's the measurement piece. I'm going to pass it over to Grace to discuss the types of food we're wasting. Grace - Americans are wasting a wide variety of foods in their homes, but the number one wasted food type is your fresh produce. So, that would be your fruits and your vegetables. I think this is really important to keep in mind, not only because, of course, fruits and vegetables are perishable, but when we think about healthy diets, many people in the nutrition space are encouraging fresh fruits and vegetables or fruits and vegetables in general. Ao this is a really important finding, and I'm excited to know this. But it's also important for our listeners to think a little bit more about this. Grace, I would like to learn a little bit more from you. Can you tell us more about the MITRE Food Waste Tracker, the app itself? Grace - I would be happy to. The MITRE Food Waste Tracker app is meant to be a tool for households who want to understand exactly what's going uneaten in their home. If you had asked me what exactly I ate yesterday and how much of that went into my trash can, I would have a really difficult time remembering an answer to that question. And that's for just yesterday, let alone multiple days or weeks ago. Not knowing what exactly goes uneaten would make it really challenging for me to cut back on that waste. So, to solve that problem, our team designed an app which allows for food waste to be logged in real-time. So, right as you're doing your meal prep or you're clearing off the dinner dishes or emptying your leftovers out from the fridge. And the app tracks details both about the food itself, like where you got that from and the food group that it belongs to, as well as where, why, and how the food was thrown away.

And you can also track how much waste was produced, and we encourage you to use your hand as a guide to estimate the volume of that waste. So, your closed fist is about the size of a cup of food and your thumb about the size of a tablespoon. The more that you use the app to track, the more you will reveal patterns in the way that you waste. Maybe you find out that you're optimistically shopping for vegetables that your toddlers at home are just not interested in eating. Or maybe you're serving up heaping platefuls at dinner time, but then find that you're not hungry to finish that meal. So learning this will empower you to make small changes in the way that you shop for, prepare and store food to make sure that as little as possible is going to waste.

And if you're money-minded like many Americans are, you might be especially interested in an app feature which estimates the cost savings that you would experience if you cut back on your waste. So less food in the trash means more money in your wallet and the savings really add up. The average American family spends over $1,500 on wasted food each year. And tracking with the app is fast and simple. For each food that you dispose, you would simply click on the icons that best describe your waste. It would be really easy to get the whole family, even your your kids involved in tracking and thinking about the food that's going into the bin. You've already touched on a few of these key findings about sort of the top foods that we end up wasting. Are there other findings that you would like to share with us? Grace - So there are two behaviors that really stood out when it came to producing food waste. The first is simply being willing to eat your leftovers. Personally, I get really excited about leftover nights. It means I get a good home cooked meal with almost no prep work that evening. A lot of us are already doing this. About a third of Americans incorporate leftovers into new dishes and about half of us frequently eat leftovers just as a meal by themselves. Those leftovers add up. We found that households who consistently throw their leftovers away are wasting nearly four times as much as households that eat those up. We also found that households' understanding of and behavior around date labels plays a significant role in their levels of waste. A lot of us don't really understand how little date labels actually mean, and how little they're standardized. Not too long ago I was cooking with a friend, and we were making dinner together and he smelled a bag of shredded cheese and he said, "Oh, this smells kind of funky, but it's not past his date." And he added it into the dish. You should actually be doing the exact opposite of that. You should trust your senses over the date label when it seems that something is spoiling. There are some dates that are meant to be safety indications, but the majority are just a manufacturer's best guess of when food will pass its peak quality. And frequently, thrown away past date food that has no signs of spoilage so this leads to wasting over twice as much food. It can be easy to feel helpless when it comes to wasting food, but it's surprisingly simple to take control over your waste As we mentioned before, if you're curious about what sorts of behaviors are leading to waste in your own home, we have an app for that. So, our latest version of the app has new features to help you understand your waste and even get a sense of how much money you could be saving if you cut back on your waste in your home. I highly encourage you to check that out. I’ve got to say I have done some work on date labels and have found this is an important area of consideration. But also, one where the modification of those date labels may actually help reduce food waste. I'm so happy to hear you talk about the sort of broader set of things that consumers can do to actually mitigate food waste in the household. You got into some of my own personal family issues around what do we do about leftovers, and I will not report this conversation to my family. So, thank you for that, Grace. Laura, I want to go back to you and ask about a big picture question. Why should our listeners reduce their household food waste? Laura - Norbert, I believe I can make a compelling case for that. This is a rare opportunity when making a small change can have a large positive impact. Let me explain the amazing cascading ripple effect that happens when we reduce our household food waste. We had Grace reminding us with the app, and the first benefit is financial. An average American household can save at least $1,500 a year or $125 a month by reducing food waste. So just focus on that personal financial benefit, and then understand the resulting ripple effects. That first ripple effect is going to impact the ecology. Most of us don't realize significant resources go into producing food. The USDA reminds us that 50% of our land in America is used for food production and 80% of our water is used to produce that food. When we reduce our food waste, we're recognizing food as this precious resource, and we are supporting our food production industry. This is really important because America is one of the top food producers in the world.

The next ripple effect impacts food security. Food security is part of national security. When you reduce your household food waste, you are also supporting national security. Next is a societal impact. Reducing food waste allows us to optimize our food and feed more people. And, finally, there is a significant environmental benefit. The number one substance going into our landfills is food waste. As it decomposes, it emits greenhouse gases that cause this pollution blanket to surround the planet. That pollution blanket traps heat and warms the planet. So, when we reduce our food waste, it's one of the top three activities we can do to reduce warming temperatures and extreme weather events. We all have the ability to combat climate change through our household food waste. These small changes in our food waste - they're going to result in positive financial, societal, and environmental benefits. It's such a powerful, impactful decision to reassess your food waste and think about ways you can reduce it.

Bios

Dr. Laura Leets is an accomplished researcher, teacher, and mentor. She brings 30 years of experience from academic and industry environments. She currently serves as an innovation lead and senior principal scientist at MITRE. In this leadership capacity, she works with researchers to identify, shape and conduct important, transformative, and impactful projects for government sponsors and the nation. She also serves as an adjunct professor at Georgetown University’s Communication, Culture, and Technology Program and previously spent a decade as a Professor of Communication at Stanford University. She has been recognized with several top paper and teaching awards throughout her academic career.

Grace Mika, B.S., is a data scientist in MITRE’s Modeling & Analysis Innovation Center, where she has worked on projects for the Center of Disease Control, Internal Revenue Service, Veterans Benefits Association, and the Office of the Undersecretary of Defense, Acquisitions & Sustainment. She is passionate about visualizing data in a clear, accurate, and accessible way. Grace was instrumental in the design of a first-of-its-kind Food Waste Tracker App, which allows users to track waste as it occurs within their homes. Grace holds a B.S. in Applied Math and Psychology from the College of William & Mary and is currently working towards her Masters of Analytics at Georgia Institute of Technology.

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Dollar stores are the fastest growing food retailer in the United States, both by sheer number of stores and consumer food purchases. Just two corporations, Dollar General and Dollar Tree, which also owns Family Dollar, operate more than 35,000 stores across the country. However, a growing body of research reveals that dollar stores offer limited healthy food options. Dollar stores shape the food environments of communities, especially in the South and Midwest regions and communities in rural areas with substantial shares of Black and Latin people and households with limited financial resources. What do we know about the impact dollar stores have on these communities and the overall wellbeing of community members? The Center for Science in the Public Interest conducted a national survey to understand how people perceive and actually use dollar stores. Today we will talk with lead author of this study, Senior Policy Scientist Sara John.

Interview Summary My first question is what do we know about dollar stores and healthy food access? There are more than 35,000-dollar stores across the country. So, to put that large number into context for people like me who have trouble processing them, that's more dollar stores than McDonald's, Starbucks and Walmarts combined. As you also mentioned, just two companies, Dollar General and Dollar Tree, control nearly all of them. Dollar stores really play a large role in food acquisitions for households. They can be especially important for households with limited incomes and those living in rural communities. These smaller store formats are much smaller than your typical grocery store or supermarket and tend to stock fewer fresh and healthy items. So, the body of evidence is still growing and we're still trying to figure out really how dollar stores interact with the food environment, whether or not they're driving out existing or potential new grocery stores or whether they're filling important food gaps in communities that otherwise lack food access. I am really blown away by the number. I must admit I did not appreciate that they have 35,000 stores across the US. I know that there is a growing body of literature, as you suggested. One of our colleagues, Sean Cash at Tufts has been working in this space along with others in various disciplines have been thinking about the role of dollar stores. I'm interested to understand why CSPI conducted a national survey of those or perceptions, and what were some of the key findings? As I mentioned, there's a lot of outstanding questions we still don't know. There have been more than 50 communities across the country that have already passed policies at the local level to ban or improve new dollar stores in their communities. But we don't understand community perceptions, usage and just I guess more plainly what people want from dollar stores. So, CSPI really wanted to take a stance to make policy, corporate, and research recommendations on this very quickly and growing retail format. But before doing so, we wanted to really make sure that we're centering our recommendations around what community members really want from dollar stores. We decided to conduct a national survey. We ended up having over 750 respondents from across the country of people with limited financial resources that lived near a dollar store. I have to say we were pretty surprised by our findings, especially given this popular sentiment that we have seen in the news media and with a lot of the local policy action. I would say that we found overall positive dollar store perceptions that people really are relying on dollar stores for food. But I would say just as many people want them to make healthy foods more available, affordable, and accessible. Could you help me understand how did people find them beneficial? What were some of the things that you discovered, in terms of the benefits? But I'd like to also hear what were the points of contention? Where did they want some difference? Community members had overall positive perceptions. I think there was about 82% of the survey respondents said that dollar stores helped their community rather than harmed it. And a lot of the key things that came up in the qualitative responses in our survey and the focus groups that we used to inform the survey was this overarching multifaceted concept of convenience. People said things like the store proximity, that they didn't have to walk a mile within the store itself to get to milk, and just an overall quick shopping trip. They also mentioned the affordability of products there. You know, not having to say no when shopping with their kids to something that's on the shelf. And then also a selection of specialty items - a lot of like different seasonal fare and things. Even using the phrase "thinking of the dollar stores as like going on a treasure hunt." You never quite know what's going to be there on the shelves. However, as you mentioned, there was also many deterrents listed for dollar stores as well. Things they could do better. So, low quality of products, the lack of predictable product availability, sometimes having bare shelves or not enough store supervision to be able to keep those shelves stocked. And also, the store appearance, both inside and out. Things like graffiti, trash, cluttered aisles. Those are all things that people that both shopped and did not shop at dollar stores noted in the survey. And all of this also kind of leads to another key theme that I mentioned at an overarching level, that people really wanted dollar stores to do more in terms of making healthy foods more accessible to them. So, 81% of our survey respondents thought dollar stores should stock more healthy items, and nearly as many thought they should do more to market and identify healthy options. We also included a list of more specific interventions of things that dollar stores could do to make healthy products more available, accessible, and affordable and one of the top responses was to provide SNAP fruit and vegetable discounts, kind of as one might see in like a Schumacher Nutrition Incentive Program at dollar stores as well. I'm really intrigued by something you all did in the survey. You looked at differences, particularly between SNAP participants and those who potentially are SNAP eligible, but non-participants. Are there any key findings you want to highlight about differences between those two groups?

Yes. Many respondents generally mentioned being able to stretch their budget at the dollar store and this included more SNAP participants purchasing more food with their SNAP benefits at dollar stores. So, this was across many healthy food categories. We also saw SNAP participants felt more strongly that dollar stores should be held more accountable for the health of their communities as well. This is really fascinating. These findings are part of what leads you to some of the key policy recommendations. I'd be interested to understand a little bit more about what are the policies that you all thought should be considered or corporate response and even research action based on these findings. I'll highlight just a few. You know the first one at the federal level is strengthening SNAP retailer stocking standards. So, the vast majority of dollar stores do participate in the SNAP program and currently SNAP authorized retailers are required to stock a small number of items. So, three varieties of items across four different categories. However, if the SNAP program did have stronger stocking standards that better aligned with nutrition promoting foods like in the Dietary Guidelines for Americans, then all SNAP authorized retailers including dollar stores, would be required to stock more healthy items to participate in the program. Which is of course a huge benefit to the community. But also, a really important part of the business model of SNAP authorized retailers including dollar stores. At the local level, I already mentioned that more than 50 communities across the country have passed local policies, mostly to stop the spread of dollar stores such as through dollar store density ordinances. These look like saying a new dollar store can't locate within, let's say an existing mile, of a current dollar store. However, these policies are really only getting at new dollar stores and don't really do anything to address the existing 35,000. We also see an opportunity to strengthen and improve upon these existing policies and address what we found in the survey that community members want by requiring dollar stores to stock healthier food, make it more available, such as through healthy stocking standards or healthy food overlays in the local zoning code or even exempting dollar stores from these dispersal limits if they do stock a specific variety or number of healthy staple foods. At the corporate level, we're hopeful that this survey and its results make the business case to dollar stores for stocking healthier foods, making them more widely available. We've seen already actually both Dollar General and Dollar Tree moving in this direction. Dollar General, especially. I think about 16% of their current stores now do offer fresh produce. So, they're building out their supply chain, their distribution centers, and I would say retrofitting and redesigning stores to be able to make more fresh and healthy foods available. But we think they can do more, and especially do more in terms of prioritizing fresh food expansion in areas with lower incomes and limited food access. Many of these dollar store models started by locating in rural areas. We think if they could really leverage their ubiquity and where they're currently located to spread healthy food access to those communities especially, it could make a really big difference. We also have seen dollar stores in recent years put out public environmental social governance or ESG priorities. We think that these should be expanded and really prioritize healthy food access and nutrition goals. And one more thing I'll say around corporate recommendations is the expansion of the Special Supplemental Nutrition Program for Women Infants and Children or WIC authorization of dollar stores. Currently, based on our scan of the current list of WIC authorized retailers, there are no corporate dollar stores that are currently WIC authorized. By participating in WIC, and by adhering to those much more rigorous healthy stocking standards, it could do a lot to make a variety of healthy product, fresh produce, whole grains, dairy, baby food, formula more accessible to moms and kids. I have to ask this question as a researcher, what are some important questions that the survey really prompted you to think more about or would like to have others come in and support research in this area? There are so many. As I mentioned, the evidence in this space is really nascent, but is growing. So, one thing I would highlight is that we really are proud of this survey and its national scope. However, the survey doesn't reflect all communities and their desires and wishes. And so we hope that this survey could be used as a model and could be replicated in local communities to inform local policy and corporate intervention. We also think there's a lot to still do to better understand the current dollar store food environment. There have been some studies that have been done at small scale in some states and localities, but we think that current instruments could be better adapted and specifically tailored to the dollar store environment to better understand them and their variation across the country. Especially as we start to see this shift in corporate practices. There is a lot of, again, variation in terms of different dollar stores and what they're offering. We also really hope that we could see dollar store corporations, and maybe this is overly ambitious, but to collaborate with researchers to better understand what corporations already know, to better lift up what challenges are associated with increasing the stock and availability of healthier foods. We know that cost space and supply chain complexities, this is not an easy solution, and so how can researchers work together with corporate dollar stores to figure this out. Also, we'd be really interested in piloting healthy food marketing interventions, thinking about how this shift in healthy product placement, price and promotion might be impacting customer purchases, customer food consumption, and ultimately health. Wow, this is a great set of ways for a variety of researchers to come in. It sounds like not only could academics do some of this work, but it sounds like there may even be space for citizen scientists to come in and look at what's going on in the food environments where they are to help inform that conversation. I think this is really fascinating. What's next for CSPI's work on dollar stores. CSPI really hopes to be able to support efforts to advance the recommendations we've made in this report. At least one I'll highlight that we've already started to work on, is we just launched a corporate campaign; Don't Discount Families, Dollar General. Really pressuring Dollar General to improve healthy food access at their stores through these WIC expansion efforts that I referenced earlier. So, making sure that dollar stores expand their healthy food offerings by adhering to those more rigorous WIC stocking standard requirements. Making those foods both available and more accessible to moms and kids participating in WIC. You know, that includes fresh, frozen, canned produce, whole grains, dairy, healthy pantry staples, baby food and formula, but also in doing so makes healthy foods more available for any customer that walks through a WIC authorized Dollar store. I would mention that in ways that you can get involved, please feel free to reach out to me if you're doing aligned work in this space. We also have a petition that consumers can sign onto, and we already have generated over 7,000 emails to Dollar General and that number is still ticking, so please join our coordinated advocacy efforts and we also working on a sign-on letter in terms of coalition building to get organizations and researchers who are supporting healthy food access through dollar stores. So, I encourage everyone to check out our resources and again, please be in contact if you have any questions. Bio

Sara John is a Senior Policy Scientist at the Center for Science in Public Interest and leads the organization’s federal policy and private sector efforts to create a healthier, more equitable food retail environment. Prior to joining CSPI, Sara served as the Evaluation Director for SNAP incentive programs across New England and worked at the Partnership for a Healthier America. She has a PhD in Food Policy and Applied Nutrition from Tufts Friedman School, an MS in Education from Johns Hopkins University, and a BS in Biology and BA in Public Policy from University of North Carolina at Chapel Hill.

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How did the Nutrition Facts label come to appear on millions of food products in the U.S.? As Auburn University historian, Xaq Frohlich, reveals in his new book, "From Label to Table: Regulating Food in America in the Information Age," these seemingly innocuous strips of information reveal the high stakes politics that can help determine what we eat and why. In today's podcast, Frohlich will explore popular ideas about food, diet, and responsibility for health that have influenced what goes on the Nutrition Facts panel and who gets to decide that.

Interview Summary

I'm really happy to have you on today's podcast. So, why don't we just jump right in. What would you say are the key historical moves in the food policy arena with respect to labeling?

One of the things I talk about in this book is an informational turn in food politics. And what I'm specifically referring to there is a shift since the 1970s from an older way that the Food and Drug Administration approached regulating the market to its current focus on informative labeling. So, at the beginning of my book and at the beginning of the story, in the 1930s, 1940s, the FDA was trying to handle this big market full of lots of different products, especially packaged and processed foods. And under the legislation in the 1938 Food, Drug, and Cosmetic Act, authorized food standards. And the idea was that for any mass-produced food, they would hold hearings. People would say, "This is what we think the food should look like." They would then publish the standards, which would look kind of like a list of ingredients and ranges of the ingredients they could use, and then say, "Okay, all foods have to be the standard form of food. If not, we will either remove them from the market or call them imitation." And this was a system they used for decades, and it created a lot of problems. Then, late 1960s people started to get unhappy about this. There was this big turning point connected to the White House Conference on Food, Nutrition and Health where Nixon administration brought together lots of nutrition scientists. And one of the conclusions that came out of that is we need to change the FDA's system. And so, in the early 70s, the Food and Drug Administration says, "We're going to pivot away from these food standards and start focusing on informative labels." This is when you get the requirement of ingredient labeling on all foods, including standard foods, and you also get the first voluntary nutrition information label. My book looks at this change in strategies away from standardizing foods towards standardizing information about foods and creating these kinds of consumer-oriented information labels.

I love the fact that you helped us understand this idea of the information age, because once you read that and think, "Oh, well you're talking about something about the internet," but it's even more foundational about how we communicate what is a product. I found it really fascinating to read in your book where you talked about what I perceive to be really laborious conversations around what exactly is peanut butter or some other product. I mean, it seems like that took up a lot of space. Do you think that was ultimately productive? Is that the reason why we see this information change? Or was there something important about that effort on its own?

So, there were advantages and disadvantages of the old food standards approach. One of the advantages is that everybody who wanted to raise an issue was invited to attend those hearings. This meant that you could have really colorful exchanges. There is one woman who ran a homemaker's association who would show up and she would get a lot of attention because she was very colorful in her criticisms of proposed standards. It could be a very democratic space in that sense. On the other hand, they could run on for years. And there were contentious hearings where you would have dozens of lawyers from different food companies. It was held like a kind of legal court proceedings, and there would be objections, and counterevidence, and counter-witnesses. One of the complaints in the 1970s is that this was another example of an overly burdensome centralized government agency and process that was expensive. And the switch towards using informative labels and moving away from food standards was seen to be a kind of lighter touch form of governance. The disadvantage is that now you have an even more backstage discussion about what goes on this label, and it means that consumers have even less access to who's making those decisions for them.

Can you talk a little bit more about that? What's in the backstage that we're not privy to?

I think one of the misconceptions about the food label is that it is this window into the food, right? Especially something like nutrition and ingredients. You look at packaged food and you don't know what you're seeing, and therefore if they require the company to print the ingredients and nutrition, then you can look at that and now you have the kind of answer. In practice, it's more complicated deciding what kind of information appears there, which nutrients do you want to do, how do you calibrate those in terms of the daily diet? Or how do you name the ingredients? Do you use the scientific name? Do you use the common name? Those questions are decided by people backstage. This could be FDA regulators. They could allow companies to make those decisions. And so, the label is actually a translation of those kinds of decisions. One of the arguments in my book is that you can't get away from the values of these expert communities in deciding what goes on that label.

Yes, and thank you for that. I am really intrigued by how you are talking about the role of FDA, and I want to come back to that in a moment, this sort of panel of experts, and something that we think is so foundational, foods that we eat. We should know what they are. We believe we know what they are. They're part of our larger history. But what I'm also hearing is actually government organizations mediate what we understand food is. I'm intrigued to learn some more. Given what you've learned about the history of food labeling, what do labels offer as a policy tool?

Often the way people see food labels is that is a kind of knowledge fix, especially with packaged foods. Because you don't know what's in them, there is this sense that there's a kind of uneven playing ground between the producer and the consumer, right? The producer knows how it was produced. They know what's in the food. They're selling this to consumers and there's concern that they might mislead the consumer. And so, this idea is that the label is a kind of technical solution to that market problem. And in many ways, it can work this way, but there's actually a kind of translation work involved in there. It's a more complicated story than just a knowledge fix. And in fact, a lot of studies that look at how people read ingredient labels, and especially nutrition labels, will talk about how they fail to understand this or that aspect of the nutrition label. Because consumers are dealing with decision fatigue, they're in this, what people call the attention economy, where they don't have a lot of time to look at labels. So often, reading the label is the least important part of food labels for policy. In fact, over and over again, in this history, I discovered that when the FDA was introducing changes to the food label, regulators and others would comment on how actually the biggest impact is that it would lead to companies changing the foods before. So, even if consumers aren't reading the label, they're affected by those changes because companies are reformulating the foods.

I'm really interested in that. I know that there is a body of literature that talks about this idea that by having to put the information out in the public, what you're saying is companies reformulate because they want their products to look better, or maybe they actually are making the products better. Is that a fair assessment?

I think this is where you get into the tricky aspect of what we mean by better. So, taking the example of the nutrition label, one of the problems that you get with the beginning of nutrition labeling in the 1970s is it really favors a particular idea of what is better. So, if better means more of certain nutrients like protein or vitamins, and less of other nutrients like fats, or certain bad fats and sugars, then companies might reprocess a food, right? They'll take out sugar. They'll take out fat in it. And maybe they'll add in other ingredients to make it taste good anyway. And they'll kind of game that profile. And for people who are concerned about nutritional health in this sort of sense of nutrition, this might be great. But if your idea of good for you is less processed, you know this older idea of wholesome, you have this idea that the food was made in a kind of traditional sense, now you have a less good food. One of the problems that nutrition labeling raises is that it's not that it's misleading consumers, but it's getting them to focus on certain attributes of the food and not thinking about other things that may be important for health.

That's really helpful. I'm doing some work on date labels, and I've been thinking about this idea of how far can these labels go, and helping people make the best choices possible, however we define best. And that these labels are, as you said, the beginning. They're definitely not the end of that decision or that process. So, this is a really a rich conversation. I want to ask you about misconceptions. What would you say is the biggest misconception about food labels from the point of view of consumers? You gave us a little bit of an idea about that, but I'd love to hear your thoughts on this.

One of the misconceptions about the food label is that it is this window into the food, right, especially something like nutrition and ingredients. When consumers receive this information label, they often take it at face value as sort of, "I now have this information about the food." And therefore, if they require the company to print the ingredients and nutrition, then you can look at that and now you have the kind of answer. In practice, it's more complicated. Deciding what kind of information appears there, which nutrients do you want to do, how do you calibrate those in terms of the daily diet? Or how do you name the ingredients? Do you use the scientific name? Do you use the common name? Those questions are getting decided by people backstage. This could be FDA regulators. They could allow companies to make those decisions. And so the label is actually a translation of those kinds of decisions.

One of my arguments is that you can't get away from the values of these expert communities in deciding what goes on that label for the informative label. And in my book, I really try to argue that it's not just a kind of conduit into the product. It's not like suddenly you have the information. Instead, you need to read these labels as kind of value and political discussions among people who often have to make compromises. My favorite example of this with the nutrition facts panel was a decision to use the 2,000-calorie amount for daily values for the average American consumer. I remember interviewing a guy at the FDA, and I asked him about that, and he said, "Well, actually that's not accurate." It's not like if you averaged out everyone's caloric needs. Even in the 1990s, based on what they knew then, it would've been 2,000. For men, it was much higher. It was like 2,350. For women, it was lower. But they settled on 2,000 as a kind of pragmatic decision for multiple reasons. One, they hoped that if it was rounded, consumers wouldn't think of it as like a precise tool and it would be easier to do math with. And also it was on the low end of what you should get. So, the idea was that this would discourage people from eating too much. So, they made all these kinds of compromises in it. But if consumers see this and they see it as a kind of science, then they tend to think it's more rational than it really is.

And that's the kind of thing I was most surprised about from doing this history was discovering that actually consumers aren't reading these labels as rational calculators. They're reading them emotionally. And the best example of this I got was interviewing Burkey Belser, who recently passed, and he was the head of the design firm that designed the nutrition box label. And he described it as a government brand. And he said, you know, "Seeing this thing everywhere, it's not just about how people read it. It's there in the background, kind of like brands and logos." And it's that emotional relationship to the information that I think policymakers really need to think about with labels, not just seeing them as a kind of rational decision-making device, but as something that is shaping consumers' emotional decisions about the food they eat.

You've raised an important point for me, because I was going to ask, what do you think policy makers may be misunderstanding about these labels? I'm wondering, do policy makers understand these labels as a brand, a government brand? Are they capturing or dealing with the things that you're just talking about, the emotional connection that consumers have with these products or these labels?

I think that one of the advantages of labeling, and I think this is why the FDA started looking at it more as an important tool in the 1970s, is that it's a lot easier to focus on the package as a kind of site where you can police market behavior. So, it's much easier to do that than to go into manufacturer's factories to kind of say, "This is good, that is bad." You can use it as a kind of accountability device. I think from the point of view of regulation in a big national and increasingly international market, that's one of its advantages. The limitations of this for reforming food systems in my opinion, is it also ends up being a kind of outsourcing of work onto consumers, right? Instead of saying, "We want to make sure foods are safe and nutritious. We want to avoid certain kinds of ingredients or discourage certain kinds of unhealthy foods." Governments are basically saying, "All right, we're going to put it on the label and let the consumer do that work." And I think that is one limitation of them. The other thing that I also think happens is it's not just outsourcing to the consumers, but it's also putting that in the market and using the market to solve those kinds of problems. And for mandatory labels, like the nutrition facts panel, this means that consumers who have the time and resources might end up adopting a healthier diet because of it. But many consumers who don't have those kinds of choices aren't going to be helped by this informative fix. For voluntary labels, and this is something I talk about at the end of the book. I call them lifestyle labels or risk labels, depending on what you're talking about. So organic, carbon footprint labels, concerned about the environment, these kinds of third-party certificate labels, it becomes this kind of opt out. Instead of reforming the political system, you're providing this kind of market upsell option for consumers to have those resources.

I'm intrigued to think about the FDA in its historical place. Your book provides a history of past FDA activities on food labeling, and you talked wonderfully about those already. How does it speak to current policy concerns at the FDA? And you were giving a little bit of an indicator of that with the front-of-pack labeling. I'm wondering are there other spaces about FDA concerns today?

I think if you're really committed to reforming the food system, then food labels are only ever just the start to that reform work. They can't be treated as the solution. And I think in the past you have had a lot of cases, particularly with public government, where the label is put forward as the kind of answer to a political problem. And then they don't think about the need for staff to keep the education up about the label or enforcement. And so, they don't treat it like the beginning of that reform work.

One of the things I find really exciting about what your book is doing, that you're a historian and you're talking about the development of this policy and it has important implications. What do you think history offers us in the current policy discourse? What do you bring to the table that we miss out by not talking with historians?

So, when I was doing this research, this event that I didn't know happened that turned out to be really important in this story was this White House conference in 1969. At the time, the impetus for this conference was the sort of sudden public awareness of ongoing hunger in America. In the 1960s, people who were involved in civil rights realized that if they could focus on the issue of hunger, they could get a broader attention to problems of poverty and disparity in America. In 1968, this became a big public issue because of widely watched TV documentary. Everyone was talking about hunger and its connection to poverty and inequalities in America. And when the Nixon administration created the White House conference, the language of poverty and the concern of poverty was central. Then, there was a kind of shift over the course of the conference. Initially it's talking about hunger and how that's a malnutrition issue related to poverty. But by the end of the conference, they're starting to focus on consumer education, better labels, better information. And in some sense, we haven't got away from that framing shift. I really saw this recently with the Biden administration. It held its own White House Conference on Hunger, Nutrition and Health in 2022, and nowhere in its report was there a mention or discussion of poverty. They were really focused on foods as a vehicle for health, improving labels instead of talking about poverty as the kind of root concerns. Again, the kind of overall framing is if we engineer better foods in this nutritional sense, or we give you better information labels, then we'll solve the health problems America's facing. I think that that policy focus is ignoring the broader context of how Americans eat and how they're making their decisions. So, I see my book as kind of providing a broader lens to think of the issues, not just historically, but also looking beyond sort of the field of nutrition or considerations of government, but looking at how these different institutions are all interacting with each other to shape policy. I think the two important things here are about what history can offer in present policy. One is that I actually think a lot of people working on these issues today have no idea where they came from. I've experienced this as I've given talks. I've had people in industry, or people who work on policies sort of say, "I didn't realize that that was where the standard for milk came from," when they were talking about recent changes in terms of the nomenclature for milk. Or "I didn't understand that," you know, "healthy, as it was defined in the 1990s, was in the context of one kind of health war, but today there's a kind of new public health concern about other types of foods." So, part of it is that I think that policymakers will really appreciate getting that older context. I often call it institutional memory because you lose that institutional memory. The other thing that's really striking is, at the beginning of my story in the 1930s and 1940s, nobody was using words like saturated fats or carbohydrates. It was a different era and people were really talking about food differently. So, it's useful. I think of it as like study abroad. You know, you go to this place, you see that people are talking very differently, and then you come back to your home country, you know, or the president, and you realize, "Oh," you know, "there's this aspect of food that I was taking for granted that has really changed in the last," you know, "five, six decades."

Bio

Xaq Frohlich is Associate Professor of History of Technology at Auburn University. He works on issues relating to food and risk at the intersections of science, law, and markets. His research focuses on the historical intersections of science, law, and markets, and how the three have shaped our modern, everyday understanding of food, risk, and responsibility. His work explores questions relating to consumerism and the changing relationships between the state, experts, and the public in the production of everyday knowledge: how do we “know” what we know about food and its relation to health? In what ways has our informational environment for food changed with the industrialization of food production and retailing? Frohlich earned his PhD in history, anthropology, and STS at MIT. He teaches courses on food and power, the intersections of science, technology and the law, and the history of business and capitalism.

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In 2022, Congress established Summer EBT, the first new permanent federal food assistance program in almost 50 years. The authorization of Summer EBT represents a historic investment in the nutrition and wellbeing of almost 30 million children who will qualify for the program. But states that piloted Summer EBT, or operated Pandemic EBT programs in the early years of the COVID-19 pandemic know that getting these benefits into the hands of families will involve overcoming complex challenges related to data and technology. That's why Code for America and No Kid Hungry, a campaign of Share Our Strength joined forces to create the Summer EBT Playbook, a comprehensive free resource designed to help state agencies plan for and implement a human-centered Summer EBT program. Today we will talk with Eleanor Davis, director of Government Innovation on the Safety Net team at Code for America. In her role, she helps government agencies adopt best practices for human-centered digital benefit delivery.

Interview Summary

Why is Summer EBT significant?

Well, I think you gave us a good intro. Summer EBT is a brand-new benefit program and it's designed to reduce childhood hunger during the summer months by providing families with a monthly grocery benefit to feed their kids when they're not receiving meals at school. So, almost 30 million kids in the US receive free or reduced-price meals at school, but during the summer many of them struggle to access nutritious food because they're not receiving those meals at school. School is out of session. Summer EBT is designed to give families $120 per child in the summer to help them buy groceries and it really has the potential to dramatically reduce childhood hunger. It's a tremendous moment because Summer EBT is the first new permanent federal food assistance program in almost 50 years. For those of us in government or in the food access space, this is really I would say, a once in a generation opportunity to shape the implementation of the program to make sure it really meets the needs of families and children.

So, why did Code for America and Share Our Strength develop the Summer EBT Playbook? What was the challenge?

Code for America is a 501 C3 nonprofit organization. We partner with government at all levels to make the delivery of public services more equitable, more effective, and more accessible using technology and data. And we've spent the last decade helping states deliver safety net benefit programs in more human-centered ways. The Summer EBT program, as we mentioned, has immense potential, but we also know that states are going to encounter many challenges in implementing this program in 2024 and beyond. I think standing up a brand-new benefits program is a huge undertaking generally, but Summer EBT will present some really specific challenges to states and we learned a lot about this back in 2020. So, at the start of the pandemic, Congress authorized an emergency response program called Pandemic EBT, that was very similar to Summer EBT in many ways. It was the same idea, really sort of providing families with a grocery benefit while schools are closed because of COVID-19. And so, in 2020 and 2021, Code for America worked directly with about a dozen states to help them deliver Pandemic EBT benefits. And through that process we saw very up close what made that program so hard to implement. Delivery of the program really relies on effective data and technology systems. So, really being able to find the right data in state systems and use that data to deliver benefits. And a lot of these challenges will also be true for Summer EBT, right? It's a very similar delivery process. So, states really needed help planning for Summer EBT and really designing systems and processes that will help them operationalize this brand-new program so that it can really live up to the promise spelled out in the policy. So, that's why we partnered with the No Kid Hungry Campaign. We really wanted to develop a resource that would help states design effective and human centered Summer EBT programs. And our goal was really just to sort of help as many states as possible implement this program.

This is really interesting, and I would like to understand a little bit more. What challenges did states face in implementing the pandemic EBT and how do you see that showing up in the Summer EBT? I mean is it just getting the right software or is it something else?

There are so many really, it's less about the software and more about the data. So fundamentally, I think some of the biggest challenges that we walk through in the playbook certainly, but that we know states are going to struggle with is really around using data to determine who is eligible for Summer EBT. So maybe just taking a step back, there are sort of two pathways for confirming who's eligible for Summer EBT. The first is called streamline certification. Basically, this means that the state uses the data that it already must determine if a family is eligible for Summer EBT and then issues those benefits automatically. So, for example, if a child is already participating in a program that should make them eligible like SNAP or in some states Medicaid, they should automatically receive Summer EBT. And similarly, if a child is in the foster system or is in a Head Start program or if a child has applied for and is therefore receiving already free and reduced-price meals at school, those children should receive Summer EBT automatically. But children who can't be certified as eligible through any of those pathways will have to apply for the Summer EBT benefits. So that's sort of the other eligibility route. States must provide a way for families to directly apply if they can't certify them through streamline certification. So, the idea is that the majority of children who are eligible for the program should actually get benefits automatically through streamline certification. And that's really fantastic, right? We should always be looking for ways to reduce the administrative burden that low-income families face when they aim to gain access to programs they're entitled to. So theoretically, if a state already has enough information to say this family is eligible for Summer EBT, they should just send that money out automatically and without the family having to do anything. That's sort of the best-case scenario. On the state side though, this is actually really complicated to do. The data that states need to use to determine that eligibility is all over the place, right? It's in Head Start programs, it's in the foster care system, it's in a state's SNAP or Medicaid eligibility system and it's in the schools, and school data presents really specific challenges for states to be able to use. So, states therefore have to identify where is all this data? What systems is it in? What agencies have this data? They then must aggregate all that data in one place that's central and usable. They have to clean and de-duplicate and match all that data across those different data sources. And then of course they have to deal with any inaccuracies or gaps in the data. So, data collection, data aggregation, data management, these are really sort of the core challenges of implementing this program. How do you collect all of this information into one place and use it to deliver benefits to families? This is really one of the core challenges that we focus on in the playbook.

It's really helpful to hear how you all are helping states think through this. And I would imagine that there are some differences across states. How in the playbook have you been able to best manage the uniqueness of these different states?

It's really tricky. I think we always say if you've seen one state system, you've seen one state system, no two states really look the same. And I'm using state really as a shorthand, tribal nations can implement this program, territories, US territories can also implement this program. So, there really is no one standard way that states backend infrastructure looks. And even when it comes to implementing this program, Summer EBT, different state agencies are sort of taking the lead in different states on administering this program. So, I think we're doing our best to help understand what unique challenges states are facing while also recognizing that the sort of themes, the main things, the primary challenges are going to remain the same basically across a lot of states. And so, we are really sort of in the playbook offering best practices, recommendations that we know will be universally helpful no matter really what a backend state system looks like.

Can you give us a little bit of the flavor of those best practices?

Absolutely. So, I want to talk about a couple here because this program gets really weedy really fast. I think the first one that we really talk about is client support. As we've been discussing, this is a really complicated program to administer. It's also brand new, right? So, families are going to need support navigating this program. They're going to have questions; they're going to be confused. Even after multiple years of Pandemic EBT, many families were still confused about why they did or did not end up receiving benefits. So, who is eligible? Can I expect these benefits? How do I get them? These are all questions that families are going to have. So, states need to be prepared to provide really consistent and clear communication to families. And they also need to have really easily accessible pathways for families to reach out and ask questions when they have them. And we can already really anticipate what a lot of those questions are going to be. One of the biggest points of confusion for families is going to be, "Do I need to apply or not?" Right? We talked earlier about the two different pathways streamline certification or filling out an application. From the state perspective it's pretty clear, but as a family, how do I know if I can expect to receive these benefits automatically or if I need to apply? And the complicated policy language here, of course you know about streamline certification, families don't understand that, right? We have to sort of really communicate clearly with families. I think one example of this is families whose children attend community eligibility provision schools or CEP schools; these are schools that serve free meals to all of their students. They're usually schools that are in low-income areas and because a certain percentage of their students are categorically eligible for free meals because they participate in other programs like SNAP or TANF, they're able to just give free meals to all of their students. So, families at CEP schools have never had to apply for school meals, their kids just get them. But because these families haven't applied for free or reduced-price meals, they're actually going to have to apply for Summer EBT. You can see how from a family perspective, this starts to get really confusing from a messaging standpoint, right? We're telling families if your income was below this level, at any point in the previous school year, you're going to be eligible for Summer EBT. But if you haven't applied to free or reduced-price meals this year, you have to apply unless you already received SNAP or TANF, in which case don't apply, you'll get benefits automatically. So, the messaging starts to get really confusing. How states communicate with families about this program and how to access it really matters. So, in the playbook we have a lot of resources on best practices for community outreach, how to talk about this program, how to leverage many methods of communication, right? Like email, text, phone calls, to really let families know about this program and give them the information they need to navigate it.

Wow, that's great. And it's interesting to hear you talk about this because early on I had the impression you were really worried about the data, but you're also really concerned about how people function in the system. So, I've heard you mention this idea of human-centered design and human-centered digital benefit delivery. Can you explain a little bit more about what that really means and why it's important?

Human-centered design really just means creating things that really meet people's needs and that are really easy for people to use and access. And that's really important, right? Just like the example I was just sharing with this program. It's a complicated program and if the systems aren't designed in a way that makes it easy for families to access, easy for families to interact with, they're not going to see the benefit of the program ultimately, and the program isn't going to meet its goals, which is reducing childhood hunger. So, the principles of human-centered design are really about thinking through what do families need when it comes to interacting with this program and how do we design the program in such a way that gives them those things? I think a great example of this is the application, right? We have a lot of best practices in the playbook related to the application component of the program. I mentioned that while many families will receive benefits automatically, the regulations for Summer EBT do require that many families will have to apply. So, states have to design applications and there are a lot of considerations that need to go into creating an application in a human-centered way, right? It needs to be accessible, which means it needs to be available in a lot of different languages, which can be really tough. California has 19 threshold languages that people speak. So, we need to translate this into the languages that people speak. The questions need to be written in what we call plain language, which is just conversational, the way that people actually talk so that they're really easy to understand and they need to flow in a way that makes sense to someone filling out the application. And this really matters because if the questions are hard to understand or hard to answer, it's likely that more people will answer incorrectly or submit the wrong answer. Meaning that they might not get the benefit even if they are in fact eligible. And then we also talked a lot about the importance of mobile accessibility. And this is really critical because more and more low-income families are what's called smartphone dependent, which means they don't have internet in their homes, but they do have a smartphone. So, they rely on that smartphone to do things online like fill out applications. But a lot of government websites are not built to fit the smaller screen on a mobile phone. And that makes it really hard for people to do things like fill out online applications for benefit programs. So, it's really important to make sure that the online application is designed to work on a mobile phone because that's how we know most families will be accessing it. I think the application component demonstrates a lot of the sort of thoughtful design work that's going to be required to create a program that's truly accessible for the people that need it.

I'm really appreciative of this. And as I heard you talk about this, especially with mobile devices and I was thinking about younger folks, but I also know that there are grandparents or older adults who will care for young children who may be eligible. What considerations do you make for older adults or people with disabilities that may make using certain devices difficult?

That's a great question. We have done a fair amount of research on this and what we found is that the sort of principles of human-centered design we really need to design for everyone. And that means designing for accessibility or ability, right? Designing for multiple languages, designing for whatever device people have access to, designing for different levels of comfort with technology. I think we really believe in the sort of principle that if you design it for the person that's going to have the most trouble accessing the program, you make it easier for everybody, right? So, we really think about the highest need population and design for that population and then really believe that we sort of make it more accessible for all populations that need to access the program.

This has been really helpful for me to consider how government can work for people by using human-centered design to really move the process of applying and attaining these assets or these benefits, easier for folks. And I'm really grateful to hear the work that you all are doing with Share Our Strength. I got to ask this last question. What are your hopes for Summer EBT in 2024 and even beyond?

I love this question. I have so many, I spent a lot of time so far talking about how hard this program is going to be for states to implement and it will be, I don't want to downplay the significant effort that it's going to take for states to stand up this program and deliver benefits, especially in this first year. That said, in my experience, people who work in government are incredibly resilient and resourceful and they are incredibly creative problem solvers. Pandemic EBT was really hard to implement, and states were trying to figure out how to deliver that program in the first few months of a global pandemic where everything was shut down and there was sort of historic need for benefit programs. But by the time that program ended, every single state had delivered Pandemic EBT benefits to families. So Summer EBT, especially in these first few years of its implementation, will be challenging certainly, but it won't be impossible. States have really proved that they can do this, right? States are good at this. So, I guess my greatest hope is that states are able to address many of the challenges of implementation this year in order to put benefits in the hands of families and that more states opt in, in future years, right? So that eventually all families get to benefit from this program. Ultimately a policy is only as good as its implementation, right? We have to help states design programs that are effective for them to implement, but also that work for the families that they're serving so that the Summer EBT program can live up to the promise outlined in the policy.

Bio

Eleanor Davis is the Program Director for Government Innovation at Code for America. In her role, she enables government agencies to adopt best practices for human-centered digital benefit delivery. She joined Code for America from Futures Without Violence, a national public health and social justice nonprofit dedicated to ending domestic and sexual violence. There she worked for 6 years on the Public Education Campaigns & Programs team, developing public-facing initiatives that support the ability of frontline providers and advocates to more effectively respond to and prevent violence and trauma. Eleanor is a graduate of the University of Chicago where she studied Sociology and Performance Studies, and received a Masters in Public Health from UC Berkeley. Outside of work you can often find her gardening in her backyard or singing in her family band.

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In 2022, more than 6 million people visited farmers markets across North Carolina. Today, we're talking with a team of people who are the driving force behind the North Carolina Farmers Market Network: Maggie Funkhouser, Catherine Elkins, and Nora Rodli. The goal of the North Carolina Farmers Market is to create and support a thriving network of marketplaces for the state's local food and farm products. The nonprofit network, which was recently awarded a USDA Farmers Market Promotion Capacity-building grant, will provide education, programming, and partnership development assistance to farmers market managers, including resources to support historically underserved populations.

Interview Summary

I would like to take a moment to actually get to know you all a little bit better. Tell us a little bit about how you got involved in farmers markets. Catherine, let's start with you.

Catherine - Sure. I've been doing this for the longest, I suppose. I went with my mom many times to Amish markets in Pennsylvania where I grew up. She was not a very good gardener. But we could buy everything that she liked at the market. I also worked a bit at the Carrboro Farmers Market, and I then got an opportunity to work with the Morehead City Saturday Market, a one-year lifespan. And the Old Beaufort Farmers Market we started up the next year, that's now in its 10th year. That makes me proud. I liked that market a lot. Managed it for two years, and I'm still one of those devotees that go on vacation and have to look up the closest farmers market just to check out new stuff.

Maggie - Like most managers, I did not go to school to be a farmers market manager. It kind of found me, I guess you could say. I went to graduate school directly after undergrad for classical languages. Then when I moved back to the Triangle, I just sort of started getting involved more and more with local food. I worked in restaurants, I worked in coffee shops, and one time I worked in an artisan bakery; I managed a culinary garden, and I just kind of kept getting drawn into different parts of the community in our local food system in the Triangle. In 2019, I applied for and was offered a job at the Carrboro Farmers Market as the assistant manager. I worked there for about a year. Then in 2020, I took over as the manager, and I've been here ever since.

Nora - So, I actually come to farmers markets as a farmer. For the past 25 years, I've farmed in various places around the country, mostly New Mexico and Hawaii and now North Carolina. That has given me the ability to see and experience farmers markets in a lot of different manners, whether it be a small market or a large market, and urban versus rural settings. I feel like I am uniquely on board as a cheering squad for farmers markets.

Thank you. We all need a cheerleader on our side, so it's good to hear that. I really would love to ask each of you more questions about your past because there are some interesting connections that I hear. Catherine, the Marine Lab is in Beaufort, and I'm intrigued to know more about how those relationships develop. Maggie, I would love to talk more about your training as someone in the classics has influenced the way you think about this. I mean, this idea of food and agriculture is deeply within that literature, and so that's really fascinating. And, Nora, I just can't wait to learn more about Hawaii. But I can't do that right now. We have other things to focus on. However, if those answers come up in your other responses, please feel free. I'm intrigued to talk to you all a little bit more about the North Carolina Farmers Market Network. What is it and who does it serve?

Maggie - I'll kind of kick us off talking about the network a little bit, and maybe my colleagues can chime in. So, we incorporated this year as a 501 nonprofit under the name North Carolina Farmers Market Network. NCFMN, for short. That's our kind of alphabet-soup title that I might say really, really fast. But there had kind of been plans and thoughts to form a statewide network in North Carolina for a long time. We gained a lot of momentum in 2020 because in 2020 we started, with the help of the Carolina Farm Stewardship Association, the State Extension and RAFI, when the pandemic hit, we started having these weekly Zoom calls that were specifically for farmers market managers. The reason we started them in March 2020 was because we were all really, really unsure about what was happening and what was going to happen to the farmers market spaces. Many of our markets across the state were shut down. Many of them had a lot of additional regulations and policies and emergency protocols that were really hard to implement, especially if there were no permanent staff or volunteer staff or part-time staff. In my position, I'm lucky enough to be full-time, but many market managers are not. So, we started out as a rag-tag group of market managers that were just trying to stay open and operating in a really difficult time. We had weekly calls, and we went over different policies we had, different marketing techniques we were using to communicate to the public about our pandemic response. I really clung to it as a source of support during that time. Then over the next couple of years, we started meeting biweekly, then we started meeting monthly. We kind of realized that we had a lot to talk about and a lot to share. Our Zoom name was COVID-19 Calls for Farmers Markets. But what started out as COVID-19 Calls for Farmers Markets turned into resource sharing, professional development, learning things like grant writing, bookkeeping, managing conflicts. And last year we decided to make it official. So, we applied for our FMPP grant, our Farmers Market Promotion Program grant, through the USDA, and we were awarded it. And then we were on the path to nonprofit incorporation.

Maggie, that is really fascinating, and it's interesting to hear how a crisis of COVID-19 drew a lot of you together. Correct me if I'm wrong, but it sounds like it was beneficial in terms of the work you were doing. And it may have also had some personal benefits - just being connected to other people who were in the same field. And you all were able to talk about how you were managing things. Did that take place? Was there more than just sort of, "Here's how to manage your books," or "Here's how to manage conflict"?

Maggie - For sure. The camaraderie was just incredible. Farmers market managers, it's kind of a funny position, and maybe Nora can speak to this a little bit as a farmer who sells at a farmers market, and maybe a different perspective about what a market manager does or the role they occupy. But we do a lot of different things. On any given day we can be planning special events, applying for grants, communicating with vendors, communicating with our boards. And so, to have connections, especially for me being in the Triangle where we have a lot of farmers markets, I had never really met their managers or interacted with them. And now we're total pals. It really was an opportunity for me to share experiences with people who have very similar jobs, and those jobs are often singular in their workplace.

Nora, since she called you out, I'm interested, from a farmer's perspective, I would love to hear your thoughts, and, of course, Catherine, please feel free to join in.

Nora - Yes, I'd love to share. I feel like before meeting this network, and I've only been with them since April, I have to admit that as a farmer, I showed up at the farmers market and thought that's when the market began and didn't really think much beyond who was behind making it happen until I got there. And I've learned and been humbled by how much of an oversight that is. I definitely am guilty of not appreciating all of the work that goes into making sure that farmers markets happen. And I've spent the last six months learning about all the details of things that market managers deal with that farmers have no idea. And it's similar to farmers, maybe, in that way where we wear many hats. And so, I feel like I've learned, one, to appreciate them, but, two, there's not a lot of collective appreciation by anybody that goes on for farmers markets managers. And so, I think that by them grouping together every month because it can be such a siloed experience, it just seems like this really beautiful connection where, when you do your job well as a market manager, there's nothing, like no one says a thing. No complaints mean success. And so, here's a group that can give you compliments, you can empathize with one another, and know that you have each other's back. It's just a beautiful network.

Catherine - I think also what we noticed was that many times the overlap and potentially collaborative nature amongst managers is really great. These are not competitive people. They have secrets to share about what their special events might be, and not everybody has to hold Tomato Day on the same day. Or they may know people at City Hall that are the right people for this kind of permit or may as well share these things. They're all on our same perspective. And plus, that, we found that there were many other states that had networks or associations. So, we could follow them, especially during a period of crisis and near panic as COVID was. Everybody's just glued to their screens looking for information. And the states that had robust networks or associations already in place seemed to be able to help their markets succeed really well.

Thank you all for sharing this. It's really fascinating to learn about the development of this farmers market network and to know that there are other farmers market networks in other states, and it's great to hear of the learnings that you all gained from each other within the state and across states. So, this is really helpful. I've got to ask this question. I mean, it sounds like what drew you all together was the pandemic and thinking about how to navigate policies. Now that, I pray, we're through the hard part of COVID, and I say that cautiously, what are things that are on your agenda now? What do you hope to see be different?

Maggie - Catherine kind of spoke to this. Even though farmers markets are separate spaces, our market is within 20 miles of four other farmers markets. But the goal is not to compete with them. The goal is to lift up farmers markets as accessible community spaces and viable spaces for our farmers to make direct sales. So, for us, we really want to strengthen that local food ethic across the state of North Carolina. Because selling at farmers markets is an extremely viable way that small-scale farmers can succeed in North Carolina. And so, if you have a market manager that is leaving after six months because they're overwhelmed or they haven't received a lot of institutionalized knowledge or training or what have you, then that's where we can step in and say, "We have training, we can give you information, we can share resources, we can provide a network to you." Our big, impactful goal that we're working for is having a statewide nutrition incentive program, and I think Virginia calls theirs Fresh Match. Many statewide organizations have Double Bucks, Fresh Bucks, Market Match, whatever you want to call it, where they provide a dollar-for-dollar match for nutrition incentive programs like SNAP EBT or the Farmers Market Nutrition Program. And as of right now, farmers markets in North Carolina, most of them are fending for themselves. There are a few regional systems like in the western part of the state, the Triangle area farmers markets, Mecklenburg County farmers markets, that are working together. But we really want to have a statewide network where farmers markets across North Carolina can offer nutrition incentives to shopping at farmers markets.

Thank you for that. I'm really happy to hear how you all are working towards addressing policy questions and thinking about who the farmers markets can better serve by using programs like Double Up Bucks or the nutrition incentive programs, and seeing that work across the state. Because there are some significant differences in economic realities across the state. So, that's wonderful to hear you all are doing that work. I'd just like to take a step back, and I'm going to go back to you, Maggie. Can you talk to us about the role of farmers markets in communities? What role do they play?

Maggie - We talk about this a lot in the farmers market space. Because from the outside, farmers markets are spaces of commerce. They're a space where farmers can get together. Maybe you don't realize there's a level of organization behind it. But, in reality, anyone who is a regular at farmers markets knows that they are not just a space of commerce, that they are a community space. They are a third space, and an opportunity to socialize, meet your local farmers. And at our market, we were founded in the late '70's, we have customers who have been coming to our market for decades. They've known some of our farms for years, they've seen them get married and have kids, they've seen their loved ones pass away, they've seen them go through hardships, and seen them go through multiple recessions at this point. It's a really unique space, especially in this kind of era where there is an increasingly globalized economy where you can order one-day shipping for everything you need. To be able to meet the person that's growing your food or baking your bread is really unique. Many farmers markets promote the sense of community, and engagement between consumer and producer. A lot of us offer different types of community programming to kind of bolster that. So, things like kids' activities, encouraging healthy nutrition and things like senior days, educational events. Catherine named Tomato Day, which happens to be a very big day for us. And we've kind of touched on Double Bucks and food access, and that's another real priority for a farmers market. And, also, I didn't mention this when we were talking about the pandemic, but we were looped under grocery stores as essential for the state of North Carolina. And so, that kind of maybe speaks to how we feel, and I hope others in our community feel about farmers markets as well.

Wow, that's really fascinating. I didn't appreciate that farmers markets were treated like grocery stores as essential workers. That's really interesting. I'm intrigued, Nora and Catherine, what about your thoughts about the role that farmers markets may play in communities?

Catherine - Well, Nora would agree with that. The farmers are their own community, and they appreciate the opportunity to meet each other across the aisle, across the tables. "How's things going on your farm?" "Let me tell you about what's happening at my place." Farming can be a really solitary profession. There's many, many hours spent as just one person on a tractor, one person planting seeds, one person weeding. To have the camaraderie and the opportunity to meet up with your peers, that's pretty powerful on a Saturday morning. It is a lot of time sometimes to give up. The better farmers markets, of course, are the ones where you're talking directly to the farmer. How did they prepare this soil, or are they certified naturally grown? What does that mean to them on their farm? You get to actually have that conversation with a client, but only in person. So, it's a big deal for the farmer.

Nora - Yes, for sure. I can speak to that. I feel like most farmers don't have a lot of neighbors close by, and we can feel isolated in our own little work bubbles. And so, a farmers market is the social event of the week for us. Many markets that I have been a part of will have a standing lunch afterwards, and it develops into friendships that are really deep. I also wanted to just mention, from the farmer perspective, the value of meeting customers who are purchasing things from me and my farm, from others and their farms. It's not just meet your farmer, but for us it's like meet your customers. And it's a chance to explain something, like why you're excited about the diversity of such and such crops, why it matters. There's only so much you can put into website descriptions and social media, and it's just two-dimensional. Having the opportunity to meet and share space, the farmers market is so essential, I think, to not only understanding our food and where it comes from and how it's produced, but increasing our value of it in this day where it seems like food is sometimes just an afterthought of convenience.

I love the idea of the farmers market being sort of like the water cooler for farmers to get together and swap stories and share in each other's joys and probably also frustrations and pains. I can imagine how that's a wonderful space for folks. I remember watching a farmers market, I was staying in a hotel, and this is how I can say it. They were there at five in the morning, and I was like, "What's all this noise?" And it was great to see all of these farmers, one, setting up, but then I could see some of those exchanges. I had a sense of like there was a real community there. So, that's wonderful. And this makes it clear that these farmers markets can be really beneficial for farmers. I'm interested to hear a little bit more on how farmers markets are supportive, if at all, to the financial wellbeing of farmers? Or is this just a labor of love? Is it just the water cooler?

Nora - I feel like they're super economically important, and I think where I would say most importantly is as new and beginning farmers who are establishing their businesses. It is an extremely unique place to be able to try out different produce offerings and pricing. It's like you're practicing everything before you're able to have a reputation to secure accounts that might be other versions of direct or indirect marketing. And so, farmers markets offer you that opportunity to gain instant feedback: "Did that sell, yes or no?" "What were the questions?" "What were the gripes?" It gives you constant feedback to be able to refine as you grow your business and make decisions for the coming years. That's not only important as a farmer independently, I was also involved with some farmer-training programs, and we really highlighted farmers markets as giving that opportunity.

That's a great insight, that it's almost like a farmer incubator. It helps farmers test out different marketing means.

Nora - 100%, yes.

I would love to hear from some of the others. Catherine, Maggie, what are your thoughts about the financial benefit of farmers markets?

Catherine - We keep talking about it, how it's so perfect for the farmer or for the producer but think of how perfect it is also for the shopper to keep coming to a place that's always trying to reinvent itself in serving better and better and better food. My local brick-and-mortar store doesn't do that. There are different priorities.

I am an economist. I am just loving this idea of price discovery in the market and the idea that each of these markets are different and they're idiosyncratic and there's something new happening. This is actually worthy of further study, but that's another conversation for another time. So, thank you for sharing.

Catherine - I think you know probably better than most that farming is not a get-rich-quick scheme by any means. There are many examples of people, friends, who are pouring their heart and soul and muscles and fingernails into growing better and better, and they have to love it. They don't usually pay themselves terribly well.

Maggie - Many of our farmers sell at multiple markets, and it's kind of funny to hear things like: "Oh, I can always sell my cucumbers at the Carrboro farmer's market, but I can never sell them at another market." It's so funny to think about how the different farmers markets are literally different economic markets, where our customer base has like their own kind of idiosyncratic interests, and maybe they love persimmons or something like that. At our farmers market, we're definitely an incubator farmers market.

I want to ask one last question. And I say it's last, and we will see how the conversation goes. Because this has been really a delight. For market managers and farmers, what does the North Carolina Farmers Market Network have to offer them? Catherine, why don't you begin?

Catherine - Just like seeing your friendly farmer neighbors in person on Saturday morning, it's also really fun and informational, educational, all those great words, to Zoom with the managers. We have a first Thursday of the month Zoom call to the managers who are members. We have a range of topics prepared. We have space for updates on legislature. We had somebody come in from Senior WIC to help us learn what they're doing for us. How to collect data from your farmers markets is really helpful for boards and municipalities and us as the network. We're going to be asking for data. How to send out a census. What's everybody doing for the kids programs that's new, haven’t been tried before? So, that Thursday morning event has a good deal of value, we think. We also have a connection to Farmers Market Network, and we'll be able to offer discounts on insurances, I believe, as well as membership and access to their resource library, which is immense. We also wanted to make sure you knew that we were seeing other states like Virginia teach their managers best practices and have a market-management certificate, something we hope we can offer someday. We certainly will be hosting regional meetings to get to know the managers better. We have five regions around North Carolina. That'll be pretty educational. That'll have a program for it.

Nora - I would love to add to Catherine's description that in addition to being a place where farmers market managers come together, we're also a network that invites others who work in the food system and who are passionate about the same issues to become members. They're valuable voices to include in every conversation. For example, just the other week I sent out something, kind of a newsletter. I had some questions that market managers had been asking me about food-safety regulation issues for farmers markets, which comes up a lot. And in the responses, others who worked with NC State or Extension roles, piping in saying, "I have a good resource for that," or "Here's the answer." And I feel like the value of bringing together all these voices in the same room is huge.

Maggie - I love all of what Catherine and Nora were saying. You know, it occurs to me also that there are over 200 farmers markets in North Carolina. Supporting farmers markets is part of supporting North Carolina's agricultural fabric. It's part of supporting small-scale family farms, organic farms, spray-free farms. So, I think that if we can assist with marketing those farms and farmers markets, that feels very important and impactful to me. And then I also want to draw us back to education for larger stakeholders and maybe government organizations about some of our statewide initiatives like Double Bucks. I think that's where we can really offer a collective kind of impact, where maybe individual farmers markets don't have the capacity to work with larger stakeholders, but as a network we can come together and we can really have a much broader impact.

Bios

Maggie Funkhouser is currently serving as the interim Board Chair of the North Carolina Farmers Market Network. She is the Manager of the Carrboro Farmers’ Market in Carrboro, NC, where she has worked since 2019. She was raised in North Carolina’s Triangle and has worked in local food systems there for many years, including as an educator, gardener, baker, and foodservice industry worker before coming to the farmers market. She carries with her a love of writing, language, and storytelling from her classical education background, and she is drawn to foodways stories and oral histories. She is especially interested in the intersection of food access and farmers markets, as well as learning more about making farmers’ markets inclusive, equitable, and accessible community spaces.

Catherine Elkins has long enjoyed the spirit and joy of farmers markets, starting in Pennsylvania visiting several Amish markets and continuing in North Carolina after moving to Chapel Hill. She volunteered for many years at the Carrboro Farmers' Market, and then after retirement, stole many of their successful strategies when designing, starting and managing the Olde Beaufort Farmers' Market. She also assists with the Carteret Local Food Network's Mobile Market which operates a red short school bus tricked out to serve many low income and senior communities in Carteret County with the freshest, most local produce and farm products from Carteret farmers.

Nora Rodli is the Program Coordinator for the NC Farmers Market Network. She brings over 25 years of agricultural experience from working as a farmer and with farmer training and education. She also has a healthcare background as an advanced public health nurse (APHN). Currently living and farming in Boone, NC, Nora is passionate about the primary roles that local food and increased access to local food can play in health promotion and disease prevention, resilient local food systems and vibrant inclusive communities.

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It has been said many times that a picture is worth a thousand words. Our guest today is documentary photographer Sally Thomson, the creative genius behind the book "Homeground." She hopes her photos of 24 ranchers and land managers can broaden people's understanding of the impact conservation ranching has on the health of the land, the animals, and the people who live, work, and recreate in Southwestern and Rocky Mountain rangelands. Her book also includes rancher quotes and essays from land managers working to address challenges of climate change and diminishing resources and to find sustainable land management solutions.

Interview Summary

I was especially interested in doing this podcast because we've had a lot of people on to talk about regenerative agriculture and there have been farmers and ranchers, some of whom we both know in common. There have been scientists who work on this, people who work with NGOs trying to promote this work, and even some policy makers, but never a photographer. It's going to be really interesting to hear from you and I look forward to what you have to say. So, we have spoken to chefs and filmmakers before who've used their arts to shape and change the food system. But as I say, you're the first photographer we've spoken to. Let's go back to the beginning. What got you interested in photography in the first place, and how can photography be used as a social or political statement?

Well, I didn't start out to become a photographer. I took a art class in college and that is really what first introduced me to photography. I was gifted a used cannon camera and a couple of lenses and I started experimenting with the camera. And I was immediately drawn to the medium. Especially watching the images kind of emerge in the dark room was just fascinating and kind of magical. But it never really occurred to me to consider photography as a career. I eventually went on to graduate school and I studied landscape architecture following my interest in environmental design and planning. I figured this would also give me the opportunity to incorporate photography into my creative process. I practiced landscape architecture for many years. But it wasn't until much later that I realized the power photography can have in storytelling, and raising awareness, and connecting me with people in places that, you know, I wouldn't have otherwise thought possible. So, up until about this point, I had used photography more for documenting my work. I had worked for a conservation organization in the Amazon Rainforest, and in order to communicate their message, I felt that photography was extremely useful in doing that. That's really what caused that shift in my thinking of turning to photography. In 2008, I created On Focus Photography, which was an effort to highlight the work of various underrepresented environmental cultural NGOs. I set about trying to learn everything I could about documentary photography at that point. That sort of led me to where I am today. What I do today is primarily divide my time between freelance assignment work, fine art and documentary photography.

Thanks for that background. It's really helpful to understand how you got to where you are now. So, let's turn to your book, "Homeground" brand new. Can you provide an overview of the book and what are some of the key things that you're hoping to convey?

Well, Homeground, of course, is a visual narrative. It explores the endangered rangelands of the American Southwest and the Rocky Mountains, and the people and the practices that are involved in restoring and sustaining these landscapes. I think one of the things that was kind of startling to me was the account of our rangelands, and I just wanted to talk about that briefly. Rangelands account for the largest share of the nation's land base. They cover more than one third of the land service in the continental US and that's according to USDA data. Unlike pastureland, rangelands consist of native vegetation, and they include a wide variety of different landscape types such as grasslands, desert shrub lands, and so on. They provide essential habitats for all kinds of living creatures, forage for livestock, and recreational opportunities. But in this country and elsewhere around the world, I learned that these lands are threatened due to land conversion, unmanaged grazing, invasive species, climate change, and things like that. The Nature Conservancy, in fact, says that grasslands represent the most threatened and least protected habitat on earth. Less than 2% worldwide and just 4% in the United States receive any kind of formal protection.

So, thinking about the Southwest and the Rocky Mountains, as you probably know, they connect vast areas of habitat and there are all kinds of organizations, federal, state, private and tribal ownership that form this mosaic of pattern on the land. But private individuals own more than half of the nation's range lands. The federal government manages about 40%, and state and local governments and tribal councils manage the remainder. I found these numbers were rather compelling, and it sort of put, for me, into perspective not only the scale and significance of these landscapes but point to the important role private land managers play in caring for this huge amount of land in our country.

There's a lot at stake, isn't there? Given how much land you're talking about and the importance of it to environment and everything else.

It is. And there's a map in the book that shows that distribution. It was based on data collected by USDA, but it was interpreted by Dave Merrill, who works for Bloomberg. It's just very insightful when you see that big square of rangeland and you realize how much landmass that really is. So, that really struck me and I wanted to make sure that people understood that.

Let's get back to the themes of your book, because I'm dying to hear about them. But tell me first, what inspired you to take on the issue of regenerative agriculture in particular?

I've always been deeply interested in the relationship between people and environment, and sort of how our actions can shape and impact the landscapes that we live in. When I moved to New Mexico in 2013, I'm originally from the East and went to school in North Carolina as a matter of fact. I got a job helping a local nonprofit organization called the Southwest Grassfed Livestock Alliance here in Santa Fe, SWGLA for short. I helped them to produce a short video about how some producers were beginning to manage their animals on the land by utilizing a method called Holistic Planned Grazing. This was a term first introduced by Alan Savory, decades earlier. So, for this project, I visited six ranches spread across the states of New Mexico, and Colorado and Arizona. Traveled all around interviewing these ranchers. And through that experience, I grew a deep appreciation for these people, the men and women who managed these vast and often very remote tracks of land, and their dedication to regenerating some of the most incredible degraded landscapes that I've seen. I was inspired by their dedication and their determination, and I continued to visit and photograph over the years dozens of ranches and others who worked toward improving the ecological health of our rangelands. I guess you could say that the book "Homeground" was my pandemic project because I'd always wanted to find a way to share these images and the information that I had accumulated over the years. The lockdown kind of gave me time to sit down and think about how to organize and present what I had learned. So, around 2021, I decided that I was going to create this book and it would be titled "Homeground." Home alluding to a place of belonging and identity relating to the land. This seemed appropriate for me and the way of life that I wanted to feature.

Sally, you mentioned Alan Savory and I wanted to make a note to remind our listeners that we've recorded a podcast with Alan Savory that's part of our series on regenerative agriculture. And, the person who connected the two of us, Nancy Ranney, a rancher in New Mexico, and I know somebody you know well also has been a guest for part of our podcast series, both very impressive people. So, now let's talk a little bit more about the book and some of the choices you made in producing it. Some of the book's photographs are in black and white and some are in color, that's an interesting choice you've made. Can you share some insights about the process of selecting and capturing images, why you did some in color, some in black and white, and how did these reflect the principles of regenerative ranching?

I've had a few exhibitions that revolve around this work, and most of those were all done in black and white. When I started putting the book together, I felt because you're up close and personal looking at these images, that color would be good in moving you along the story. Also, some of the images were old, some were taken back in 2013, some were taken in 2022 and 2023. So, it was sort of a way to differentiate the flow of the work. Along with the images, there are three essays in the book that are written by well-known land managers in the region. Nancy Rainey provided one of the essays on community engagement, Bob Budd, who works in Wyoming, and Tony Berg, who has also worked in Wyoming but is now in Oregon, and he's a mentor with the Savory Institute. Each of them provided insightful personal accounts of their experiences in regenerative ranching, highlighting themes of the book, which are the importance of rangeland biodiversity, healthy soils, and community engagement. Ranchers also have some quotations in the book, but I worked quite closely with various state federal agencies and local nonprofits and academic institutions, and there's a lot happening out there in terms of all these other people that are involved in helping ranchers to manage their lands more sustainably. So, some of those are like the Covera Coalition, the Western Landowners Alliance, Holistic Management International, and of course Alan Savory Institute. It's a very complex and interesting world that is evolving and growing, fortunately.

Well, that's so true. I mean, if you go back just a few years even, there's a lot less knowledge about these sorts of approaches to ranching and agriculture, and now a lot more people are talking about it, thinking about it, studying it, writing about it, and photographing it, which is really wonderful. You mentioned that the work took place over a period of 10 years. Are there any specific stories or experiences from this journey you had that you found particularly impactful or enlightening?

Every time I set foot on a ranch, it was impactful. And it's hard to separate out just one story, but one of the most interesting experiences, I think we talk a lot about holistic grazing and how it tries to mimic the bison that roamed hundreds of years ago on the land. I had an opportunity to go out and visit one of Ted Turner's ranches in Central New Mexico where they were having a bison roundup. I rode out into this landscape, which was like actually transporting myself back 200 years where there were no cars, no telephone poles, just the land and the animals. It was pretty fascinating to see those bison, 500 of them roaming across the landscape. When I was out there also, there was a herd of antelopes and another herd of elk. So, I really felt privileged to be out on that land and to witness, almost like stepping back into history.

There are a lot of young people now that are getting involved, which is really great because there was a time when it seemed like people talked about ranching dying. And there have been organizations like the Covera Coalition that have really worked hard to get young people involved in now there's a lot of interest. And not just amongst doing ranching work, but also in the scientific and academic communities. And so, I was able to work with some scientists from the University of Colorado and they were working in robotics of all things, using these robots to monitor the ground and collect data on the temperature of the soil, the composite of the soil, all sorts of things.

Another ranch I went to in Lamar, Colorado, they had reintroduced the black-footed ferret, an endangered species, that almost went extinct in the 1980s and they were bringing back to, you know, regenerate the soil in that part of the country. So, I actually went out with a team of scientists at night because they're nocturnal animals and the only time you can see them and that they can figure out what they're doing and where they're living, and how they're living is to spot them at night. They ride around from maybe 10 or 11 o'clock at night until the early hours of the morning searching for these black-footed ferrets. They'll stick their heads up out of a hole in the ground, but they're determined. And that determination and that interest was really exciting to see.

You paint a wonderful picture of all this when you were talking about the bison and being transported 200 years in the past created this very vivid image in my mind, and I can imagine how powerful it must have been to be there and how wonderful it is that you've captured this in your photographs. It is just so important that this kind of work gets communicated. One of the reasons I'm delighted that you did your book. Let me ask you a final question. How do you envision your book contributing to the broader conversation about regenerative agriculture and ranching, and the sustainable use of land, and what do you hope readers will take away?

I think the book provides a broad understanding to a very complex issue. Sometimes those issues are difficult to understand because they're wound up in a lot of statistics, or the media is not reporting accurately, or even reporting at all on the issue. I'm hoping that a book like this that shows photographs will draw people in to want to understand more. The other thing I wanted to mention was that these land managers that I have met, they understand that ranching and healthy systems go hand in hand, and making the regenerative transition is a slow, and it's a complex process. There are no quick fixes, there's no one size fits all answers. And that's most likely true, I would say, for anyone, anywhere who's trying to make that regenerative switch. In our fast-paced world, it seems like that nothing is happening, but it just takes time. That's one thing that I can see over this 10-year period is I can see a change. That's pretty gratifying.

Grasslands in particular are very overlooked ecosystem in our country, but they play a crucial role in guarding against climate change. And one thing that amazed me was that a three-foot-tall grassland plant has a root system that extends more than three to four times below the surface of the earth. And those deep roots work to stabilize and they nourish the soil and can sequester huge amounts of carbon from the atmosphere. So, rangelands are important in that way, and I think it's important for people to understand about that. Another thing is that I think our Southwestern and Rocky Mountain Rangelands, they're a part of our collective history and legacy, and their landscapes that provide us all with clean water and clean air. They offer us respite and recreational opportunities. And in our world now where 80% of the population resides in urban areas, it's pretty easy for us to overlook what we don't encounter every day. It's my hope that "Homeground" will engage viewers from across the country to consider the significance of regenerative ranching and its potential benefits to all of us regarding climate and conservation, wildlife, and food production.

Well, what an important goal. So good luck looking forward. So, for people who are listening, who'd like to obtain a copy of the book, how should they go about doing that?

They can go onto my website: sallythomsonphotography.com.

Bio

Sally Thomson is a documentary and fine art photographer based in Santa Fe, New Mexico. Her work explores the relationship between nature and culture and how that forms our perception and expression of where and how we live. Thomson's previous experiences in landscape architecture and conservation planning inform her work as a photographer, which aims to inspire the conservation and regeneration of endangered environments and the cultural legacies they support. She holds a Master of Landscape Architecture from North Carolina State University School of Design. She is the Past President (2017-2021) of the American Society of Media Photographers New Mexico Board of Directors.

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Our guest today is Jasmine Crowe-Houston, social entrepreneur, and founder of Goodr.co. Jasmine started her journey cooking soul food for hungry unhoused people in her kitchen in her one-bedroom apartment in Atlanta. She fed upwards of 500 people a week for years with pop-up kitchens and parks and parking lots. Then in 2017, she founded Goodr, a technology-based food waste management company that connects firms with food surpluses to nonprofit organizations that can use the food. She has worked with organizations that have food waste issues, such as the Atlanta International Airport, Hormel Foods, and Turner Broadcasting. Today, Goodr has expanded nationwide and sponsors free grocery stores and schools. She has combined charity, innovation, and market-based solutions into a for-profit waste management company that Inc. Magazine called a rare triple win.

This episode is in collaboration with Policy360, a podcast of the Sanford School of Public Policy at Duke University.

Interview Summary

Would you describe what Goodr is today?

Goodr is a blessing. We are a sustainable food waste management company that leverages technology to connect businesses that have excess food to non-profit organizations that can use that food. And at the same time, we have a line of business, which is Hunger Solutions, and we're helping brands and government and other municipalities rethink how hunger is solved in their communities. We believe that hunger is not an issue of scarcity. It's really a matter of logistics. And so, we are using technology and logistics to drive out hunger and food waste. We've built technology that includes our mobile app and portal. Imagine you are using an Uber Eats or DoorDash app. You go onto your favorite restaurant; you click the item that you want. Similar experience for our users. So, for example, a restaurant in the airport. Their menu is in our system. They click chicken sandwich; they tell us 50. Our platform is going to calculate the tax value of those sandwiches, the approximate weight of those sandwiches, and our algorithm is automatically matching those sandwiches with the non-profit that is serving 50 or more people that can take those items and then get it distributed to people in need. Another big thing that our technology is capturing is the poundage that we're keeping out a landfill. So, it's really important because we're able to tell our clients we have kept 2 million pounds of food from landfills. This is equal to this much CO2 emissions that you've helped to prevent. We do a lot of fun gamifications as well, but we're data-driven and we believe that you can't manage what you don't measure. And for too long, people have thrown everything away. They've never measured it. And now we're giving them real insights and they're seeing things like, wow, my number one wasted thing is pork. Why am I making pork so much? Maybe people here at our offices don't eat pork. Start to make changes. So, we really work on the source reduction, but the number two on the EPA is the food hierarchy chart is feeding hungry people. And so that's really where we are.

Wow, that's amazing. I want to ask because I've seen this in the food waste and food donation world, that sometimes food that's donated isn't appropriate or fit for human consumption. What happens to those food products?

Traditionally, they end up in landfills. One of the big things that we have to do at Goodr, and I'll tell you too, that change is by county. So, think of not by city, not by state. Wake County and Durham County probably have different rules because it's based off the health department in each city. So, a good example is when we were working in Florida, what we do in Miami is absolutely illegal in Fort Lauderdale. They're 10 minutes away from each other. Broward County and Dade County have different rules. So, we spend a lot of time, our R&D team, creating quality assurance checklists. And we know this food is going to live for three hours. So, you've got to get this either cooled, frozen, or donated within three hours. So, we tell our businesses that. We are moving food in an average of about 30 minutes from the time it gets picked up. Some of our customers will put in their pickup requests and ask that it's picked up the next morning. So, they're going to automatically put it in their refrigerator. That's their comfort level. They feel a lot better. It makes the food last longer and they don't always have to worry about it being fresh. A lot of the time when we're dealing with weddings, really big events, that's when we have to move right away because maybe that business doesn't have access to the kitchen the next day. And so, we need to move a little bit differently. Most of the time when a business has food that's passed that timeframe, they typically do throw it away. But what we've done is we've introduced organics recycling into our fold. So, our customers now have the ability to send that to an animal farm. We can also send it to an anaerobic digester and turn it into an organic product, or we can compost it. We're still keeping it out of landfill. It doesn't have to end up in landfill ever. That's the positive.

Yeah, that's amazing. I saw your 2019 Ted women talk entitled "What We're Getting Wrong in The Fight to End Hunger". And it has been viewed by more than 2.2 million times.

Wow. Yeah, it's so good. I didn't know if you gave me those last million, but that's good to know.

Good job! No, it was over that by the time I got to it, but it's really amazing and I'm just intrigued to get your opinion about why do you think people are interested in solving hunger and food waste?

I think people are questioning why it hasn't been solved yet. It's almost like it's not as big as cancer, right? But it's as big as cancer. Cancer's big, it kills people, right? But we spend a lot of money and there's a lot of research and we feel like we're getting closer to the fight. I don't know if people feel that we're getting closer to the fight as it relates to hunger. And if you think about it, Norbert, when me and you were kids, we probably did a canned food drive. Anybody that's listening right now is probably thinking, "I did some kind of a food drive when I was in elementary school to solve hunger in our communities." Why are we still doing that? Why are we still doing the same things? I always look at it as being the definition of insanity, right? Doing the same thing over and over again and expecting a different result. I think that's what people are interested in. What are we getting wrong? Why is my kid, 35 years later, why am I still doing canned food drives for my kindergarten kid and this is something that I did in kindergarten? And is this moving the needle? Is this really working? People want to know that. People want to know are we pacifying problems or is the money that we're putting behind these actually driving solutions and should we look at something else that's different? Even with my TED Talk, I remember the first week it came out, we got a lot of, "Oh, you're talking negatively about food banks, and they do great work and I volunteer at the food bank every weekend." There's a whole section in my TED Talk where I say food banks and food pantries are vital. They play a pivotal role, but they don't solve hunger alone, and we need to be open to doing new things. We're using technology in every other area of our lives. I mean, we're getting our groceries delivered, we're meeting our spouses, we're going to college. Why are we not using technology to try and solve a big problem like hunger and food waste? And so, it's just getting people open. I think that's what people are interested in finding a solution.

I'm really intrigued by the model of Goodr, the fact that it is a for-profit company. What's also interesting is given all the success that you've had up to this point, it's hard to believe now that investors hesitated to support you.

Yeah, shame on those investors, I would say. I'll tell you, Norbert, the sad thing is, right, any woman listening should know this. Women as a whole get 2% of all venture capital funding from investors as a whole. So, you take a pie and then you take 2%, and now of that 2%, you have women that are Asian, women that are Black, women that are Hispanic, women that are White. We're all taking a piece of that small 2%. So, there's part of that. I think another thing is it's hard to sometimes get conviction around that, which you don't understand. And a lot of investors, quite frankly, have never been hungry, you know? They don't really understand food waste. It's probably not... It's not AI, it's not blockchain, it's not crypto. It's not always in the headlines. It's not the cool thing. So, I think those all played a factor in it. I think that's just the reality. Investors like to invest in things that they can get excited about, and sometimes hunger and food waste just are not exciting. I also think a lot of people felt like this is so good, they should be a nonprofit. And for me, I saw the business case in what we were building right away because businesses were already paying to throw food away. That's the simple thing about it. So why would I create a nonprofit and must ask everyday people to donate so that we can get this food picked up, have to rely on volunteers that may or may not come, which possibly would cause more food to go to waste. Because if you're being paid to pick something up, you're being paid to do something, you're 99% more likely to go, right? If you're volunteering and it's raining, you may not go that day. It doesn't matter how much you care about the cause. You may not want to get in your car, you may not like to drive in the rain. Those are the things that happen. And so I also believe that businesses would value what they pay for. So, if you're investing and you're paying in a service to divert your food waste from landfill, you're more likely to make sure that your employees are actually packaging that food, recording it for donations, scheduling pickups, than you would be if it was just a free thing, and it was a nice to do. I think that was kind of like we needed to prove that, and now we've proven. We have world-class customers. We work with... You name some of them. And I mean, we've worked with everybody from the NBA to Google to Oracle, Nike World Headquarters. These are our customers, you know? People have now seen that this works. One of our biggest customers, they sent over a testimonial the other day and it says, "All the other locations are banging down my door to try and get Goodr." People just needed to give it a try. And so now hopefully when we have those investor conversations the next go around, this market's a little crazy, but hopefully we'll have a bit more willingness to give our solution a try. And there have been great investors who have made an investment in what we're doing.

Right. Thank you for sharing that. And we're at a university and we have a lot of young people who are excited about social entrepreneurship. What can you say to them to encourage them along this path?

I could say to them that they are needed. We were talking about my goal of wanting to be a professor one day, and what I want to talk about is social entrepreneurship and this model of being able to do well by doing good. That there is a way to do that in business and that it ultimately works. And we've seen the big companies that I think are pretty keen and they've seen success for are your Warby Parkers, your Patagonias. These are other B Corps, Goodr is a B Corp as well, who are kind of existing. The first model I ever saw of social entrepreneurship was Toms Shoes. They were really popular maybe 15 years ago, maybe not as much now, but there was a point when it was like, I'm going to buy a shoe and give a shoe. Bombas, the sock and undergarment company, the same thing. They're supporting homelessness. You buy a sock, you're giving a sock, you buy a T-shirt, you're giving a T-shirt. People love to do good. And so, these students that are interested in creating ways and solutions to solve some of our biggest problems, are needed now more than ever. I mean, this world is... I read an article the other day talking about all that millennials have lived through. And I was thinking to myself, goodness gracious, I've lived through a lot, two recessions, a couple of wars, a pandemic, just like everything, technology. I mean, that's the reality of it. I don't recall a smart cell phone when I was in high school and college. That was... I think the iPhone came out maybe in 2008, 2009. I graduated college by then. I didn't have that. Facebook wasn't around until 2008. You start to see what's happening to young people now because of social media, their self-esteem, the anxiety. There are so many things that we need people to be addressing because we're creating a lot more technology, but we're also creating a lot more problems, and they need to be solved.

They do. And it is interesting to think about the anxiety that's associated with some of these issues.

Oh yes.

And the fact that Goodr is trying to address food waste, which is a contributor climate change, I mean, you're providing a solution. And this is great and it helps me think that our students can start to think differently about what they can do to help address these issues.

The Project Drawdown, which is pretty much a leading climate solutions organization, they named, in 2022, food waste. Reducing our food waste is number two after fixing our energy grid. Number two thing that we could do to combat climate change is to reduce our food waste. In America, nearly 2% of GDP has been on food we never eat, which is just insane to think about. 2% of everything that we spend is on food we never eat, from production to transportation to the disposal. And so even around the food waste chain, there's still a lot more solutions that are needed. So even if that's going to be what we're producing at the farm level, what's going to waste? What can we do with it? Can we reuse it? Can we turn things into other products? I was reading an article recently about there's a new kind of leather that's going to be... It's already kind of on some runways, but it's made out of banana peels. That’s a social entrepreneur that thought of that.

I love the fact that you're so welcoming and you're trying to bring people in. And that brings up the book that you've published recently, "Everybody Eats," and it's there to inspire young people in the fight against hunger. It is beautiful. And I see my daughter in this text and so I'm really appreciative of it. And it was illustrated by Nadia Fisher. And there is also a website with resources for parents and kids and teachers. What do you want to accomplish with this outreach effort?

I am often asked, will I solve hunger in my lifetime? I want to say yes, but I have to think possibly not. Hunger grows every single year. I mean, there's a new study I just was reading that it was in the Washington Post two days ago. It's increased 12%. Childhood poverty is up 20%. So sometimes I'm going, or you make the shot, we're at Duke, right? This is a basketball place. So, you make this shot and you can't keep your hand there because the team is already down, the other team's already on the other side of the court. That's often how I feel about hunger. It's like I do something that's really good. It's monumental. We've got grocery stores in schools, we're feeding students, and then I read that childhood poverty is up 20%. How do I leave a legacy that really focuses on solving hunger? I need to inform the next generation and I need to do it in a way, and how I wrote that book is really my story in the eyes of a kid. Me learning that one of my friends, my college roommate did not have food in her household, and that shaping my whole life. And now thinking like your daughter, what would she come back and tell you if she learned that a friend of hers at school doesn't have food in her kitchen like you have food in your kitchen? And they ask questions, and they want to understand that. She goes on this journey asking grocery stores and her school like, "Hey, what's going on with this food? People are going hungry. My friend at school doesn't have access to food," and she's trying to help her friend. And the reality is just like with my friend and the young protagonist in the book, her father just lost the job. I mean, so many people read these stories. I think the most recent article I saw said something like 75% of Americans are living... Are one paycheck away, just one paycheck away. And to see that, that happened to my friend, and it's the most jarring thing that has ever happened to me, probably in life. Because I had a completely different picture in my mind of what hunger looked like until that happened to me. And this happened to me probably three years into feeding people that were experiencing homelessness on the street. I've been feeding people for over a decade of my life. To learn that someone who had volunteered with me, someone who had been out feeding people with me, that they too wouldn't have food in their home, it changed my whole life and my life story. I use all the proceeds from the book to fund a Neighborhood Eats program where I feed kids on the weekends, and I know that I'm making an impact in the lives of children. And they will. My hope is in 15, 20 years, you'll be sitting here talking to someone else who's doing something around this. That's the goal.

You've touched on this, but I just want to push it a little bit further. Food waste and hunger are longstanding challenges and they touch people all along the supply chain. How do you manage the complexity of this problem?

Yeah, I think we have to continue to focus on the verticals that we're really good at because it is big. You'll probably think I'm lying to you, Norbert. I may get a hundred phone calls and emails a week. "Hey, we need Goodr here. We want it... How can I bring this here? Can I bring this to my community? I need food. My senior home needs food. The trailer park that we live in, a lot of us are... It's rural. We're not near a grocery store." I look at myself as trying... I think it's like hero overload. I'm trying to solve all this. How do I get to Canada? Oh, someone just called me from Denmark. How do we go to Denmark? How do we get here? I think what I have to really focus on is US first. I do really well with large scale venues, colleges and universities, enterprise corporate cafeterias, stadiums and arenas, airports, convention centers, places where there's a lot of food in one location. A lot of people wonder, why don't you go to small restaurants? We get calls from, "Hey, we have a deli in Long Island, New York," And we're like, "Hey, we're not there yet, but here's our resource guide for how you can donate food. Here's organizations that you can look for in your community. Here are ways you can create your own food donation programs." We try and give them resources to still solve the problem while realizing that we can't do it all ourselves. And I could tell you as an entrepreneur and as a social entrepreneur, that's the hardest thing ever. Because at first, when I first started Goodr, I'm very happy people in Canada didn't call me then because I probably would've been from Atlanta to Vancouver, and just missing a whole other part of the process. But you've got to follow the process and you've got to get really good at something and then drill in and just become the best at it. The best in class. And that's what we... When we have our all-hands meetings and our team retreats, we talk about what are we the best at? And we also say are there things that we're doing that we're not good at? And to your point, that's why I said I'm inviting other people in, right? Because I know that there's other use cases. We don't work with grocery stores. That's something that's really fascinating to a lot of people. I spent probably the first six months of customer discovery, when I was really trying to figure out who are going to be the Goodr customers that we're going to pitch to of working with trying to work with grocery stores. And what I learned is the two largest grocers in the country created and kind of funded Feeding America. There's a strong system there. I was like, okay, they've got that. Now I'm still trying to work with them on prepared foods. That's my hope with the grocery stores now is those rotisserie chickens, those are the things that don't get donated and so that's what we're really trying to focus on. But the shelf stable things, the produce items, they have a strong solution for that. And it took me six months of trying and hitting roadblocks to see that sometimes people don't want to change what they feel like they've focused on. I had to go and say, okay, well where's the food not going? Where's it missing? And I realized it was prepared foods. And that's why I'm really trying to stay on those rotisserie chickens at these grocery stores, because I think if a parent can get a rotisserie chicken, you could pull some other things together. The meat is kind of what you really need.

So how do you stay inspired?

I try and keep my eye on the prize. I got an email from a lady and her name was Bertha, so I've assumed that she was a senior. Her email said to me, Norman, "I just want to thank you guys for your food today. When I got home, my meat wasn't brown. It was fresh and everything was good. And it came from good stores, I could tell it was quality." And I'll never forget that because I thought just imagine, she's saying I got meat that's fresh. That's her thing. I'm hungry. I'm getting food from your organization and it's good, and I'm shocked by that. So shocked that I needed to send an email to say, "Hey, when I got home today, you gave me something that was good." So that's the stuff that I think keeps me going. I got another email from a lady; this is when we were doing a lot of work. We did a ton of work around hunger during the pandemic if you can imagine. And her email was just like, "I was sitting on my porch, my kids were sleeping, they were napping. And my only thought was what am I going to feed these kids when they wake up? because they're going to wake up hungry. Kids ask me for snacks. We're running low, we don't have anything. And I get a call from a driver named Jarvis who says, 'I'm around the corner. This is Goodr. I've got this food delivery.' And not only did he bring a box of food for my family, but he also brought me a pizza that was warm." because we had... I think Papa John's at the time was giving us pizzas, this is heavy in the heat of the pandemic, to deliver boxes of food that we were bringing to families. And she was just like, "This was a godsend." And she said that we gave her hope in her darkest hour, and I'll never forget that. Those are two emails, and I think both of those emails are from 2020, 2021, that still are in my head today. I think about that as a guiding light to continue to keep going and just knowing that we are really making change.

Bio

Jasmine Crowe-Houston is the creator of Goodr, a tech-enabled sustainable food waste management company that strives to eliminate hunger and save food from landfills. Through her years of work feeding vulnerable populations, Jasmine saw a great opportunity for technology to solve a real problem: hunger. In January 2017, Jasmine founded Goodr, a food management platform that allows users in the food industry to track and redirect surplus food. She's a proud alumna of North Carolina Central University. A resident of Atlanta, Georgia, she enjoys spending time with her family and friends and being a new mom to her daughter Journey. She is an avid traveler who has visited more than 30 countries. Jasmine sits on several nonprofit boards and continues to use her time for good. She was named by Entrepreneur Magazine as one of the top 100 influential female founders and recognized on the Black Enterprise 40 Under 40 List.

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Stories from the past help us understand who we are and who we can be. In today's podcast, we will explore a gripping new book titled "Food Power Politics: The Food Story of the Mississippi Civil Rights Movement," written by African American Studies Assistant Professor Bobby J. Smith II at the University of Illinois at Urbana-Champaign. The book tells how food was used as a political weapon against African Americans and describes how black people fought against oppressive regimes by creating their own food systems, Bobby sets the stage for understanding how black youth today in Mississippi and beyond are building food justice movements and grappling with inequalities that attempt to contort their lives.

Interview Summary

So, Bobby, what inspired you to write "Food Power Politics?"

So many different ways to answer the question. I have a family background in agriculture. I did food justice activism while I was in graduate school. I also worked on food policy councils. So, I was inspired to write it because I was already interested in understanding the ways in which food was produced, consumed, and distributed. But what inspired me to write "Food Power Politics" was actually a class I took while I was in graduate school at Cornell University in the Department of Developmental Sociology. I'm taking a course around community development and organizing and we read a book by sociologist Charles Payne entitled "I've Got the Light of Freedom." It's about the Civil Rights Movement in Mississippi, particularly the area called Greenwood, Mississippi in the Yazoo Mississippi Delta Region of the state of Mississippi, which is the northwest quadrant of the state. And in the book, Payne talks about the organizing tradition of the Civil Rights Movement. And during that class, I'd already been interested in understanding, again, issues of food justice and food security. So, as I was reading that book, I learned about the ways in which food became a weapon used against the Civil Rights Movement and civil rights activists responded by organizing their own food programs. And essentially, I wrote "Food Power Politics" because I wanted to raise awareness about how food can be used in different ways. But I also wanted people to rethink the idea of food. Many times, people think about food as something that's on your plate or something you get at the grocery store. But what inspired me to write "Food Power Politics" was to show a different story about food and how it impacts the lives of African American people.

Thank you for that. And I have got to tell you, I'm intrigued by the phrasing of "Food Power Politics." Could you please unpack its meaning and explain how you map it across the landscape of Black life?

"Food Power Politics" is the title of my book, but it's also the theoretical framework that I created to begin to understand, or for scholars and other people to interpret, how food can be used as a weapon. The book started as ideas for my dissertation. When I first learned about the ways in which food had been used as a weapon against African American communities, I started looking to the literature to find out how have people talked about food as a weapon. I remember talking to a number of my colleagues about the book itself and they were telling me stories about how the idea of food as a weapon is just what we call wartime tactics. So, food has been weaponized for many, many years, and centuries. So, I went to the literature, and I found out that scholars, typically legal scholars, historians, and political scientists, when they talk about how food when used as a weapon, they use the term food power. I had never heard of food power before or this framework of food power. So I, of course, as a diligent graduate student, delved into the literature and learned more about food power. And it's a concept that is usually understood in the context of international conflict whereby one nation withholds food from another nation in times of conflict as a way to mitigate the impact of the conflict, or that the nation that wills the power against another nation can win the conflict. That's what they call food power. So, I used the concept of food power and transposed it into the context of the Civil Rights Movement. And while I was studying the Civil Rights Movement, food power allowed me to think about how food had been used as a weapon against African communities, but it didn't allow me to pick up on how African American communities fought back. And that was a key part for me because many times when we think about times of oppression or social struggle, we tend to think about how oppressors oppressed people and not have those who are oppressed fight back. So, when I observed what African American communities were doing in Mississippi in response to food being weaponized against them, I theorized ideally emancipatory food power, which allows or creates this way for us to understand how African American communities use food as a way to emancipate themselves from those kinds of conditions and circumstances. So, the conflict between food power and emancipatory food power equals or is a sense is where I theorize as "Food Power Politics" which captures those struggles. I didn't want to show just one side of the struggle by which food is used against African American communities. I wanted to show both sides. And that's what the concept of "Food Power Politics" seeks to do. It gives us language to understand these instances, whether it's during times of enslavement in the African American experience or in times of Jim Crow or civil rights or even today. It gives us language to understand the ways in which food is used in times of social struggle.

This is really rich. I'm so intrigued by the idea of taking from geopolitical conflict, this notion of food power and this idea of food power against, but you also talk about food power for, and that was an important move because it shows how people can take possession of their lives and use food, that can be so complicated, for their good. And so, I hope we'll talk a bit more about that. But I really want you to take us back in time. So, what is the food story of the Mississippi Civil Rights Movement and why do you think it's important?

So, thinking back when I talked about Charles Payne's piece, "I've Got the Light of Freedom." He talks about how food was used as a weapon against African American communities. So, although Charles Payne's book is not about food, it's not about agriculture. It's a strictly civil rights, Black Freedom Struggle type of book. But in chapter five of the book, he recounts this moment activists now called the Greenwood Food Blockade. And the food story of the Mississippi Civil Rights Movement, or the story that I want to tell, begins with this Greenwood Food Blockade. In short, it is this moment where the White political structure there in the Yazoo Mississippi Delta Region through the city of Greenwood, Mississippi, in Ford County, is where they begin to use food as a form of voter suppression. So, there's this federal surplus commodities food program. Government cheese, or government peanut butter, meats, and things like that. At the time in the Delta Region of Mississippi, that program was a big program for rural African American communities. In 1962, the Florida County Board of Supervisors decides to dismantle that program. And that was the only way that our poor world Black communities were able to even get food. Many of them were sharecroppers or farm workers or day laborers, and many of them didn't have any money to buy foods. So, all the food they got and the ways in which they fed themselves was mostly through this federal surplus commodities program, which is what they call the Surplus Food Program. So, in 1962, the Florida County Board of Supervisors in November of 1962 decide to dismantle the program as a form of voter suppression. So, what ends up happening is that now activists who are in Mississippi begin to make connections between food and the struggles of sharecroppers. And so essentially the food story of the Mississippi Civil Rights Movement begins with this event called the Greenwood Food Blockade. And in response to the blockade, activists organized what they call the Food for Freedom program. So, that's one of the first times we see these tensions between food power against and food power for. The blockade itself is one where food power is used against these communities. And then the Food for Freedom program is designed to respond to that lack of food that is engineered by the Greenwood Food Blockade. That's my entry point and that's how I even found out about this food story of the Mississippi Civil Rights Movement. And in 2017 when I was a graduate student, I went to Mississippi to learn more about the Greenwood Food Blockade. I wanted to locate activists who knew about it. I went to the places where the Food for Freedom program operated, and I learned so much about the Greenwood Food Blockade. But while I was in Mississippi, I also learned about another part of this story. So, during the Greenwood Food Blockade, while activists are responding to this use of food as a form of voter suppression, there's also this food stamps campaign that is engineered by White grocery store owners in the Delta and across Mississippi. Now, I call it a food stamps campaign because in 1962, our nation did not have a Federal Food Stamp program. It was a pilot program at the time. White grocery store owners in Mississippi wanted food stamps, but not food stamps to feed people; they wanted food stamps to make profit. They also wanted to get rid of the federal surplus commodities food program because they believed that that program would cut into their profit. So, once I learned more about this Federal Food Stamps campaign in Mississippi, I soon learned that another way in which food had been used as a weapon against African American communities was also through the Federal Food Stamp Program. The Greenwood Food Blockade is food as a political weapon. And then this Federal Food Stamp campaign by White grocery store owners is food used as an economic weapon, and how activists and how sharecroppers in those communities responded to that campaign was how they developed food cooperatives. Throughout each chapter of the book, I provide a case study of how food is used as a weapon against African American communities and how they respond. But they respond in different ways because when it's a political situation, they respond by attaching food to civil rights activism and freedom. Whereas the food stamps, they realize whether we have surplus commodities or whether we have food stamps, we can't control when, where, and how we access food. In response, they start developing these food and farm cooperatives in Mississippi, and that's the way we see how food can be used as a weapon against, but also how being those communities counter weaponized. And then I follow that story and situate it through today and show how particularly Black youth in the Delta today continue the food story of the Mississippi Civil Rights Movement, recognizing that things are different today and that a lot of the power structure has morphed to fit today's context. But communities are still struggling to counter weaponize the ways in which food has been used against them.

You are already leading into the next line of questioning and that's this idea why your text mostly is about historical events. You do, of course, bring it to today. And I'd like to hear you talk about this. How do you envision your book contributing to the contemporary work of food activists and their communities?

Honestly, when writing books or articles, you never know who might have access to it or who might get it. And my hope for at least communities or those who are actually on the ground doing the work around food justice or food sovereignty or any type of food movement, I want them to use the book as a part of their arsenal of stories to develop blueprints to think about the future. The reason why I wanted to end the book with thinking about Black youth, because the Black youth that I studied in the book, they were directly continuing this food story of the Mississippi Civil Rights Movement, which also showed me that there's some unanswered questions left from the past that we still need to address if we're going to create this socially just food futures. I'm hoping that my book can be used by activists to show them that they're not by themselves. In fact, they're part of a legacy, a genealogy if you will, a lineage of people who have always put food at the center of social struggle to think about how can we ensure that everybody is food secure? I couldn't leave the book in the civil rights era. I wanted to think about how people today, so the rural Black youth that I write about in chapter four in the book, they continue this story, but they're thinking about how can we, one, reclaim the past but also make it fit today? The local foodscape of the Delta is different now, back then, the Delta's Foodscape was shaped by mostly commissary stores and a few grocery stores as well as these plantation stores. And they all worked together to create this type of food outlet or food environment for to be poor world Black communities. But today we have a prevalence of corner stores, a prevalence of liquor stores, dollar stores, and those type of stores that carry cheap and highly processed foods or even no foods. And that's the foodscape by which activists are navigating today in the Delta. And I wanted to create a type of book that could help them think about how we can use history as a way to shape our strategies? Because while I tell the food story of the Mississippi Civil Rights Movement, there's a food story of the Alabama Civil Rights Movement, a food story of the North Carolina Civil Rights Movement. And I want to give people permission to begin to excavate those stories and think more about how it relates to the work they're doing today.

That's really helpful. I mean, you clearly have an eye toward the public to say, "What can folks who are on the ground doing the work of trying to fight for food justice pull from the past to use as strategy, as motivation, as even hope?" And I really appreciate that. Now I want to shift gears and talk a little bit about policy because I'm at a policy center and I'm interested to understand what we can learn about current conversations about federal, agricultural or food policies, given what you say?

I appreciate this question, Norbert. So, next year marks 60 years since Lyndon B. Johnson signed the Federal Food Stamp bill, which created food stamps. We call SNAP today the Supplemental Nutritional Assistance Program. What does it mean to think about food stamps 60 years later? My book provides an untold history, if you will, about the food stamp program. When many people think about federal food policies, they think about these policies as a way to ensure that people get something to eat. People need these programs to get access to groceries, get access to foods from a number of places. But historically, these food policies and ag policies were not necessarily designed to impact the public at large. And I think it's important for us to understand it as we think about how we're going to revise these programs to ensure that they're meeting the needs of the actual recipients. What we do know about food stamps is that in the past, it was designed while Lyndon B. Johnson and others argued in the 1960s that it was a part of this larger war on poverty and that it would help people get out of poverty. But food policies are not necessarily designed to get people out of poverty. It doesn't necessarily give them more actual money for them to take care of other things in their lives. Now, while it gives them some type of supplemental food assistance that then could possibly increase their income, it doesn't give them direct aid. And what I want my book to do is for us to begin to complicate how we think about ag and food policies and recognizing that while on the surface or when we read the legislation, it's designed to do X, Y, and Z, what actually happens and what we do know in the 1960s after the Federal Food Stamp program is passed, and it comes in Mississippi, people become more food insecure in Mississippi. And that's interesting to understand because people think when food stamps come to Mississippi, oh, now everybody can eat. And in fact, civil rights activists were saying, "Actually, no, we can't even eat now because you have these requirements." And that's also what we're seeing today. Activists have been organizing to shift the requirements of what it means to get SNAP or what it means to get food aid. And year after year or every five years under the Farm Bill, it gets harder and harder for people to get something to eat. But somebody's still making money from these policies and I'm hoping that my book provides at least an entry point or a window into complicating those conversations. I mean, if the goal is to feed people through food policy, then I'm hoping that we can learn this history, learn from it and as a way to revise what's going on presently to impact the future.

As you know, USDA just released its most recent estimates of food insecurity in the United States and there's been an increase.

Yeah, I saw that. Yeah.

Yeah, and the fact that we're now in the conversation around the Farm Bill and what's going to happen there. I think there's some important policy conversations that need to take place. And one thing, of course, given the origins of your book and where you're located, in addition to thinking about the policy, there are racial and societal concerns that also crop up. Thank you for exploring these issues and trying to recognize the complexity of the lives that we live. So, I appreciate your project there.

Thank you for framing it the way that you did. I'm glad you borrowed the food insecurity increasing because it's important to recognize that nationally, it's gone up. So, what does that mean for those demographics that were already disproportionately impacted by food insecurity? Thank you for bringing up that particular point.

I understand that your book is the inaugural publication of the newly launched Black Food Justice series at the University of North Carolina Press. That's wonderful. Congratulations.

Thank you. I appreciate that.

My last question for you is how do you see your book reshaping our understanding of food justice?

I've been thinking a lot about food justice, at least for the past 10 years. And in many conversations about food justice, there's been an explicit focus on thinking about race, but mostly thinking about race in the context of what we called the local food movement. So many of us, even myself, have argued before about how the local food movement is overwhelmingly White and overwhelmingly affluent and that poor people or people of color or Black people can't even get access to the movement. And while that was important, some maybe five years ago thinking about food justice, what my book shows is that the story of food justice or the development of the movement has deep roots in the arc of the Black Freedom Struggle in the United States. And I think that's important because when we begin to think about food justice, we tend to automatically connect it to the Environmental Justice Movement of the 1970s and 1980s. And what my book shows is that in fact, Black folks have been doing food justice since they were enslaved. They just didn't have the language to call it food justice because they were just attempting to survive. They were trying to make new worlds in a strange world they were brought to when they were enslaved because there wasn’t any knowledge. So, what my book shows or extends or what it does or what it begins to reshape, if you think about this idea of food justice, is that it shows that there's more to food justice than just an opposition to local foods or just opposition to the absence of Black people at farmer's markets and CSAs. In fact, food justice has a deep history in how Black people reimagine their worlds and how they put food at the center. And I believe that's what my book does. It reshapes our understandings of food justice, and it provides concrete examples of how food justice morphs with the times. How it looked during times of slavery versus Jim Crow versus civil rights versus current that we find ourselves in. In the sense, what I'm attempting to do is I'm showing how it connects food justice connect to civil rights, but also, I'm showing more largely how the food justice movement, in many ways, African Americans provide the blueprint for understanding how we can achieve food justice in our nation and around the world today.

Bio

Dr. Bobby J. Smith II is an interdisciplinary scholar of the African American agricultural and food experience. Trained as a sociologist, with a background in agricultural economics, Dr. Smith is an Assistant Professor in the Department of African American Studies at the University of Illinois at Urbana-Champaign, with affiliations in the Department of Food Science & Human Nutrition and the Center for Social & Behavioral Science. He is the author of Food Power Politics: The Food Story of the Mississippi Civil Rights Movement (University of North Carolina (UNC) Press, 2023), the inaugural book of the newly launched Black Food Justice Series at the University of North Carolina (UNC) Press. Dr. Smith earned a B.S. degree (summa cum laude) in Agriculture, with a focus on Agricultural Economics, from Prairie View A&M University in 2011. He earned a M.S. degree in Agricultural and Applied Economics in 2013 and a Ph.D. in Development Sociology in 2018 from Cornell University. Most recently, Dr. Smith has been awarded fellowships from the American Council of Learned Societies (ACLS) and the National Endowment for the Humanities (NEH), among others.

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In August of 2023, the Food and Drug Administration issued something known as a direct final rule, disregarded trans fats in the food supply. Consumers won't notice changes as the rule just finalizes FDA's 2015 ruling that partially hydrogenated oils - trans fats - no longer had "GRAS status." GRAS stands for generally regarded as safe. We cover this issue today because this trans fat ban was the product of lots of work by a key group of scientists, the advocacy community, and others. The anatomy of this process can teach us a lot about harnessing scientific discovery for social and policy change. At the center of all this is today's guest, Dr. Walter Willett. Willett is one of the world's leading nutrition researchers. He is professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health, and for many years served as chair of its Department of Nutrition. He's published extensively, been elected to the National Academy of Medicine, and it turns out, is the world's most cited nutrition researcher.

Interview Summary

There are so many things I could talk to you about because you do work in such an array of really important areas and have just made contribution after contribution for years. But let's talk about the trans fat because you were there at the very beginning, and it ended up with a profound public policy ruling that has major implications for the health of the country. I'd like to talk about how this all occurred. So, tell us, if you would, what are trans fats, how present were they in the food supply over the years, and what early discoveries did you and others make that led you to be concerned?

Yes, this is a story from which I've learned a lot, and hopefully others might as well. Trans fats are produced by the process called partial hydrogenation. This takes liquid vegetable oils, like soybean oils, corn oil, canola oil, and subjects them to a process with high heat and bubbling hydrogen through the oil. What this is doing is taking essential molecules, essential fatty acids like the omega-6 and omega-3 fatty acids and twisting their shapes just subtly, and this turns them into a solid fat instead of a liquid fat. And, of course, the food industry likes this because our culture, the Northern European eating culture, emphasizes solid fats like butter and lard. Industry really didn't know what to do with all the liquid oil that they were able to produce by another process that was discovered back in the late 1800s. The partial hydrogenation process was actually developed in about 1908, and someone actually got a Nobel Prize for that. It wasn't used widely in the food industry till the 1930s and 1940s when it was upscaled because it was cheaper, for multiple reasons, to partially hydrogenate oils and turn them into solid fats like Cricso and margarines. I got worried about this, actually, back in the 1970s, when other scientists were discovering that these essential fatty acids are important for many biological processes, clotting, arrhythmias, inflammation, and counteracting inflammation. I realized while studying food science at that time that there was nobody really keeping an eye on this. That there were these synthetic fatty acids in massive amounts in our food supplies. Margarines, vegetable shortenings were up to 30% and 40% made of trans fatty acids. And that may me concerned that this could have a big downside. So, back in 1980, with the help of some people at the Department of Agriculture developing a database for trans fats in foods, we began collecting data on trans fat intake in our large cohort studies. And about 20 years later, we saw that trans fat intake was related to risk of heart disease. We published that in 1993. That got us started on the pathway to getting them out of our food supply.

Let's talk about how present they were in the food supply. You mentioned some things like margarine and Crisco, but these fats were in a lot of different products, weren't they?

Yes, they were almost everywhere. You could hardly pick up a product that had a nutrition facts label that didn't say partially hydrogenated fat on it. It was really in virtually everything that was industrially made in our food system.

Just because they could produce them at low cost? Or did they have other properties that were desirable from the industry's point of view?

These trans fats had multiple characteristics. One, they could be solid. And again, because they mimicked butter and lard, it fit into lots of foods. Second, they had very long shelf life. Third, you could heat them up and use them for deep frying, and they could sit there in fryolators for days and not be changed. So, this was all good for the food system. It wanted really long shelf life and started with cheap ingredients.

So, after those initial findings that raised red flags, what kind of research did you do subsequently and at what level of proof did you feel policy change might be warranted?

Within our own group, we continued to follow our participants. These are close to 100,000 women in the Nurses' Health Study, and also another 50,000 in the health professionals follow up study. We confirmed our initial findings and then found that trans fats were related to risk of many other conditions, from diabetes to infertility. And simultaneous with our work in the 1990s, some of our colleagues in the Netherlands were doing what we called controlled feeding studies. These studies take a few dozen people and feed them high trans fat or low trans fat for a few weeks and watch what happens to risk factors like cholesterol levels and triglyceride levels. And they found that trans fats had uniquely adverse consequences. They raised the bad cholesterol, LDL cholesterol, and reduced the good cholesterol, HDL cholesterol. So, they had unique adverse biological effects. It was really that combination of that short-term kind of study and the long-term epidemiologic studies we were doing that made a compelling case that trans fats were the cause of cardiovascular disease.

So, a line of considerable work took place over a number of years, and then got to that point where you felt something needed to be done. And the fact that you did that science and that you were worried about these trans fats in the first place is impressive because you were really onto something important. But what happened after you did the series of studies? What steps occurred and who were the key actors that finally led to policy change occurring?

Well, as we expected, there was pushback from the industry about this because they were so invested in trans fat. And I was actually disappointed that a lot of our colleagues in the American Heart Association and others pushed back as well. They didn't want to distract from saturated fat. But, when studies were reproduced, it was really undeniable that there was a problem. But, if the studies had just been put on a shelf and sitting there, probably nothing would've happened. And it was really important that we partnered with advocacy groups, particularly Mike Jacobson, Margo Wootan at the Center for Science in the Public Interest, because they had a readership and audience that we didn't have. And they also were more familiar with the workings of the Food and Drug Administration and government in general. But I also was told somewhere around that time that women, who are the main food purchases, pay most attention to a lot of the women's journals, Family Circle, those kinds of journals. And actually, for good reasons. Their journalists are very good. So, I've talked to those journalists every opportunity. And it turned out it was really important to have some public awareness about this problem. If it was just good science and things worked as they should have, the FDA would've looked at the evidence and just ruled out trans fat from our food supply early on, but they didn't. It really took major concerted effort by the combination of the scientific community and the advocacy group.

Did you bump into conflict of interest problems with other scientists who were receiving funding from the industry and you know them talking to the press or speaking at conferences or things like that?

Well, there's plenty of conflicts of interest within the nutrition community, but actually, I don't think that was so much of an problem here. In some ways, there was a conflict of sort of personal commitment to entirely focusing on saturated fat and not wanting to see any distraction. I don't think a conflict of interest in the economic monetary sense.

Walter, I remember back when this discussion was occurring and industry was fighting back. They made claims that food prices would go up, that the quality of foods would go down, that it would be a real hit to their business because consumers wouldn't like products without the trans fats. What became of all those arguments?

It's interesting and it's important to keep in mind that the industry is not monolithic. And I have to credit Unilever, actually, with paying attention to the scientific evidence, which was really rejected here. Interestingly, at that time, all the major margarine manufacturers were owned by the tobacco industry. And you can imagine that those CEOs were not getting out of their bed in the morning and saying, well, what can I do to make Americans healthier? No, they were not interested in health. But Unilever was a food company and it was invested in staying as a food company for the continuing future. And they did realize that this was a problem, and they invested a lot of money to re-engineer their products, re-engineer their production of margarine and shortening. And they did take trans fat out of their products. They obviously did a lot of taste testing to make sure they were acceptable. And once they did that, the industry could no longer say that it's impossible to do it. It's sort of like the automobile industry when Detroit said, you just can't build low pollution cars, but then the Japanese did it and then they could no longer deny it.

Boy, it's such an interesting story that occurred. With Unilever getting involved as they did. That must have been a very positive push forward. They're second biggest food company in the world.

That was really helpful. And again, I think it was because they had a lot of scientists, both nutritionists and food chemists. I was told they had about 800 such employees at that time. They could see, if you looked at the evidence honestly, this was a serious issue. One of their chief scientists later told me that it was actually one of our editorials in the American Journal of Public Health where we estimated that there would be about 80,000 premature deaths per year due to trans fat. And once they saw that, they said, we can't have Willett going around saying there's going to be 80,000 premature deaths, and they realized they had to do something. It's interesting, you write an editorial, you don't know who's going to read it, but sometimes it hits one person who can really make a difference.

It is nice to know that people read things like that once in a while. Let's go to where you were at that point. You produced a lot of science. You were communicating this to professional audiences, but also to the general public with interviews and magazines and things like that. And the advocacy community, especially the Center for Science in the Public Interest, got activated. What happened then?

Well, a couple things happened. One is that they brought up and proposed labeling trans fat on the nutrition facts label and submitted that to the FDA. The FDA sat on it. There was, of course, lots of backdoor action by the American food industry that did not want to change what they were doing. And despite some prodding by CSPI over the years, that sat there for about 10 years almost. Ironically, there was a faculty member at Harvard Chan School of Public Health at that time who had seen a display we had done on trans fat. We built a big tower out of blocks of trans fat and had a little poster there talking about it. He went to Washington and became a senior person at the Office for Management and Budget. And Mike Jacobson went to go visit him with a petition to label trans fat, and our faculty person said, I know about trans fat because Willnett had that display in our cafeteria. He wrote a letter to the FDA that was quite unprecedented, basically saying that either put trans fat on the food label or tell us why not. Which is a quite strong letter. And then the wheels started turning, and there was delay and delay for a pushback on the food industry. But by 2008, trans fat actually did get on the food label. And that had a very major impact, because once it had to be on the label, the food industry took it out. They sort of knew it was coming because they didn't want to admit it publicly. But I think they understood for quite a while that they were going to have to get it out, but that was really the turning point. All of a sudden, almost all the food products had zero on the trans fat line there.

Let's talk about the public health impact of this. You mentioned 80,000 or some deaths occurring each year attributable to consumption of trans fat. Can we conclude from that that we're saving that many lives now with trans fat out of the food supply? And does that mean 80,000 lives year after year after year?

It's hard to know exactly and of course, so many things are going on at the same time. And the trans fat didn't go down abruptly because Unilever was, even in the American market, a pretty major producer, starting by the mid 1990s, trans fat intake actually did start to go down. And other things are going on, obviously obesity epidemic counterbalancing a lot of positive things that were happening. But, there were some economists looking at communities that adopted trans fat bans early on versus those that did not, and they could show there was a divergence in heart attacks and hospitalizations for heart disease. So it's hard to pin an exact number on it, again, because all these things happen at the same time. But it's quite clear that we would be having quite a bit more heart disease if trans fat had not been eliminated. I would also look back to another important step in the process because even though we got trans fat on the food label, and the products that had it quite quickly became, almost all of them, zero trans fat, but that didn't deal with a restaurant industry, which was also a very big source of trans fat. And there it took community activists to make this happen. There was a small community in Northern California that was really the first community that banned trans fat in restaurants, and a few other places did. But then Mayor Bloomberg of New York, there's another backstory why he got interested in this. But it's one of these things, you put out information and you don't know who's going to read it, and someone had read some of our work and to convince his health department and Bloomberg himself that trans fats had to go, and New York banned trans fats. And then some other communities, Massachusetts and elsewhere in the food industry, the restaurant industry realized they couldn't have a patchwork distribution system. And so that was a tipping point that trans fat was eliminated in the food service industry long before the FDA finally made the ruling. In fact, by the time the FDA made the ruling about trans fat and pressure hydrogenated fat, it was almost gone.

To go back and look at the history of this, it's a relatively small number of key people taking the right actions at the right time that ultimately led to change. And thank goodness for those people like you and Mike Jacobson, Margo Wootan, and Mayor Bloomberg, and a few other people in political circles that took the bull by the horns and really got something done. Very impressive. As you look back on this, what lessons did you learn that you think might be helpful for future policy changes?

I think there are a number of lessons. I'd like to think, first of all, that solid good science is really important. Without that, we couldn't have a hard time making changes that we need to do. But that's usually not going to be enough. It's really important to work with advocacy groups like CSPI. It's important, sometimes, to work with journalists and provide good information, education. But it's hard to know exactly which path is going to be successful. One thing is quite clear, in this country, in many areas, change does not happen from the top. It's not enough just to have good science. And oftentimes, changes happen from the bottom up at the local level, the state level, and the national government may be the last place where action occurs.

So what changes in the food supply do you feel would be most pressing right now?

We certainly have a lot of problems in our food supply. If you look around, most people are consuming diets and beverages that are quite unhealthy. And there are so many issues, I think, still and we've worked on this issue is a sugar sweetened beverage issue, and we've had some real progress in that area, but still, there's a huge way to go to reduce sugar sweetened beverages. But that's part of a bigger problem in terms of what we're consuming. And I would call that carbohydrate quality, that about half of our calories come from carbohydrates. In about 80% of that half, in other words, about 40%, of all the calories we consume are refined starch, sugar, and potatoes which have adverse metabolic effects, lead to weight gain, lead to diabetes, lead to cardiovascular disease. So that's a huge area that we need to work on.

You've talked, so far, with the trans fat and, you know, and with other things in the food supply like salt, these are things that you'd be taking out of the food. That all makes good sense. What about putting things in? Talk about things that might support the microbiome, more fiber, or things that might support brain health and things like that, so what are your feeling about those things?

You're right, our problems are both what's there in quantities that are unhealthy and also what's missing. Inadequate fiber intake is actually part of the carbohydrate problem. Clearly, we should be consuming many more whole grains compared to the amount of refined grains that we consume. And, of course, we get some fiber from fruits and vegetables. So I think, in addition to this huge amount of unhealthy carbohydrates and inadequate amount of whole grains, we do need to be consuming more fruits and vegetables. And then on the sort of protein source side, we're clearly consuming too much red meat and replacing that with plant protein sources like nuts, legumes, and soy products would be really important for direct human health. But also, that's an area where the environmental and climate change issues are extremely pressing and shifting from a more animal-centric diet to more plant-centric diet would have enormous benefits for climate change as well as direct effects for human health.

Bio

Walter C. Willett, M.D., Dr. P.H., is Professor of Epidemiology and Nutrition at Harvard T.H. Chan School of Public Health. Dr. Willett studied food science at Michigan State University, and graduated from the University of Michigan Medical School before obtaining a Masters and Doctorate in Public Health from Harvard T.H. Chan School of Public Health. Dr. Willett has focused much of his work over the last 40 years on the development and evaluation of methods, using both questionnaire and biochemical approaches, to study the effects of diet on the occurrence of major diseases. He has applied these methods starting in 1980 in the Nurses' Health Studies I and II and the Health Professionals Follow-up Study. Together, these cohorts that include nearly 300,000 men and women with repeated dietary assessments, are providing the most detailed information on the long-term health consequences of food choices. Dr. Willett has published over 2,000 original research papers and reviews, primarily on lifestyle risk factors for heart disease, cancer, and other conditions and has written the textbook, Nutritional Epidemiology, published by Oxford University Press, now in its third edition. He also has written four books for the general public. Dr. Willett is the most cited nutritionist internationally. He is a member of the National Academy of Medicine of the National Academy of Sciences and the recipient of many national and international awards for his research.

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White Oak Pastures is a sixth generation, 156-year-old family farm in Bluffton, Georgia. It's also the home of Rancher Will Harris who runs an expansive, zero waste production system with the animals he pasture raises and butchers on the farm. White Oak Pastures produces grass fed beef, lamb, goat, and Heritage pork, and pastured turkeys, chicken, duck, geese, and more. Will is a vocal and passionate champion of radically traditional farming as the path to regenerative land management, humane animal husbandry, and revitalizing rural communities. This is the second time we've spoken with Will Harris. The first time came right on the heels of a really interesting national meeting held in Tennessee on regenerative farming, where I became very impressed with Will and the work he's doing. He was kind enough to join us for a podcast at that time. Our discussion today happens to coincide with the release of a book that Will has written entitled, "A Bold Return to Giving a Damn: One Farm, Six Generations, and the Future of Food.”

Interview Summary

I really would love to dive into the meaning behind the title of your book, and what you wrote about. But let me ask you a few lead-in questions. Many years ago, you made a profound change in the way you approached ranching and farming. What convinced you back then that this kind of change was necessary? And tell us what you did if you would.

My dad ran the farm before me. He was born in 1920, took over the farm post World War II, 1945. He was the generation that really industrialized, commoditized, and centralized the farm. It went from being the really typical 19th century farm under my great-grandfather and grandfather, to being a monocultural cattle operation. My dad was very, very good at it, a great cattleman. He ran the farm profitably. And all I ever wanted to do was come back and run the farm as a monocultural industrial cattle operation. I just loved it. I went to University of Georgia in 1972 and majored in animal science with the intention of coming back, and I did. And I loved it. You know, we weren't wealthy people, but we made money every year. We paid taxes every single year. And I was happy for a long time. But, in the mid-nineties, the excesses of that industrial monocultural model, became displeasing to me. When it started, it happened fairly quickly, and I decided to change. I did not have a goal to move towards, I just knew what I wanted to move away from. I started moving away from it almost 30 years ago, and I've been moving away from it ever since.

I'd love to follow up on one thing that you mentioned, and it's the generational nature of kind of farming overall, and your farm. Several years ago, I did a tour of farms in Eastern North Carolina, and I was really impressed with how important the family aspect of that was. Could you just tell us a little bit about that? What does that mean to you and six generations? That's really impressive.

The family aspect of it is a blessing and a curse, but it's been a blessing for us. This is just the way it is. My dad was an only child, and I am an only child. So, the passing down of the asset, the farm, farmland was very easy for us. I'm reminded that the old European way of all the assets going to the eldest son was certainly not fair, but I think that went a long way towards ensuring that the asset was passed down and kept intact, as opposed to dividing it up equally among the two, three, four, six, seven siblings. I have three daughters, two of which have come back to the farm. And I will leave the farm to those two daughters. So, our farm is unusual. And it's five, maybe six generations old, but it too will cease to be at some point. That's the way it is. There are other people that want to start farming, that need the opportunity. So this, it's just a good healthy, natural business system.

You referred to the farm as an asset, but I have a feeling it's more than that. I mean you could be passing down to subsequent generations a service station, or a convenience store, or a dry cleaner or something like that. But I have a feeling that the fact that you're passing along something that is tied to the land, it just has so much more meaning. Tell me if I'm wrong.

No, you're exactly right. But I put a finer point on it. There are not many non-depreciating assets. Land is a non-depreciating asset. I guess gyms are a non-depreciating asset, probably art. There just aren't many assets that don't have a finite life for them. But land is one of them. It's perpetual. And I would argue that the herds also are perpetual. Certainly, the individual animal in the herd has an expected lifespan, but the herd itself is perpetual. My cattle herd literally goes back genetically to the cattle my great-grandfather brought here 150 years ago. So, when you take that perspective, it turns the asset that you inherit or build up or however that goes, it turns it into something very, very special. And I think it should be treated that way.

So, let's get back to the farm itself. What have some of the effects been on your land, of the practices that you use on the environment, and also on the food you raise? How do you work to achieve zero waste production? And what do you mean by that?

Well, the impact on the land has been incredible. When I started changing the way I farm, which means principally giving up tillage, pesticides, chemical fertilizers, and grazing my animals differently and having a broad spectrum of species of animals on the farm, it changed dramatically. My land went from a half a percent organic model - point five, one half of one percent - to five percent. A 10X increase, okay? It's incredible. And just to talk about the water holding capacity, I don't want to go too far down that hole, but 1% organic matter generally holds 27,000 gallons of water per acre. So, when you go from a half percent to 5%, a 10x increase, you can see what that does to the water holding capacity. The change is just as dramatic in terms of microbial life, and other aspects of soil productivity. So, it is incredible what it does. As far as the animals go, I had a monoculture of cattle, but I had a lot of them. And I always believed that our animal welfare was just great. I mean, I thought it was fine until I had my eyes opened and I realized that keeping them well fed, watered, in comfortable temperature range, is not good for the welfare. I thought it was, but it's not. It's also incumbent upon the herdsman to give the animals the opportunity to express instinctive behavior. Cattle were born to roam and graze, not stand in a pen and eat out of a trough. Chickens were born to scratch and pick. Hogs were born to root and wallow. And in the industrial model, those species don't get to do that. So, that's a beautiful thing to me. And then the environment, you know, I really believe that we're sequestering a lot of carbon. You mentioned zero waste. And when I say zero waste, I don't want people to think that there's never any plastic that's hauled off from here. Certainly, there is. But we slaughter our animals here on the farm, we've got a pretty big slaughter plant for red meat and poultry for private farm abattoir. And it generates about seven tons a day of packing plant waste. That's the term USDA uses. We compost that and make just wonderful compost that we reapply to the land. And it's just, it's just a beautiful thing.

That is beautiful. So, let's talk about the zero-waste concept. When people hear that, I think some people think that it means you don't waste any parts of the animal when it's being turned into food for human consumption. But you're talking about more than that. And you mentioned the carbon sequestration in the soil. Can you explain what that means and how that fits into the zero-waste idea?

I will but let me also address the fact that it does mean what you said. It does mean using all the animals. We render the fat into the lard and tallow, which we sell or make soap out of. The hides go to make raw hide pet chews, or I send it away to be turned into leather. We have a shop where we make leather goods. I can go on and on about the things we do to not waste. We grind the bones that are not marketable as soup bones. We grind them and apply them to the land as well as a source of calcium and phosphate. So, zero waste takes a lot of different ramifications to achieve that. And as for the carbon, you know, the carbon in our soil, the organic amount I mentioned earlier? Having increased this so dramatically is yet another way of not emitting. A company called Quantis, an environmental engineering company, did a lifecycle assessment on our farm several years ago. It's called LCA. And it's actually on my website, https://whiteoakpastures.com. And it shows that we sequester carbon. It's 3.5 pounds of carbon to sequestered soil for every pound that we put up. So, it's certainly doing positive things, we believe, for the environment.

That's so important, because otherwise that carbon would be up there in the atmosphere, creating a lot of damage that people know about. So, the fact that you're drawing it down, and sequestering it in the soil is doing a really good turn for our environment overall. Tet me say also, I love your website, https://whiteoakpastures.com, because it tells the story of what you do, it provides some history and resources about the farm, but also you have a lot of really pretty amazing products that you sell. And so, it's nice to know that these things are available to people who might be interested in buying the products for your farm.

It is so interesting and frustrating to me that a certain brand of environmentalist has identified cattle as being the primary culprit in climate change. And of course, it's simply not true. It is not fair to brand cattle with that claim, that, you know. If you want to blame the cattle feeding industry, confinement feeding industry with that, then I support it. But the way we raise cattle not only does it not contribute negatively, but it’s also part of the cure. And that's, it's just so unfair.

Let's think about the radical change you made in the family's farming practices. Tell me how risky this was? I mean, how risky was it to you in terms of your reputation, your place in the community with other people that may have been continuing to use all kinds of industrial farming and ranching methods, and financially, how risky was it?

That's a great question. And when I give the answer, I certainly don't sound very smart. Because there was a lot of naivety in the decision I made. I really did not understand how much risk I was taking on. I should have, in retrospect. I was just a little reckless. But I always ran the farm, and I'd always made money. I was going to change the way I run the farm, and I assumed it would continue to make money, but it didn't. I was adding value to the product I was producing, grass fed beef, that I was not able to extract from the market at that time. Partially because I didn't have processing available, and partly because grass fed beef had not come into its being in the consumer community. So, we had some pretty tough times, but we made it through it. And my timing going in the grass-fed business in that mid-nineties to early two thousands was so, so lucky. And I really, really do mean lucky. Today, I don't think we would've made it. There's too much imported grass-fed beef. That is labeled as "Product of the USA." The market has tightened and tougher because of that. We made it then, but I don't think we would make it today.

What does that say for farmers today who might be considering making the kind of changes that you made many years ago?

Well, I don't like reporting this, but I've gone from really being a recruiter urging people to embrace this kind of agriculture to really warning people, "Be careful." I don't recommend people not do it, but I really do focus on them being careful. And we sat up a 501 C3 called Center for Agricultural Resilience to help people learn the things that we've learned, so that they won't make a mistake. I really want people to farm this way. And my goal is not to grow White Oak Pastures. White Oak Pastures is as big as I ever wanted it to be. I never really intended it to be as big as it is. Growth is not important to me and my family. We've talked about it, and we're in agreement on that. But I do want to see regenerative food production grow. The way we farm is very cyclical, as opposed to the industrial food market, which is very linear. The food product system is very linear. And linear systems scale up really well. Cyclical systems, I think they kind of have a maximum level at which they perform well. And I think we're at it. So, my goal is not to grow White Oak Pastures bigger and bigger. Again, as a family, we've talked about it and decided not to. We don't want a business so big that we've got to hire a CEO to run it for us. We sell $25 million worth of products a year. And that's enough. It's bigger than we intended it to be.

Given that you said that it's not risk free to make this kind of change, and that people need to go into it with their eyes open, it seems to me, that there's a lot more attention now and awareness of regenerative agriculture. People in the general population know about it much more than they did even just a few years ago. And you have, you know, movies about it and television shows, and you have big institutions like the Rockefeller Foundation investing in it. I see that as a positive sign. I don't know if you do as well. But are there other things that can be done to create more inducements to farmers to make this change? Are there policies, for example, that might be put in place that would be helpful?

Well, and that is opposed to the multinational food corporations. There re only a handful of them, that are feeding the entire planet. And they're very linear, and there are many, many, many unintended consequences to their production system. It's really adverse to the environment, the land, the water, the atmosphere, the animals, and rural America. I can go on that on.

So, let's dive into that just a little bit. What can consumers do? Where do they look for their food? What do they look for? Where can they buy things? What can they do to help?

The things you said are certainly great positive signs. They're very, very, very good. But unfortunately, big food has focused on this market. And engaged in very, very talented, skillful greenwashing that tricks the public. And that's the impediment and that's the problem. I just don't know how it's going to come out. I used to believe that I was an early innovator in this new way of producing food that was better for the land, and rural America and the environment, and the animals. I was happy about it, very satisfied in it. And I still hope that's the case. But new, young, or old, a person who is moving from industrial commodity agriculture into what we do today, has a harder go of it than I had 20 years ago, because of greenwashing. From the consumer perspective, it's a lot better today. There are a lot more people talking about it, and a lot more general information out there among the public. But the multinational corporations that are tricking people, they're just very successful. When I called my book "Return to Giving a Damn," that was what I was referring to. That the consumer has got to educate themselves and see where their food actually comes from.

There are more opportunities to do that, I know. Where I live in North Carolina, there are a number of butcher shops around. And some of them in particular make it very clear that they're sourcing everything from local farms, and they talk about how the animals are raised, and they're tied into the kind of thing that you're talking about. So, it's nice that there are more such opportunities out there. And butcher shops seem to be one good place to go if you're a person who consumes meat.

That's a good question. And I think that the more locally you can shop, the better. We sell food online, and we ship to 48 states. And I don't want to. Now I appreciate everybody that's been buying from us. I'm grateful for it. Thank you. But I really want to sell my products to people in my geography. And I want people in the Pacific Northwest and the New England, and the other areas of the country to have producers, that they support, that are local to them, local food systems. I'm happy to sell anybody anywhere, but I'd really rather to help somebody get started. I will just say that.

It's nice that you offer your foods for sale online, because that does give people the opportunity to buy some of the things that you raise, and be connected with the story of the food that you've told us all about.

That is very pleasing to hear.

Say just a little bit more about greenwashing. How does it take place, and how can consumers know that it's occurring?

The way for consumers to avoid greenwashing, is also to know as much as you can about who you're buying your food from.

I hope the kind of education that you're doing, things like joining us, and writing your book will alert consumers to these kind of practices, and hopefully there will then be demand on legislators, change the way they write the laws to prevent this kind of stuff. But boy, it takes time, doesn't it?

Greenwashing is messaging. Big multinational food companies and Ag companies hire brilliant marketers to convey the message they want to convey to consumers about how the food is produced. And I mean, it can be as simple as industrial milk having these beautiful barns and meadows, and cows on the carton too, some really technical things that are done. But it allows industrial food to be sold under the guise of being very green and humane. Big multinational food companies can import grass fed beef from 20 countries. Uruguay, New Zealand, Australia, being the three biggest or almost prominent. And sell it as American grass-fed beef. Literally and legally label it "American grass-fed beef." If the animal was born, raised, and slaughtered in one of those other countries, it can be brought into this country and legally labeled by USDA, "Product of the USA." And that is the epitome of greenwashing, and it's so very wrong. But it is allowed if any value was added here. And that changed from when I first started selling grass fed beef in the early 2000's. That's not the way that rule read, the rule changed, and this was not an accident.

So, let me ask a final question then regarding that. Are you optimistic? If you look at the current generation of young people, do they care more about these things than what used to be the case? And do you think that leads to some optimism about what might occur in the future?

Well, it does, and there's so much money behind it. I think if the food production system in this country changes, it won't be changed by Big Ag, it won't be changed by the Department of Agriculture, it won't be changed by land grant universities. It'll be changed by consumers, and what they demand.

You know, it's so nice to hear that from you. And consistent with my own experience, you know, in the classroom, you know, I've been teaching people for many years. The most recent generations of young people seem very motivated around these issues, and informed and passionate. And I see that as a very positive sign for the future. So, I'm glad your opinion on this and mine converge. And there's reason I think to be hopeful for the future. So, Will listen. It was wonderful speaking to you, and the first time we did a podcast. And equally wonderful today. So I'm really grateful you could join us. And good luck with your work. And it's clearly inspired.

There is no doubt there's more enthusiasm and optimism among young people. In fact, we have an intern program. We only take six per quarter four times a year. And we get 20 something applications for the six openings every quarter. And it's incredible. And we don't push it, we don't advertise it, because I just can't have any more than that. But the number of young, smart, enthusiastic people that come through here, most of them do not come from agricultural backgrounds, is very, very heartening. That part is just great. So, many of our young people that came through here, have gone on to do really, really good things in other places. I'm very proud of them.

Bio

Will Harris is a fourth-generation cattleman, who tends the same land that his great-grandfather settled in 1866. Born and raised at White Oak Pastures, Will left home to attend the University of Georgia's School of Agriculture, where he was trained in the industrial farming methods that had taken hold after World War II. Will graduated in 1976 and returned to Bluffton where he and his father continued to raise cattle using pesticides, herbicides, hormones, and antibiotics. They also fed their herd a high-carbohydrate diet of corn and soy. These tools did a fantastic job of taking the cost out of the system, but in the mid-1990s Will became disenchanted with the excesses of these industrialized methods. They had created a monoculture for their cattle, and, as Will says, "nature abhors a monoculture." In 1995, Will made the audacious decision to return to the farming methods his great-grandfather had used 130 years before. Since Will has successfully implemented these changes, he has been recognized all over the world as a leader in humane animal husbandry and environmental sustainability. Will is the immediate past President of the Board of Directors of Georgia Organics. He is the Beef Director of the American Grassfed Association and was selected 2011 Business Person of the year for Georgia by the Small Business Administration. Will lives in his family home on the property with his wife Yvonne. He is the proud father of three daughters, Jessi, Jenni, and Jodi. His favorite place in the world to be is out in pastures, where he likes to have a big coffee at sunrise and a 750ml glass of wine at sunset.

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As the parent of a 12-year-old child, I know that raising a child is one of the most profound and rewarding experiences of a person's life. It is also shockingly expensive. The high cost of child rearing is particularly difficult for families with limited resources. To help us think through this issue, it is my great pleasure to welcome a colleague here at Duke: Dr. Christina Gibson-Davis, Professor of Public Policy. Christina studies economic inequality, and particularly how it affects families with children.

Interview Summary

So, let's do a bit of level setting. We often hear words like poverty and wellbeing. For our conversation today, what is poverty in the US and what do we mean by wellbeing?

In the US we have a definition of poverty that relies on a certain threshold. Every year the US government publishes a set of thresholds for families that say - if you are below this threshold, then you are poor. If you're above this threshold, then you're not poor. The thresholds are actually based on data from 1963, when the federal government decided it really needed a way to count the number of poor people in this country. Prior to 1963, we really didn't have any way to do that. They looked at how much money people spent on food, and from that number, they derived these poverty thresholds. In 2022, the poverty threshold for a family of four, just to give your listeners some idea, was about $22,000. This means that if you earned $21,999, you were considered poor. But if you earned $22,001, you weren't considered poor. That's what I mean about the threshold and about falling either above or below that threshold in order to determine whether or not you're poor.

Thank you, Christina, that's really helpful. It is interesting that the measure of poverty really is centering on food, or at least traditionally has. We’ll get back to that in a moment. I want to go back to the question of wellbeing. Could you tell our listeners what you're talking about when you talk about wellbeing?

When we talk about wellbeing, we mean things like how healthy kids are, or how they get along with peers, or how they do in school. Basically, it's the way we measure how kids are functioning and whether they're functioning to the best of their ability.

It sounds like it's a broad notion that represents all the ways a child is a child, how they move in this world.

That's exactly right. It's going to cover a whole bunch of different areas. Everything from health and education to social relationships, to behavior, to delinquency, to how far they get in school. All of that goes into our definition of wellbeing.

Great. Thank you for that. I want to now focus a little bit more on children themselves. What does childhood poverty look like in the US?

We can have a technical definition of poverty, which is what I alluded to before, but really, that technical definition I don't think paints a very illustrative portrait of what it looks like to be poor in the US. To be poor in the US as a kid means you're growing up in an environment with very low levels of economic resources. You're probably growing up in a household where you're not sure if those economic resources are going to be enough for your family to maintain their home or pay their bills or get enough food. It's a very sort of unstable situation for kids because they may be worried that their parents just don't have enough money. It also sort of affects the kids' outlooks. We know that poor kids tend to have sort of lower aspirations or hopes for the future. Not that they're not hopeful, but they sort of also know that some of the things that they see may be depicted on TV that are open to other kids may not be an option for them; because they simply don't see a path between where they are and how they're going to get there.

That is actually pretty sobering. I'd like for you to explain something about households with children, and I noticed that a lot of our conversation is going to not focus on an individual child but about children in household context. So, how does poverty look different for households with children than households without children? Is there a difference?

Yes, there's a difference in poverty rates. One of the things that distinguishes poverty in the United States relative to poverty in other Western or developed countries is that we have very, very high rates of child poverty. And one of the biggest risk factors, in fact, for being poor in the United States is being a kid. Kids tend to have higher poverty rates than other groups. Why is that? Well, obviously kids aren't out making money. They're relying on their parents for their financial wellbeing. But it really has to do with the public policy choices that we've made. Your listeners have probably heard of Social Security and Medicaid, and those are two huge programs that make huge differences in the lives of say, people over the age of 65. We really don't have those kinds of corollaries for kids who are poor. And so, when you look at our policy priorities over the past, say half century, they've really been oriented more towards elderly people rather than kids. That's just a policy choice that we have made.

Thank you for sharing that. I know in some of the work that you've done, you've also looked at these issues through an equity lens. Can you tell us a little bit more about the wealth inequalities of households with children. And how does that work shape how we should look at child wellbeing?

We've been talking up until this point primarily about income, which for most people is the money that they earn through their job. We think about income as the money that flows into your house. There's also this really important concept, which is called wealth. Wealth is a household's assets minus its debts. So, for most households, their primary asset is their house. And then they might have debts because they owe money on their house, or they have medical loans or education loans or things like that. So, wealth in the US is distributed far more unequally than income. In particular, the racial gaps in wealth are staggering. So, in the US, for every dollar of wealth that is held by a white family with children, a black family has less than 1 cent. Again, that's a $1 to less than 1 cent ratio. When you have those kinds of inequities, it's really hard for some families to make a difference in the lives of their kids. We know that wealth really helps, for example, for kids to go to college or to make a successful transition to young adulthood. And when we have these kinds of race-based inequities, it really hampers some of these kids from realizing their full potential.

I know we have a number of colleagues like Sandy Darity who work on this racial wealth gap. So, this is a critical topic that has influence on how we need to think about these issues. And that's going to connect a topic that I have worked on, and that's a great interest of our center. It's the topic of food insecurity. Christina, can you help connect childhood poverty to food insecurity?

Food insecurity, as many of your listeners may know, is the ability to have enough food for a healthy, active lifestyle. Not surprisingly, being poor puts you at increased risk of being food insecure. It's probably the predominant risk factor for being food insecure. The reason we care about that is because we know that food insecurity has all kinds of detrimental consequences for children. So, we were talking earlier about wellbeing covering a wide range of outcomes. Food insecurity really diminishes kids' wellbeing in many of those areas that we were talking about. Kids who are food insecure are less healthy, they do less well in school, they may have more behavior problems. So, food insecurity is really something that can undermine the life chances of children.

I'm interested in now turning our focus to this issue of policy. We're at a policy school and I would like for you to talk a bit about what our current policies are for addressing food insecurity.

For children, there are a number of food programs in the US. I would say the three most relevant ones for children are SNAP or Supplemental Nutrition Assistance Benefits, and WIC, Special Supplemental Nutrition Program for Women and Children. And then there is a free and reduced lunch program. Those programs together really try to address food insufficiency among children. The evidence suggests that they work pretty well. None of them by themselves are going to reduce all food insecurity among kids, but they definitely lessen the levels of food insecurity that kids experience.

There was an article in the "New York Times" about a year ago, the Fall of 2022, and it talked about readjustments to the measure of poverty, and they followed the family out of West Virginia. One of the things they did was they looked at the income that this family received, and it showed that 25% of the total, if you will, resources that came into this family were food-based programs, WIC, SNAP, and School Lunch Program. So, it's an important part of how families with limited resources are able to meet some of their needs. I'm appreciative of you sharing that.

I think it's absolutely vital, particularly when you think about families that may be living in places with really high rents. There's been a lot of talk lately about how the cost of housing has gone up, and really these sources of food assistance that they get from the government is just absolutely critical to helping them meet the basic needs of their families. So absolutely, these food assistance programs are just a linchpin of how these families survive.

It's interesting now that we're in this moment of debating the Farm Bill, which is the federal program that supports SNAP, how it's important for us to keep in mind that beneficiary of the SNAP program are children and children whose wellbeing can be affected by a program like this. I'm grateful for this conversation. Now, how effective are these policies at reducing food insecurity and addressing child wellbeing?

These programs work fairly well. They're not, I would say, large enough or convey enough resources to eradicate levels of food insecurity. I think it's also important for your listeners to know that there is no such thing as a federal food policy. So, we let states set the limits, for example, as to how much they're going to spend on SNAP. This leads to large variations in like the SNAP limits. So, for example, if you live in New York, you get about $100 more in SNAP benefits than if you live in Oklahoma. So, what does this mean? It means that these programs are going to be more effective in some states than in others, simply because of the amount of resources that people may get based on where they live.

As we wrap up, I wonder if you have any other points of consideration about policy and how policies that we currently have can actually help us address child wellbeing more effectively.

One of the other things that distinguishes the US food policy landscape, if you will, is we also have a relatively large private sector. So, people may be familiar with food banks or other places where they distribute food. And, you know, that's sort of the best and the worst that America has to offer, right? The best is that charitable organizations recognize the importance of providing food for people. And these organizations are very effective at providing meals and groceries, and it's a really important source for these families. But I say it's also the worst because there's a giant need for these private sector places. And because the provision of these private sector food goods can vary depending on where you live or how much money the nonprofit organization has, it can be a very variable source of support for food. So, in some ways, our food policy landscape is kind of a crapshoot, if you will. And that I think that makes it hard for us really to get a handle on childhood food insecurity.

Bio

Christina M. Gibson-Davis is a professor at the Sanford School of Public Policy, Duke University, with a secondary appointment in sociology. Her research interests center around social and economic differences in family formation patterns. Her current research focuses on the how divergent patterns of family formation affect economic inequality.

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Diet-related disease such as cardiovascular disease and diabetes create a crushing burden on individuals, families, and the healthcare system in the United States. However, Produce Prescription Programs where medical professionals prescribe fruits and vegetables and health insurers pay, promise to improve nutrition and health. Today we will talk with Dr. Kurt Hager from the University of Massachusetts Chan Medical School and lead author of the largest assessment of Produce Prescription Programs to date.

Interview Summary

So, let's get into it. Before we dig into the study itself, can you tell our listeners more about Produce Prescription Programs?

So, the programs that we evaluated in our study gave participants electronic cards. So, either a debit card, a gift card, or a loyalty card that they could use at retail grocery stores and some farmer market partners as well to get free fruits and vegetables of their choice. The food could be either fresh or frozen fruits and vegetables. These programs acknowledge that nutrition education alone likely is not sufficient to increase healthier eating for many low-income households, for which just the cost of healthier foods is really the primary barrier in improving their diet. These programs seek to overcome that barrier, and it's really exciting to see that clinics across the country are turning to these. I think physicians, from our conversations with the clinics we partnered with in this study, are really excited to have a tool they can use and provide to patients to offer higher-quality care and help improve their nutrition when they're talking with their patients about managing diet-related illnesses like diabetes, hypertension, or obesity.

Thank you, Kurt. Could you tell me a little bit about why you and the team decided to do this particular study?

Food insecurity has been consistently associated with poor health outcomes, higher healthcare costs, and lower dietary quality. Many food insecure households tend to have higher rates of diet-related chronic illnesses. We worked with a wonderful organization called Wholesome Wave. They have operated Produce Prescription Programs across the US, and they have been collecting data on these programs for about five years now. Wholesome Wave reached out to our research team at Tufts University's Friedman School. They wanted to see if these programs are working at improving health outcomes. The key thing, I think, to contextualize where this study stands, is prior to this work, there had been a handful of studies that had shown, not surprisingly, that Produce Prescription Programs can improve dietary quality and improve food insecurity. However, very few had gone that extra step to see if Produce Prescription Programs were associated with improvements in really important clinical outcomes. Things like hemoglobin A1C, which is an important measure of average blood sugar levels in the past three months. This is critical for managing diabetes, and outcomes like blood pressure and obesity and overweight. Previous studies had found mixed results on these outcomes, and most had been very small, maybe about 50 participants. We built on this by doing the largest analysis to date. Our study had nearly 4,000 participants from 22 programs across the US, from 12 states. These ranged from cities like Los Angeles to Minneapolis, to Houston, to Miami, Idaho - so all over the US.

So, it was the fact that previous studies have had relatively small samples, and some of these other studies did not take all of the sort of important measures of health into consideration. So, you were able to build on that past work in a unique way in this study?

Exactly. I think the key thing is that Wholesome Wave had excellent relationships with their partner clinics. This meant that the clinics were willing to share medical record data with us. This is always just very challenging and many other studies weren't able to go that extra step. We were blessed with access to a lot of medical record data and we were able to do analyses that looked at important clinical biomarkers. I will say though, our study is a step in the progression. I'll be the first to admit, we did not have a comparison group in this analysis. So, the results that we found also could have occurred due to other reasons. Such as, for example, perhaps when someone is referred to a Produce Prescription Program, their physician might also make other referrals, or perhaps change their medications because this patient has been identified as high need. We certainly built on previous literature by having a much larger sample size and pooling data across the US, and to me, our findings really provide us with a strong rationale to continue research into this area. But also, to confirm our findings with randomized trials similar to what you would do, for example, for drug research.

That is helpful to hear. One of the things that's really important about what I understand of this study is the fact that you worked with Wholesome Wave, and that allowed you access to a lot of different programs across the US as you described. Could you give us a little bit of a sense of what some of those programs were, and how did they provide the support that you were able to study in this project?

Most programs provided the benefits on electronic card. It's similar to in WIC or SNAP, where participants have an EBT card, they can use it at retail settings. It's administratively very simple. From interviews among SNAP participants and other research, this tends to be lower stigma - when you're using a card at a checkout. These cards gave about $50 a month for six months on average for the adult programs, and $110 a month for the pediatric programs. Some of the children's programs were also a little longer. Some of the child-focused programs that we include in the analysis were up to 10 months.

So I understand from this description that the Produce Prescription Programs also look different. There were some programs for children, some for adults. How did you manage that? There's a lot of other things that could be going on. How do you sort of do that in this work?

Participants were referred to these programs because they were either food insecure or were recruited from a clinic that served a low income community and were very likely to be food insecure. Individuals also had a risk factor for poor cardiometabolic health. So, this means that they either had diabetes, high blood pressure, or were overweight or obese at baseline. That was really the common thread across all of these programs. We did all the analyses for adults and children separately. So, we report changes in fruit and vegetable intake, and changes in self-reported health status separately. Food insecurity - we did assess at the household level, but then for other outcomes, for example, hemoglobin A1C, we restricted that to the adult population that had diabetes when they enrolled into the program. For blood pressure, we restricted those analyses to adults with hypertension at baseline. For Body Mass Index, we restricted analyses to adults who were overweight or obese at baseline, and then did those same analyses separately for children for age and sex, only looking at children with overweight or obesity at the start of the study.

This is really important then. Thank you for that clarification. You know, you've talked about some of these critical measures such A1C for diabetes. You've talked about obesity measured in BMI. Can you tell us a little bit more about the importance of these findings and what they mean in real terms for participants' health?

Absolutely. So, we found that participation was associated with improvements in dietary quality and food insecurity. For example, among adults, they were reporting that they were eating, on average, about 0.8 more cups per day of fruits and vegetables by the program end. And food insecurity rates were cut by about a third. So, the program seemed to be working as intended, which was excellent to see. But then looking at the clinical biomarkers, for example, hemoglobin A1C among those with diabetes dropped by 0.3 percentage points. And among those with uncontrolled diabetes, those having chronically high blood sugars that are very difficult to manage, dropped by about 0.6 percentage points. So, to put that in context, that's about half the effects of commonly prescribed medications to manage high blood sugar levels. So, for just a simple change in diet, that is I think fairly impressive and very encouraging to see. And the effects on the reductions on blood pressure were also about half as large as we would see with commonly prescribed medications. I think it's really important to highlight that, one, we don't know if these changes will be sustained long-term when the program ends. There might be some participants where this program caught them in a moment of crisis perhaps, in which this helped stabilize them, and maybe they would be able to maintain these new improvements in dietary intake long-term. But I suspect many participants might not be able to maintain this healthier eating because the cost of healthier foods was the main barrier to healthier eating at the onset of the program. And so, this is an area that we're really interested in looking at in future research. But I will say, if one were to maintain these improvements that we would see in hemoglobin A1C, blood pressure, and BMI among adults, they really were clinically meaningful. And if sustained long-term, it could reduce risks of things like heart attack or stroke years down the line. Any reduction in these biomarkers can really have a meaningful impact on patient quality of life. Things even like averting diabetes complications with damage to the circulatory system, to nerves, to the retinas in the eyes and having vision loss. So, sustained long term, I think these really are meaningful impacts on health and wellbeing. The last thing I'll say, is for children, we did not see a change in BMIs for age and sex. I'm not too surprised, given it's a relatively short program on average six months. But also, child BMI is a notoriously challenging metric to move. But I do want to highlight that among the households with children, we did see an improvement in fruit and vegetable intake, and reduction in food insecurity, and self-reported rates of higher health status. And I think if we're thinking about childhood development, to me, that is still an important success. We know that having enough access to food in the household and having higher dietary quality is really, really important for childhood development and wellbeing. There's certainly a nutrition causal pathway here. But it's important not to forget that there's so much stress and anxiety when someone is experiencing food insecurity, about not knowing necessarily where your next meal is going to come from. Just worrying constantly about managing household budget, about trade-offs, say between buying healthier food, paying for medications, paying for other needs. So, I suspect these programs are improving health outcomes both through a nutritional pathway, but also through like a mental health pathway, perhaps reducing anxiety for some households as well, which can also have an impact on things like blood pressure.

So, given these results, it says that there's some important implications of these Produce Prescription Programs for the health and wellbeing of the participants in this study. I mean the fact that just changing fruit and vegetable consumption through a program like this had an effect similar to half the effect of some medications is really a powerful finding. I have got to ask, what are the policy implications of this work?

There is very exciting momentum across the US federal programs, promoting produce prescriptions and other forms of, for better or worse, what is known as food as medicine. And these programs all provide free healthy food to patients in partnership with the healthcare system or through a physician's office. So, Produce Prescriptions are the focus of this study, but the other Federal programs also include things like medically tailored meals, which are healthy, home-delivered meals, often to patients with even more advanced chronic disease who also might have activity limitations or disabilities that makes it really challenging for them to shop and cook independently. Last fall there was a historic White House Conference on Hunger, Nutrition & Health, in which the Biden administration in the summer prior engaged at a national level, major stakeholders in the anti-hunger space, large health systems, researchers, and government agencies to bring together a policy agenda to address hunger in the US, and the really high rates of diet-related chronic diseases. And it's important to note that, I think it is the first recommendation in the section of the final national strategy from this White House conference under the healthcare sector highlights Produce Prescriptions as a policy priority and expanding them in Medicare and Medicaid. So currently Medicaid, which is the federal health insurance program for individuals with low incomes or who have a disability, Medicaid is managed in partnership between each state and the federal government. And this means that states have some flexibility in how they manage their Medicaid program. They can apply for what is known as Section 1115 waivers. The federal government can approve these waivers if the state makes a good case that if they propose an innovative pilot, an innovative change, that they can make the case is likely to improve health outcomes and remain budget neutral, then the federal government can approve them to pilot this idea. So, currently in Massachusetts, we are several years into an 1115 pilot that is actually paying for produce prescriptions and medically tailored meals through the state Medicaid program. And currently about 10,000 people in Massachusetts have received some sort of nutrition support through the state Medicaid program. About 10 other states now have either similar waivers approved or pending approval to allow other Medicaid programs to do something similar. So, this is a really exciting area where expanding access to these programs is happening. And then in Medicare, which is the health insurance program for older adults, in Medicare Part C, which is the Medicare private health plans, those health plans can choose to cover Produce Prescriptions as a benefit. They're not required to, but they have the flexibility to offer that service if they would like. And then finally, I'll just say that there's also new pilots that were announced in Indian Health Services and the Veterans Health Administration. All these examples show that across the federal government there are exciting pilots and expansions occurring to cover Produce Prescriptions, and other foods and medicine programs. However, they remain unavailable to the vast majority of Americans who might benefit. And so, they're not a core component of any of those programs at the moment. And rather, these are pilots that are being tested, but very exciting movement, nonetheless.

Thank you for that really comprehensive set of examples of how policy is implicated in this work and potentially the need to expand this work. It makes me think of USDA's Gus Schumacher Nutrition Incentive Program. That would be another way that folks could access some of the benefits of federal dollars to support produce-type prescription programs. How do you hope to build off this study in future research?

At UMass Medical School, we're the official independent evaluator for the state Section 1115 waiver, which means we are essentially responsible for evaluating if things like the Produce Prescription Program in the Massachusetts Medicaid program is improving health outcomes. So, that is what we are working on right now. In our partnership with the state, we actually have access to all of the claims and encounters data within Medicaid. And we also are working with several health systems that are also sharing medical record data with us so we can evaluate the impacts of food as medicine programs on hemoglobin A1C, blood pressure, and BMI, so similar outcomes to this study. We actually have a large study funded by the NIH in partnership with former colleagues at Tufts University that is doing a deep dive on the Medicaid medically tailored meal program. And we're hoping to do something similar for the Produce Prescription Program in Massachusetts Medicaid. And the nice thing about these studies, they aren't randomized trials. Since this is a kind of a policy rollout, anyone who's eligible for these programs can receive the benefits. But we will be improving upon this study that we just published by leveraging two really strong comparison groups, and using some statistical techniques to make sure we're identifying patients who are as similar as possible to those who are receiving services, but ultimately didn't enroll. So, we're excited to have these results a couple years down the line and see if these programs are working in the context of a large state Medicaid pilot.

Bio

Kurt Hager is an Instructor in the Department of Population and Quantitative Health Sciences at UMass Chan Medical School. Dr. Hager’s interests lay at the intersection of structural determinants of health, food insecurity, and government nutrition and health programs. He is currently evaluating the effectiveness of the Flexible Services Program, which addresses food and housing insecurity in Massachusetts Medicaid. His involvement in state and federal policy initiatives underscores his commitment to translating science into policy, including initiatives with the Task Force on Hunger, Nutrition and Health and the National Produce Prescription Collaborative.

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Does the term Policy Advocate conjure up the image of a chef? Today we're speaking with Katherine Miller, Founding Executive Director of the Chef Action Network, and author of the book "At The Table, The Chef's Guide to Advocacy". Katherine formerly served as the Vice President of Impact at the James Beard Foundation and serves as an adjunct professor at the Culinary Institute of America. She's worked for 20 years at the intersection of policy, politics, and social impact, and says chefs have an important role to play in this space.

Interview Summary

Chefs are more and more visible in this advocacy and policy space. I assume that they've been doing this for a long time, but you see more attention to it now, which is nice. Let's talk about sort of its fundamental concept of chefs being involved in the food system at this level. Why do you think chefs and other people in the restaurant industry are equipped to make the food system more just and sustainable?

I think that chefs are some of the greatest translators, right? Chefs, as we know them, are the people who cook us delicious meals or host us for events in our lives. But in reality they are taking the ingredients from the farmers and producers and fishermen and translating them to the plate to make them interesting and enjoyable for all of us, right? And the food system is incredibly complicated. It is deeply rooted. The root system overlaps and is incredibly complex. It's off-putting for people to think about how they might get involved in food policy or even understand the different controls on our food. Chefs can really help tell a better story, right? They can take the what's happening in the field and on the boats, and then they can put it on our plate, and they can help explain to us the stories behind all the food, how it's grown, the things that we should be interested in, the decisions that we should make differently. I think they're the ultimate translators and making the world a more delicious place.

That makes perfect sense! What inspired you to write your book, "At The Table"?

I've been working with the chef community for 10 years, first as a consultant and the founder of the Chef Action Network, and then working with the James Beard Foundation as the first vice president of advocacy and impact for the foundation. Then, after leaving the foundation, continued to work with organizations who are really interested in helping chefs step into policy arenas on things like healthy soils or food waste or medically-tailored meals. All those things are impacted by the policies that our state houses and our federal houses. And it's hard. The restaurant industry is enormous. There are 11 million or so restaurant employees. There are tens of thousands of people who are considered chefs or leaders in the kitchen, and we weren't going to reach them one Chef Bootcamp for Policy and Change at a time. You know, when I left the foundation in 2020 at the sort of tail end of the first year of COVID, we had over 1000 people on the waiting list to get into the Chef's Bootcamp for Policy and Change. We knew we were on to something, but we didn't really have the capacity to expand at scale. So, you know the great thing about a book is it can reach many chefs, culinary students, restaurant workers, farmers. And that's the other thing - I think there's a sort of duality to this idea of chef. It's really anybody who's a food system leader, anybody who is really interested in how the policies control our food system. I'm very excited to have a book out because I wanted this message and the examples and the tips and tools to reach the biggest audience that it could.

Boy, it's nice to hear there's so much interest among chefs and work of this type. I'm interested in whether this kind of thing is finding its way into culinary education. You have a position at the Culinary Institute of America, highly visible place. Is this the sort of thing that's showing up in discussions in culinary schools and classes and the training people receive?

More and more. I really credit Robert Egger for so many things in life, the great food system advocate and co-founder of DC Central Kitchen. But Robert was one of the first to write an op-ed that was like, culinary education should include advocacy, right? Because in culinary schools all over the country and all over the world, we teach people about flavor, we teach people about dish composition, we teach people about cleaning their station, and being a good person on the line, right? But we don't teach them about sustainability and that concerted way, we don't teach them business school skills and we don't really teach them about policies that impact their business, their sourcing, the way they run their restaurants. So that is growing. I think it's also a benefit of this next generation of chefs and consumers even who are really leading with their values. They want to see people step into this arena. The Edelman Trust Survey, which comes out every year, shows that food systems and food communities are some of the most trusted networks in the world. These leaders of that community have sort of a right, but also an obligation to get involved. The thing I like about the book and the thing I love teaching is that it's easy to do. It's not as difficult as you think it is, but I really think that the students and the consumers are demanding a sort of values-based approach. We're going to see all of the culinary schools add at least one class, if not more, of this type of training, I think in the future.

Let's go a little bit deeper into the bootcamp. You've directed the James Beard Foundation's Chefs Bootcamp for Policy and Change. Can you describe what goes on at the camp, and how this has affected your view on the chef's role in the advocacy world?

The Chef's Bootcamp for Policy and Change was an idea that Chef Michel Nischan and a James Beard trustee by the name of Eric Kessler had the idea for way back in 2012. They found me because I am a experienced trainer and facilitator. I've worked all over the world with, whether it be land advocates in Nigeria, health experts in China, folks in Australia, democracy in Lebanon, and they approached me and they said, “Hey, we have this idea. Chefs are highly visible. They are celebrities in their own right and we want to help them better use their voice.” That first bootcamp took place in July of 2012. We trained the first 15 chef advocates, and the penny sort of dropped for me that this was a community who are sitting in every single street corner. They have visible storefronts in every single community in America. They are trusted not to kill us, right? They are trusted to deliver something delicious and an amazing experience. They are networked heavily through the producers, both within their region and their city, but also globally in terms of what they source and how they buy. They have an authentic connection to fans, right? The bootcamp, which still continues to this day, trains 15 to 20 advocates at a time. The training module is still the same it was with a few tweaks in 2012. We really put them through their paces on introducing them to this food system and the complications of the food system. They also did role plays and learned techniques on how to be a better advocate. So how to create a message, how to reach out to their networks, how to use their social media profiles to talk about advocacy. And also, how to deal with the sort of haters of the world who might be like, "Shut up and get back to the kitchen". So, a little bit of that. Then the other piece that is so important to the entire food movement is created community amongst themselves. Every bootcamp ends with a dinner cooked by the chefs, for the chefs together with what they source on the working agricultural farm that would take them to. That community then spills out and it grows and grows. So exponentially, you could grow from 15 to 150 to 1000. They take it with them, they teach their staff, they host their own bootcamps or programming in their own cities. So, the bootcamp is one piece of it, but it's really about giving people the tips and tools they need to be an advocate, and then creating community amongst the chefs themselves and also their staffs and their greater community, and really just putting them into the places where they can use their voice to make a difference.

You know, it sounds really exciting! So, you have talked us through the process of how this education and training on advocacy and policy takes place. But let's talk a little bit more about the issues. Let's just say the Chef's Bootcamp was happening today and we walked in and we could overhear the discussions. What would we hear people talking about? Would they be talking about how children can be educated about food, about sustainable food systems and regenerative agriculture? Would they be talking about? state law, federal policy? What kind of issues would be important to them today?

Today? The Farm Bill, right? Chefs do advocacy in three places really. They do it on the table, right, through what they source, how they market to their customers, the types of labor practices they have in their own restaurant, like that is a self a form of advocacy. They do it within their community. So, a lot of chefs will get involved with local feeding organizations, will get involved with school gardens, things that they can put their hands on and bring people into their restaurant or visit regularly. I see a lot of community interaction. Then there's the hard and long work of state and federal policy reform. We are not going to be able to just uproot our entire food system and throw it out the window. Policy reform is gradual. It takes time and it takes a concerted effort. So, throughout each bootcamp or throughout different programs that I do, say with the Natural Resources Defense Council or programs that are run through No Kid Hungry, where alumni of the bootcamp have really gone on to shine is this federal policy piece. If you walked into a bootcamp today, you'd probably be hearing information about the Farm Bill, the impact of the Farm Bill on local regional food systems, the impact of the Farm Bill on food as medicine programs and SNAP programs, and really looking for ways a chef or a food system advocate could use their voice effectively to make the case for greater funding, to protect funding, to really encourage more progressive policies.

That sounds good. You brought up the Farm Bill, so let's talk about that in a little more detail. The last Farm Bill was passed in 2018, so it needs to be passed again now and reauthorized. Vast amounts of money are at stake for this. You mentioned that chefs can advocate for protecting funds that have been used in the past for particular purposes, and also argue for new uses of funds. What would be some of the top priorities? You kind of alluded to several of these, but tell us a little bit more specifically about what the chefs might be fighting for.

The Farm Bill is our food bill. I think we don't say that often enough. I think when we look at how the Farm Bill is constructed, we are looking at programs that are everything from specialty crops, i.e., fruits and vegetables, to the Supplemental Nutrition Programs that help people in times of need to not go hungry, to food as medicine programs that help us reach vulnerable populations with more fruits and vegetables at farmer's markets or medically tailored meals in hospitals or in systems. The Farm Bill reaches into all of those things. One thing I like to say about chefs is they're not monolithic. They're not all running around saying this thing. They are well-informed narrators and translators of a complicated food system and encouraging people to pay more attention to things like the Farm Bill and more things like the political nature of our food system.

If we want in the long term to redirect subsidies to support more climate smart agriculture, or help us have local and resilient food systems, that's going to happen through the Farm Bill. I was just recently with a bunch of chefs who were on Capitol Hill talking about healthy soil and the need to incentivize farmers through a bill called the Cover Act to help them change growing practices so that their soils would be healthier, and they could do more regenerative agriculture techniques. In a few weeks, there will be folks here really advocating to protect SNAP benefits. I think as we see a growing partisan divide and the growing divide on how to spend government money, SNAP, the Supplemental Nutrition Assistance Program, is always going to be a constant target of that.

There's a great anecdote in the book by chef Elle Simone, who talks very eloquently and proudly about the fact that at an early point in her life, she took SNAP benefits. She was broke, and she was financially insecure, and she needed help. She took those SNAP benefits at a time when she needed them, and they helped her complete her education and complete her path to the future. Now, she's a cookbook author and the first woman of color to be on America's Test Kitchen. She is a known celebrity chef around the country, and she wouldn't be there, she will always say, if it hadn't been for SNAP. So, somebody like Elle will come to Capitol Hill and tell that story to put a human face on a program that is often demonized by people who think there are other ways to spend money rather than make sure that people don't come hungry.

You know, there's a lot built into what you just said on lots of different levels. SNAP program, relationships with farmers, et cetera. Let's talk about farmers for a moment. I know that chefs have, of course, always had a strong relationship with farmers because that's where they secure what they serve in their restaurants, but it sounds like it's going beyond that. This alliance now is out there in the bigger policy arena around issues of regenerative agriculture and things like that. I'm assuming you've seen some interesting cases of farmers and the chef community coming together to argue for a common purpose.

Chefs and farmers are natural partners. There wouldn't be any food on our plates if there weren't for farmers. The types of food and the types of vegetables and meat, and even seafood, fishermen, the world, you wouldn't be able to put things on the plate without those humans. They produce amazing, delicious food, and they do it in ways that are better for the environment. It's nutritionally dense. So, they're a natural partnership, but they haven't always worked together. In part, because they had completely opposite schedules. The farmers are up at 5:00 AM and go to bed at 2:00 PM and you know, chefs are out until 5:00 AM, and at work, they haven't always been able to come together. But more intentionally, organizations are bringing them together. The Natural Resource Defense Council is working a lot with zero food print as a chef-led organization. Those two organizations are working in deep partnership to put chefs and farmers together regularly on Capitol Hill or in state houses, talking about things like the Cover Act, talking about regenerative agriculture, talking about the health that's contained in our soil and how that translates into healthier and more delicious food. They are natural partners, and I'm really excited that they seem to be coming together more on common issues that really are about putting healthy and delicious things in front of us all.

Well, it makes good sense that those kind of partnerships have evolved to where they are now. Let me ask you a final question. Well, let's just say I'm a chef and I meet you or people involved in this kind of sphere of work, and I'm thinking, boy, my life is pretty crazy. It's a high stress life, very long hours, lots of decisions to be made and people to supervise, and all kinds of stuff going on in these restaurants. How in the world would I have time to do anything like this? And then also, what are the actionable steps that such a chef might take to help create a better food system?

It's a great question, right? We're all really busy people. Everybody's calendar is full, whether it's kids or parents to take care of, whether it's jobs, whether it's volunteering, and we all look at our calendars, and we're like. How could I possibly fit one thing else in here? The number one tip I give chefs and anybody who really wants to be an advocate is you learn to say no first. You learn to look at what you care most about and decide that that is the thing that you are going to focus on. And all the rest of it, you're going to say no very politely to. So, in the beginning of work with chefs, I did an audit of dozens of restaurants and essentially chefs were being asked to donate on average about $50,000 each year to dozens of organizations in their local community and even nationally. When we think about that from a fundraising perspective, if you donated $50,000 to one organization, you would be a top donor to that organization. You would have a totally different relationship with them. I really encourage all of us, but especially the chef community, to take a deep look at the issue that drives you most, whether it's hunger, the environment, ending violence in our communities, mentorship, whatever it is. And really, one, pick that issue and prioritize that issue. Get to know the organizations and the experts that are already working in it, right? We all think that we're so smart and we must be the first people to have thought about X, Y, and Z, and you're not, right? There are lots of experts in the field, and there are now even experts in the field of chef advocacy. There are dozens of organizations actually in the appendix of my book that point you in the direction of different issues that you might want to get involved in. So, get to know the experts. And number three, take a baby step. Schedule an appointment with an organization, sign a petition, do some research. Just take a baby step into, okay, now I'm going to learn more. Now I'm going to do something. And it doesn't have to be a big thing. And then your advocacy will go from there. I'm a political activist at heart, and I want everybody to make sure that they're registered to vote, and vote because that is the ultimate form of advocacy and probably the biggest baby step that we can all take once we've picked an issue and become informed on that issue. There are other tips and tools in the book. I'm all about opening conversation, not closing conversation. So I really encourage people through the book and through some exercises in it to figure out their own narrative that opens conversation, their own set of questions that turns them into sort of active listeners and not lecturers. I think food certainly has enough judgment in it that it doesn't need advocates pointing fingers at each other, talking about how one's point of view is better than the others. It's really simple to get involved. The first step is say no. Pick the one issue that's most important to you. Do the work and get to know the issues and the experts. Take a baby step, register to vote, vote, and then you can grow from there.

Bio

Named an industry leader and “Fixer” by Grist magazine and called one of the most innovative women in food and beverage by Fortune and Food & Wine magazines, Katherine Miller was the founding executive director of the Chef Action Network and the former vice president of impact at the James Beard Foundation. She was the first food policy fellow at American University’s Sine Institute of Policy and Politics and is a Distinguished Terker Fellow at George Washington University’s School of Media and Public Affairs. Miller has built a 20-year career working at the intersections of policy, politics, and social impact. She develops and manages award-winning campaigns, trains activists around the world, and helps deliver millions of supporters – and hundreds of millions in funding – to efforts focused on global health, climate change, gender bias and violence, and food system reform. She is a member of the International Academy of Digital Arts and Sciences (IADAS) and serves on the Board of Directors of both the New Venture Fund and Re:Her DC. Miller is an adjunct professor at the Culinary Institute of America. She lives in Washington DC, on the land of the Anacostan and Nacotchtank people, with her husband, Lou, and their cat, Lily.

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With record-breaking food prices in 2022, it has become more expensive for families to buy the foods that they need. The Supplemental Nutrition Assistance Program, or SNAP, helps families purchase foods but families frequently spend their benefits before the next benefit cycle. USDA modifies SNAP benefits every year as a cost-of-living adjustment. But was the change in fiscal year 2023 enough to keep pace with food price inflation? Today, we talk with Elaine Waxman from the Urban Institute to find out.

Interview Summary

You recently completed an analysis on the gap between SNAP benefits and the real cost of a meal. Can you tell us what you found?

Absolutely. I think it helps to start with the fact that for many households, SNAP is a supplement to their budget that they would spend on food. But for about four in 10 households, it is their food budget. In other words, they're deemed to have zero income available to purchase food. What we've done is look at how adequate is the benefit for those households, the ones that receive the maximum benefit. Given overall questions about SNAP adequacy, but because there's such wide variation in geographic food prices, something that I think we all know intuitively based on our everyday lives but don't realize that, in fact in the lower 48 states, SNAP is not adjusted for any of those differences in food prices. It doesn't matter if you live in rural Texas or rural Idaho or on the Coast, your benefit is the same if you're receiving that maximum benefit. What we find is that particularly, based on those experiences in 2022 that we all felt when we showed up at the cash register, 99% of counties in the US had cost for what we would call a moderately priced meal that exceeded the maximum SNAP benefit when we think about that on a per-meal basis. So that was very concerning obviously because people have been relying very heavily on SNAP throughout the pandemic. For a period, there were extra benefits, what is known as emergency allotments, but those have gone away now. As you mentioned at the start, we do get a yearly cost of living adjustment and it was pretty big last year compared to most years and it did help, but the maximum SNAP benefit did not cover the cost of a meal in 78% of count. So that's an improvement from 99% to 78%. But clearly, in the majority of the US, we're still not really able to fully tap the value of SNAP. And since SNAP is a big part of our strategy for reducing food insecurity, that's something we should all be concerned about.

I think this is really important for listeners to understand. There aren't regional adjustments in the SNAP benefits and there are huge price differences depending on where you are in the US. I know some work out of the Economic Research Service of USDA found that same finding in some earlier years. And so it's really important to see what happens, especially during an inflationary period. Thank you for sharing that. I want to talk about one way that we understand how SNAP benefits are set. And so, USDA updated the Thrifty Food Plan which is the basis of SNAP benefits or at least the maximum benefit level in 2021, and it was the first time since the mid two-2000s. What did that mean for the adequacy of SNAP benefits? And what do we know about how inflation has further affected SNAP benefits?

Yes, great question. It was a very important move on the part of USDA to implement that update to the Thrifty Food Plan, which basically is the market basket of assumptions about food purchasing that USDA relies on to set all SNAP benefits. So it's a critical piece of information. Even though it might sound like inside baseball, to some people, the Thrifty Food Plan really matters. As you noted, it had not been updated since I think 2006. And we all know that not only have prices changed a lot, but the ways in which we acquire food has changed a lot. We buy a lot more prepared foods even to eat at home. A lot more people are working and so the assumption that you can cook everything from scratch doesn't really hold for a lot of households anymore. a number of those assumptions were updated. And for a period, that made a big improvement in that SNAP maximum benefit that we just talked about. Unfortunately, that was eroded by the pretty unprecedented rise in food prices throughout 2022, which of course, partly relates to supply chain issues that emerged during the pandemic. The Ukraine war has certainly had a significant impact on food supply chains. The upshot was we had food price increases that we hadn't seen since the early 1970s. So that's where we were this time last year in terms of the maximum benefit, even with those improvements back to not covering the vast majority of counties in terms of cost adequacy. That cost-of-living adjustment helps somewhat, but I think the lesson we should take from this is that we have an underlying adequacy problem with the Thrifty Food Plan. It's really a bare bones assumption set, and a lot of folks have advocated that we move away from that to something that's called the low-cost food plan. It's a little bit more generous. It's a sort of bare bones basic shopping, but the Thrifty Food Plan may just not be the right template anymore. And if we want to tackle the persistent issue of food insecurity in this country, we've got to deal with this underlying SNAP adequacy issue.

I think this is really an important issue. I want to push a little bit further on the Thrifty Food Plan itself in terms of what it means. Please correct me if I get it wrong. It's this idea of a least-cost diet that is nutritionally adequate. It's looking at the dietary guidelines to help provide constraints to make sure people are eating a nutritious meal and it's also based off a minimum cost expenditure for what that diet would look like. It's based off a family of two adults and two children, and it doesn't incorporate lots of different family structures. Is that a fair assessment? And are there then some concerns about what the Thrifty Food Plan is?

I think what you're suggesting is basically correct and one of the issues about the Thrifty Food Plan is that when it was first developed, it really wasn't envisioned as a sustainable diet. It was really more of an emergency sort of meal plan. Like you're very strapped for resources, you can provide minimal nutrition for your household. But this is not what we want for people on an ongoing basis. One of the problems about the assumptions in the Thrifty Food Plan has also been that when we think about a household of two adults and two children, well, children eat really differently depending on their age, right? A five-year old doesn't eat anything like a 15-year-old. There are a lot of issues around household composition, but also just what do we mean when we say we want nutrition security for people, right? We want people to be able to eat healthfully in a sustaining way and I really think our ongoing look at SNAP adequacy suggests we're not there. We're not leveraging the tools we need to tackle not only food insecurity, but the fact that we have an epidemic of chronic diet-sensitive disease in this country.

Thank you for that. You know, this raises important questions about policy frame and the policy space around food access and food security. The Farm Bill is usually the legislative vehicle for making major changes to SNAP. But this past spring, the debt ceiling debate negotiations resulted in adjustments in the SNAP work requirements for some groups and new exemptions for others. What changes were made? And more broadly, what does research tell us about the impact of work requirements and time limits?

It's been an interesting year, to say the least, for the progress of the Farm Bill. Just to remind everybody, the Farm Bill is that place that we normally make major changes and reauthorize significant federal nutrition programs like SNAP roughly every five years. This year, the debt ceiling negotiations sort of preempted a lot of the ongoing discussion in preparing for the Farm Bill, because it took up this issue of time limits specifically focused on benefits for what we call individuals who are able-bodied adults without dependents. Sometimes, you'll hear the term ABAWD. I prefer not to use it because people are not the policy, but it's really focused on single adults who don't have custodial children. The idea is that if you are not able to meet a minimum work requirement of 80 hours a month or equivalent activities, you are limited to three months of benefits in a 36-month period. So that's extremely draconian, especially when we think about what we all know about the instability of low-wage work, right? And in periods where we have widespread unemployment, like we did for a bit in the pandemic, we have the ability to waive those requirements for everyone but they are now coming back. In addition to them coming back, they are now being increased in terms of the number of people it will cover based on the debt ceiling deal. It used to be folks 18 to 49. It will phase in now for people up to age 55, which is also an interesting thing. Because as people age, they sometimes have less ability to be flexible in the workplace and to move into new positions. There's a whole another conversation we could have about that. I guess a bright side of the debt ceiling bill was that it also created some new exemptions for those requirements, and they were focused on very specific groups including veterans, people who are unhoused, and young adults moving out of foster care. So those are all groups that we know are particularly vulnerable when it comes to just monthly finances and their ability to engage in the workplace. And that's a good thing but it doesn't mean that there aren't lots of other folks out there who have other significant challenges that ought to be recognized. And because it's a very sort of discretionary kind of process, we don't even have confidence that everyone in those groups we just talked about would actually receive a waiver. So why does all this matter? It matters because there's quite a body of research now that suggests that these time limits and work requirements don't do what they set out to do, which is to meaningfully increase either work effort or household income. They don't really accomplish the stated goal. They also cost money because you have to administer them and have a lot more interaction with the clients. And not only then do they not achieve those work goals, but they actually push a lot of people off of SNAP and/or trim them through, as we call people who move in and out because of administrative problems. What we have is a group who already has higher than typical food insecurity rates. We're making it more difficult for them to engage in SNAP. And SNAP is our number one tool for reducing food insecurity from the federal program portfolio. On balance, I think a lot of folks in the food security space would argue that time limits should just go away, right? That's not where we should be putting our investment if we want people to have more self-sufficiency and if we want them to eat better.

I really do appreciate the way you are humanizing the experiences of individuals who may depend on SNAP, but as the new policies are being implemented, may age out in a strange way. This is really a useful way for us to understand the implications of when we make decisions or changes to policy, it can have really negative consequences and may not achieve the goals that are at least stated. This is an important part of this conversation. But we're looking at a federal shutdown and if an agreement isn't reached, we could see some serious implications for families. Some lawmakers are calling for across the board cuts of most discretionary spending programs as part of any agreement. Would those cuts affect federal nutrition programs?

Good question, so the short answer is it's just going to be generally disruptive across the board, but the type of program does matter. So SNAP is what we call an entitlement which means that anybody who is eligible for it will receive those benefits on an ongoing basis. But another very important program that many people are familiar with is called WIC and that is a program focused on prenatal care and postpartum care for moms and infants and children up to the age of five. WIC reaches millions of children across the country, and it is not an entitlement program, which means that it's subject to an annual budget. We already have a problem with the WIC budget this year because we've had bigger increases in enrollment than were expected. I think that speaks to this issue about the continuing pressure of food prices, the loss of other pandemic supports at a time when families are still struggling to navigate basic needs. We've had more pressure on the WIC program and there was already concern that there would not be sufficient funds, let alone going into a shutdown situation. The administration has estimated that there will be a significant impact on families who will not be able to receive WIC if the shutdown were to persist. And then the bigger issue is that the time that we invest, so to speak, in shutdowns is time we're not working on the Farm Bill and having a thorough reassessment of program needs. It's likely to delay the Farm Bill agreements as well. While shutdowns, you know, are obviously very much about politics for people who have to put food on the table every week, some of which are paid for by federal salaries, right? Then this is a very real economic shock and it's unfortunately an economic shock that we could avoid.

Yes, it is important to think about how we can avoid this and reframing this as an issue about politics. But at the end of the day, there are families who are dependent on these policies, and we just had a conversation with Travis Smith at the University of Georgia about what happens when kids roll off WIC and that sort of in-between time before they enter school and that had this negative effect on the nutritional quality that these children consumed. And you can imagine that if there are disruptions in WIC while it's a smaller program than SNAP, it has important implications for the wellbeing of the families that use it. This is an important time and I'm hopeful that we will move past this impasse. Discussions about how to strengthen healthy eating for the US population are ever present. And this is particularly true for those individuals who participate in the SNAP program. What proposals are being considered for SNAP and how could we see any of those in the Farm Bill?

This is a really important topic because we actually have an evidence-based strategy for increasing the ability to purchase healthier foods like fresh fruits and vegetables and that is what they call nutrition incentives. Some people will know it as Double Up Bucks, but basically, they're programs that allow people to receive additional money for SNAP if it's put towards those kinds of purchases. That's something that's been evaluated over the last several years and seems to do exactly what we want, which is to increase those purchases. Unfortunately, it's a grant program. It's not an integral part of SNAP. It very much depends on where you live and what year it is as to whether you can access that kind of program. We're underutilizing a tool that's already there and the Farm Bill does currently reauthorize that grant program. Some people will maybe know it as what's referred to as GA/SNAP grants. But we did an analysis and showed that while they do a good job of targeting GA/SNAP grants to areas of high food insecurity, there's still lots of high food insecurity areas that don't have one available, and they're always time limited to a few years. We're not using the knowledge that we've already gained to accomplish this goal again that we're beginning to talk about, which is to really focus on nutrition security and not just basic adequacy of diet. The other thing that people often raise is, well, perhaps we should restrict purchases of certain kinds of benefits. And I think, in general, we find that Americans don't respond well to those kinds of limitations. And a concern, I think, that the food security space has about restrictions is that it's potentially very stigmatizing just to low-income people who are using a benefit when the truth is that most of America doesn't eat as well as we need to and that's a larger structural conversation. The upshot is some people would advocate for restrictions on things like soda and candy, maybe other snacks. I think we could all understand why we wouldn't want to prioritize that, but the fact of the matter is that restrictions don't make the other things more affordable, and that is exactly what the nutrition incentives are intended to do.

Bio

Elaine Waxman is a senior fellow in the Income and Benefits Policy Center at the Urban Institute. Her expertise includes food insecurity, food access, federal nutrition programs, social determinants of health and broader issues affecting families with low income. Waxman previously served as the Vice President of Research and Nutrition at Feeding America. She has co-authored numerous publications, including an article on SNAP benefit adequacy in the Agricultural and Resource Economics Review, which was named the journal’s Best Paper in 2019. She received her MPP and PhD from the University of Chicago, where she is a lecturer at the Crown School of Social Work, Policy and Practice.

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A diversity of bacteria and microorganisms making up the gut microbiome supports both our physical and our mental health. Research has shown that stress and trauma can negatively impact the microbiome. But a recent study took that finding to a new level. This was a study published in the Proceedings of the National Academy of Sciences. Scientists now see inflammation-related microbiomes in babies born to women who experienced mistreatment or adversity during their own childhood. These microbiomes predispose children to physical and mental health problems. We'll talk today with the co-author of that paper, Fran Querdasi, from the University of California, Los Angeles. Interview hosted by Kelly Brownell.

Interview Summary

This topic is so important, and you just hear time and time again from experts all around the world how profoundly the microbiome was influencing our health and how many factors affect the microbiome. But now to think about this generational matter that you addressed in your research is interesting and scary, in a way. Let's first start off with this question about how you studied these mothers and the children. What were you looking for?

The goal of the study was to see how experiences of adversity or hardship across two generations might be related to the composition of the children's gut microbiome, or in other words, which microbes were living in their guts. So, for this paper, I worked with colleagues at the University of California-Los Angeles, as well as a team of scientists in Singapore who are currently conducting a big birth cohort study called Growing Up in Singapore Towards healthy Outcomes, or GUSTO for short. That study has thousands of mothers and families enrolled but, in this paper, we focused on around 450 families who had data on what we were interested in - the mother generation, as well as her child generation. We specifically wanted to study the children when they were around two years old because the gut microbiome develops really rapidly during that period from birth until around two years of age.

In this study, we asked mothers to tell us about three different kinds of adversity. First, their history of maltreatment. That would be things like abuse and neglect in their own childhood and then kind of moving forward in time, any symptoms of anxiety during their pregnancies. Then moving forward again into the children's generation, their children's exposure to stressful life events. So, things like their parents' divorce or the death of a family member from birth till two years of age. At two years of age, we collected poop samples to analyze the children’s microbiomes. Then we also asked families to report on their children's social emotional problems. So, things like aggression, sadness, issues with attention on when they were two years old and then again at age four because we really wanted to see also how their microbiomes were related to their early childhood health.

I'm eager to hear what you found but first, let me say I'm impressed that you even bothered to ask this question because one wouldn't think that traumatic experiences decades ago in the life of a mother would affect the microbiome of a child today. So, tell us, please, what did you find?

We found that each of the adversity experiences that we asked about - so abuse or neglect that the mother experienced in her own childhood, the mothers' symptoms of anxiety during pregnancy, as well as children’s experiences of stressful events in their early life - all of those seem to have an impact on the children’s gut microbiomes. Specifically, we found something interesting, which was that some of the microbes that seem to be related to adversity we think that they might perform similar functions to those that we found were related to the children's social emotional health, both at two years and then at four years of age. We think that those microbes probably play a role in regulating the immune system and inflammation. Our findings kind of hint that maybe disruption to some immune-related functions within the gut could help explain how some children go on to develop mental health struggles after they experience adversity. And how that intergenerational experience of adversity shows up in subsequent generations.

Like I said, it's hard to imagine that things so distinct in timing can have such a big impact. How is it possible that adversity experienced by a mom in her own childhood could affect her child now in terms of the microbiome?

That is pretty surprising. You think that it's so far in the past, but it's really striking that it does still appear to have an impact. This study was the first one to find evidence for that in humans. There have been studies in animal models, researchers that work with rats and mice, and there was evidence the mom's experiences during childhood affect their children's gut microbiome. There is other research that studies this phenomenon, called intergenerational transmission of adversity, and that's when trauma, chronic stress, adversity, those kinds of experiences experienced in one generation have impacts on the following generations. Even in those who have never directly experienced the event. Research has brought up many possible explanations for why that might happen, from changes to gene expression after adversity to changes to the parent's health and behaviors. In terms of the microbiome specifically, it's possible that the mother's health or underlying biology and physiological response to stress was affected by that adversity that she experienced in some way. And that shaped her child's development in terms of brain or stress response systems during her pregnancy. Then, because the microbiome is really connected to other biological systems that had an impact on the microbiome, the mother's microbiome plays a big role in shaping the child's initial microbiome during birth, and then after birth in terms of contact with the child and breastfeeding, things like that. The bottom line is that the mother's microbiome was affected by her adversity and then directly shaped the child's microbiome.

A fascinating set of possibilities you're talking about. Let me ask you a down in the weeds question. How can you isolate the impact of the adverse childhood experiences in the mother in terms of its impact in the microbiome from other things that just might co-occur with the adverse childhood experiences, social disparities, economic disparities, health disparities in general and things like that?

That is definitely really challenging to do, and we did that to some degree in our study. There's definitely a lot of future research that needs to be done to tease apart the different factors that might play into that relationship between the mother's adversity in childhood and her child's microbiome. But we did account for the mother's socioeconomic status in terms of the family's income, and we also accounted for the birth mode of the child, so whether the child was born by C-section or vaginal birth. So, in that sense, we tried to isolate the impact of the mother's adversity.

That makes sense. It sounds like you took care to address that issue. Now let me ask a question about what can be done given this relationship you found. Is there anything that can be done to disrupt this connection? One might think perhaps if the mother had eaten a diet that was specifically designed to optimize the microbiome, would that help, for example?

That's a really important point. There are many things that impact the gut microbiome in addition to adversity experiences. Diet, other things in the environment like exposure to nature and other people, the urbanity of your living environment and overall stress levels as well. That also highlights that many things can be done, both on an individual and societal level to promote a healthy gut microbiome and possibly counteract or mitigate impacts based on adversity. We're very far away from knowing exactly what the perfect way is to address this because there's just so much more that we need to know about the gut microbiome. But there are some general things. We know that eating a variety of foods that have a lot of fibers like fruits and vegetables, that's good for your gut microbiome. So, policies that make those foods more widely accessible and affordable. And then things that can help you manage stress in a healthy way. So, meditation, exercise, really strong supportive social relationships, as well as policy supports for families that reduce financial stress and precarity. Then, in terms of focusing on specifically early life policies that allow parents the time to form positive relationships with their kids, like parental leave and things that help maximize the mother's health broadly. So, affordable perinatal care can set the child up for the best possible start to life. Those are changes that would promote microbiome health broadly in addition to overall health.

Those things all make sense. And the good news is that every one of those things you mentioned would have health and mental health benefits way beyond the microbiome. So, good reason to focus on those things. Now let me ask you one final question. Are you working on follow-up studies to this?

Yes, we are. So, in that study, as I mentioned, we were looking at microbiome composition, which means which microbes live in the gut. We found evidence suggesting that immune functioning was really important, but the methods that we used were not able to test the function of the microbes directly. So, we're following up on this work by looking at the same questions of how adversity experiences impact the microbiome but looking at function of the microbes directly. So, in this group of families that we studied, as well as others, I'm also interested in looking at how adversity might impact communication between the immune system and the gut microbiome. The gut microbiome is really intimately connected to other systems. For example, there's many connections between the gut microbiome and the brain and the brain and gut microbiome influence each other. I'm looking at communication between the gut microbiome and brain as well. So, trying to get a more complete and whole-body picture of the processes that are affected by adversity and if those changes relate to mental and physical health and kind of the specifics of how that works and I really hope that that work will open up new ways to treat and prevent health problems in families exposed to adversity.

Bio

Francesca Querdasi, M.A. is a PhD student in developmental psychology at the University of California, Los Angeles, with minors in health and quantitative psychology. Her research focuses on understanding how experiences of adversity or hardship predispose individuals to develop physical and mental health problems, with a particular focus on depression, anxiety and chronic pain disorders. Her prior work has examined the intergenerational transmission of adversity by way of the gut microbiome, and how adversity is related to communication between the brain and gut microbiome in early childhood. In the future, Fran plans to examine the role of the immune system and immune-gut microbiome communication in the development of mental health problems during the teenage years. The ultimate goal of Fran’s work is to inform new prevention and treatment strategies that promote health and well-being for children and families impacted by adversity.

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I read a study recently featuring a term I had not heard or seen before: "disproportionate beef eaters." The study was done by Dr. Amelia Willits-Smith, Diego Rose and colleagues at Tulane University. So, who are such beef eaters and how are their consumption patterns associated with environment and climate change? Today we're joined by one of the authors of that study, Dr. Diego Rose, who is a professor and nutrition program director in the School of Public Health at Tulane.

Interview Summary

You, your colleagues, and your students do the most interesting work on really important issues, such as how diet lies at the intersection of health and environment. This sort of work is so important because there's a lot of talk about it. But not enough empirical work to really make policy decisions has been done, at least regarding some questions and you're helping fill like gap. I'm really delighted you could talk to us today. Let's start talking about this study. Give us some context if you would. Why did you set out to study the characteristics of disproportionate beef eaters?

Kelly, I've been doing this work for about seven years - working on a connection between diet and climate change. In the early days when I would do presentations on this research, I would always start the presentation with a slide or two of some big government report or intergovernmental report. Sort of legitimizing the whole topic. Now I find that climate change is so connected to people's daily lives whether it's the floods and the heat waves, droughts, fires that that are happening that people know it's a problem. I don't need to preface what I'm saying by that. When people think about climate change, they tend to think about it being caused by the transportation sector, perhaps energy use or construction but they don't tend to think about food systems. But it turns out that human food systems account for a third of greenhouse gas emissions. Most people don't think about that. Within that category, livestock is the most important contributor to greenhouse gas emissions. What's more, within livestock it's beef. Beef, it turns out, accounts for eight to 10 times more impact than chicken and over 50 times the impact on greenhouse gas emissions than beans. Naturally, we were concerned about beef. If we were going to do an education campaign to let people know about this, we thought, well, who should we target it to? We should target it to the people that are eating the most of it. And how you would target that? Well, you would set a threshold for what's disproportionate beef consumption and then go about looking at some data to see who's contributing the most to beef consumption.

That makes perfect sense. Let me ask you sort of a fundamental public health question in this context. Sometimes you get a big impact at a public health population level by making big changes in people who are the biggest users of something. Heavy smokers would be an example or heavy drinkers. That's the approach you're taking here. But I know in other cases some people have said that with some consumption patterns that are hard to change, like maybe what people are eating or smoking or drinking, that it makes sense to focus on a different part of the population where you get smaller changes but spread across a larger number of people who are more willing to change, and hence you get a bigger impact. So how do you define who were the disproportionate beef eaters and what were the findings of the study?

To think about disproportionate beef eaters we used the dietary guidelines for Americans. We looked at the healthy US meal plan. The data we had was on daily intakes. That meant that for somebody with a 2200 calorie consumption level that a recommended amount would be four ounces for meat, poultry, and eggs. We thought, well, if you're exceeding the recommended amount with just one of those foods, say beef, where you could be meeting the recommendation with chicken or eggs or even vegetarian if you wanted to, we thought that was disproportionate. So, we used that as a benchmark, for a disproportionate diet. So, what did we find?

Before you do that, let's give people some sense of this. When people talk about a recommended serving of meat, they say something that might be about the size of a deck of cards. Is that four ounces you're talking about? I'm imagining you're talking about people that eat multiples of that.

You can think of four ounces as a quarter pounder, thinking about a burger, except that it's cooked weight. Usually when McDonald's puts out a quarter pounder, that's the raw weight. We're really thinking about one and a quarter or one and a third quarter-pound hamburgers. That's what the threshold is. So, if you're eating more than that, more than one and a quarter, quarter-pounders a day every day, that's what we're considering disproportionate.

Okay, thanks. So, now tell us about what you found in your study.

We found three kinds of things in the study. First, that 12% of people consumed this disproportionate amount of beef. They were more likely to be men, they were less likely to be young people under 30, or older people over 65. They're also less likely to be college graduates. So, those are the kinds of things we were looking at when we went into it. The other things that we saw were that those 12% of people - and this is what really surprised us because we weren't looking for this, but what ended up happening - the 12% of people that are disproportionate beef eaters are consuming 50% of the total beef on any given day. That was the surprise. That's the one that's got all the headlines. There's another piece in there that didn't get as much play, but I think it's interesting. When you think about beef, you tend to think about a steak on my plate or maybe there's a burger on my plate. But the truth is over 50% of the total beef that we saw consumed was in the form of mixed dishes. I'm talking about stews and soups and burritos and tacos and sandwiches and pasta dishes. That was the other finding - a lot of the beef that's been consumed, a majority of it, is consumed in these mixed dishes not just on a hunk of beef on the plate.

Those are really striking findings that 12% of people eat 50% of the beef. And that it's clustered in certain demographic groups! Really pretty interesting. I also am surprised by the mixed dishes because the vision of my head as we were speaking is that people eating the hamburgers and steaks and things like that. But the mixed dishes are really an interesting part of the picture. So, what do you think some of the factors are that drive meat consumption in some of these groups?

It's interesting. I think young people are more concerned about the planet in general. They are more clued to these issues and that might be part of the reason they are eating less beef. I think older people might be eating less beef because they're concerned about health issues. We haven't talked about that. There are a number of studies, and it is pretty consistent evidence showing that the connection between red and processed meats and heart disease and mortality. I think older people might be more concerned about that and therefore eating less meat. College graduates may be just understanding these connections better, possibly. That is part of it. I think men over women because there are some studies that show that meat plays into masculinity. There is also the idea that men are more willing to sacrifice animals for their own good than women are. These are some studies in the psychology of eating. We don't do this kind of work, but I think it's interesting.

From my own observations, and this is in the past more than I've seen it currently, but there was a time when the fast-food companies especially were reacting to messages that eating meat wasn't very healthy. The kinds of messages that they were putting out at the time were, don't let anybody tell you what to eat. Be a man, stand up, eat our massive burgers. I imagine that all these things are linked together, aren't they? The marketing practices, the masculinity, the imagery all of it's a pretty complicated set of topics.

It is. I think they are connected as you pointed out. That makes it all the more challenging to try to do something about it.

So, back to your study now. What do you mean by eating a disproportionate amount of beef? I think you defined it already, but is there more to say and how do you translate your research definition for the public who might be interested in their own consumption patterns?

That's an interesting point because we do our research and then we have the challenge of trying to communicate it to the public afterwards. Part of that is there are different concepts. What we do in the research setting is not necessarily related to what you would do at home. So, let me describe how that is. For example, in this study, we're looking at 24-hour recall data. This is a tool that nutritionists use to get a snapshot of what someone ate on the previous day. And they're very comprehensive. There's a whole methodology around it to get what is in that day's food intake. And that's what we have in our study here. The National Health and Nutrition Examination survey which we use is a nationally representative survey. So, we have over 10,000 adults here that we're looking at a snapshot in the day. And so, when we're trying to set up a threshold for what's disproportionate, we take a look at the dietary guidelines for Americans and translate those into one day. That's where we got these four ounces of beef more than that would be disproportionate. Then the question becomes, well, what do you do if you're a consumer? Can I eat a burger and not reach the disproportionate level? Yes, on a given day. But the way that the guidelines are set up is across a whole week. So, really the way to think about it is disproportionate in your daily life would mean eating a burger and a third or more every day, not just on a given day.

That makes perfect sense, so I appreciate that specific advice. What are the connections between consumption patterns that you're describing and agricultural emissions and climate change?

This idea of a dietary carbon footprint is what are the greenhouse gas emissions inherent in the foods you eat? It's not the eating that's the problem, it's the producing. That is where most of the emissions come from. How does eating affect emissions? If you eat less of something then the idea is that will send a signal back to producers to produce less of it. So, to the extent that emissions are coming from the production side and you are not participating in that, this would send a message to producers to produce less of it. Now if that link is broken, for example, and it can be broken, if American Beef Producers export which they do, then it doesn't help the planet. In other words, if they keep producing beef and shipping it to Indonesia or someplace else then it's not enough for us to eat less. It has to be a sort of a global effort.

It does make good sense when you state it that way that a lot of people making these kinds of changes could add up to a big difference, given the role that beef consumption is playing in agricultural impact on the climate. I appreciate you focusing on that. What would you say is the broader importance of this topic?

Diego - I think really the broader importance is to point out that beef is a really extravagant source of protein. You can get the same nutritional equivalents, even better because it doesn't come with saturated fats, not associated with cardiovascular disease to the degree that beef is. If you were to eat chicken, it’s like one-eighth or one-10th the amount of greenhouse gas emissions to produce chicken than it is beef. If you go vegetarian, even more so. I think the significance is that there are little changes that can be made that would add up. And they can come in from lots of people and they can come in lots of ways in anyone's diet.

Bio

Diego Rose is professor at Tulane University’s School of Public Health and Tropical Medicine. His research explores the social and economic side of nutrition problems, with a focus on nutrition assistance programs, food security, and the food environment. He has studied disparities in access to healthy food in New Orleans and has developed a framework for how the neighborhood retail food environment influences dietary choices and obesity. His latest research projects examine grass-roots efforts to improve healthy food access in New Orleans and the environmental impacts of U.S. dietary choices. Dr. Rose has served as a consultant to the UN Food and Agriculture Organization and the World Food Programme. He teaches nutrition assessment and monitoring and food and nutrition policy. Prior to joining the faculty at Tulane, he worked for USDA’s Economic Research Service on domestic food assistance policy and in Mozambique and South Africa on food security and nutrition. He began his nutrition career as the director of a local agency WIC nutrition program in a farmworker clinic in rural California.

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The third largest food assistance program in the United States is the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC for short. WIC is designed to safeguard the health of low-income women, infants, and children up to the age of five who are at risk of inadequate nutrition. WIC provides funds for specific foods to supplement diets, information on healthy eating, and referrals to healthcare. However, regardless of school attendance and access to school meals, children age out of the program the month after their fifth birthday. Today, I am talking with the University of Georgia's Travis Smith, an agricultural economist who, along with his co-author, Pourya Valizedah studied the effects of aging out of WIC on children's diets.

Interview Summary

Before we discuss your recent paper, why did you decide to study aging out of WIC?

There's been a lot of work on pregnant and postpartum women participants of the WIC program, and also infants, and all of that research is definitely very important. There's been less work on child participants, and one thing we were interested in was this arbitrary rule about kids losing access to WIC in the month after they turned five years old. We knew that this rule was set up because most kids start school when they turn five, although it's not WHEN they turn five. Some previous work that I had done with my co-author Pourya on school foods, we knew that school foods really impact kids' diet quality in a positive way. We were interested in what happens to some of these kids that have this potentially long gap in their food assistance.

It's really fascinating to learn that there was a lot of research in this space on WIC oriented to mothers, and it sounds like what you're saying, little or not as much was focused on children. I'm interested to understand why do you think that's the case given the orientation of this program?

That's a great question. I think there's probably two ways to look at this. I think the most important is that most people would consider pregnant women and infancy the most vulnerable times of your life, and so understanding how the program impacts the most vulnerable would be of first order importance. Also, some of the early work that came out in the 1980s when people started really looking into the efficacy of WIC, focused on birth weights, for example, and you see that WIC's impact on low birth weights far outweighs the cost of WIC itself. For example, we're talking about women that live in low-income households, so in most cases, when these women go to give birth they most likely might be on Medicaid. Any outcome that would be a negative outcome or an adverse outcome at birth would be paid for through Medicaid. That was the first place that people looked, and that's when researchers realized very quickly that WIC is paying for itself just on the women participants and the child participants together at birth. There is definitely other research on children, it's just not as much research.

That's great. Let's go ahead and dig into the paper that was recently published in the American Journal for Agricultural Economics. What's the upshot? What did you find?

The upshot is that it seems like that WIC does work in terms of providing nutritious foods to the child participants. These are kids that are two, three, and four years old. One reason that that's important is that we know as kids age, the probability that they stay on WIC, even when they're eligible, declines dramatically. For example, at birth, as I mentioned earlier, I think the take-up rate is over 95%. That is because postpartum, immediately after birth, medical providers will give a screener at the hospital and if they see that Moms are eligible for WIC, they'll ask if you want to sign up. Part of the WIC package is to get free infant formula if the mother doesn't want to breastfeed or she's partially breastfeeding. So, you see a large uptake at that point. But then after the kid turns one and the package switches to milk and cereal and fruits and vegetables, that's where we start to see parents and caregivers not re-certify the children. Over time, by the time you get to four-year-olds, you're looking at, out of all the four-year-olds that are eligible, depends on what study you look at, but it's definitely under 50% participation, probably in the 30 to 40% range that are taking part in the program. For those that are participating, we're looking at what is being reported by the parents that the kids are actually eating. What we're finding is that foods provided through WIC, which are healthy foods, do impact foods that the kids are consuming.

This raises an important question about what you did in the study. This idea of how you describe food as nutritional or healthy - could you tell us a little bit more about how you measured diet quality? I know that there's also an interest in the quantity, so please explain.

That's right. We use this measure called the Healthy Eating Index developed by nutritionists. It gives you a score from between zero and 100, just like you'd have a test in school. The way it works is there are 13 different components, for example, one would be fruits. As you get closer to eating the recommended fruit consumption for that age group, you can score more and more points. There are other food groups such as vegetables and whole grains, etc. There are even some components that are nutrients, like saturated fats and added sugars. As you get closer and closer to the recommendations on all these different components, you get closer and closer to scoring a 100. We use this algorithm based off what the parents are reporting that the kids are eating. Then we're able to score how well they eat on this range from zero to 100. Now, I'll tell you, the scores that they're getting aren't that great, right? It's around 50 out of 100, so there's already room in improvement. This is not just for kids that are on WIC, this is in general, across all ages. Americans have a lot of room to improve their diet, and so that is our main outcome in terms of the quality. But we did also look at the quantity or the overall calories that the kids were consuming as well.

So, what you found was those kids, when they aged out of WIC, before they actually entered into school, they had lower quality diets? Was the same true with the quantity? I mean, in terms of the number of calories, could you tell us a little bit about that?

That's right. When we first looked at the sample in total, we didn't really find much of an effect of aging out of WIC program. But we were concerned whether the kids are in school or not. So, where we find the reduction in diet quality is for the kids that are born in, say the winter, late fall period. These are called late school starters. These are kids that generally are born after the cutoff date to go to kindergarten. So, for example, if a kid was born in September, they would miss the kindergarten cutoff. For most states, that would be August. So, they would lose WIC in October, and then they must wait all the way until the next school year before they would go on to most likely free school meals. We were able to split the sample into these late school starters, and then you have the other kids that are born, for example, maybe in the summer, so they would lose WIC but then could seamlessly slide into school food programs. For those kids that lose WIC and then go into the school programs, or maybe they even lose WIC while they're in school, depending on the state, we see no effects at all on the quality of their diet or the quantity of their diet. But for the kids that are these late school starters, the ones that are born in the winter or late fall, that's where we see this decline of on average of 20% decline in the quality of the food that they're consuming. But we still, for them, for those kids, we still find absolutely no effect on the quantity. What we're seeing is that parents or caregivers lose access to these nutritious foods that are being provided for free through the WIC program. But they're still feeding their kids the same number of calories. They are just switching to lower quality foods.

Is that finding true for everyone? Or are there differences in the individuals that you looked at in this study?

You can kind of imagine that if you were able to rank kids in households based on who's consuming the lowest quality diet, they would be on the very lower end of this HEI score versus kids that typically consume a much higher quality diet. They would be up higher at the end of this spectrum. This could be for a whole host of unknown reasons, right? It could just be the kids' own food preference, the household that they live in, and the parents' preference. It could be the food environment. But regardless of whatever those reasons are, what we found was that the kids that typically consume high quality diets at home, so they're on the upper end, we see really no effects for them when aging out of WIC. Where all the action is, where all the deficits and the diet quality come from are at the lower end. So, these are the most vulnerable kids that live potentially in areas with inadequate access to healthy food or whatever it may be, they're the ones that are taking the largest hit, and arguably, they're the most vulnerable.

This difference across households or across children is really important to recognize and it's an important place for interventions as we think about what the implication of your work suggests. So that's one of the questions I'm interested in understanding. What, if any, are the long-term effects of children aging out of WIC? It seems like there's a special period that this is happening. Do you think there are effects beyond that window of time before they start school?

I think that there probably are. Now, we couldn’t address that specifically in our study because of the way our study was designed. The effects that we're looking at are just for this transition when they're around the period that they're losing access around five. One reason just intuitively to kind of understand is why we can't extrapolate this out is that. As we add months past five years old, the probability that that kid is going to go into school is going to be increasing. So, you're going to start muddling the positive effects of school food programs. But to speak to these long-term effects, there's this whole long literature from nutritionists, and your listeners will probably just know this anecdotally, if you have small children or had kids or been around kids, is that it's really hard to get them to eat healthy, right? Or to try new foods. The WIC program is providing this opportunity to have access to these healthy foods, and the problem is that, I think, many people would also realize, or again, anecdotally, you would kind of realize that it's really easy for kids to have a reversion, right? You've been trying really hard, you're getting them to eat that broccoli, but then if all of a sudden you lose access to broccoli, and they say, oh, I can eat the French fries. It's really easy to go back to just eating those French fries and you take all this kind of nutrition capital, so to speak, that's been developed over these years of being on the WIC program, could quickly be wiped out. So that is a very important period. That's what the nutrition literature says. We haven't looked at these longer-term effects yet.

Well, thank you for that. Travis, it's interesting to find this idea that the calories don't change. So, if you will, the quantity doesn't change, but the mix, the nutritional value of the foods that children are eating changes if they age out of WIC. So, the question is, what challenges do you think parents are facing to continue to buy the WIC items or to buy these more nutritious foods during this age out period?

Yes, that's right. WIC is acting as a small income transfer, and so when you lose WIC, parents must then use their own money to buy food. By and large, whole grain bread, for example, will be more expensive than refined grains. Processed fruits and vegetables that may be canned that come with added syrups or fats will be cheaper than fresh produce. All these things add up when the parents are still feeding their kids the same amount of food and they're making these small substitutions for the lower quality foods. You do see that add up. I will point out that in terms of the calories, there was also another paper that came out right after our paper by Marian Bitler that showed that they were able to look at what was going on in the households. What they find is that the moms actually do reduce their own calories, which is a finding that we've seen in the context of WIC and other programs, and also, I think it seems, I guess obvious, is that the parents would be more likely to take the hit and shield their kids. Your paper doesn't speak to that, but there are these other implications for others in the household.

Wow, this is really important work. Thank you for sharing that. I'm interested in the policy shifts that could happen. How could policy change affect this issue, this problem, and the negative effects of aging out? What kind of policy tweaks are possible, and do you have a sense of the cost of that?

The obvious policy fix is to change the arbitrary rule of kids lose WIC in the month after they turn five years old, and just say, "Hey, you can stay on WIC until you get into kindergarten." We were curious about how much that would cost. We know from administrative cost data from the USDA how much it costs on average per month for a four year old to be on WIC, and so we just extrapolated that number out, assuming that births are random across the year, so that would mean you would have 1/12th of the population that would have to stay on WIC for 11 more months and then you have another 1/12th that would stay on for 10 months, and so on and so forth. We calculated the total cost of that under the current rules, and it came out to about a hundred million dollars, which sounds large, right? A hundred million dollars. But you must put that into context of the current spending. WIC currently costs about 5.7 billion, with a b, so that change comes out to about a 2% increase in the program to allow kids to stay on WIC until they turn five years old. Not only is that a small percentage of the WIC program, but that’s also less than a drop in the bucket in terms of food assistance spending. Again, to have a better context, the SNAP program costs, last year, I think it was about $120 billion, so it's actually a very small amount to allow kids to stay on the program.

Is there any political movement or any movement in the legislature to address this problem?

Somewhat. There's been a bill called the WIC Act, which would allow states to seek a waiver from the federal government to do just that: to allow kids to stay on WIC until they get into kindergarten, or they turn six, whichever comes first. This has been proposed, I think at least since 2015, over and over. It's bipartisan that has sponsors on both sides of the aisle, and it's been proposed in the House and the Senate and in both also bipartisan support. But it's never gotten out of committee, which means they sent it to committee, doesn't get marked up, and it's never left. I don't know if this year will be any different. There's been several other bills that pertained to WIC that have also been proposed. I think there's more interest in revamping WIC. Whether this will happen with this particular one, I'm not sure, because as you may know right now, Congress is asking for more money to pay for WIC because it is discretionary, it's not mandatory. So, who knows, right? But there is this proposal to allow this to happen.

Bio

Travis Smith is an associate professor at the University of Georgia, Department of Agricultural and Applied Economics. His research interests focus on the economics of food, health, and nutrition, with a focus on food assistance programs.

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Our guest today is Dr. Caree Cotwright, director of Nutrition Security and Health Equity at the Food and Nutrition Service at the US Department of Agriculture. Dr. Cotwright is leading a USDA-wide approach to advancing food and nutrition security in the United States. Part of her responsibility includes the charge from Secretary of Agriculture Tom Vilsack to make MyPlate a household name. MyPlate is the official visual reminder of the US government to make healthy food choices from each of the five food groups. Now, this turns out to be a tall but important order. About a quarter of US adults have heard of MyPlate, according to a recent survey.

Interview Summary

You came to USDA while on leave from the University of Georgia (UGA) where, by the way, you were the first Black woman in the Department of Nutritional Sciences to earn tenure. Congratulations for this, and please know how much I appreciate the important role that you've played in our field. So, let's start with discussing what drew you to food policy and what makes you excited about your role in public service at USDA?

I am really excited about this role because it's just a privilege. When I think about the fact that USDA has the title or has a position for the director of Nutrition Security and Health Equity, I get excited about that. It's been a privilege to work on advancing all of the things that have come about because of the White House Conference. I came to nutrition policy really in a kind of a roundabout way. I was working on my master's at UGA and I was doing an internship at the Center for Science and the Public Interest (CSPI). At that time, I was wanting to write on the Nutrition Action Health letter, but they had someone who was mentoring in nutrition policy and that someone was Margo Wootan. She kind of took me under her wing and helped me to learn about what nutrition policy was.

After completing my master's and my PhD, I did my postdoc, and then did a RISE fellowship at the CDC. I was working on disseminating policy around early care and education obesity prevention policies and just really to understand the keen role that policy plays in the advancement of nutrition and policies in general. That was really eye-opening for me. I knew that during my role at University of Georgia as a faculty member that I would focus on both policy and intervention. I've had such a wonderful experience of being able to use different creative approaches, but also using policy. Some of those approaches have earned me the opportunity to talk to a variety of communities in different ways, including having a TED Talk. It's just been a joy to do this work.

You've had so many interesting experiences and I could see how you'd be passionate about food policy after spending time at CSPI, especially with Margo Wootan. There aren't many people that know food policy like she does. But one thing I wanted to ask you about is one of the highly novel part of your work and your approach to nutrition has been to incorporate the creative arts, including storytelling. Tell us about this if you would.

Storytelling has always been near and dear to my heart. When people ask me about that question, I've been doing it since I was about five years old when I was asked to come and give the commencement speech for my nursery school. I wasn't afraid, it was fun for me, and I just said, "Wow, this is really something that I can do." I enjoyed connecting and engaging with others. As I think about my work, I know that telling stories and using creative approaches to meet people where they are helps us to promote a variety of topics. Of course, it's kind of entertainment education, but using these approaches is a catalyst to get people interested in what we're doing. We know we're competing with so many things that pull people's attention now.

Some of the things that I've done are I have a play about nutrition for young children, I have a hip hop song. I tell stories even in my speeches because I know that when I can connect, people will remember that story. And that's so important. Through my work, I promoted the Child and Adult Care Food program. I worked on the SNAP-Ed program at University of Georgia. We've done creative things like having skits and have enough care to call Healthy Bear that the children relate to. Even in some of our work that I've been blessed to have and had the privilege to work with Robert Wood Johnson Healthy Research to have social media and to use all of these approaches, but to use it to promote health and use it to promote healthy messages and messages specifically about nutrition. That creativity and those approaches are things that I bring to my current position in thinking about how do we engage the public, especially as we continue forward with advancing nutrition security and health equity, as well as making MyPlate a household brand?

I love that creativity. I think back on memorable speeches I've heard or talks I've listened to and things, very often, it's the stories that you remember. The fact that you're recognizing that, appreciating that, and perfecting it, I think is really impressive. I'm glad to learn a little bit more about that. Let's talk now about your federal service at the CDC. This was another experience that I know helped shape your interest and your passions and your desire to return to public service at USDA.

That's a wonderful question. It was such a wonderful opportunity to come to CDC at a time we were on the cusp of really thinking about how do we develop and disseminate policy related to obesity prevention for our youngest children, age zero to five. I had just finished a postdoc in community-based participatory research at Morgan State University working with Head Start children. At the time when I got to CDC, we had former First Lady Michelle Obama working on Let's Move! One of the key initiatives was Let's Move! Child Care. We modeled the initiative and the work we were doing related to policy on the work of an outstanding researcher. Her name is Dr. Dianne Ward. Not only was she an outstanding researcher, she became a mentor, colleague, and friend of mine. I just have so much admiration for the work that Dianne Ward did and the trailblazing efforts that she did to advance policy in the early care and education setting related to obesity prevention, but also in equity.

So we were working on these things and my task was to go around to stakeholders all across the country and make sure that they understood what we were saying. So again, bringing in that community engagement and the training that I had, I said, "We can't just put this on a website and say, 'Hey everybody, you should go out and do this.' We have to go in and teach people and train people and explain it." Fortunately, my mentor there, Dr. Reynolds and Heidi Blanck, they agreed. I was able to go out and help to disseminate the policy, and again, it gave me such a strong and firm understanding of how to really relate.

I'll tell you just a quick story. At the time, I didn't have kids, Kelly, and we were talking about these obesity prevention policies and we said, "Okay, no screen time for children under two," and those things. It wasn't until I had kids and I thought, "Well, how do you do that?" Because it has to be realistic and you have to think about how these policies work on the ground. As I talk to childcare providers, as I talk to stakeholders, as I talk to people working at the state level across the country, we help gain an understanding for just how these policies will go into place and gain support for policy implementation because we can't do the work without the people who are working on the ground level.

Two things I want to make note of that you just said. First is if it's easy to to talk about how children should be fed and learn about food until you have them, and then all of a sudden, it gets a lot more complicated, I know. But the other thing I'm grateful that you did was to pay tribute to Dianne Ward. Many of our listeners may know she was a professor at the University of North Carolina at Chapel Hill and recently passed away. There are people all over the country in the world who were just broken hearted by this because she was such a dear friend and colleague to many of us, and just a completely inspired researcher who wanted to make a difference in the world and really did. It's not surprising that she touched you and your professional career in such positive ways and that's true of a lot of us. I'm really happy that we were able to talk about her for a moment. So thank you.

Thank you. Thank you for allowing me the opportunity.

Let's talk more about your current position at USDA now. Can you tell us what your primary responsibilities are and what your vision is for your work ahead?

Yes. My primary responsibilities are to advance the work of food and nutrition security and health equity. I know that's a part of my title, but we really are working to make sure that people are able to get access to the food they need. Our definition is that nutrition security means that everyone has equitable access and consistent access to healthy, safe, and affordable food that is optimal for their wellbeing. We do this at USDA through four pillars. We think about having meaningful support for nutrition and nutrition education, making sure that people have access to that healthy, safe, and affordable food, making sure that we work through collaborative action through partnerships, and then making sure that we prioritize equity every step of the way.

When you think about USDA and the programs that FNS has and the programs that we are working on in our mission area, we have lots of opportunities to advance nutrition security because our work is just so closely related. I work very closely with our programs and I work a lot with our stakeholders, both internally and externally, to make sure that people are aware of the work that we're doing. But not only that, that we are leveraging things like the historic White House Conference, making sure that we have lots of commitments from people all over. We've had over $8 billion of commitments. But making sure that with our stakeholders and our partners, that we lean into new creative approaches that will help us to reach our goals. We have some really big goals to end hunger, to improve nutrition, physical activity, and to reduce diet-related diseases and disparities. We are holding ourselves accountable and making sure that we're getting the word out and making sure that we're partnering in very meaningful ways.

A part of my larger vision is a part of the secretary's vision, which is to make MyPlate a household brand. We think about what does that mean? We want to make sure, you said early on that about 25% of Americans are aware of this tool, but we want to make sure that not only are they aware, but they use the wonderful resources that are attached to MyPlate because it is our federal symbol for healthy eating.

It's heartening to hear about your vision and to understand the kind of progress that's being made to advance food and nutrition security, and also to specifically leverage some of the commitments that were made at the White House Conference. In addition to what the federal government can do, are there things that individuals can do like our listeners, for example, or the ways they can help?

Yes, and I'm so glad you brought up your listeners because that's so important. So every voice matters. And so all of our actions add up collectively. I've heard up from some wonderful, wonderful people in West Virginia and Oklahoma, just all across the country. When I go out and speak and I tell people, "You have to help me with this mission of making MyPlate of household brand." They sent me back things that they're doing. Creative things like setting up kids farmers' markets, popup markets in places like hardware stores that don't traditionally do that. But they will set it up and let a farmer come in and set up a popup shop, and then they provide the tokens through some of our wonderful programs like SNAP-Ed and FNA. When we think about these creative solutions where there are already existing things, but we're solving a problem, we're solving that access problem. Just thinking about that and making sure that we are all collectively working together, we want to hear from you. We want to hear from you. I always give out my email. It's caree.cartwright@usda.gov. We want to hear from your ideas. We also have our pillar pages on our website. If you just look at nutrition security at USDA, we have our pillar pages so you can learn more. But we also have a very short video where we're talking about the work that we're doing and highlighting that work, and a blog that is attached to that. So again, if you're wanting to promote efforts that we're doing, that's a very quick synopsis and a short way to get it out there to people to spread the word and increase awareness about all of the wonderful things that we're doing to advance food and nutrition security.

I never thought of my hardware store as a place to learn about nutrition, but why the heck not? Let's talk about MyPlate a little bit more. What's your role and how are you going to go about trying to make MyPlate a household name?

It's a very multi-pronged approach. My role is to bring those creative approaches. One of the things I love about this position is that it's a culmination of so many of the things that I've already been doing. Using my creativity, thinking about the equity focus, and working with our Center for Nutrition Policy and Promotion. They're a wonderful team. They've already been doing wonderful things on MyPlate but helping to amplify that work and helping to get it out there so we make it a household brand. We have a multi-pronged approach where we'll be using social media. I told you I was able to use that in my research. Not only that but doing things where we're celebrating the great work that people are doing around MyPlate. Like for example, I know in Oklahoma, they had a wonderful day at the capitol and the lieutenant governor was working with students to put food in the right MyPlate categories and making sure that people are aware of them. There are artists making songs about MyPlate. And so, making sure that we are making the public aware of what we're doing. With this multi-pronged approach, we'll be doing listening sessions. We're hearing from people about what can we do better? What do you really like? Are here things that we can change? Really hearing from the community on that level. Then, also thinking about industry and how can industry partner to promote MyPlate and promote those food categories so that people have an understanding of MyPlate and the branding of the icon. Making sure that people recognize MyPlate and the icon and are knowledgeable about the resources that we have. I'm really excited about doing partnerships because this is a one USDA approach. We're going across all levels to make sure that we get the word out about MyPlate. And we do have a MyPlate national strategic partnership with partner organizations all over the country that are already helping us to do this work. We want to attract new partners, to have new partners to come in, and lean in to help us to amplify MyPlate and all the wonderful resources for the public.

I'm assuming it's pretty easy to find out about MyPlate online, is that right?

It is. It's myplate.gov. It is very simple. All of our materials are branded with that, but it's very simple. You can remember MyPlate, you can remember our website. So it's myplate.gov. You can go directly there and find all of our wonderful resources, and we'll be having more, as I said, on social media. I don't want to forget this point too as well, Kelly. There are cultural adaptations. When I'm out in the field, people ask me about, what about for my culture? What about for the things that I eat? How is MyPlate relevant to that? What I love about MyPlate is that it's so adaptable. During our listening sessions and the work that CNPP is doing, we are working to address that as well. Again, meeting people where they are, having them understand that your cultural foods are healthy foods too, and how do we use MyPlate to guide our healthy choices when we're making our meal choices. Again, you look at the plate, half the plate is fruits and vegetables and that can be from a variety of sources and a variety of cultures and preparations and lots of different foods. And so we want to make sure that people are understanding that and that we get the word out there.

Bio

Dr. Caree Jackson Cotwright serves as the Director of Nutrition Security and Heath Equity for the Food and Nutrition Service at the United States Department of Agriculture (USDA). In this role, Dr. Cotwright leads a whole-of-Department approach to advancing food and nutrition security. She also serves as one of two Departmental representatives on accelerating action on the White House Conference on Hunger, Nutrition, and Health goals to end hunger, improve nutrition and physical activity, and reduce diet-related diseases and disparities and implementing the corresponding National Strategy. Her work includes building public awareness of USDA’s actions to advance food and nutrition security, as well as collaborating and building partnerships with key stakeholders to maximize our reach and impact. Dr. Cotwright is on leave as an Associate Professor of Nutritional Sciences in the University of Georgia’s College of Family and Consumer Sciences’ Department of Nutritional Sciences. Her research centers on promoting healthy eating among infants through age five-years-old with a particular focus on accelerating health equity among historically underserved populations via community-based participatory research and focusing on developing, implementing, evaluating, and sustaining best practices and policies in the early child education setting. She has developed a variety of innovative interventions, which use theater, media, and other arts-based approaches. She is the author of numerous peer-reviewed publications and secured over $1M in grants focused on obesity prevention and health equity from Healthy Eating Research, a national program of the Robert Wood Johnson Foundation, and the USDA. From 2010-2013, she worked as an ORISE Research Fellow at the Centers for Disease Control and Prevention Division of Nutrition, Physical Activity, and Obesity, where she was highly engaged in the early care education elements of the First Lady Michelle Obama’s Let’s Move! initiative dedicated to helping kids and families lead healthier lives. Dr. Cotwright holds a PhD in Foods and Nutrition and Community Nutrition and MS in Foods and Nutrition both from the University of Georgia and a bachelor’s degree in Biology from Howard University and is a Registered Dietitian Nutritionist. She lives in Athens, GA with her loving husband and adorable three daughters.

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In the United States, food insecurity is unevenly distributed. Recent data suggests that white households have nearly a third to one half the food insecurity rate of Black and Hispanic households. While research on the reasons for food insecurity typically focuses on income, a body of research suggests that wealth could be an important factor in food security. According to today's guest, Conner Bailey, professor emeritus of Rural Sociology at Auburn University: "Land is one of the major sources of wealth controlled by Black families in the South, and much of this land continues to be owned as heirs property." Thus, if we want to understand differential food and security, we need to consider that the wealth implications of heirs property.

Interview Summary

Connor, recently, the topic of heirs property has attracted much attention from researchers, policymakers, and civil society. Can you briefly describe the phenomenon of heirs property and why you think it's important?

I think of heirs property as, in a phrase, "the legacy of Jim Crow." By that, what I mean is that during the Jim Crow era, imagine say 1880, you're 15 years after the end of the Civil War, and you're a Black farmer, and you've bought some land, are you going to write a will to pass that property down to your heirs? Probably not, because your access to education is pretty limited. Moreover, there are no Black lawyers because where are the Black lawyers going to come from if there's no education for Black people, right? That's the Jim Crow era. So, what's your choice? You're not going to go to the white lawyers for the courthouse gang that you simply don't trust. The whole legal system is something that Black farmers, and Black people generally, fundamentally did not trust. This is the era of lynching after all, when people would be pulled from their homes, and in front of the law, nobody would be able to say who perpetrated these crimes. It was a difficult time for African-Americans, for Black people, for Black farmers generally. They wouldn't write wills because they didn't trust the legal system. What we end up with is that family that bought land in 1880, and they pass on, and the next generation, and the next generation, they're still not writing wills. We know that many people don't have wills. I don't know, Norbert, if you have a will. I don't need to know, but the fact is, many people, white and Black alike, and Hispanic and others, in this country don't have wills. But when they die, they're able to sort things out before it passes on to the next generation and becomes increasingly complex and confused and tangled. That's not true in the case of African-Americans and some other politically marginalized populations, white people in Appalachia, Hispanics, Native Americans, Hawaiians. heirs property is not just a Black phenomenon in the South, though that's where my research and most research on heirs property has been.

What we end up with in the case of the Black South, heirs property is something that is multi-generational. It's not simply dying without a will intestacy, but it's the dying without a will over multiple generations so that you end up with maybe 200 people who own a house or a piece of property, farm, or some forest land. How do you make decisions in a situation like that on maintaining a house, or improving the farmland, or planting trees, or whatever it is you're going to do with that property? How are you going to go to a bank and say, "I want a mortgage"? They're going to say, "Well, how do we know who's got the rights to sign on a mortgage?" As a result, there's no access to commercial credit. Until very recently, and we can come back to this later, Black farmers had no access to government credit programs through the US Department of Agriculture. They could not get credit loans. If you were in the Lower Ninth Ward of New Orleans and you were wiped out by hurricane Katrina, you had no access to FEMA support because you did not have clear title. Heirs property is a form legally called Tenancy in Common. That means you don't have clear title. Nobody has clear title. Everybody owns a share of the property as a whole. Now, one of the reasons it's important is it's not a small phenomenon.

Today, based on research that I've done with my colleague Ryan Thompson at Auburn University, there are in the 11 states of Appalachia and the South, 5.4 million acres of heirs property worth something like $43 billion. That's after enormous amounts of land have been lost through predatory actions. Legal but predatory partition sales, tax sales, and the like. Heirs property is a source of vulnerability. People have lost property in large areas. That whole stretch of coast of the South Atlantic, from Myrtle Beach down to Jacksonville, Florida, all that resort land, that was Black-owned land until after World War II. In the 1950s, once malaria was controlled in that area, bridges were built to the Sea Islands, developers followed, and properties were basically stolen through legal means, through something called a partition sale. Now you've got this enormous resorts being built there, much money being made, but these people who have lived there for generations have been dispossessed.

So, why is it important? It's for all these reasons, for these moral reasons, for the impact of the fact that you've still got millions of acres that's tied up in heirs property that people can't develop and utilize effectively for farming or forestry, or even for their own homes. It's one of the main reasons of wealth disparities, as you mentioned at the outset, Norbert. That the wealth disparities between white and Black are enormous. The St. Louis Fed just last month put out a study that showed that for every dollar of wealth that white Americans own, Black Americans own 24%. Black Americans own very much less wealth. Heirs property is one of the reasons. It's not the only reason, but it's one of the reasons, because lands have been stolen, lands have been lost, and those lands that still remain in heirs property, five-plus million acres just in the south of Appalachia, are underdeveloped, underutilized, and under-preserved.

Thank you for that. Connor, I want to ask you a question about trust. It's in the paper, and you mentioned it earlier, this idea of African-American, Black households, Black individuals not trusting the legal system. The reason I want to push on this is one could argue that trust could be because you may not know any better or you don't have enough information. We don't trust strangers because we just don't know what they could do. I'm wondering if another way of looking at this, something I've learned from people who do work on bioethics, Wylin Wilson here at Duke and others have talked about this, about the systems being untrustworthy. It's not that people aren't aware or can't navigate, but rather that the system or the institutions have proven not to do right by individuals. How does that characterization sit with the work that you've been doing?

Well, as I've been working on heirs property, as I have for 15, 16 years now, this phrase, "Black farmers, property owners generally did not trust the legal establishment, didn't trust lawyers, the courthouse gang," that's an easy statement to make. But as I started looking at the literature on heirs property, there wasn't a lot of background to that. I spent several months reading a bunch of older literature, W.E.B. DuBois, Arthur Raper, and others who were documenting what it meant to be Black in the rural south in the early decades of the 20th century. It's very clear to me that Black property owners and Black residents of that region as a whole had very good reasons not to trust the legal system. It was used against them in many cases. People simply avoided going to the courthouse whenever possible.

Now, this is an important point, and so thank you for exploring that with me. I've got to ask, I know you were at Auburn University and you're now retired. What led you to study heirs property and unearth its importance? Why are you still doing this work?

The second question is very easy to answer but also very important. There is a moral quality to the research that is done on heirs property. The work that I'm doing - and others, and I'm not the only one - the work that we are doing has a moral quality to it. We're trying to identify problems and redress wrongs. That's what gets me up in the morning. I mean, I'm seven, eight years, seven and a half years out from retirement. but I'm still publishing on this topic because it's important. Now, how did I come to realizing that? From a very good graduate student of mine named Janice Dyer, who was working in West Alabama on a different project, having nothing to do directly, we thought, at the time, on heirs property. The project was really on small scale wood harvesting and processing so that people could build homes using wood that's on the land that they owned. Janice came back after spending some time out in the field and said, "Hey, there's this thing, heirs property. People don't have clear title to their land." I said, "Oh, okay." I read a little bit about that, but she said, "No, no, this is a really important thing. Pay attention." Okay, Janice, I'm going to pay attention. And you know, here I am 16 years later. I'm still paying attention. One of the reasons professors get better at their jobs, and Norbert, you should appreciate this, is that we work with really bright students over time, and we gain so much from working with these students and undergraduates as well. So, I came to this because a graduate student pulled me into it and said, "Pay attention. This is important."

Thank you for that. I do agree there is something critical about engaging students to understand that topic. I want to actually take that a step further and because I know of some of the other work that you've done, how have you engaged communities in this work? Obviously, this is not an ivory tower kind of issue. This is something that affects the livelihoods of everyday people. How and in what ways are you engaging that community of folks?

I work with people in civil society organizations like the Center for Heirs Property Preservation in Charleston, South Carolina, created by a woman named Jenny Stephens back in the early, I think, 2004 or 2005, and other organizations that represent people who own heirs property. I've been working with people in the legal community through the Uniform Law Commission and all kinds of other groups. It's simply a matter of understanding that what we can do in the ivory tower is important because we can document the extent of heirs property, for example. That doesn't take working with communities, but we need to be working with people in communities affected by heirs property so that we understand the real significance of it and to keep the moral energies flowing. So, for example, my co-author on a couple of recent papers, Ryan Thomson at Auburn, he did his doctoral dissertation with the Gullah Geechee in South Carolina, which is near where Jenny Stephens in the Center for Heirs Property Preservation is located. Ryan worked actually far more closely with people who were heirs property owners and organized around that issue than I have done. But it's really important to understand from the people who are living the life of heirs property owners and who are facing the struggles to understand what are the issues so that as researchers, we can try to address those issues and try to come up with policy recommendations that might be helpful.

Thank you. One of your recent publications titled, "Heirs Property, Critical Race Theory, and Reparations," recently won the annual Rural Sociological Society's Best Paper of the Year award. First, congratulations, but secondly, can you explain your approach and your findings.

As I was saying earlier, I was looking at the question of trust, the trust of Black property owners and Black residents of the South to the legal system. As I was reading that literature, the idea of critical race theory simply emerged into my consciousness. I did not start off my reading saying, "Okay, I'm going to go look for evidence that's going to show critical race theory." Rather, it kind of emerged because critical race theory talks about the longstanding, deep institutional patterns of discrimination that are built into our legal system, our cultural system, our educational systems. They are so deeply ingrained that we often don't even recognize them, or we consciously, sometimes, ignore them. But there are discriminations built deeply into our systems sometimes that we don't recognize. What heirs property represents, as I said at the very outset, the legacy of Jim Crow. The legacy of Jim Crow is all these institutional limitations placed on Blacks in terms of access to education, legal services, and commercial loans, insurance for their properties, redlining in cities of where you could get government assistance or not. All these things are built in and are deeply embedded. Even though we have removed many of the outward mechanisms and trappings of racial discrimination, these patterns are still there. To speak of heirs property in terms of critical race theory simply made sense. It emerged the realization in my mind that this phenomenon of heirs property is rooted in these institutional relationships. It sort of hit me between the eyes with a two-by-four. It was like, wow, this is a perfect use of a theory to help explain a phenomenon. That's what academics, we should be pretty good at that, but that's what I've basically done. I don't think of myself as a theoretician, but the theories help us understand here are the key variables, the key phenomenon that we need to focus on if we're going to understand that particular phenomenon.

The question of reparations, which is the last term in that title, refers specifically to the Gullah Geechee, and I was talking about earlier, about that stretch of land. It's now billion dollar resorts. It's unrealistic to think that anybody's going to come and take that land away from Hilton and Sheraton, and all these major corporations, and give it back to the Gullah Geechee. That's just not realistic. But what if we charged a 1% lodging tax? There are already people coming and using those resorts who are already paying six and 7% on top of their bill for police and fire protection and things for the local counties and municipalities. What if we added 1% and gave that to the Gullah Geechee? There's a couple of entities, and I believe to others to make that decision. Who? But there's the Gullah Geechee Nation, and there's also a federally mandated Gullah Geechee Cultural Heritage Corridor. It's a 501 organization. Monies from that could be utilized to support the Gullah Geechee in clearing title for their remaining heirs property or for buying new properties to replace those that have been stolen, legally, but still stolen. So, to support the subsistence fishing and farming activities that have supported the Gullah Geechee for many, many generations, stating back to the post-Civil War era.

Thank you for that. This is going to really move us into this last question that's connecting this idea of, and I appreciate how you talked about how theory can help us as researchers do the work that we do, but then there are implications of that theory to actual policy and the lived experiences of folks. My question is, how has the research that you and others have done on heirs property affected policy at the local state or even federal levels?

As I said, there's a large number of researchers and others working on heirs property. I want to give a shout out to a couple of organizations that have been really critically important. The Southern Rural Development Center based at Mississippi State has become a really important convener of a lot of us working in this heirs property space. We have regular monthly Zoom calls. We have subcommittees on research, on policy, and on education and extension that meet regularly. There's a policy center at Alcorn State University that has become very important in helping organize and support research on heirs property. There's the Federal Reserve Bank of Atlanta that has also served as a convener and bringing people together. So, we've got individuals. We've also got some really important institutional actors that are providing continuity for those of us who are wanting to find a mechanism to interact, but they're providing that mechanism. There's a lot of people working on the question of heirs properties becoming increasingly visible not only in the research space but also among policy makers. For example, in the 2018 Farm Bill, there was wording introduced and passed in the 2018 Farm Bill, that allowed heirs property owners who were farming land to gain access to what's called a farm number through the Farm Service Agency. The farm number is critical, because if you have a farm number, you can now get a loan from USDA. Before that, heirs property owners could not. Basically, farmers operating heirs property now for the first time have access to credit through the USDA. That's a very important step forward. It actually came from a South Carolina Republican Senator Scott, and an Alabama Democrat Doug Jones, who worked up the wording on this, and it got later placed into the Farm Bill.

The other thing that's happened is that FEMA, I mentioned Katrina earlier, FEMA has revised their policies so that now, if you can prove you've lived in that home, you've lived on that property, you've paid property taxes, you've got maybe home insurance or whatever, if your property is damaged, destroyed in a natural disaster, a storm, FEMA will now help you. But 10 years ago, that was not the case. This happened only in the last couple of years. The point is, people have started to pay attention to heirs property. I've got to say people working in the media like Politico and The Atlantic and the New York Times, and The Washington Post, they've picked up on this. They've called researchers. They've called people like me and colleague Ryan, and they've gotten the facts from us, and they've developed it. They've gone and interviewed people, and they've developed the stories. And the media has also drawn a lot of attention to the issues associated with heirs property. It's been kind of a full-court press. We've all been moving forward on this.

Bio

Conner Bailey is an emeritus professor of the Department of Agricultural and Rural Sociology in the College of Agriculture at Auburn University. He holds a Ph.D. in development sociology from Cornell University. His research has focused on the problems of persistent poverty associated with resource dependence, the emergency of grassroots environmental movement surrounding issues of environmental and natural resource management, issues of environmental justice, and the human dimensions of fisheries and coastal resource systems. Bailey has been working on the issues of heirs property for more than 20 years. His publication "Heirs Property, Critical Race Theory, and Reparations," recently won the annual Rural Sociological Society's Best Paper of the Year award.

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The Supplemental Nutrition Assistance Program is one of the largest poverty alleviation programs in the United States and provides help to around 14% of the US population. Since 1996, the program has required able-bodied adults without dependents to work in order to receive food assistance. Proponents of work requirements say it prevents government dependency. Critics, however, argue work requirements push out the people who need food assistance the most. Today we'll talk with two economists about the impact of SNAP work requirements: University of Rochester's Elena Prager. and Adam Leive at the University of California, Berkeley.

Interview Summary

You two were part of a research team that also included economists from MIT, Harvard, and the University of Maryland and recently published an analysis of the effects of SNAP work requirements in the American Economic Journal: Economic Policy. Adam, before we jump into the study, would you tell our listeners what SNAP work requirements are and how proponents and critics see them?

Adam - Sure. So, SNAP's work requirements dictate that some recipients must be working, training, or volunteering to receive benefits for more than a few months. So the policy is historically applied to childless adults who are younger than 50 and don't have a disability, and as you mentioned, this group is often referred to as able-bodied adults without dependents and called by their acronym ABAWDs.

So, the work requirement stipulates that ABAWDs must be working 80 hours per month, participating in a qualifying training program or volunteering. If they don't satisfy that requirement, then they're only entitled to three months of SNAP benefits within a three-year period. Counties with high rates of unemployment may temporarily be granted exemptions from the policy by USDA's Food and Nutrition Services as well. So in terms of kind of the proponents and opponents of the policy, those in favor of work requirements are concerned that providing government benefits discourages work. These people generally believe that those recipients of government assistance should work as a condition for that help. Their argument for the policy is that by incentivizing work, people will develop a stronger attachment to the labor market. Eventually they become self-sufficient, and they can earn enough to get by without the government assistance.

By contrast, the critics see work requirements as a policy that prevents people who are economically vulnerable from receiving food assistance, and it prevents them from accessing assistance in times when they need it the most. So, the opponents argue that if the reason people are not working is something other than the economic incentives of the policy, then the work requirements are really just going to cut people's benefits without getting more people to work. It's worth noting that work requirements have long been contentious and most recently were the main issue in the debt ceiling debate. So as part of that compromise, the SNAP work requirements will gradually be applied to ABAWDs up to age 55, but additional groups will now be exempt from the requirement, including veterans, the homeless, and those who are 18 to 24 who were previously in foster care.

I really appreciate how you've brought in the changes to the rules around work requirements under the Inflation Reduction Act. This is going to be an important policy discussion as we move forward. It's interesting, particularly the exemption for individuals who are unhoused because of the work that shows up in the paper that you all have. So Elena, let's now turn to you. How did you study the effect of work requirements in this paper?

Elena - As you might imagine, studying the effect of work requirements on SNAP recipients and potential recipients is actually a little bit tricky. You have to be able to find comparable groups of people, some of whom face work requirements in SNAP and some of whom don't, but are otherwise similar enough to one another that it would make sense to compare their employment trajectories and their use of SNAP. Generally speaking, you don't just directly want to make that comparison across people to whom work requirements apply versus people to whom work requirements don't apply in SNAP because they're pretty different groups. The ones who face work requirements tend to be younger, tend to not have disabilities, and tend to not have dependents like children, especially, in the household. As you can imagine, if you look at the folks who are exempted from work requirements under typical SNAP rules, there are lots of reasons why they may be less likely to hold a job than the ones who do face work requirements. They may be older, or they may be disabled. So, you can't just attribute that difference to the work requirements themselves, which means in order to study the effect of the work requirements, you have to go looking for a context where the people who face them and don't face them are much more similar to one another than that.

What we ended up doing is looking at essentially the same set of people as work requirements policies changed over time. In fact, what you end up doing is comparing the same person before work requirements exist to the same person after work requirements exist. Now, you might say, "Okay, but work requirements have been part of SNAP for decades. Where did you find a time when they didn't exist?" The answer is that temporarily, many states suspended work requirements for a few years starting in the Great Recession when the job market was very weak and it was just considered too hard for people to find jobs even if they were trying. States were attempting not to be punitive during a very difficult job market. One of those states was Virginia, and so we got very detailed data on both SNAP use and employment and earnings from employment from the State of Virginia. Then we were able to trace what happened to SNAP recipients when that work requirements suspension expired in the fall of 2013. Virginia then put work requirements back into SNAP, which meant suddenly the same people who could use SNAP without work requirements just a month before were facing work requirements newly. We could compare how their employment responses changed to the changes of the employment responses of other groups who continued to be exempt from work requirements, for example, because they were just a little bit older than 50 when work requirements came back. We followed both of those age groups, comparing whether they were working and whether they were getting SNAP for several months and years after work requirements were reintroduced by the State of Virginia. That allowed us to both solve this problem that it's generally very hard to make comparisons across groups. In this way we were comparing sort of across groups but also within the same person.

In addition, the nice thing about designing the study this way is that we got to study not just those people who got on SNAP knowing that they would face work requirements and so thinking it was worth all the administrative hassle to get on SNAP in the first place because they expected to be able to meet the work requirements and continue to receive SNAP. But we were also able to study those people who knew at the time that they got on SNAP that they probably wouldn't be able to meet work requirements if those work requirements existed. But because work requirements were suspended at the time, that actually didn't discourage them from signing up in the first place because they knew that they were going to be able to stay on SNAP for a longer time while work requirements continued to be suspended.

Great, thank you. I realize this is a critical part of your study to be able to find the exact cohort and the fact that you were able to follow those individuals over a period of time compared to what some other studies have done, where they look at the sort of a sample of people that changes on an annual basis or that's more cross-sectional. I really appreciate the great care that you all put in to discerning who that sample should be, and that offers up really clean ways of understanding the effect of a ABAWD work requirements, so thank you for that. Adam, what did your research show about who's right about the effect of work requirements? Can you help us understand that debate a little bit more carefully given the findings of your results.

Adam - Let me begin by kind of summarizing our main results. So, we found no evidence that work requirements led more people to work. The same number of SNAP recipients worked whether work requirements were in effect or whether they were not, and the large size of the administrative data that we had access to allowed us to be very confident from a statistical perspective that any effect on employment that's positive is likely to be extremely small.

We also didn't find that earnings increased on average either. However, what we did see was a substantial drop in the number of ABAWDs enrolled in SNAP. We found that work requirements cut enrollment by more than half among ABAWDs, and this is a dramatic reduction in food assistance. This drop in SNAP enrollment was largely driven by people who were already on the program when the work requirements turned back on in 2013, as Elena was just describing, but we also found that many people who were newly enrolled exited the program sooner, and then some potential SNAP recipients did not enroll at all compared to what we would've expected in a world without work requirements. So, putting all of that evidence together, overall we found no evidence in support of the arguments that are made by those who favor work requirements.

Great, thank you. Elena, do work requirements have any other effects on potential SNAP recipients?

Elena - Well, Adam already covered the two primary study outcomes that we looked at and that policymakers usually refer to, which is are people staying on SNAP and continuing to receive benefits and are people working? But in principle separate from just getting a larger number or a larger fraction of people working, economic theory might predict that work requirements could increase income, either through the amount of work or the hourly wages among the SNAP recipients who were going to be working anyway, right? We find no effect on who's working, in other words, how many people are working. But in principle you might say, "Okay, maybe those who were going to be working anyway are now more attached to the labor force. They're working more hours or more weeks out of the year than they would've been absent the work requirements." As Adam said, we actually on average did not find evidence that work requirements increased incomes, and so we can't really say that work requirements improved labor force attachment on this dimension. We ran this analysis lots of different ways, and in the vast majority of our analysis versions, we found just no change in income. But if you were very motivated to cherry pick a couple of analyses in support of work requirements and ignore the totality of the evidence in the paper, then you can find a couple of versions where there's sort of suggestive evidence that a small fraction of potential SNAP recipients, maybe something like 10 to 15%, might have had some income increases that could be attributable to work requirements.

Now, I say that you would have to ignore the totality of evidence in the rest of the paper if you wanted to run with those results because it really only was a couple out of very many analyses, and the results even there were quite weak, especially compared to the very stark findings of no effect on whether people are working and very large negative effects on people's continued SNAP receipt.

Elena, thank you for that. Do you see any differences by subgroups? I realize that's not maybe a part of the paper as it's written, but knowing that different subgroups have greater unemployment, do you see any differences, say among racial or ethnic lines or along gender lines?

Elena - Well, we essentially couldn't find effects on whether people were working as a result of work requirements for any subgroup. We are somewhat limited in our ability to do subgroup analyses because of issues like sample size and statistical power, but to the extent that we were able to cut the data, we didn't see impacts on whether people were working for any of these subgroups, which is actually very different from what we see with people losing access to SNAP. So, we saw quite a large disproportionate impact on use of SNAP, meaning people's ability to stay on the program and continue to receive food assistance for individuals with a history of homelessness. Further, here was some suggestive evidence of disparate impacts along racial lines, but that wasn't statistically strong enough for me to feel comfortable claiming anything about it.

Adam, why do you think work requirements do not have much of an impact on work?

Adam - Our results suggest that the SNAP recipients that we studied likely face other barriers that are more important for employment than the work requirements policy itself. As Elena just mentioned, we found this disproportionate effect in terms of people who lack stable housing, and that can make it really difficult to hold down a job, and to be able to apply for jobs. People may also not have reliable or affordable transportation. So, without those things, you can see how it'd be very difficult for people to maintain gainful employment. Another possibility is that people's hours may fluctuate in ways that make them ineligible in terms of meeting the requirements of 80 hours a month, and so several of those explanations come from other studies of enrollees in different safety net programs in various states. One great thing about the data we had is that we could track people's earnings and participation in SNAP over a long period of time, but we don't see information on how many hours they worked, for example, or what their transportation options were. Those are issues, though, that many others have noted as being important in different contexts, both using quantitative studies as well as more qualitative studies. We think this is something that future research should really focus much more on - how to quantify the importance of those different barriers that ABAWDs likely face, and then trying to figure out how to best design solutions that address them.

This does make me think about another potential issue, and that's the benefits cliff. So, if someone is working and there is an increase in their wages, there actually could be a drop in their benefits that they receive from SNAP, and that could make this story a lot more complicated. Elena, I do have this question for you. How did you handle individuals who dropped out of having the ABAWD status, say if they had children or if a disability came up? Was this an important factor in evaluating that subpopulation?

Elena - For the validity of the study results, it was very important for us to keep a consistent sample throughout the time period that we were evaluating these outcomes over. This meant that if people were eligible for our sample definition at the beginning, then we kept them in the sample for the rest of the time period. That means that there were some people who dropped out of ABAWD status for various reasons, and actually, if I recall correctly, and Adam can jump in if this is not right, the most common way that people in the sample dropped out of ABAWD status is by having a newly documented disability. Our understanding is that what's happening with those folks is that many of them might have been eligible for a disability documentation that would've made them exempt from work requirements even during the time that Virginia had suspended work requirements. But there was essentially no point in their going through the hassle and their caseworkers going through the hassle of getting that documentation because the work requirements didn't apply to them anyway. So, when the work requirements came back, some at least of those folks got their disabilities officially documented so that they were, again, exempted from work requirements. This illustrates why it's important for us to keep a consistent sample before and after the work requirements come back, because we want to make sure that we're not sort of changing who's in the comparison group, right? You don't want apples to suddenly turn into oranges halfway through your study period.

Adam - Elena's description was exactly right, and in terms of the magnitudes of that response - in terms of people who were exempt for a reason other than their age - it basically doubled the proportion of people who dropped out of ABAWD status. On average, about 10% of people had some exemption besides age from ABAWD status, and then we saw that the policy increased that by 5.6 percentage points, so a pretty large relative change.

Bios

Elena Prager is an assistant professor at the University of Rochester’s Simon Business School. She is an empirical economist whose research is in the industrial organization of health care markets and labor markets. Prior to joining the Simon School, Prager was at Northwestern University’s Kellogg School of Management. She earned a Ph.D. in managerial sciences and applied economics from the University of Pennsylvania’s Wharton School, and an international Bachelor of Business Administration-Economics from the Schulich School of Business at York University.

Adam Leive is an assistant professor health economist at the University of California-Berkeley who uses large administrative datasets to study policy-relevant questions about health insurance and safety net programs. His research seeks to understand consumer behavior in complicated life-cycle decisions that impact economic security, such as health insurance and retirement saving. He has also recently studied the effects of employment incentives in safety net programs on labor market outcomes and program participation. He earned his Ph.D. from the University of Pennsylvania’s Wharton School and his B.A. from Princeton University’s School of Public and International Affairs. Prior to his doctoral studies, Leive worked at the World Bank and the IMF.

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There's much excitement out there about regenerative and organic agriculture, but how can they be financed and how can capital providers support these important approaches to agriculture? A new report by the Croatan Institute addresses this issue by emphasizing soil wealth areas. So, what does this mean? Well, we're going to learn about that from researcher Jamie Silverstein, an author of that report.

Interview Summary

So, let's begin with this. How is farm financing usually done and how does it come up short in this context of regenerative agriculture?

Sure. A lot of conventional farm financing comes from local banks and farm credit branches in the form of debt, operating loans, and lines of credit. These lending instruments tend to favor farms that grow commodity crops or raise animals in conventional ways. The farms often have a history of farming. They may come from farm families, they may have established relationships with these lenders and they're practicing agricultural systems that are very common and known, and the models have been proven out. The lenders are very familiar with these models. Regenerative and organic farms often have diversified systems. They're growing lots of different crops. They may be beginning farmers who don't have a long history of farming or come from farm families. All these factors make them perceived as riskier to the lenders. The other aspect of regenerative and organic agriculture is that they often are operating on longer time horizons. The implementation of these practices or transitioning to organic agriculture may take a longer time and may need more time to repay back a loan. Often traditional lenders are not as familiar with these systems or don't have the flexibility to extend the loan repayment times.

Okay, that makes sense. So, there needs to be some ingenuity here because the traditional models aren't applying. Can you tell us what a soil wealth area is? It's a very interesting term.

Sure. We define soil wealth areas as special purpose soil wealth improvement districts that act as magnets for investment in regenerative agriculture. I can break that down a little bit, starting with the word soil wealth. We coined that term in a 2019 report and it really encompasses both the environmental and social benefits of sustainable regenerative organic agricultural practices. A lot of people are familiar with the word soil health. So, that is building soil health. It's improving biodiversity, improving ecosystem services. But the other really important aspect is the people side the social side. So, how do we build social equity through these agricultural practices? How do we build wealth in rural communities, create resilient landscapes, healthier environments to live in? Looking at the term 'area,' we're referring to a district model that is actually pretty common in agriculture. There are conservation districts that have been established by USDA, NRCS, there are farmland protection districts and economic development districts. So, the reason behind why we're prioritizing this sort of place-based approach is that we think places is actually really important, and this helps build trust with the communities and the practitioners in these soil wealth areas. It helps to prioritize culture and heritage, social connection and the community dynamics of that region. So, the soil wealth area is a region or a a district that connects both capital providers with the capital seekers on the ground - so agricultural producers or value chain businesses - and it also can provide resources like agronomic technical assistance or business and financial readiness, technical assistance which also is really important in terms of the viability of these place-based businesses.

It's a very appealing concept because there's a lot more going on in a community or about district of land than just the number of bushels per acre. You're pointing to not only the soil health, but to the health and wellbeing of the people who live there and work there and things like that. It's a very interesting and and holistic concept. So, given this broad focus of this concept of a soil wealth area, how can financing be done differently?

That's a great question. I think financing can be done differently in a lot of different ways. There's not really a one size fits all when it comes to financing regenerative organic businesses. So, I can provide some examples of what that looks like. Sometimes it's one particular type of finance and sometimes it's lots of different types that are blended together. This could look like a low interest loan or a loan with flexible repayment terms that may come from a community bank or a CDFI. It could look like a loan guarantee or credit enhancement that actually enables a lender to make a loan they may not otherwise have been able to make potentially because of perceived risk or allow them to reduce the interest rates so that it becomes a little bit more viable for these agricultural producers and entrepreneurs. Through this research, other CDFIs and impact investors and peer-to-peer lending networks have come up with innovative and creative ways of how to finance place-based producers and practitioners. In addition, I think philanthropic capital and grants are also a really important part of this and that they can support farmers and entrepreneurs either directly, or they can help fund technical assistance that really helps support them understand the types of financing they need or makes the lender actually a little bit more confident in making that loan.

So, are there steps that can be taken to get to the point where these creative forms of financing are happening?

There is definitely the need to scale up this type of financing and access to capital for agricultural producers and value chain businesses. The model that we are proposing is top pair the soil wealth areas, this very place-based component, with a network of capital providers that may not be place-based. They may be national in scope. We want to help facilitate and coordinate these types of relationships. We call this whole ecosystem the Soil Wealth Community. And, then we have what we're calling the Soil Wealth Capital Collaborative. That is the network of capital providers that can come together, learn from each other, and use that network to allow them to expand and increase how much they are providing and able to fund regenerative businesses.

Bio

Jaime Silverstein is a Senior Associate at Croatan Institute. She also sits on the board of directors for Metta Earth Institute. Previously, she has worked as a farm business advisor for NOFA-VT; crop R&D specialist for Freight Farms, a Boston-based urban agriculture start-up; program coordinator for Slow Money Boston; and senior research fellow at the Sustainable Endowments Institute, where she led research on responsible investing practices at colleges and universities. She holds a B.S. in Business Administration from Boston University and an MBA from the University of Maine. Silverstein has collaborated on various sponsored research projects addressing finance and sustainability, including “Soil Wealth” (2019) and “Institutional Pathways to Fossil-Free Investing” (2013). She has contributed to outreach and research, surveying institutional investors and money managers for the US SIF Report on US Sustainable, Responsible and Impact Investing Trends.

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Sugar replacements, known generally as artificial sweeteners or non-nutritive sweeteners, have been in the news a lot. Rising concerns exist about safety and the effects of the sweeteners on many key features of health, including the microbiome. We need the help of talented scientists to sort through this complex web of information. Today's guest, Professor Eran Elinav, has done some of the seminal research in this area. He's an expert on systems immunology at the Weizmann Institute of Science in Israel.

Interview Summary

So back in 2014, you and your colleagues published a study in the prestigious journal Nature showing that sweeteners could induce glucose intolerance - a highly concerning finding, What's more, they did so by changing the microbiome. Would you tell us a little bit more about this study and what subsequent researchers found.

In the study that published in Nature back in 2014, we explored the consumption of several kinds of artificial sweeteners when administered to mice. We wanted to ask a very simple but important question - are dose formulations of hypersweet compounds, which are so massively consumed by humans, in fact being responded to by our gut microbes. We know from our other studies that gut microbes contain a very well-developed machinery that enables them to respond and to digest multiple very complex formulations of food. We asked ourselves whether these seemingly inherent compounds could induce changes in the gut microbiome that could impact the health of these mice. And indeed, when we tested this, we mainly focused on saccharin, but in several experiments saw that could also be true for other common artificial sweeteners. We saw that the gut microbiome of mice being given saccharin in different concentrations, (using different strains of mice and different obesity conditions) were indeed capable of reacting to saccharin, changing their microbiome composition and behavior accordingly, and in some cases, resulting in a very surprising, counterintuitive worsening of glucose control towards diabetes. That was very concerning to us, because many millions of people worldwide consume artificial sweeteners with an aim of satisfying their sweet tooth without having to pay the caloric price. Especially people who are prone or already suffer prediabetes or even type II diabetes. What we could show was that the gut microbiome in some configurations could actually drive a disturbed control of sugar levels in the blood of these mice, which could suggest that in some cases, the gut microbiome could actually be bad for you when you consume artificial sweeteners in terms of your sugar management.

That is a landmark study by any standard, so congratulations for doing such important science. That was back in 2014. So what has research shown since then?

We were able to prove in that study that consumption of artificial sweeteners was not only associated with changes in the microbiome and with the trend towards altered sugar control, but it was actually costly. We did this by transferring microbiomes from mice that were exposed to saccharin or to other artificial sweeteners into mice that do not have any microbiome of their own. They're called germ-free mice. We could see that these recipient mice who never consumed artificial sweeteners were developing the same exact disturbances in their sugar control just by the exposure to microbes that were previously exposed to artificial sweeteners. Now, this was very surprising, very important, and also caused a lot of backfire from the industry as one would expect. But it led to an array of follow up studies by multiple groups, mainly in other mice models and utilizing other formulations of artificial sweeteners, which basically suggested that our observations were correct. Artificial sweeteners were not inert when given to mice in different contexts and disease states. Now, the biggest limitation of our original study and all these many follow up studies was that all of these experiments were conducted in mice. The billion-dollar question was, can we recapitulate these findings at least, to some extent, in the human setting? This prompted us to perform a very ambitious human clinical trial which took multiple years to complete. It was finally published a year ago. The take home from that study which focused on all four commonly consumed artificial sweeteners was the concept that we've highlighted almost a decade ago - it was correct when applied to humans.

Those findings raise alarms on many different levels. I appreciate you sharing that information with us. Recently, the World Health Organization has expressed concern about the sweeteners and their impact on people's ability to control body weight and health, and even risk for cancer. One of the counters from people who are in favor of these sweeteners is that the doses provided in these studies are many times what a human might ordinarily consume. What do you say to that?

I will say two important things. First, this may have been true in previous studies a decade ago in which we all started by testing artificial sweeteners at relatively high doses. However, with years of follow-up studies and the expanded field of the doses of tested artificial sweeteners that were in many cases, reduced to those below the recommended daily allowance in humans. And, in the controlled clinical trials published a year ago, doses of four artificial sweeteners that we supplemented our participants were well below the recommended daily allowance. And still in some people, we could see that these seemingly inherent compounds were able to reproducibly change the microbiome and to change to our configuration which could induce alterations in blood sugar control in these individuals. When those microbiomes were transferred to mice that had never seen artificial sweeteners, the microbiome integrations could also induce identical disturbances of blood sugar control in transfer mice. So, I think that our studies and plethora of other studies generate knowledge suggesting that artificial sweeteners may not be natural to the human body even when consumed in conservative doses.

Well, thanks for that clarification. You mentioned some pushback from industry. Tell me what form that took. Was there a particular player in industry that was doing the pushback? Did you think that their concerns were valid?

Well, I think that it is a natural part of the evolution of a set of discoveries that have a direct impact on human health and human nutrition. And also, of course, economic considerations. Some of the claims were less than fair, and others were more relevant. One needs to understand, and I'm saying this both as a physician and as a scientist, especially given our early studies, that you can make the best effort that you can and comprehensively try to tackle a question. But there are always things people can claim that were not done or should be done better. Science is not a one-shot profession. We come up with a discovery and then we build upon it, and others also come in, validate it, build upon it, and this was the process. So, I take everything with love. Many other people have experienced a healthy discussion with the industry, and I think we've all matured into understanding, at least in our group, we are not against artificial sweeteners or any other food compound. We are just keen and interested in learning how different food compounds including artificial sweeteners, impact our body in unforeseen ways, and we focus on the gut microbiome. This huge and poorly explored ecosystem, which we now understand is an integral part of our body, has amazing biochemical capacities to degrade and respond to almost any substance. With artificial sweeteners, I think that this revelation is actually very helpful to the industry because with this knowledge, and knowledge that is added by others, we are hopeful that by understanding that artificial sweeteners are not inert to the human bodies, we would be able, together with the industry or with whoever is interested in helping this effort, understand which formulations are safer than others. Which doses are safer than others; and which are the human populations at risk, who should think twice before they consume these compounds. While others could consume them and enjoy them with relatively little risk. I think this maturation of our knowledge and maturation of the field is, in general, a very positive one.

So, with respect to the impact of these sweeteners on the microbiome, is there reason to have special concern about children?

When we conduct human clinical trials, we're always hypersensitive about special populations at risk such as children, people who are incarcerated, and so on and so forth. We usually tend at least in groundbreaking first human trials, such as the one that we've conducted with artificial sweeteners, we try to avoid these at-risk populations just so our initial observations are based on populations that are not at special risks. So, children, as you know, are always a special population that we're even more concerned about than a general population. Our own setting was not inclusive of children, though our inclusion criteria included healthy adults 18 years of age and older. So, with respect to children, I can say that our own data did not explore them to date. But in general, we are always especially concerned about children. Any potential metabolic perturbation during that critical growth window for children is of special medical concern to us.

Let me ask you one final, big-picture question. The defenders of these products are basically implying, if not sort of stating directly, that the pursuit of sweetness is a reasonable thing to have and that these products can deliver the sweetness that people enjoy, but potentially without negative effects. That's the position. But what about that basic proposition that the pursuit of sweetness is a reasonable thing to do, because couldn't one say that this pursuit, whether it's delivered or whether the remedy to wanting to have more sweetness comes from either sugar or artificial sweeteners, there is potential to be harmed. Wouldn't it make sense to just gradually reduce the level of sweetness in the food supply, so that people become accustomed to less sweet taste overall?

I couldn't agree more with your statement. I have to say that our findings related to the non-inertness of artificial sweeteners and the potential adverse impacts on human metabolism do not imply in any form or shape that we recommend that people convert back from artificial sweetener into increased consumption of sugar. We know from endless medical literature that sugar is probably an ultimate evil when consumed in excess and is directly responsible for contribution to multiple human diseases including obesity, type II diabetes, fatty liver, and even other diseases including cancer. So going back to sugar would be a big mistake. But I totally agree with you that positioning the public opinion as one which must choose between two sweet solutions, either sugar or non-nutritive sweeteners as the only options, basically is biased because we as a post-industrial revolution human population, have dramatically increased our sugar consumption. I don't think that we need to choose between these two options. I personally opt to go back to water rather than choose between these two options which carry along probably adverse health consequences, at least in some human populations.

Bio

Eran Elinav is an Israeli immunologist and microbiota researcher at the Weizmann Institute of Science and the German Cancer Research Centres. He is an international scholar at the Howard Hughes Medical Institute and the Bill & Melinda Gates Foundation and a senior fellow of the Canadian Institute for Advance Research. Elinav studies the molecular basis of host-microbiota interactions, and their effects of diet, environmental factors, immune function and host genetics on the intestinal microbiome and associated multi-factorial metabolic, inflammatory malignant and neurogenerative disease. His most-cited papers have more than 2,000 cites each. Elinav developed precision microbiota interventions, including Personalized Nutrition, Precision Probiotics, small molecule ″postbiotics″, Phage Therapy, autologous fecal microbiome transplantation, Vaginal Microbiome Transplantation (VMT) and gut epithelial interventions.

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The microbiome is fascinating and how diet affects it is something we all want to know. The work of today's guest, Dr. Abigail Johnson, tells us a lot. She's on the faculty and the School of Public Health at the University of Minnesota and is an expert on diet and the microbiome and their impact on health and disease.

Interview Summary

So there's an awful lot of interest in your work but let's start with kind of a broad question. So there's much talk in the news and obviously in the scientific world about the microbiome and one fundamental question is this, how much should we pay attention? How important is this all? Is it important enough for dietary recommendations to be modified? For policies to be affected? Give us the big picture from your perspective.

I think it's really important. I wouldn't be studying it if I didn't think it was important. I think that there's so much that we don't know about what all of the microbes that are in and on our bodies are doing that impacts our health. There's just so much that we don't know at the moment that I think it's very important that we continue to study it. From a nutrition perspective which is where I spend my time, I think that there is a lot of potential that we could eventually understand how we can use food to change the microbiome. From that perspective, we might get to the point that we can make recommendations that affect national nutritional guidance like the Dietary Guidelines for Americans, for example. I don't know that we are there yet, but I do think that we are learning more and more with every passing year that gets us closer to being able to say some things definitively.

That's consistent with the way I've been seeing it and it's nice to hear it affirmed by an expert. So, your research on diet and health uses, and now I'm quoting from your website, "novel computational methods," can you explain what the methods might involve and how they improve the assessment of what people eat?

I did my postdoc with Dr. Dan Knights here at the University of Minnesota. I joined his lab as a nutrition scientist with very minimal background in statistics but an interest in computer science. I told him when I joined his lab that I wanted to learn to code. I immersed myself in this world of people doing bioinformatics and using computer science and bioinformatics to answer questions about the microbiome. What I noticed while I was in my postdoc was that a lot of the questions, statistical problems, and computational problems that exist in the microbiome space where people are coming up with unique ways to solve those problems mathematically are really analogous to issues that the field of nutrition has also been grappling with - sort of since its existence. When I say novel computational methods, I'm often referring to really stealing methods from the microbiome space and applying them to nutritional data. Like microbiome data, nutritional data have these sort of strange qualities that make them interesting from a mathematical standpoint. To be more specific, I've developed an approach that uses trees. In microbiome space we use phylogenetic trees to share information in statistical approaches to understand how communities are different. For example if we both haves E. coli species and they're actually different species, we can still use the fact that they're both E. Coli to understand the similarities between our different microbiome compositions. In the nutrition world, we think about foods as they fit under umbrellas of food groups. I've basically stolen the method of using trees in the microbiome and applied that to nutrition. That's kind of the novel computational approach that I take when trying to understand diet and dietary patterns.

That sounds like a real advance. What are some of the highlights of your work on microbiome in the diet?

In my work, I've been able to find signatures. We can pick up the signature of what you ate in your microbiome and the way your microbiome changes. We can link that back to your diet on a daily timescale. So if we have information about what you ate in the three days prior to providing a microbiome sample, then we can make some prediction about how your microbiome is going to change the next time we sample you. So not really good at predicting how it's going to change yet, but at least if we have the data, we can link you up with your diet and understand that the changes that happen in your diet show up in your gut microbiome. Also, being able to identify to some level of specificity, how much of the variation in microbiome, be it across populations or within an individual, can be connected back to differences in dietary intake.

You know that work that you're doing on using the microbiome as a measure of what people eat is a real advance, isn't it? For so many years the nutrition field has relied on people's reports of what they eat to make judgements about the relationship between diet and health and even individual dietary recommendations. But it's hard for people to be accurate about that. Having something like this could be a real breakthrough, couldn't it?

Yes, I'm really hopeful. We're not there yet, but in my dream we would be able to take a fecal sample and know something about what you ate and that could help us avoid having to do dietary recalls, for example. We can get past this fact that people can't remember what they ate. That's sort of the dream where I see methods development going in the future.

One of the titles of one of your papers really fascinated me and the title is this "US Immigration Westernizes the Human Gut Microbiome." That's really fascinating. Can you tell us more about that study?

Yes, so this was a study that took place in Dan Knights Lab at the University of Minnesota. It was led by Pajau Vangay, and she's an incredible computational scientist and food scientist. She is also a second generation Hmong immigrant to the United States. So I was lucky enough to support her work. She was the one who led this study and basically the study to evaluate microbiome samples from groups of Hmong and Quran immigrants (there happens to be a large Hmong and Quran immigrant population in the Twin Cities in Minnesota). They asked could we collect microbiome samples from these groups of people? Many of them came to the US during the Vietnam War. So there is a time course to look at. We've got first generation and second generation immigrants. They collected samples from first generation, second generation immigrants. Pajau went and visited a refugee camp and was able to get samples from people who were still living in Thailand. And, a small group of people who actually moved to Minnesota during the time that she was collecting data. She got this rich data set as well as information about diet from all of these people who participated in this study. We were able to see a trend toward the microbiome changing from the Thai sort of looking microbiome to a more US looking microbiome when we compared across this continuum to people who were born in the United States. It was really cool. The first question that everybody who sees this data asks is well, it must just because of dietary acculturation, right? You move to the US and you start eating Big Macs and burgers and that's what changes your microbiome. What we actually found, which is very interesting, was that the dietary shifts didn't really account for that much of the changes. We were able to attribute about 16% of the change in variation that happened in the microbiome to changes in diet - so dietary acculturation - but it wasn't as much of the variation change that we expected we would find. It leaves a lot of questions out there about what is causing changes in the gut microbiome when you move to a new location. Is it because of the food? We know that some of that can be explained by food, but there's also this unexplained variation that we're still interested in figuring out what's driving it.

Boy, you're right. That's a very cool result. I was going to ask about the acculturation issue because I know when people move from one country to another, their food habits are some of the things that will live the longest in the new culture. The fact that you're not finding diet to be 100% responsible for that finding is really interesting. Is there speculation about what it might be?

Yes, we have some theories. We speculate a little bit about could it be environment that you live in. You know, are there microbes that you're coming into contact within your environment, microbes that you're coming into contact with by interacting with new people living in new spaces, going to work in new environments. Could it be that there was something that we didn't measure? Like were you given a lot of antibiotics or antifungals at the time of immigration that we didn't capture properly? We did capture information about antibiotic exposures but maybe not enough information or is there something about the water that you drink when you moved to the US that's different? Those are sort of some of the theories that we had around what might be explaining some of the variation.

Do you think it's within the realm of possibility that greater exposure to the forever chemicals that are coming in things like plastics and food wrapping and water bottles and spinoff from tires and things like that could be contributing?

I don't know. It's a good question. How would we study it?

I don't know. I'll have to rely on you for that but I can imagine it shows how complex the issue is because when people move from one place to another, there are thousands of things that are changing and isolating any one of them is not easy. Thank you for the description of that study. It's really interesting. Now I'd like to ask you about precision medicine and precision nutrition. These terms are coming up more and more. What is precision nutrition and how does the microbiome fit into the picture?

Great question. Precision nutrition is a really interesting and exciting concept. In clinical dietetics, if you asked a clinical dietician, they would tell you that what they do is already precision nutrition. They work with patients who are trying to control their cholesterol or manage their diabetes and their blood glucose, and they provide personalized dietary recommendations based on what that person usually eats and what they want to see change in their biomarkers, for example. If you talk to a clinical dietician, they will tell you that they already do precision nutrition. But what I think we are starting to move towards and what the excitement is around is that precision nutrition could be using big data to do that type of individualized nutrition advice for big groups, almost population level nutritional recommendations. Where the microbiome fits in is that there was a pivotal study by Zeevi et al that linked changes in blood glucose response to foods to individualized signatures that were in part informed by the gut microbiome. There's a lot of excitement that understanding the gut microbiome might help us to better provide precision or precise nutrition recommendations to people with big data. That's how I conceptualize precision nutrition right now.

For the people listening who may want to do everything they can to have a healthy microbiome, what are the dietary things they might consider?

I don't think that we have a clear single answer for this but when I'm asked this question, I come back to three dietary features that seem like, at least in cross-sectional observational studies show up again and again. The first is dietary fiber and getting enough dietary fiber. There's some pretty good evidence that the amount of dietary fiber that we currently recommend, around 28 grams a day, give or take a gram or two, depending on your specific needs, that amount of fiber is probably good for your gut microbiome. There's some evidence that may be going up to say 35 grams of fiber per day might be beneficial. The piece that goes on top of that from a microbiome perspective is potentially having a diverse variety of fiber types. We often talk fiber about as this monolith but really fiber is a whole bunch of different biochemical components, non-digestible parts of plants primarily that feed our gut bacteria. Getting diverse variety of fibers is probably important. To do that, it looks like getting a variety of plant foods into the diet is what might be most important to support a quote unquote "healthy" microbiome. Although a caveat that we don't really know what a healthy microbiome looks like yet. When people talk about healthy microbiome, they're often mostly talking about having a higher diversity of gut microbes. The third piece of the puzzle, at least from what we understand at the moment, is that possibly adding fermented foods and maybe specifically fermented vegetables or fermented plant foods may be beneficial for the gut microbiome. So those three things - diversity of plants, and diversity of fiber that kind of goes along with that, and then some sort of fermented food - those look like the three things that might be beneficial from my perspective.

Let me just ask about the fermented foods for a second. So I hear people talk about yogurt, kefir, things like sauerkraut and kimchi. Are these sort of things all kind of interchangeable with one another as people think about adding fermented foods to their diet? Or are there some that would be preferable to others?

I don't know if we know yet. We have a lot of good data going back many, many many years looking at fermented dairy. Most of our research in the nutritional literature looks at fermented dairy - so yogurts. More recently we are starting to get data to look at things like kefir, but there's not very much literature available looking at fermented vegetables like lacto-fermented vegetables. Like your sauerkrauts and your kimchis. I think it's an active area of research. We need to do a lot more work in that space before we can make more specific recommendations. Right now, I would lump them all together but from my perspective, I suspect that a fermented vegetable might have different impacts on the gut microbiome when compared with a fermented dairy product.

Okay, thanks. It's a fascinating question and it sounds like as the research marches ahead that we'll have some answers to that. Let me ask kind of a big question to end. It strikes me that there's real cause to be optimistic here, that there's a kind of a whole new level of understanding about diet and health and how the microbiome is playing a big role in that. We might be headed toward the point where there are some policy priorities that would be in place or some dietary recommendations. Do you think it's too early to be thinking about those or are there some things we could say now?

I think it might be a little bit too early. I think what we really need to do as a field is to make sure that we are thinking about everyone when we're doing this research. By that I mean that we're enrolling diverse groups of people into our research studies so that we're not only learning about precision nutrition and the microbiome from this white American centric approach. Then, I think once we have a diverse data pool to look at, including different eating traditions that are not just western eating traditions, then we might be able to make some of these steps towards enacting policies or making recommendations at the population level that incorporate some of these precision nutrition or microbiome targeting approaches. I think the first step is just making sure we're doing really solid research that doesn't leave anyone out and that we're not just doing precision nutrition for people who have a lot of resources.

Bio

Abigail Johnson is an assistant professor in the Division of Epidemiology & Community Health at the University of Minnesota School of Public Health. She is the Associate Director of the Nutrition Coordinating Center there. Her research explores the relationships between diet and the human gut microbiome in health and disease using novel computational methods for dietary data. She focuses on 1) analysis of diet and microbiome after dietary interventions, 2) methods development for dietary data analysis and visualization, and 3) understanding the interactions between foods, microbes, and fungi during different stages of development. She is interested in exploring how diet and the microbiome interact to influence chronic diseases including prediabetes, diabetes, and cancer.

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If you want to improve your digestion, your immune system, and your overall health, one might begin with a focus on a healthy gut microbiome. Today we're talking with Stanford University professor of microbiology and immunology Dr. Justin Sonnenburg, co-author of the book entitled, "The Good Gut: Taking Control of Your Weight, your Mood, and Your Long-Term Health." He and his wife, research scientists Dr. Erica Sonnenburg, argue that our typical modern diet has caused the microbial diversity or intestine to shrink substantially. Turns out that's a big problem.

Interview Summary

My impression is that this field of work on the microbiome is just exploding. It seems like every day something new comes out, something exciting, some kind of major breakthrough. It's wonderful to have a leading scientist like you to join us to help explain this. Let me begin with this question. I recently read something very interesting in the article that discussed your work, namely that you've hypothesized, and this is a quote from this article, "Humans may merely be elaborate vessels "designed for the propagation of bacterial colonies." Now that's pretty interesting. Tell us more if you would?

Yes, absolutely. I should note that this is an idea that has been propagated, just as microbes are propagated over time. I did say that, but I'm now attributing it to the great scientists that came before me. I will say that the microbes in our gut have been for a long time a curiosity. For hundreds of years we've known that they live there. Over time we've learned that they're affected by what we eat. We know that they're involved in digestion and gut health. But what is really phenomenal is, as you alluded to in the introduction just the ability of these microbes to impact so many dimensions of our health. Everything from our immune system, to metabolism, to things like moods, behavior, and neurodegeneration. When you start to think about microbes getting passed from generation to generation - because as a new baby is born, their gut is sterile in the womb, and then they're rapidly colonized when they come to this world largely by microbes from their mother and other adults around them - you start to realize that these microbes may actually be the ones calling the shots and dictating aspects of our biology to promote their growth through evolutionary time. It does change the way you think about this relationship in some ways.

One might jump to the conclusion that microbes are a bad thing, and you'd like to have fewer of them. That's in fact what antibiotics do, they get rid of them. But we need more rather than less, and it sounds like the shrinking diversity of the microbiome is really a problem. How do our diet and lifestyles damage the vitality of the human microbiome? I'm imagining this is a 'let me count the ways question,' but what are the leading concerns in your mind?

Yes, completely. I think you're right in that it's very hard to single out one particular factor, because as populations become more industrialized and embrace all of the technologies and medical practices that go along with the industrialized lifestyle, we have so many factors that can impact our microbiome. Certainly, diet is a major factor, and we can come back to this. But we know that most of the microbes in our gut reside at the far reaches of our digestive tract - at the very end of the line down in our colon in our large intestine. That means that if we're eating simple nutrients, like most of the things in a western diet - sugars, starch, fat, protein - a lot of those things get digested and absorbed in our small intestine, which leaves nothing remaining for the microbiota. It's really complex carbohydrates and dietary fiber, that serve as the major fuel for the microbiota because we can't digest those complex carbohydrates. The western diet has greatly reduced dietary fiber content, which has left a lot of our gut microbes starving. But there are other aspects of diet, certainly artificial sweeteners, emulsifiers, and probably the high fat content of the western diet are not great for our microbiome. Then beyond diet, antibiotics as you mentioned known to be great for fighting infectious diseases, but not so great for maintaining all of the friendly microbes that we harbor in our body. A variety of other factors like C-sections, baby formula, the incredible sanitation in our environment, again, a lot of these things are a trade-off because we have reaped a lot of benefits from a lot of the lifestyle medical practices technologies. But at the same time, we've implemented these in the absence of understanding the importance of our gut commensals, and the other commensals on our body for our health. Now we really need to start thinking about do we need to restore diversity to this community? Certainly, we need to start thinking about taking care of the community more diligently.

You mentioned in some detail how diet affects the gut, but how does it happen in the reverse? Is there a reciprocal relationship going on?

Yes, it's a great question, and there are some papers that have been published looking at how gut microbes can affect food choice in model organisms like fruit flies and other organisms that are studied in the lab. We know that microbes in the gut as they metabolize things are producing a lot of interesting chemicals, little metabolites that get absorbed into our bloodstream can circulate through our body. Certainly, some of them cross the blood-brain barrier and can interact with our central nervous system. Now, whether some of those molecules can actually impact our food choice, I think is an interesting topic, we don't know a lot about that. You can imagine a microbe that's really good at, for instance, degrading pectin and it might grow very well. We know there are many microbes that grow well when we, for instance, eat an apple. If that microbe happens to produce a molecule just by chance that then can go in and increase our craving for an apple, that microbe has hit the jackpot for proliferating, it can guide our actions to choose an apple and then it actually profits from the pectin that comes in when we eat the apple. While this would be a very rare quirky event to happen, when you think about the trillions of microbes that exist in every person and have existed in every person across the planet throughout time. It's possible that things like this have happened, and it's a matter of us as scientists trying to track down those stories.

There's at least some optimism that there could be virtuous cycles that gets set up rather than these destructive cycles potentially. Help us place this in some sort of a context. You talked about a myriad of dietary things that could affect the microbiome, and probably other things out there in the world too. How serious is the impact?

Yes, and this brings up kind of the question of what is a healthy microbiome? Has lifestyle impact that our microbiome? What would be ideal would be to have a time machine to go back, and actually survey what the microbiome looked like thousands of years ago before industrialization, and maybe even going back greater than 10,000 years to what our gut microbiome looked like when we were hunter-gatherers even before we started farming. Just to get a sense of what are the microbes that humans harbored over long periods of time during our evolution with the idea that perhaps our human genome was shaped over evolutionary time in some way by these microbes, that we have adapted our human biology to deal with the specific set of microbiome features or species. We don't have a time machine, but there have been groups that have surveyed paleo feces for instance - the fossilized stool from humans from 1 to 2000 years ago. These data indicate that the microbiome has changed drastically. As we have industrialized, we have totally departed from this more ancestral microbiome. The other way that we can gain insight into this is by looking at modern humans that live lifestyles similar to our ancestors. Hunter-gatherer populations and rural agriculturalists, and we've done a lot of work studying the Hadza hunter-gatherers of Tanzania looking at their gut microbiome. That exactly supports what the paleo feces have told us. That there were features in the microbiome from before industrialization that have changed drastically. We've lost species, they've gone extinct. Hunter-gatherers and many rural populations still harbor these microbes. We expect that there's probably around 500 to 1000 different species of bacteria in an individual's gut microbiome. We've lost hundreds of these species over the course of industrialization. Then, the flip side of that is hundreds of other species have come in and replaced them. We've actually had this kind of wholesale change in configuration in our gut microbiome, and what this means to our biology, we're trying to figure out right now, but it is a really marked change.

I have to say I admire the breadth of your work all the way from basic laboratory studies to in the field studies with hunter-gatherers. I could see how your big picture view of this is really pretty unique. Let's talk about how the gut communicates with the brain, and does the health of the microbiome affect things like eating regulation? We've talked about that a little bit already, but also things like mental health.

I just want to start by saying that this is a field of research that is in very early days still, we have a lot of work to do to really figure out the connections. You can imagine then the gut microbiome composed of hundreds of species, and then trillions of cells and changing over time within an individual, and different between individuals, and then secreting thousands of chemicals that go into the bloodstream. Then put on top of that the complexity of the central nervous system and brain, and then try to map the interactions between the microbiome and the central nervous system is exceedingly complex.

I think that one of the really important things to note here is that if you look at a lot of the anxiety, and depression, Alzheimer's disease, neurodegeneration in general at this center of a lot of these diseases much like other diseases of the industrialized world lies inflammation. The immune system actually becoming too inflammatory, and that leading to, you know, in some cases autoimmune diseases, but in other cases Alzheimer's disease, and/or anxiety and depression. One of the things that our lab is focused on is really trying to understand how when you change the gut microbiome, how does the immune system change? How does the inflammatory status change of the system? Because we really think that this is the key mediator of many of the things that have gone wrong including things like diabetes and metabolic syndrome.

We're now at the point of understanding that certainly if you go into an animal model and you change the gut microbiome in a major way like industrialization has changed the microbiome of people living in the United States, you completely change how the immune system functions. You can really change how an individual would react to a respiratory infection, how well they would respond to an immunotherapy if they were battling cancer, you can just completely change immune system functionality. In trying to understand this better we've started to do dietary interventions in people to see if we change the gut microbiome in beneficial ways with diet, can we make the immune system less inflammatory? We've done this so far in healthy adults, and now we're really interested in extending this into all sorts of populations that are suffering from different inflammatory diseases, including things like anxiety, and depression, and neurodegenerative diseases. We'll have more information about this. There's some beautiful fundamental research out there that shows unequivocally that the gut microbiome is regulating behaviors, and cognition, and fundamental aspects of what happens in our brain. But a lot of this has been done in animal models, and it's very hard to extend to humans in a detailed way.

I can't wait to see these studies, they're just absolutely fascinating and so important. You know, something occurred to me as I was thinking about this, and this may be outside the area of work that you're focused on, but there's a lot of interest out there in the world and the impact of endocrine disrupting chemicals, or things that leach from plastics and things known as forever chemicals, and their impacts on a whole host of things like cancers, and obesity, diabetes and more. Is there any reason to worry about the microbiome in this context?

Yes, completely. I think everything that we come in contact with, particularly things that we ingest, but even things that are absorbed through our skin or we inhale, the microbes that live in and on us are just incredibly sensitive detectors of everything going on in the environment. I mean, their survival depends upon it. One of the, in fact, key features of one of the first species from the gut microbiome to have its genome sequenced, Bacteroides thetaiotaomicron this is a bacterial species that was sequenced in the lab of Jeffrey Gordon, it was published in 2003. One of the key interesting features of that genome was the expansion of environmental sensors that were encoded by that genome. It was very clear that this bacterium was living in a dynamic environment, and having to sense and respond to minute to minute variations in the chemical cues that were coming in. That means that when you start to change those chemical cues, you start to change the function of the microbiome because those sensors that those bacterial encode are wired into their function and how they behave. This is again, hypothesis, but I think your question is a a great one because there are these realms of inquiry where we are just right at the beginning of understanding that major things that are going on in our environment could be impacting this really essential component of our biology. And we really have no specific idea of how the perturbations may cascade through our microbiome and our biology. A lot to look at there, but I have no doubt that those chemicals are having an impact on this community filled with environmental sensors.

It's going to be so interesting to see that work take shape. It would be great if community of people working on the microbiome could come together with the people in interested in the impact of these forever chemicals on health so that a full picture of their impact can get painted. So what do you think are the most pressing scientific questions that need to get addressed?

I think that we're still really searching for the definition of a healthy microbiome. And this is something that dates back to a wonderful project that was started by the National Institutes of Health, the Human Microbiome Project. That was an effort from sequencing centers that had sequenced the human genome to turn these sequencing technologies to this uncharted aspect of our human biology, our microbiome. One of the goals of that sequencing project was to determine what a healthy gut microbiome is. And our assumption at the time was, well, we should sequence a bunch of healthy Americans, and kind of look at what's common between them. We now understand that the healthy American most likely harbors a microbiome that is not really optimal for health, it's actually probably a microbiome that's predisposing us to a number of inflammatory conditions.

Our human genome probably dictates whether you as a person will get an autoimmune disease, or cancer or you know, a different inflammatory disease. But it's really a microbiome that appears to be pro-inflammatory, and so that doesn't mean that it's terrible and that we need to scrap the whole thing. But it means that it probably can be improved. A big part of that improvement probably can come through feeding it better food and getting better functionality out of the microbes we have. But it also probably means that we need to bring back certain functions or certain species that we've lost over the course of industrialization, to bring back some of that biodiversity.

You know, I think of the microbiome as similar to this complex rainforest, just hundreds of species interacting in this really dynamic way, and as you start to degrade that ecosystem it's really hard to maintain its full functionality. You start to lose functions, and it starts to operate suboptimally. And so thinking about ways to bring back the health and biodiversity of this ecosystem, I think is super important. One of the key things that we have to do as a field, and I want to just reflect back on the work that we're doing with hunter-gatherers and implications for what might be a healthy microbiome. It is not at all clear that all of the microbes that we've lost are healthy and need to be reinstalled in our gut. I think that we've probably lost species that we, you know, just as soon not have. But mapping which ones are health-promoting, and in which context, because you know, what's health-promoting for one person may not necessarily be health promoting for someone else that's going through something very different in their life in a different life phase. So we need to understand all that complexity, and really crystallize how can we optimize a microbiome for an individual in a given context.

This sounds like a really complex problem, and it is, but I think that one of the really exciting things that's happening in the field right now is this combination of what we call omics data, the ability to measure so many different aspects of the microbiome at one time so we can get a really detailed picture. Then all the great computational approaches for bringing all that data together, using things like machine learning and artificial intelligence on big data sets to really distill out meaningful signals that give us a better idea of some of these complex questions. It is a complex thing to go after, but I think it's not out of reach and that's I think the big frontier for the gut microbiome.

Well, speaking of the big frontier, let's end with a big picture question. What can be done to make things better? You mentioned improving diet would be one thing, but how do you look at those big picture questions?

One of the incredible things about the gut microbiome and its relationship to its human host, is this like feedback system. For instance, if you are in a slightly inflammatory state, it can be hard to get out of that inflammatory state because the inflammation is reinforcing microbes that are then reinforcing the inflammation. You end up with these feedback loops that are very hard to break, so even if you were to do something like a fecal transplant in some instances of inflammation where you try to reinstall healthy microbes, those may not engraft and take up residence because the host inflammation will get rid of the good microbes and select in the microbes that feed the inflammation. There are these feedback loops that are very hard to break, and we know the gut microbiome is very resilient, so you can perturb it and it will by and large return to a starting state, not exactly what the starting state was, but there is this great resilience and recalcitrant to change over short time periods. This is why industrialization has been so powerful because it's happened over multiple generations across an entire population, and it's driven our microbiome in one direction.

I think if we want to bring back a more diverse healthy microbiome, it requires changes in our habits, changes in what we eat day after day for years on end to really change the species that are in our microbiome and what those species are doing. We got a little bit of insight into this, but I'll finish with one specific example. One of the dietary interventions that we did, we compared a high fiber diet, so this is eating things like legumes, whole grains, vegetables, fruits, thinking that that would be kind of optimal food for a healthy gut microbiome. We compared that diet with a high fermented food diet, so another cohort of individuals, we gave kombucha, kefir, yogurt, kimchi sauerkraut, food with living microbes in it that had been transformed by fermentation. Basically, so these were just healthy adults we let them eat those foods, they ramped up on the foods for four weeks, and then for six weeks they maintained high levels of those foods. We actually saw that the high fiber diet had very different effects on individuals depending upon their starting microbiome. If you had a very diverse microbiome to start with, you actually improved your inflammatory status, you got less inflammatory over the course of the intervention. But if you start with a low diversity microbiome, the high fiber diet doesn't do much for you. The fermented foods actually had a really amazing effect, they increased microbiome diversity and they also decreased over two dozen inflammatory markers that we were able to survey through these great technologies that give us comprehensive immune profiling. We really saw a signature of exactly what we'd want to see to counter the industrialized deterioration of the gut microbiome with the fermented food diet, increased microbiome diversity, decreased inflammation, and this was just over the course of a 6 to 10 week intervention. We're really curious to pursue these findings in more detail, and see if now we can go into diseases that are pro-inflammatory, and counter those diseases to actually treat them in some way with the fermented food diet.

If I were to tell people what to do to counter all the negative impact of industrialization on our microbiome, I would say consume some fermented foods every day, and then start to integrate dietary fiber. As you eat the fermented foods, you'll increase your microbiome diversity. And our hope is that will allow you to harness the benefit of the high fiber diet as your microbiome diversity increases.

Bio

Justin Sonnenburg is a professor of microbiology and immunology at Sanford University. His research focuses on the basic principles that govern interactions within the intestinal microbiota and between the microbiota and the host. He is the coauthor of The Good Gut: Taking Control of your Weight, Your mood, and Your Long-Term Health.

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Today's podcast is a continuation of our series exploring the safety of non-sugar sweeteners in both food and beverages. In 2022, the World Health Organization conducted a systematic review of the most current scientific evidence on the health effects of non-sugar sweeteners. This analysis of 283 studies reveals that non-sugar sweeteners can impact health conditions such as cardiovascular disease, type 2 diabetes, adiposity, bladder cancer, and preterm birth. In 2023, the WHO released a guideline on the use of non-sugar sweeteners based on this 2022 review. Our guests today are Dr. Jason Montez, scientist with the World Health Organization, and technical lead on the systematic review and guideline. And, the director of the Department of Nutrition and Food Safety at the World Health Organization, Dr. Francesco Branca.

Interview Summary

This is really important work, so let's get right down to it. So, Francesco, let's begin with you. Would you help our listeners understand why the WHO, developed this guideline, and what do you hope to accomplish now?

Francesco: So our interest in the topic really came after the release of the WHO Guideline: Sugars Intake for Adults and Children in 2015. That recommendation was, of course, to reduce the amount of sugar to less than 10% of energy, and better if less than 5% for weight control and for dental hygiene. At the time, there was an interest, particularly from the food and beverage manufacturers, to consider the use of non-sugar sweeteners as part of the interventions in reducing sugar intake. This has been taken up by consumers since, and the availability of non-sugar sweeteners has increased. We thought it was important to review the evidence in a systematic manner, and to see whether this move was actually achieving the intended aim to control weight gain. So we thought of looking at non-sugar sweeteners use through the WHO guideline development process. Our hope, first of all, is to make sure that people achieve their intended health benefit, but also to avoid an unintended consequence on health.

I remember how much impact that report on sugar had, back when WHO released it. And boy, the same thing seems to be happening with the guideline that We are talking about today. So Jason, can you walk us through the key findings of the systematic review?

Jason: Sure. So the top line results of the systematic review are that in short term randomized controlled trials mostly lasting three months or less, those consuming higher amounts of non-sugar sweetener, compared to lower amounts or no non-sugar sweetener, has slightly lower body weight. So around 700 grams. And, slightly lower BMI; about 0.2 units. However, in long-term prospective cohort studies, many with several years of follow-up, body weight was either unchanged, or greater in those consuming higher amounts of non-sugar sweeteners. In addition, associations were also observed between non-sugar sweetener intake and increased risk of type 2 diabetes, cardiovascular diseases, and premature mortality. For diabetes, for example, we found about a 25% increase in risk. In RCTs - markers of these diseases - such as blood glucose, insulin, cholesterol, blood pressure, were largely unaffected by non-sugar sweetener use. In addition, we saw an increased risk of bladder cancer coming from case control studies and it was primarily driven by saccharin. Also, a 25% increase in risk of preterm birth in pregnant women in terms of body weight, and the risk of non-communicable diet-related diseases. We essentially have seemingly opposing results between the short-term randomized controlled trials and the long-term cohort studies.

Those are really concerning findings. Somebody in their own calculus might say, "Well, I'm willing to accept the risk for those things as long as it helps with my body weight." But, you are talking about greater weight in people using the non-sugar sweeteners.

Jason: Right. In terms of long-term impact on body weight, there is not a lot of evidence. This is all coming from cohort studies, and cohort studies have caveats associated with them. But, what we see in those studies is it is either really not much of an positive impact, but we did see some increased risk. For example, there was an increased risk of incident obesity in one study. They looked at people at baseline without obesity using standard WHO cutoffs. Then they followed them up over time. They counted the number of people who transitioned over the obesity threshold, and they found that it was higher in those using non-sugar sweeteners. So there is some evidence, but I think we need additional evidence to be really sure about that in the other associations.

So Jason, you alluded to this earlier that there were differences in the health outcomes reported in randomized controlled trials versus observational studies. Can you explain why this might be?

Jason: Yes. So it is a bit nuanced and I think a lot of it has to do with the nature of the studies. To really understand this, we need to unpack that high-level evidence a bit. I think I'll start just by talking about what is maybe the elephant in the room and that is reverse causation because it has been frequently invoked as a reason for the associations observed between non-sugar sweeteners and body weight and disease outcomes. Basically, reverse causation suggests that those already at elevated risk of disease initiated or increased the use of non-sugar sweeteners because of their risk status, rather than non-sugar sweeteners leading to the increased risk in otherwise healthier low risk individuals. That would make sense in this case. However, researchers who conducted the individual studies that we included in the review were also well aware of the potential for both reverse causation and residual confounding. Most of them really went to great lengths to minimize the possible interference of these phenomenon and they adjusted extensively for confounding variables and all the lifestyle variables. Quite often, they adjusted for other dietary variables. They looked at body weight, they stratified, and they did sensitivity analysis where they would limit the analysis to individuals with normal body weight. They also removed from the analyses, in some cases, those at risk for disease at baseline. Many of them did a sensitivity analysis where they excluded the first several years of assessing the outcome, just to make sure that someone who wasn't already really at risk to develop a disease right away was not part of the analysis. You know, in some cases the effect was attenuated. But, for the most part, the associations were not affected. Certainly, that is the case for type 2 diabetes. So I think that reverse causation might have contributed, but, really the lengths that the study authors took to address it I calms us a bit in terms of whether or not We are worried about it.

It is very helpful to know that. You know, we've gone for years and years thinking that these things are safe, or at the worst have neutral effects. Now the studies are showing the negative effects. Partly, it is just because the science has marched ahead. There are many more studies now. People have been more careful with the design of the studies. More sweeteners have been studied. This seems like just kind of a natural progression of the scientific process.

Jason: Yes, that is how it works. We continually add. There is still a lot to look at in terms of the differences. Another really important thing to remember is that in the RCTs, a variety of interventions were employed. A lot of the studies took people who were consuming a normal diet, and they just gave them, for example, a sugar-sweetened beverage, or non-sugar sweetened beverage. They wanted to look at what the effects of a sugar-sweetened beverage are. Very few actually looked at individuals who were habituated to sugar, mostly sugar-sweetened beverages. They then asked study participants to replace the sugar with non-sugar sweetener. When you look at just those small number of studies, the results really get attenuated for both body weight and for BMI. That is another reason why if you look at it that way, the results between the long-term and short-term tend to gravitate towards each other.

One last thing - I don't want to overdo it here, but it is important - there are likely big, big differences in terms of how non-sugar sweeteners are used in these highly experimental randomized controlled trial settings and cohort studies, which are really more like real world use. In a randomized controlled trial, you're instructed to do this, or that. Drink this, take that. You get quite a bit of support from the study team. You'll get counseling, follow up, etc. Everyone knows they are in a scientific study. Quite often, they actually know which arm they are in. Whereas in the cohort study, in the real world, people use non-sugar sweeteners in a variety of ways. Sometimes they do it as a conscious replacement for sugars. But quite often, they just consume beverages containing non-sugar sweeteners or foods containing non-sugar sweeteners because they have a diet label on them, and they just perceive that those types of products to be healthy. Sometimes they use them as a way of having something sweeter or something that maybe they shouldn't have later on in the day. It is much more complex in the real world and obviously the real world is how these things are used. So how sweeteners are used also can contribute to these differences between what we see in highly experimental randomized controlled trials and the real world.

• [Kelly] So how do these non-sugar sweeteners cause these negative health effects?

• [Jason] We don't know for sure. Let me just say that upfront. But we have ideas and the scientific community has ideas. A lot of mechanisms have been put forth to explain how this might be happening. A lot of them are actually linked to the expression of sweet taste receptors. They are expressed in the mouth, obviously, that is how we perceive things to be sweet. But they are also expressed elsewhere in glucose sensing cells, such as the gastrointestinal tract and pancreas. So there are a number of different ways that this might work. There could be effects on taste perception, sweet taste preference, a threshold of sweet taste sensitivity, and eating behavior as it impacts on hunger or appetite. There could be other neural responses. There is this whole discussion about the hedonic response to any sweet taste. Also, there might be release of metabolic hormones, and other biological molecules, in response to non-sugar sweetener intake. Then, of course, There is a lot of buzz around potential alterations to the gut microbiome, which is a really interesting area. But There is a lot of understanding still to be gained there. Also, as noted, in terms of potential mechanism, it could be that the behavioral component we just spoke about, in terms of how people actually use non-sugar sweeteners in the real world, could also contribute to the association between non-sugar sweetener use, and body weight, and disease outcomes.

A vast number of effects happen once these things get into the body. So Francesco, let me come back to you. What is WHO recommending? I know some recommendations that have been made are conditional. What does this mean?

Francesco: So the recommendation reads that the WHO suggests that non-sugar sweeteners not be used as a means of achieving weight control, or reducing the risk of non-communicable diseases. It is a very simple one. It is basically saying that you're using the sweeteners, but they are not going to help you in weight control, or reducing the risk of that related non-communicable disease. So Kelly, as you said earlier, would I take the risk potentially associated with non-sugar sweeteners if I knew that this would benefit my weight? But in this case, what we are saying is, "Well, look, it is not going to benefit your weight control." We are leaving it there, because the purpose of this review was, particularly, to look at weight control. We were not looking at other aspects of safety - which is actually the task of other regulatory/advisory bodies, although we had to consider in the recommendation when we called the balance of benefits and harm. So here, the recommendation was clearly to say, "Well, you shouldn't use it, because there is no demonstrated benefit, and there might be some harm."

Now, WHO can make two types of recommendations. Recommendations can be strong or conditional. The decision on whether to go for the stronger condition is based on a number of factors - certainty in the supporting scientific evidence, and the balance of desirable and undesirable consequences. A strong recommendation is the recommendation for which WHO gathering group is confident that the desirable consequences of implementing the recommendation outweighs the undesirable consequences. In most situations, this would be something that government can take on immediately and use in their policymaking. A conditional recommendation is a situation where the WHO guide group is less certain about that balance between the desirable and undesirable consequences. Therefore, we are basically saying, you need to consider the context, and then decide what to do with this particular recommendation. So, in this case, why did we go for conditional? There is an element related to the balance and the evidence that Jason described earlier on. There is also an issue about short term versus longer-term consumption. We have been trying to explain why not using does not create a problem. The action also depends on the context of use of this particular product. For example, the levels of consumption in different age groups in the population. So, in a sense, our understanding of the issue, is still not complete. We believe that we need to have more science on the topic. We decided to take a bit of a conservative approach. That is why we end up saying conditional, which means we still recommend that people not use non-sugar sweeteners. But in terms of making use with this recommendation, we would like governments to also do their own assessment on how to translate this into policy practice.

So Francesco, on one hand, we have sugar being a bad actor and now the replacements for sugars can be bad actors. So how does this get balanced out? Should people go back to sugar? Should they just get used to things being less sweet? How does this work?

Francesco: So definitely people should not go back to sugars because we know that consumption of free sugars has been linked to unhealthy weight gain, type 2 diabetes, cardiovascular disease, and dental caries. We definitely maintain the recommendation that we should limit free sugar intake. But unfortunately, non-sugar sweeteners are not producing a good benefit if we replace them with sugar. What they are saying is that both free sugars and non-sugar sweeteners should be limited. So yes indeed we would need to adjust our own taste to consuming products which are less sweet. We should also ask the producers to reduce the sweetness in their product.

So Jason, do you have some thoughts you'd like to share about this?

Jason: Yes. Again, from a scientific evidence standpoint, it is interesting. If you look at the literature, and you look at the studies, and we have lots of studies now, and a lot of systematic reviews, and umbrella reviews that really tried to make sense of all of this. But if you look at some of the impacts, associations between sugar intake, and diet-related noncommunicable diseases, especially type 2 diabetes, and you look at the actual magnitude of associations, the increased risk, they are really in line with what they are for non-sugar sweeteners. In fact, some recent modeling published in 2022, modeling in the prospective cohort studies, shows that when you replace sugar with non-sugar sweetener, you basically end up with a no result. Which means that non-sugar sweeteners, at least in terms of type 2 diabetes, are just as bad for you as sugar-sweetened beverages. These studies are all looking at beverages. It is interesting that we have to keep in mind that they may both be bad actors as you indicated, Kelly.

What an amazing picture. Francesco, so do you think that non-sugar sweeteners should not be used as a harm reduction mechanism to help people reduce their sugar intake?

Francesco: Yes, that is what our recommendation basically says. We are encouraging individuals, but also government, to think of other ways to reduce sugar intake that does not require the use of sweeteners as a replacement. There are ways to do that. I mean, certainly, there are unsweetened variants of the same food or drink. There are alternatives in diet patterns. You don't necessarily have to have a dessert at every meal. You can have fruit. We know that the fruit sugars do not have the same metabolic effect as free sugars. We know that, for example, certain countries, like in the UK have given options to companies to use sweeteners instead, to avoid the sugar levy. Probably, we would ask those countries to have an assessment of what has happened and see whether that policy is still a useful one, or if it should be revised.

So Jason, I'd like to ask you about diabetes. Does the recommendations apply to people with diabetes, and can people with diabetes use these non-sugar sweeteners?

Jason: I'll tell you, that is a question we are getting a lot of. Our guidance really is for preventing the development of disease, and not for treating, or managing existing disease, including diabetes. In terms of the process, making recommendations for preventing disease is very different than making recommendations for managing disease. Different scientific evidence needs to be reviewed. In the case of diabetes, some of the evidence is overlapping. But we really do need to look at a different body of evidence and a different assessment of potential risks and benefits needs to be made. This is all in the context of a larger plan of treatment, which may also include medication, and other lifestyle changes. Therefore, managing disease requires greater input from clinicians. Something else to remember is that individuals without diabetes do have the option to include some sugar in the diet when something sweet is desired. But for many with diabetes, this isn't really an option. With that said, individuals with diabetes can certainly manage their disease without the use of non-sugar sweeteners. However, such decisions really should be made on an individual basis, and only in consultation with one's healthcare provider.

So Jason, let me ask you a question about Stevia in particular. So there are some thinking that because it is natural, unlike the artificial sweeteners, it is somehow different. So why doesn't the recommendation make distinctions between different non-sugar sweeteners?

Jason: That is a great question. Although all non-sugar sweeteners have unique chemical structures, and consequently may differ in their sweetness intensity, organoleptic properties, and routes of processing by the body, we don't make a distinction in our guidance between individual sweeteners or between so-called natural sweeteners, like Stevia, and artificial sweeteners. This is because all sweeteners, including sugar, use the same biological pathway when it comes to how we perceive them as sweet tasting, so the sweet taste receptor I mentioned earlier. And, consequently, how they might impact weight and risk of disease. Also relevant is the possibility that we discussed before, which is that people may use these in ways that promote weight gain and disease, irrespective of what type of non-sugar sweeteners being used. We feel that the evidence for a class effect is sufficient to include them together in our recommendation.

That is very helpful to know. So Francesco, some organizations, for example, the Food and Drug Administration in the US, have declared over the years that these non-sugar sweeteners are safe for use. If those organizations feel they are safe, then why is WHO recommending that they not be?

Francesco: In a sense, it is a different issue. Before any of these compounds are used in food, it has to go through this safety assessment. You mentioned the Food and Drug Administration. FAO and WHO are managing a joint expert committee on food additives that is providing advice to the Codex Alimentarius. And all these bodies, basically what they are saying is, they look at the toxicology of the products and they use animal studies. In some cases, they look at human studies. But they are basically looking at acceptable daily intakes that provide usually short term impacts. We are also encouraging these bodies to consider longer-term epidemiological studies to look at other kinds of effects. For example, at the moment there is a big debate going on because both the International Agency for Research on Cancer, and the JECFA, are looking at the safety of aspartame and considering, for example, certain longer term epidemiological human studies. These bodies are talking about certain aspects of safety and looking at the very high levels of intake. Just to give you an example, at the moment the acceptable daily intake for aspartame is about 40 milligrams per kilogram per day, which is 2.8 grams for an average individual. That is about what you would get from 14 cans of a commonly consumed drink. That is a lot. We are saying maybe that is something that can be moderated. So these bodies talk about safe or maximal levels of intake of individual sweeteners. Here, in our recommendation, we are saying this practice of replacing sweeteners with sugars is not going to lead you to improved health gains, but you're getting into an area of risk that even if it is within the agreed safety level, is something that you may want to avoid.

That is helpful context. So, what are the policy implications of all this?

Francesco: Some countries are already considering giving a warning on the content of non-sugar sweeteners in products. For example, what you have in Mexico. Some countries might decide to give the same warning if it is something that should be at least not encouraged. So that could be a way to do it. Other countries, while using nutrient profiling system, for example, for front of the pack labeling, or for marketing regulation, may decide to include sweeteners in the list of food that should be avoided. That is also happening, again, in South American countries. From our point of view, I think we would really like to give the message that the sweetness of food should be reduced. The same way we are having a dialogue with the food industry about reduction of the sugar content of food, particularly in foods that are intended for young children. We would really like to give a message that we should reduce the content of sweeteners. That is possible. And not relying entirely on sweeteners as an alternative for the reduction of sweetness or, reduction of calories, but really looking at a change in the strategies in peoples' daily diets.

Thank you, I appreciate that. You know to the extent one person can be instructed in this, 11 or 12 years ago, or so, I stopped drinking diet beverages because of the very concerns we were talking about today. I just switched over to tea with no sweetener in it at all. I'm completely accustomed to that now and I find it very enjoyable. I also find the things that I used to drink to be completely oversweet now. So people can get calibrated at different levels of sweetness, can't they?

Francesco: Absolutely. In a sense, this is the same discussion we've had with salt. I mean our capacity to adapt is there and it happens relatively quickly. People can enjoy foods without having that enormous level of sweetness. As we know, sometimes the excess presence of other salts, or sugar, or sweeteners, is some have a way to cover the lack of good taste from the other ingredients. So good foods and drinks can certainly happen without the unnecessary addition of this compound.

Bios

Jason Montez is a Scientist in the Department of Nutrition and Food Safety at the World Health Organization (WHO) in Geneva, where he works on the development, dissemination and implementation of nutrition guidance. Prior to joining WHO, Dr Montez was a consultant to WHO and other international organizations and co-founder of a biotechnology start-up. He received a PhD in Biomedical Sciences from The Rockefeller University and MPH from New York University, both located in New York, USA.

Francesco Branca is the Director of the Department of Nutrition and Food Safety at the World Health Organization (WHO), Geneva. He graduated in Medicine and Surgery and specialized in Diabetology and Metabolic Diseases at the Università Cattolica del Sacro Cuore, Roma. He obtained a PhD in Nutrition at Aberdeen University. He was a senior scientist at the Italian Food and Nutrition Research Institute (INRAN). He was President of the Federation of the European Nutrition Societies from 2003 to 2007.

Rios-Leyvraz, Magali; Montez, J. “Health Effects of the Use of Non-Sugar Sweeteners: Systematic Review and Meta-analysis,” World Health Organization. https://www.who.int/publications/i/item/9789240046429

WHO guideline on use of non-sugar sweeteners https://www.who.int/publications/i/item/9789240073616

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No one actually wants to waste food, right? And yet, a new national study on food waste at home shows we've become more wasteful recently. US families self-reported a 280% increase in discarded food between early 2021 and early 2022. What's more, households tossed out more food during weeks they ate out. Today, we will explore results from a national tracking study published in the Journal of the Agricultural and Applied Economics Association. Our guests to help us learn more about this topic are economist Kathryn Bender. Katherine studies consumer behavior and food waste at the University of Delaware. We also have Brian Roe, who is an agricultural economist from the Ohio State University. Brian's research focuses on food waste and consumer economics.

Interview Summary

Norbert: Kathryn, let's begin with the big-picture question. Why should we care what people do with their food once they have purchased it?

Kathryn: Great question. So we know that food waste has huge environmental and economic impacts. Thirty percent of food that's produced for human consumption ends up going uneaten. When that food is wasted, we know that all the resources associated with producing it, such as land and water, are also wasted. And those resources themselves have their own cost. Decomposing food emits methane, which is a greenhouse gas that is 25 times more potent than carbon dioxide. There's also emissions from the transportation and distribution of that food from farmer to consumer. I don't think that most people set out to waste food, nor do they feel really good about doing it. In addition, households fall at the end of the supply chain, so consequences from upstream decisions made by manufacturers and distributors, may fall on the households themselves. For example, if there's milk that has not been kept cold along the supply chain, the consumer may end up throwing it away because it starts smelling or tasting off sooner than it really should. Another example is dates placed on food packages. Producers have more information about the quality and the safety of their product than consumers do. Many individuals use those dates on the package to determine when they should throw something away. If producers are conservative in this labeling, or if that language is unclear, consumers may the discard perfectly good food based on the date alone. If we can identify policies aimed at producers to effectively communicate information about the product to the consumer, as well as methods such as strict adherence to cold chain processes, we could help reduce food waste at the household level. I think, overall, we want to develop the tools necessary to set consumers up for success in minimizing their food waste.

Brenna: Kathryn, thanks so much, for laying out all the reasons why we should care about this topic. We so appreciate the work you and Brian are doing to help us better understand it. So with that, Brian, can I turn to you? Would you mind telling our listeners about the national tracking survey, what you all are hoping to learn, and some of the findings you have so far?

Brian: Sure. The United States set a national food waste reduction goal back in 2015. Three different administrations from vastly different political viewpoints have all kind of gotten behind that, and really want to see that goal met. And yet, we don't have great data to track how our food waste habits are changing over time. Particularly for consumers. Some other sources of data suggest consumers are the source for 40% to 50% of wasted food that we see. We really wanted to try to start to develop some data in this area. Hence, we set up a national tracking survey. We used an online survey approach, which has some known issues with it. It tends to under report the absolute level. But we're asking the same questions over and over again - we now have seven waves of data collection between 2021 and 2023. We have a consistently asked set of questions that we can use to understand patterns and trends that might be emerging across the country among consumers as they're wasting food in their households, and this helps us get perhaps a bit more level with the United Kingdom. They have got this great survey data series that they use with consumers to track food waste going back to, I believe it's the early 2000 and teens. We really hope to learn some things from our findings, and we are seeing some interesting patterns emerge.

Brenna: It's great that you are starting a tracking survey. Most of us on the podcast work on food waste, and we know that it can get literally very messy trying to measure it in other ways. There are limitations in all the ways measuring. I appreciate the work that you all are doing. So Brian, you started collecting data as Covid restrictions were lifting. Why did you choose this time to start the tracking survey?

Brian: That's just kind of when we got organized. My early research portfolio was very focused on going into homes with apps and things like that to get a very granular view of food waste. But then, it kind of really struck me that we need to have data on consumers, even if it's not perfect. We need to ask those questions consistently. That's when we were able to muster our resources and begin to collect the tracking data. With the help of the National Science Foundation, we've been able to solidify that tracking approach and now we have a funding stream that will allow us to continue this for at least five years. That's very helpful.

Brenna: Perfect, thanks for clarifying that. Kathryn, if we can come back to you. According to the Bureau of Labor Statistics, food-at-home prices rose 8.6% over the period of your study. I'm curious why consumers were actually wasting more food as food prices are going up.

Kathryn: I think it really comes down to how consumers are managing their food stock at home. Two things that we noted from this study was that over that year we analyzed, food that was bought in bulk and was subsequently thrown away doubled. So increased food prices may have prompted households to purchase more food in bulk. We also found in a previous study that households really increased their cold storage capacity by buying refrigerators and freezers during lockdown. I think that the increase in cold storage capacity and purchasing more bulk food adds kind of this new dimension to food stock management that households may not have adjusted to yet. We also saw that food waste attributed to unplanned dining out events increased. This makes sense as we were able to go out more. Restaurants weren't closed down, and didn't have as many restrictions. We were able to go out more, and we had more food that was wasted because we planned on eating at home. But we took advantage of an opportunity instead to go out with friends or something like that. So as people go back to their more hectic lifestyles, I think that just food management becomes a little bit more difficult. We need to make sure that we provide support and educational campaigns to help households manage their food at home. With higher prices being at the forefront of a lot of people's minds right now, I think that highlighting food waste reduction is a great method to save money.

Norbert: Kathryn, that's really interesting, and it makes me think of a couple of studies that I've done with Brenna and our colleague Linlin, and some other work that I've done, where we did see a relationship between the price of food and the predicted waste. What we saw was that there was a negative relationship. So it's interesting to hear this example of increases in the price leading to or at least associated with this increase in food waste. But, I think what's really fascinating is it may be a reduction in the per-unit cost because people were buying in larger quantities. That's a really fascinating thing. One of the things that we were looking at right when Covid started, people were reducing their food away from home significantly as we weren't allowed to go out and we weren't ordering out. So, it's interesting to see this kind of change. I look forward to seeing what subsequent rounds of the survey will show about what happens with food waste and hopefully as price inflation goes down. Brian, I want to turn back to you and ask: a 280% year over year increase in food waste is really high. Do you expect that food waste will continue to increase at this rate?

Brian: Yeah, we've actually got some data in on that now. So the published data shows that 280% increase between the beginning of 2021 and the beginning of 2022. That was right after the Omicron Christmas, if we remember that, and vaccines were coming on board. What we've shown now is that behavior has retracted a bit. We're down to now merely a 200% increase from that February '21 wave to the February '23 wave two years later. So it came down from that 280% peak to a doubling of food waste between early Covid days to back-to-reality-here for many people in February 2023. I think part of that is what Kathryn talked about before. That we had probably a big purge, I would guess that spring cleaning after Omicron, right? People probably were sitting on a fair amount of money in terms of finances. Restaurants were really fully reopening. They went out unexpectedly, spur of the moment, ate out during their reporting week and that caused them to report more waste. They probably looked through their cupboards and saw all this bulk stuff they might have bought during Covid and said spring cleaning time. Maybe we need to get rid of some of that stuff as the date labels grew longer and longer in the past. Once they got that out of their system, and this is the thing, we don't know what pre-Covid was, but maybe this is kind of a return to pre-Covid level. We'll never know that because we can't reproduce data that we don't have to pre-Covid days, but perhaps that February 2021 was kind of that peak studying our fridge over and over again trying to find every last leftover and shows a very low level. The data that we're getting here in February of 2023 is kind of a return to normal. That's what's happened in the United Kingdom as well, where they do have a longer tracking survey. They found right after the onset of Covid, a pretty big drop in reported food waste; about by half in terms of their metric. And then, a kind of a slow but steady march back towards pre-Covid numbers is what they found right about the end of 2022. So a little bit different in the pattern, but not dissimilar in terms of overall trends.

Norbert: Your explanation makes really good sense, and so thanks for explaining that. I'm hopeful that this is going back to a lower rate of waste. It will be important to see how subsequent surveys tell us what happens with food waste as we move forward, and hopefully without a pandemic in between.

Brian: And perhaps new approaches to finding other sources of data so that can maybe validate our hypotheses here about what's going on with these trends, would also be very important. It's nice to have tracking survey data, but it's correlative, right? We're not doing any randomized experiments here to be able to understand the true links and causality. So as always, we need more research to validate this to help us understand how we can jump in, intervene and help the US meet its long-term food waste reduction goals.

Bios

Kathryn E. Bender, Ph.D. is an Assistant Professor in the Department of Economics at the University of Delaware. Her research in environmental and experimental economics focuses on consumer behavior and food waste. She has a Ph.D. in Agricultural, Environmental, and Development Economics from The Ohio State University.

Brian Roe is the Van Buren Professor in the Department of Agricultural, Environmental and Development Economics at Ohio State University. Roe attended the University of Wisconsin – Madison where he received a bachelor’s degree in Agricultural Economics. Roe went on to receive a Ph.D. in Agricultural and Resource Economics at the University of Maryland. Prior to his employment at Ohio State, Roe worked on policy issues surrounding food safety and health information disclosure as a Staff Fellow at the US Food and Drug Administration in Washington, DC.

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Today we speak with an expert on sugar and things meant to replace it. The stakes are high. Very high. Sugar consumption in the population is astronomical and so is the use of sugar replacements. Knowing the impacts of both could help experts provide dietary guidance and help consumers make decisions. Dr. Robert Lustig is Professor Emeritus of Pediatrics in the Division of Endocrinology at the University of California, San Francisco. He specializes on the regulation of energy balance by the central nervous system; body weight regulation, appetite, metabolism, and is very well known for his work on sugar and their substitutes and on policies aimed at improving the diet of the population. A YouTube video on the effects of consuming sugar called “Sugar: The Bitter Truth,” has now been viewed 24 million times.

Interview Summary

URL for “The Bitter Truth video (https://youtu.be/dBnniua6-oM)

Let's start out with this - so the big hope is that sugar replacements, artificial sweeteners, non-nutritive sweeteners, all known as different things, replace sugar and that people can enjoy sweet taste without the calories. But, of course, the picture is way more complicated. Being an endocrinologist, you are in a good position to explain what happens when the sweeteners enter the body. I'd like to get to that in just a moment, but let's lead off with another question. Why is it so important for people to consume less sugar?

First, let's talk about what sugar is. The food industry tells you that sugar is just empty calories. I wish that were true. If that were true, then you could basically spend your discretionary calories on sugar with no problem. But it's not true. There are two molecules in dietary sugar: the sucrose or the high fructose corn syrup or honey maple syrup agave. They are all basically the same. One molecule of something called glucose, one molecule of something called fructose. Glucose is the energy of life. Glucose is metabolizable by every cell on the planet. Glucose is so important that if you don't consume it, your body makes it. The liver will take fats and turn it into glucose. It will take amino acids and turn it into glucose process called gluconeogenesis. Glucose actually makes your cells work better. It makes your mitochondria function better, the mitochondria being the little energy burning factories inside each of your cells. Glucose, for lack of a better word, we can call good. Fructose, on the other hand, it is completely different, is metabolized completely differently inside the body and inside the liver. What fructose does is it inhibits mitochondrial function. It actually inhibits three separate enzymes necessary for mitochondria to do their job. So, fructose inhibits energy generation. Now, the food industry will tell you fructose is four calories per gram. Fructose is ready energy. That is why they put high fructose corn syrup in the sports drinks, for example. Well, turns out, that fructose may be ready energy for a bomb calorimeter, but it is not ready energy for your mitochondria. You don't burn in a bomb calorimeter (a laboratory instrument), you burn via your mitochondria. It turns out, mitochondria are actually poisoned by fructose. So in fact, fructose is a chronic, dose-dependent mitochondrial toxin and this is why we have to eat less of it. But the problem is the food industry keeps putting it in anyway despite the fact that it is killing us.

How much more of it are people consuming than what you might suggest?

The American Heart Association years ago came up with a upper limit per day of about 25 grams, which would be about six teaspoons per day. I was actually part of that group that came up with that and I stick to it because that's what the data show. We are currently consuming 94 grams. We are consuming almost quadruple the amount that is the upper limit. Now, the notion that something could have empty calories but still be bad for you is not a crazy one. We have two things in our diet that we know are calories but are clearly toxic to us. One is alcohol. Alcohol, seven calories per gram, but alcohol is a poison. And then also trans fats. Trans fats are nine calories per gram, but trans fats are a poison. So just because something has calories doesn't have anything to do with its metabolic impact.

Where are people getting all the sugar from? I'm assuming it's not from their sugar bowl.

Exactly. It is not the sugar they add. It is the sugar the food industry adds. Now, where is it? Well, the obvious source is soft drinks. That's number one by far and away. I mean soft drinks are basically, you know, the devil incarnate. Several municipalities have actually figured that out, and it's one of the reasons we have soda taxes because it's actually directed at the problem. A lot of it is in other things that we identify as sweet: candy, cakes, ice cream. A lot of it is in other things like breakfast, cereal, yogurt, even cured meats. It is in a whole host of other things. When you add it all up, 65% of the sugar you consume is in ultra-processed foods. It is not in regular food. It is not in sugar you added to your own food. It is in ultra-processed foods. An ultra-processed food is the vehicle by which the payload, that is that fructose, is doing its damage.

Thanks for that background. We're really here to talk about the artificial sweeteners but it is irresistible talking to you about sugar in general because you described the whole picture in such a compelling way. So thank you for that. So, onto the artificial sweeteners. What are the main ones in the food supply?

Well, there are a whole bunch. The most common ones that the food industry uses the most, obviously aspartame, which is Equal. And also sucralose, which is Splenda. But there are others now out on the market: Neotame, there's Acesulfame-K, there's monk fruit, there's Stevia, and all the Steviol glycoside derivatives. There's now Allulose, and there's Tagatose. There's a whole host of different sweeteners that are considered "non-nutritive” meaning they don't have calories.

These things show up in ways that people don't necessarily recognize. I mean Diet Coke, Diet Pepsi, those sort of things, it's obvious they're artificially sweetened. But these things are showing up in a lot of places, aren't they?

Indeed. The food industry now understands that sugar is a problem and people have been calling for less sugar but what they're not calling for is less sweet. And so the industry has a job. It has to deal with that dichotomy.

I know understanding their impacts is complicated by the fact that there are a lot of these things and they're all chemically different from one another. I'm imagining they have different metabolic effects. What happens when these things get into the body?

Right, and that is the issue. It has nothing to do with calories. People think calories are the issue. This has nothing to do with calories. That's one of the reasons, Kelly, that I'm committed to one concept: kill the calorie. Kill the calorie as a unit of measure. It was never appropriate. It was actually subterfuge, and it was actually promoted and promulgated by the food industry because if it is about calories, they can assuage their culpability for what they've done to our food supply. This has nothing to do with calories. This has to do with metabolic health.

Now, the World Economic Forum just published a white paper called the, "True Purpose of Nutrition," and it comes down to two words: metabolic health. That is what is going on inside the cell and that's where the artificial sweeteners do their damage, inside the cell. That's what we have to talk about. There are several places in the body where artificial sweeteners can do damage that have absolutely nothing to do with calories. The first, you put something sweet on your tongue. Message goes tongue to brain, "Sugar's coming." Brain sends a message to the pancreas, "Sugar's coming, release the insulin." Then the sugar never comes because it was a diet sweetener. What does the pancreas do? It turns out it releases the insulin anyway even though it had no calories, even though it wasn't sugar, just because of the sweet taste. So this is known as the cephalic phase of insulin secretion. That insulin is driving energy storage into fat, number one, and it's also driving cell proliferation in your coronary arteries, cell proliferation in your breast tissue, in other words, cardiovascular disease and cancer and ultimately leading to burnout of your pancreas, and now you've got diabetes too. Even though these artificial sweeteners have no calories, they still generate an insulin response, which is still problematic from a metabolic standpoint.

So because of the sweet taste and the body's response to that, I'm assuming what you're saying would be true to all of sweeteners?

Exactly. All of them do that. The next step is the artificial sweetener goes down your gullet, goes into your intestine, and the intestine has these bacteria in it called the microbiome. Most people have now heard of that. Different bacteria lead to different effects in the intestine. But think of your intestine - I mean it's a sewer. It has a whole lot of S-H-you-know-what in there. The goal of the intestine is to keep the S-H-you-know-what IN the lumen of the intestine and not allow it into the bloodstream. It uses three barriers. It has a physical barrier called the mucin layer. It has a biochemical barrier known as tight junctions or zonulins. It also has an immunological barrier called Th17 cells. Those three barriers have to work right to keep the junk out of your bloodstream because if the junk gets into your bloodstream, you now have systemic inflammation, which drives insulin resistance and drives chronic metabolic disease as well. So keeping your intestine in tiptop shape is really important. Well, it turns out those diet sweeteners alter the microbiome. Some of those bacteria like those sweeteners and utilize them to make toxic byproducts, which damage the mucin layer, damage that biochemical tight junction barrier and allow for things to seep through. This is a process called leaky gut. For reasons that are still unclear, sugar tends to deplete those Th17 cells, rendering the immunologic barrier devoid of function. The sum total of which means all the you-know-what in your intestine ends up in your bloodstream, goes to your liver, generates insulin resistance, and you are off to the chronic metabolic disease races as well, from diet sweeteners having nothing to do with calories.

What an amazing picture your painting of these things.

We’ve got one more mechanism. At the fat cell, now this I really don't understand and it's early data but seems to be consistent. Turns out adipocytes, fat cells, have receptors for diet sweeteners. Don't ask me why. I don't know why. But it turns out, diet sweeteners can act like insulin right at the fat cell to increase energy deposition into the fat cell. Growing those fat cells all by themselves, due to the diet sweetener rather than due to insulin. Now how dumb is that? As a result, there are a lot of different ways diet sweeteners might end up causing problems as well, having nothing to do with calories, having nothing to do with fructose. There was a paper that came out in the European Journal of Clinical Nutrition. It was a meta-analysis of sugar and also of diet sweeteners in terms of diabetes and heart disease. What I can say in one sentence to sum up what this paper showed is that the toxicity of one Coca-Cola equals the toxicity of two diet Coca-Colas. Half as bad. That doesn't mean good. It means half as bad.

Boy, I mean, any one of the three major pathways to harm would be of concern. If you add them all together, it is a pretty striking picture, isn't it? I imagine, even if somebody knew about this, they might say, well, you know, I'm willing to accept those risks. I mean, even though you are making them sound substantial, but I'm willing to accept those risks if these products help me control my weight. Do they?

Well, they don't. That's part of the problem. There is not one study, not one study in the entire world's literature, that shows that switching from sugared beverages to diet beverages actually controls weight. The reason is because even though the diet sweeteners don't release as much insulin now, when you drink the diet sweetener, the pancreas releases it later. That's actually been shown in several studies now. You get a delayed insulin response, so that the 24-hour insulin burden is the same whether you consume the sugar or the diet sweetener.

Let's talk about safety for a minute. What about sort of the typical toxicology concerns that people have had for years about these substances, irrespective of what they're doing to the pancreas and to the other, the microbiome, et cetera? What about the just kind of pure safety of them?

Right, so the one that has generated the most heat, not too much light, unfortunately, is aspartame, NutraSweet. It turns out that aspartame has a very long and checkered history. Did you know that aspartame was made by Searle, G.D. Searle? And, do you know who the CEO of G.D. Searle was at the time that aspartame was approved by the FDA?

I do not.

His name was Donald Rumsfeld.

An interesting character in history.

Indeed, wouldn't you think? It turns out that G.D. Searle actually buried most of the toxicology of aspartame in order to get it approved. It is a long complicated and involved story, which we don't have time for. I'm not even privy to most of the details on that. The bottom line was it ultimately did get approved despite the fact that there was a significant amount of concern about toxicology of this compound. Those questions still remain today. That is one. Another one that is a big issue is sucralose. Sucralose is also called Splenda. Sucralose is a chlorinated poly-fructose and it's extremely sweet, no question about that. It seems to have some GI side effects that a lot of people don't like. It also has now been associated with cancer. And most recently, the one that's gotten the most attention and almost assuredly, Kelly, the reason you called me is the paper that came out about three weeks ago in science about erythritol. So erythritol is a sugar alcohol, and now the meta-analysis of erythritol consumption suggests that it may in fact contribute to heart disease. Now, is that true? Meta-analysis are complicated. People think meta-analysis are the piece de resistance, the highest bar of medical information and analysis. I have four words for meta-analysis: garbage in, garbage out. Meta-analyses are only as good as the studies that they base the data on. If those studies were done by the food industry, which almost all of these are, because that's who stands to benefit from them. These are almost never NIH studies. These are almost always food industry studies, as you know, the odds are 7.61 times more likely to find in favor of the compound of interest. So all of these are, shall we say, biased. All of these are tainted, and meta-analyses are basically a conglomeration of tainted studies. So what do you expect the result to be?

Thanks for that background. I'm imagining also regarding toxicology and safety, that some of the newer sweeteners like Splenda for example, sucralose, there hasn't been enough years of use to pick up long-term chronic effects.

Well certainly, if you're using cardiovascular or cancer events, you're absolutely right. A lot of these events, you know, take a long time to manifest themselves. Sometimes, a generation or even two generations for that matter, especially for heart disease and cancer. The 15-year-old is drinking 10 diet sodas. When do you expect the heart attack to show up? You know, it's complicated.

So we use biomarkers to try to answer these questions, but then the biomarker has to actually be a good proxy for those events and often they're not. Let me give you an example, LDL. Everybody thought LDL was the bad guy. Turns out triglycerides are the way worse guy. LDL has a hazard risk ratio for heart disease of 1.3. Triglycerides have a hazard risk ratio of 1.8. Triglycerides are 50% more important in determining heart disease than LDL is, but we use LDL as the biomarker because it's more stable. So you have to use the right biomarker and you have to interpret it properly and it actually has to mean something and it has to change relatively acutely. All of which are problematic for all of these biomarkers. It's hard. It's hard to do these kinds of analyses. Having said that, my group, a scientific advisory team that I convened to help an offshore ultra-processed food company improve the health of their products. We've published this just last month in Frontiers in Nutrition. The company is called Kuwaiti Danish Dairy Company, or KDD. The title of the paper is, "The Metabolic Matrix: Re-Engineering Ultra-processed Foods to Protect the Liver, Feed the Gut, and Support the Brain." We did a deep dive on diet sweeteners. We looked at all of these diet sweeteners and their proxies, all the biomarkers. The one that actually popped out that looked to be the most beneficial, at least acutely, is a new one that we're actually kind of interested in and is picking up speed and it's called allulose. Allulose currently is 12 times the cost of sugar, but that's coming down. It turns out allulose lowers LDL and raises HDL. So it may have a better cardiovascular profile, but again, all the caveats that we mentioned before.

That's very interesting. So given your interest in pediatrics, what about children using these sweeteners?

I am totally against children using sugar because they get fatty liver disease and Type 2 diabetes, and I am totally against them using diet sweeteners because, number one, we don't know what they're going to do. Number two, they don't actually lead to weight loss. That data we do have. So as far as I'm concerned, we really only have one option and that is de-sweeten our lives. We have to de-sweeten the food.

Perfect lead in to the next question I was going to ask. So do you think it is possible for people to become accustomed to less sweetness? I mean, let's say the food industry is required to gradually reduce sugar and sweetness from the sweeteners. What do you think would happen?

Absolutely. It is not only possible, it is eminently doable. And I know why and we have the data for why that is. So there is a very smart lady, neuroscientist at the University of Michigan by the name of Monica Dus, who has done all this work in fruit flies of all places. She has shown the desensitization of the tongue to sugar has to do with changes in receptors and changes in specific substrates in the taste buds of the tongue. When you stop the sugar availability, it takes three weeks for those receptors to increase and repopulate, and for those problematic substrates to go away. You can actually retrain your tongue in three weeks to be much more sensitive to the sugar that is in the food naturally. After a three-week abstinence period or a reduction or a weaning period, a blueberry will taste like a sugar bomb in your mouth. So we know this can happen and we actually have proven this for salt previously. The UK, as you know Kelly, back in 2003, the Blair government convened all the food industry concerns in Great Britain. So Marks & Spencer, and Weight Rose, and Tesco, et cetera, all around the big table, didn't let media in, and basically said to every single food industry concerned in Great Britain, "Look, we have a hypertension and stroke problem and it's because of the salt content of the food and we are going to play referee here in the government. And each of you is going to reduce the salt content of your food by 10% per year over a three-year period so that you'll reduce your salt by 30% at the end of this and everyone's going to play together, so that there's no competitive disadvantage and most importantly, we're not going to tell anybody." That's what they did. Sure enough, in 2011, a paper appeared in Burge Medical Journal, demonstrating a 40% reduction in hypertension and stroke because of the public health effort that the Blair government made in terms of reducing the amount of salt in processed food. We can do the same with sugar today.

The salt example is a good one because I think many people have sort of experienced this in their day-to-day lives, even in the United States, where industry hasn't done exactly what's happening in Britain. People have tried to reduce salt in their diet, add less salt, and buy products with less salt. And then sometimes they'll go back and consume something that they had before and find it extremely salty, even unpleasantly salty. It's interesting to hear on the sugar front that that same experience might be possible and that there's a biological reason for it. It is not just that you psychologically get accustomed to different levels of sugar, in this case, but there's a biological change occurring that might help keep that going.

Absolutely. You can change people's behavior by changing their biochemistry. This is how I got into this field by using a drug that suppressed insulin and getting kids who were 400 pounds due to their brain tumor to actually lose weight and start exercising because we got their insulin down. You can fix the biochemistry and the behavior will follow suit. The food industry could do that and we wouldn't even notice.

So I'm guessing I know the answer to this question before I even ask it, but let's go ahead. Would you suggest the food industry be mandated to make gradual reductions in sugar, just like you mentioned with salt in the UK?

Absolutely, I'm working toward that. The only thing that I say is we should not tell anybody.

So it would be sort of a stealth move then. You would not necessarily have to make a big deal of it to the public, because they might assume there's going to be a change in the desirability and the pleasure of the products when that's not necessarily the case.

As soon as you do something to their food, someone's going to scream, "Nanny state!" This is not nanny state. Ultimately, this is a public health problem. We have to deal with it with a public health solution. You know, that means changing things. If the amount of sugar in our food supply went down, say by 3% every six months down, so that we were able to cut our sugar consumption by 25%, which would be the same basically as what a tax would do. We would save so many billions of dollars in healthcare costs, and we would increase productivity so much. We actually published a paper, a microsimulation analysis in BMJ years ago where we quantified the savings to government, to insurers, to the public. If we actually got sugar down and, you know, actually listened to what the USDA told us, it would be amazing. There is data, there's a pathway forward, there's precedent for doing it. I absolutely think that is where we need to go.

Rob, you're making me feel very smart at the moment, because I figured this was going to be a podcast filled with information and helpful bits of knowledge and it sure was. I'm really grateful that you were able to join us and the topic couldn't be more important. Thank you again for being with us.

Bio

Robert H. Lustig, M.D., M.S.L. is Emeritus Professor of Pediatrics in the Division of Endocrinology, and Member of the Institute for Health Policy Studies at UCSF. Dr. Lustig is a neuroendocrinologist, with expertise in metabolism, obesity, and nutrition. He is one of the leaders of the current “anti-sugar” movement that is changing the food industry. He has dedicated his retirement from clinical medicine to help to fix the food supply any way he can, to reduce human suffering and to salvage the environment. Dr. Lustig graduated from MIT in 1976, and received his M.D. from Cornell University Medical College in 1980. He also received his Masters of Studies in Law (MSL) degree at University of California, Hastings College of the Law in 2013. He is the author of the popular books Fat Chance (2012), The Hacking of the American Mind (2017), and Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine (2021). He is the Chief Science Officer of the non-profit Eat REAL, he is on the Advisory Boards of the UC Davis Innovation Institute for Food and Health, the Center for Humane Technology, Simplex Health, Levels Health, and ReadOut Health, and he is the Chief Medical Officer of BioLumen Technologies, Foogal, Perfact, and Kalin Health.

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As a society, we are eating and drinking low-calorie sweeteners more and more. Researchers are working to understand the long-term impact of such sweeteners for adults and, of course, for children. This interview is part of a series on the impact of sweeteners. Our guest today is Dr. Allison Sylvetsky, Associate Professor in the Department of Exercise and Nutrition Sciences at the George Washington University - Milken Institute School of Public Health.

Interview Summary

Boy, these sweeteners are in the news all the time, and that's been the case for many years. And people are really interested in whether they're safe, whether they help people control their weight and the like. You have a vast knowledge on this, and I'd like to begin with kind of a fundamental question. So, how has the consumption of these sweeteners changed over time? How much are they being used and who is using them?

What's really interesting is that these sweeteners have been around, at least some of them, for quite a while. But what we've seen is that as there's been more and more emphasis on reducing the consumption of added sugars and sugar sweetened beverages, there's been a widespread increase in the use of various low-calorie sweeteners in the food supply, which of course has been followed by increases of consumption. So, across all different population subgroups, we're seeing increases in the intake of low-calorie artificial sweeteners.

So, how much are they used and who are the people who are using them the most?

So, in terms of how much they're used, that depends to some extent on how we look at this, because it's very hard to actually quantify the intake given that manufacturers are not required to disclose the amount of different artificial or low-calorie sweeteners in food and beverage products. So, most of the data that we have to rely on either comes from household purchasing data or comes from self-reported dietary intake data from large surveys, for example, the National Health and Nutrition Examination Survey. But, what we've seen in these data are that low-calorie sweeteners are being used across the population, though the highest consumption or highest prevalence of consumption is seen in females, in individuals with diabetes and obesity, individuals from higher-income households, and also older adults and older individuals. However, more and more, we are also seeing consumption of low-calorie sweeteners among children, and consumption in products that people wouldn't necessarily expect would contain these artificial or low-calorie sweeteners.

Let's talk about that. So, where do the low-calorie sweeteners show up in the food supply? Has this changed over time?

This has definitely changed over time. Several decades ago, you would think of low-calorie sweeteners as being in diet beverages, which of course they still are. Or in sweetener packets that you find on the tabletop. For example, Sweet'n Low that contains saccharin or Equal that contains aspartame. But now we're seeing these sweeteners showing up across product categories. So, in products including light yogurts, artificially sweetened yogurts, dairy desserts such as ice cream, snack foods such as microwave popcorn, cereals, ready-to-heat oatmeals, all sorts of different products, protein bars, protein shakes, really, you name it. I've actually even seen low-calorie sweeteners show up in pickled ginger that usually is used along with sushi. So, again, places where people just wouldn't expect to find them. We see these sweeteners popping up, and this is more and more the case as there's been more and more emphasis on reducing the intake of added sugars.

Low-calorie sweeteners in microwave popcorn, who would've thought? I mean, that's just one example and you gave other ones about where these things are showing up. So, big time exposure to these, isn't there?

Exactly. Also, something like microwave popcorn typically wouldn't be thought of as a diet food, and that's part of what is very confusing to consumers. It's one thing if the product is labeled as "diet" or "no sugar added" even. Not that everybody would recognize that as perhaps being suggestive of having a low-calorie sweetener, but in products like microwave popcorn or certain English muffins, for example, people typically aren't using these products as a way to manage their weight or as some sort of a diet or reduced calorie food, because they're not diet or low-calorie foods.

Let's get right to one of the most fundamental questions of all. What are your thoughts on how these low-calorie sweeteners affect health?

So, that is the big question, and there's a lot of uncertainty and there's been more and more research on the topic, which has been exciting and informative. But there still are a lot of questions with regard to how these sweeteners affect health. One thing that is important to clarify right from the start is that, at least the work that I do and the work that a lot of people are focused on to understand their health effects, is different from more of a traditional toxicological safety assessment. So, when I'm talking about their effects on health, I'm really referring to their metabolic and health effects, their role in weight management and chronic disease prevention as opposed to more traditional safety outcomes. Because of course, these low-calorie sweeteners have been reviewed and approved for use in food by the Food and Drug Administration and other regulatory agencies worldwide. But, in terms of weight management and chronic disease prevention, what's really interesting is, it depends on the type of evidence that you look at. There have been quite a number of randomized control trials primarily in adults that have shown that when added sugars or sugar-sweetened beverages are replaced with low-calorie sweeteners on a one-to-one basis, there typically is either a neutral effect or a modest benefit. Where we do see some modest reductions in energy intake as well as a modest reduction in body weight. But that doesn't necessarily tell the whole story because that doesn't necessarily reflect how they're used, especially given what we've just discussed about the use of low-calorie sweeteners in the food supply. What's interesting is when we look at observational evidence from large perspective cohort studies, typically the vast majority of these studies show positive associations between consumption of diet beverages and low-calorie sweeteners with a variety of adverse health outcomes. This includes higher risk of obesity, higher risk of diabetes, heart disease, and some recent studies also showing an increased risk of certain types of cancer.

So that then leads to the question of: well, what explains this discrepancy? There are several explanations. One is that there are flaws to any type of study, including that a lot of these studies that look at associations may be subject to reverse causality or sort of a chicken and egg situation - which is what's happening first. But they're also very plausible biological and behavioral mechanisms that have been put forth to explain how low-calorie sweetener intake may be causally related to some of these outcomes. And that's really where a lot of the research is focused right now, is trying to understand, what do these low calorie sweeteners actually do metabolically in the body and how does that impact health?

That whole range of metabolic consequences is a very interesting one. You led off this discussion by mentioning toxicology, and I realize that you're not a toxicologist, nor am I, but I do have a question in that arena. Whatever standards of the FDA uses to assess safety for these things, I'm assuming it's a range of standard toxicological tests, do you think there's still a chance that these things, even though they're considered safe, will have long-term consequences that people don't know about yet? Just because some of the newer ones, for example, haven't been on the market long enough for people to have 20 or 30 years of exposure? Is there a reason to be concerned on that front, do you think?

I would say there's a reason to be concerned in terms of while the levels that they're consumed are believed to be safe in terms of, as you said, these thresholds that are set forth based on toxicological data - we don't know what the threshold of exposure is that would be required to have these metabolic effects. When we're talking about metabolic and health effects, as you've alluded to, these are long-term processes, right? We don't develop diabetes or cancer overnight, but it takes months, years, decades of exposure to see some of these outcomes. So, it is very possible that even though these are safe from a toxicological standpoint, the repeated exposure in the ways that we consume them, in addition to the fact that we don't consume these in isolation, we consume low-calorie sweeteners in combination with each other, other low-calorie sweeteners, as well as other food additives, other ingredients in various forms. So we don't fully understand yet what that means for long-term human health.

Thank you for that explanation. Thus far, we've been talking about these low-calorie sweeteners as a group, but of course there are different compounds that have different biological effects. What do you think about the different effects of the different versions of low-calorie sweeteners?

That's become an extremely important question, especially because over time there's been changes in not just the use of low-calorie sweeteners as a group, but in certain low-calorie sweeteners. As you mentioned, these sweeteners are different compounds. Of course, they're grouped together because they contain characteristics, such as low-calories that have high potency sweetness and are palatable replacements for added sugars in food. But they are of course, different compounds. And therefore, while they may have some overlapping effects due to their sweetness, they also may have different effects due to their specific chemistry and their way that they are absorbed, metabolized, processed in the body. That's something that we're really, as a field, just beginning to understand. In a lot of the research to date, low-calorie sweeteners have been referred to as a group. And that's in part because, especially in observational studies, it's very difficult to tease out which ones are being consumed. And that's in part due to limitations of dietary assessment approaches, and in part due to constantly changing formulations of these products by food and beverage manufacturers.

So, it's difficult in a lot of the existing research to actually tease apart what specific low-calorie sweeteners we're talking about. That said, there is more and more of an emphasis on trying to understand these as individual compounds and then hopefully be able to make more tailored and nuanced dietary recommendations for or against their consumption. There's been some recent studies looking at, for example, comparing different low-calorie sweeteners on outcomes such as body weight over 12 weeks. What that study showed (that was a study out of Purdue University), is that while saccharin consumption actually led to weight gain that was similar to real sugar, sucralose consumption in this particular study led to reductions in body weight. So, while this is just one example, clearly it's possible and likely that these sweeteners may actually have some different effects, which really reiterates the need to look at them separately and compare their effects on different outcomes.

It's interesting that you mentioned the research at Purdue, and I'd like to remind our listeners that we reported a podcast with Dr. Richard Mattes, who's a professor at Purdue, who's done a good bit of work on this topic. So, let's turn our attention to children. And I know many parents are very concerned about consumption of these products by their children. So, is their worry warranted? What do you think about use of these things in children?

Yes, I would say their worry is warranted. That said, it's also not conclusive that these are harmful, but at the same time, it's not conclusive that these are actually beneficial for their intended benefits of helping to reduce sugar intake and help with weight management. Really when it comes to kids, it's a question of how you look at the data, because what is obvious is that there is a lack of data in kids. In some cases, kids could be thought of as small adults. But kids also are very different than just being small adults, not just because they're smaller, but because they're developing. And we know that early life exposure makes the difference in terms of future dietary patterns. Given that there are many questions about the metabolic and health effects of low-calorie sweeteners in adults that have yet to be answered, to start in a widespread manner, providing these to children is concerning until we have a better handle on how these actually work in the body. As mentioned, there is very limited evidence in children, but at the same time, we've seen an explosion of low-calorie sweeteners in products, including products that are directly marketed to children. For example, fruit drinks that have often added sugar in addition to low-calorie sweeteners such as sucralose and acesulfame potassium. We've done some work talking to parents as have others, and trying to understand, "Well, what do parents think about this?" And most parents will tell us that they do not want to provide these to their children. Meanwhile, other research has shown that parents cannot identify or recognize products that contain them. What's happening is that given a lot of different factors, but particularly the fact that more and more of these sweeteners are showing up in children's products, children are being exposed to low-calorie sweeteners from a very young age. And it's unclear what that means for their health. There is reason to be concerned, both based on data in adults as well as some of the more mechanistic evidence that's come out recently related to how these sweeteners may adversely impact glucose homeostasis or insulin resistance, or alter the composition of the gut microbiome. There are a lot of questions when it comes to this topic in general, but particularly for children, it would seem that we may want to take a more cautious approach before widely incorporating these into products that are going to be consumed by youth.

What are some of the key questions that people in this field are addressing now?

So, some of the key questions, and there are many of them, but one is really just to understand the mechanisms through which these sweeteners work, both as a group and individually. That will provide really much needed insight to explain these epidemiologic findings and also to understand some of the discrepancies between the randomized control trial literature and the observational data. That's one big area of focus. Another is to understand early life exposure. Both exposure among children as well as intergenerational exposure. What happens when a pregnant mother or breastfeeding mother consumes these every day or multiple times a day? We know that they are transferred to the baby. In the case of breastfeeding, for example, we've done some work in that area. What we don't know is what that actually means for the child in terms of their taste preferences, their appetite, their weight trajectory, and their future health. Understanding that early life exposure and intergenerational transmission, as well as focusing on cardiometabolic outcomes beyond body weight. So, we know that when these are used in a certain way, very judiciously, these may... Low-calorie sweeteners, and I'm generalizing the term here, but may be useful for helping with weight management. But we need to study these in a way that better reflects how they're actually consumed in real life. And then also, as we've already discussed, really start to understand the effects of these different compounds as individual sweeteners in addition to as a group of compounds that have some similar sensory property, that being that they're sweet. I think those are some of the main areas in addition to continuing to translate some of the more mechanistic work that's been done in rodent models into the context of human consumption.

The whole idea behind these artificial sweeteners in the first place is that people enjoy sweet taste in things. And so, why not go ahead and provide that? And it better to have it in some form that's not creating the same health problems that sugar has. But what about just changing that assumption and saying that people should get accustomed to less sweetness in things overall, which would then lower intake of both artificial sweeteners and sugar. And I'm wondering if you think that might be possible? Let's just say that the food industry agreed to or was required to reduce the sweetness in its food by 5% each year for the next 15 years or whatever it would be, so that people wouldn't notice it from year to year, but generally you would get accustomed to lower levels of sweetness in things. Do you think that would be possible for people to become accustomed to?

I would think it would be possible, certainly that we know that repeated exposure to different levels of sweetness will affect sweetness preference and dietary choices. What you're describing is very similar to what's been done with sodium in terms of gradual voluntary reduction of sodium. And I am aware, and as I'm sure you are, of efforts through, for example, the National Salt and Sugar Reduction Initiative (NSSRI), to do exactly that, which is to set targets for lowering the sugar content and therefore lowering the sweetness, assuming that there's not replacement with low-calorie sweeteners of different products across different product categories. I think there is a lot of promise in that concept, but I do think we would need to obviously see how that actually affects various outcomes before knowing whether it was effective or not. But I think that concept of it's not just sugar, but also we need to think about the sweetness and how that pertains to other dietary choices and longer term dietary patterns, is really important.

Bio

Dr. Allison Sylvetsky is an Associate Professor in the Department of Exercise and Nutrition Sciences and is Director of the Bachelor of Science in Nutrition program at the George Washington University Milken Institute School of Public Health. Dr. Sylvetsky joined the GW faculty in 2014, prior to which, she was a post-doctoral fellow in the Diabetes, Endocrinology, and Obesity Branch of NIDDK in the Intramural Research Program of the National Institutes of Health (NIH). She received a doctorate in Nutrition and Health Science from Emory University. Dr. Sylvetsky's research focuses broadly on obesity and diabetes in youth. Her primary research interests are in studying the consumption and health effects of sugar-sweetened beverages and low-calorie (artificial) sweeteners, with a key focus on their consumption during childhood.

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In 2016, the Chilean government implemented a comprehensive set of obesity prevention policies aimed at improving the food environment for children. Results from a multi-year study of that regulation, published in the International Journal of Behavioral Nutrition and Physical Activity, can now tell us if Chilean children are better off as a result of the policy. Guests on this podcast include: Dr. Gabriela "Gabi" Fretes. She is an Associate Research Fellow at the International Food Policy Research Institute. Dr. Camila Corvalan is the Director of the Center for Research in Food Environments and the Prevention of Chronic Diseases Associated with Nutrition at the University of Chile. And, Dr. Sean Cash is an economist, Associate Professor of Agriculture, Food, and the Environment, and the Bergstrom Foundation Professor in Global Nutrition at Tufts University.

Interview Summary

Sean, let's set the stage for this conversation. When crafting food policy, what should policymakers consider with respect to children and adolescents, both as current and future consumers in the food system?

I would argue that children and adolescents should be a priority, if not the priority in how we consider dietary policy for a few reasons. In the United States and elsewhere, we often argue quite heatedly about the proper role of government, with the arguments for health-promoting policies seemingly running into conflict with concerns about paternalistic interventions and restrictions on personal choice. These are important and perhaps unavoidable discussions to have. But when it comes to kids, we've already long had standards for school meals, what packaged snacks can be sold in schools, etc. We don't treat children as legally independent in other ways. So while there's still a lot of room for disagreement, it may be less daunting to actually keep child nutrition in the forefront when we consider how food policies around diet need to evolve. Perhaps more importantly, I would note that food marketers have long seen children as an important three-in-one market. One, kids have influence over food choices within their households. Think of a kid shopping with a parent in a supermarket and pointing at things she'd like mom or dad to buy. We sometimes call this pester power. Two, kids have their own spending money, and much of what they choose to spend it on is food. Often the types of energy-dense, nutrition-poor snack foods that are exactly the foods subject to labeling under the Chilean law we're talking about today. And three, kids grow up to be adult consumers, and their preferences and knowledge are heavily influenced by the things to which they're exposed in childhood. For the same reasons that food marketers are interested in children, policymakers should be. Kids have influence in in their households now. They're buying food on their own now. What they do now will influence their future behaviors and future health.

Thank you, Sean. I have got to say, I went grocery shopping with my child yesterday and I appreciate your thoughts on how we should think about what policymakers should engage, not just in the U.S. but anywhere when we are thinking about helping kids make good choices that will have long-term implications. Thank you for that. I want to turn our attention to the research paper that we're discussing now, titled, "Changes in Children's and Adolescent's Dietary Intake "After the Implementation of Chile's Law "of Food Labeling, Advertising, and Sales in Schools." So, Gabi, my question to you is this. One of the key components of the Chilean law was regulating food offerings in schools. Can you explain the focus of that policy and how it is intended to work?

Yes. Before we speak about schools, we should speak about Chile's law in general. Chile's law of food labeling and advertising includes three main components. The first one being mandatory front-of-package warning labels on packaged foods and beverages. The second being restrictions on all forms of food marketing directed to children younger than 14 years. The third one is school regulations at the preschool, elementary, and high school levels. Briefly, food manufacturers must place front-of-pack warning labels on packaged foods and beverages that are high in added total sugars, saturated fats, sodium, and energy. This law was implemented in stages starting in June, 2016. The law mandates that food and beverages with at least one front-of-pack warning label cannot be sold, promoted, or marketed inside schools. That includes school kiosks, cafeterias, and events that happen inside schools. Additionally, food and beverages with front-of-pack warning labels cannot be offered as part of the school meals program or as free samples or gifts. Chile's set of regulations is unique because it includes a package of interventions covering several aspects of the school food environments, such as the availability of foods for sale inside schools, school meal program standards, and restrictions on food marketing directed to children.

Wow, Gabi, this is a very comprehensive law. So what did the team hope to test in the longitudinal study? Could you explain the main findings?

Yes. So with this study, our team aimed to assess if children and adolescents' intake of total sugars, saturated fats, and sodium consumed at school changed after the initial implementation of the regulation. The team was also interested in exploring how children navigated different food environments. We also evaluated changes in intake at home and different settings from home and school. So, what did we find? Intake of most nutrients of concern, those nutrients under the scope of Chile's law, including total sugars, saturated fats, and sodium significantly declined at school both for kids and adolescents. At home, we also found significant declines in kids' total sugar intake, but no changes for adolescents. What makes this more interesting even is that we found evidence of partial compensatory behavior at restaurants, corner stores, street food, among others. Which means that kids and adolescents were consuming less healthy foods outside their school and home.

Thank you, Gabi. I want to now turn to Camila. I'm really curious about this compensatory behavior. The study found this evidence of students compensating somewhat for the healthy foods at school by eating more sugars, saturated fats, and sodium at other locations outside of school. Why do you think this happened?

Norbert, I believe this is a very interesting finding, and there are probably three main reasons why we observed this result in the study. First of all, we know that children, as they age, start to consume much more food from places outside of home. This is something that has been shown previously. We know that when kids start to age, they start to get more sugar, more saturated fat, more energy from restaurants and fast food outlets. This is something that we would expect in a longitudinal study such as the one that we conducted. Secondly, the Chilean law did not include regulation around the schools - so in the neighborhoods that surround the school. This was originally part of the regulation. But, during the discussion and designing, we had to drop this component of the regulation. Basically what we approved is that there were restrictions in the schools, but outside there was no restriction in terms of marketing or the offer of unhealthy foods to children. Finally, it's likely that the regulation influenced some kids in a positive way. They really changed their behavior. But it's also possible that other kids did not really change their behavior. Once they had the opportunity of going outside of the school, they just kept buying unhealthy foods with high content of sugar, saturated fat, and sodium.

Thank you so much for that. It does reflect the complexity of the decision patterns that children have in terms of how they eat. I think this is true for all of us. If we are trying to improve in one area, there may be some changes in other areas. But I want to pick up on something you said about why you believe the result occurred the way it did. It had to do with dialogue that went on in Chile about the law. So, I want to ask now, how can we best center the needs and voices of communities in the development of similar regulations? It sounds like some of this happened in Chile. Could you share your thoughts about this?

Yes. So, during the process of developing the regulation in Chile, the Ministry of Health held some participatory discussion throughout the country with families, parents, school teachers, and different stakeholders to actually get their ideas and also assess their concerns about the different components of the regulation. We do believe it's very important to include the community's views when we define this kind of policies or programs because what we actually want to modify is people's behaviors. We really want to understand what is the best way of actually achieving that transformation. We really need to get their view for doing that. In Chile, we did not have a very strong civil society organization that could coordinate these views, and that is why the Ministry of Health had to actively engage the community through participatory dialogues that actually delay a little bit the implementation of the law. But, we believe that certainly strengthened their application.

It's really interesting to hear about this deliberative process and to see what ultimately came out of that. I want to turn my attention back to Gabi. In the big picture of policymaking, what can we actually learn from Chile's experience with the food labeling law?

Thank you, Norbert, and I think that we can learn a lot. But, I will highlight three things that we learned from this study. First, I want to say that Chile was the first country in the world that implemented front-of-pack warning labels on packaged foods and beverages high in sugar, sodium, saturated fats, and calories. So, the first thing that I want to highlight is that what's unique about Chile is that it wasn't only a labeling regulation but a comprehensive set of actions that included restrictions on marketing as well as school regulations. Food environments as a whole should be conducive to healthier and sustainable diets, and therefore isolated actions would be limited in scope. However, we need to acknowledge that the policy process in Chile was not without complications because there was significant pushback from the food and beverage industry. This is something that countries in the process of designing or implementing similar regulations should expect to happen. They should be prepared to respond with arguments based on evidence. The second highlight is that our results showed that the set of policy interventions may be promising to improve kids and adolescents' diets at school, but that actions in out-of-school settings should be strengthened to improve overall diets. So for example, I will cite some actions that could complement these regulations, such as the introduction of junk food taxes, the reinforcement of nutrition education in schools and the community, particularly relevant now as we move into the post-COVID-19 era, social marketing campaigns, actions in other settings such as menu labeling in restaurants, improving the availability and acceptability of healthier foods by street vendors, among other actions. And lastly, the third point that I want to highlight is that moving forward, countries should consider equity aspects to overcome structural barriers that limit people's ability to choose healthier foods and combine mutually-reinforcing strategies to stimulate a holistic food systems response where everyone has access to and can afford healthier foods.

Thank you for those comments, and I really do appreciate this idea of even though this was a comprehensive law, that there are some other spaces that the law could touch on or think about because of the results that we saw with this compensatory behavior. Thank you for sharing that. Sean, my last question is for you. I'm wondering if you could share your thoughts on whether Chile might serve as an example to inform the current front-of-package label discussions we're having right now in United States.

Oh, absolutely. Chilean law has already served as a model for consideration in many other countries in the region and around the globe, including in our top food trading partner, Mexico, which enacted a Chilean-style labeling law in 2020. Several multilateral health organizations have also expressed support for the Chilean approach to be used elsewhere. And it's hard to argue against the logic of policymakers in the United States paying close attention to what works well and what doesn't work in other countries in considering any policies around dietary guidance that we choose to pursue here. But for me, one particularly compelling part of the Chilean law that we should pay attention to in the U.S. is how the standards are consistent, and that the same foods that bear the front-of-pack warning labels are those that are restricted in schools and cannot be marketed to children. Looking for opportunities for similar types of harmonization across different areas of dietary guidance and policy within the U.S. moving forward would certainly help with consumer education, and I think would make sense in other ways. And one interesting thing to keep in mind when talking about the use of mandatory warning labels in a U.S. context is that there are some potentially binding limits on what the government can or can't compel food manufacturers to put on a food pack. Think of cigarette labels for a moment. We've long required that cigarette packages have the rather bland, plain text Surgeon General's warning that we're all familiar with seeing. But in the late 2000 aughts, the FDA proposed rolling out a series of graphic warning labels modeled, in part, on similar images used in other countries. And in that case, the effort was scrapped because of a widespread concern that requiring tobacco manufacturers to put a picture of a body in a morgue with a body tag on it, for example, is interpretive language that appeals to an emotional response, and that this would actually be a form of government-compelled speech that runs up against our First Amendment protections in a way that a scientifically-factual, text-only statement would not. While I personally don't know that the Chilean labels would be interpreted in the same way here, I'm quite certain that legal challenges would be raised to clarify this question in the U.S. context. So, it might be a little bit tougher to take some warning label approaches here in the United States than what we've seen enacted elsewhere.

Bios

Gabriela (Gabi) Fretes is an Associate Research Fellow in the Nutrition, Diets, and Health (NDH) Unit of the International Food Policy Research Institute. She received her PhD in Food and Nutrition Policies and Programs at the Friedman School of Nutrition Science and Policy, Tufts University, USA in 2022 and holds a Masters in Food and Nutrition with a concentration on Health Promotion and Prevention of Non-Communicable Diseases from the Institute of Nutrition and Food Technology, University of Chile. Her research interests are at the intersection of child obesity prevention, food policy and consumer behavior, and her doctoral thesis involved evaluation of a national food labeling and advertising policy designed to improve the healthfulness of the food environment and address the obesity epidemic in Chile, particularly among children. She has worked with a broad range of government, international organizations, academia, public and private sector stakeholders and decision-makers in Paraguay, Chile, and the United States of America.

Camila Corvalán is a surgeon, a Master in Public Health, and holds a PhD in Nutrition. She is the Director of the Center for Research in Food Environments and the Prevention of Chronic Diseases Associated with Nutrition (CIAPEC), at the Public Health Unit of the Institute of Nutrition and Food Technology (INTA) of the University of Chile. CIAPEC is dedicated to the population study of the early nutritional determinants of obesity and associated chronic diseases, particularly metabolic diseases and breast cancer. Their work focuses on carrying out longitudinal epidemiological studies (both observational and intervention) in stages considered critical for the appearance of these diseases, such as pregnancy, childhood, and adolescence, considering various determining factors in both the environment food (set of factors that define population feeding patterns) as individual. CIAPEC is a part of the international network INFORMAS for monitoring food environments, and also carries out policy evaluations such as the Chilean Labeling Law; CIAPEC works in coordination with several governmental bodies.

Sean Cash is an economist and associate professor of agriculture, food and environment at Tufts University. He conducts research both internationally and domestically on food, nutrition, agriculture and the environment. He is interested in the environmental impacts in food and beverage production, including projects on crop quality and climate change, consumer interest in production attributes of tea and coffee, and invasive species management. He also focuses on how food, nutrition, and environmental policies affect food consumption and choice, with specific interest in children's nutrition and consumer interest in environmental and nutritional attributes of food. He teaches courses in statistics, agricultural and environmental economics, and consumer behavior around food. He is currently Editor of the Canadian Journal of Agricultural Economics and on the editorial board of Agribusiness, and has served as the Chair of the Food Safety and Nutrition Section of the Agricultural and Applied Economics Association.

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With the widespread presence of artificial sweeteners in the food system, scientists and consumers want to know about their safety. Safety concerns have been expressed for years, and lots of research has been done, but relatively new on the scene is work examining the effect of sweeteners on the microbiome. This interview is part of a series on the impact of artificial sweeteners. Our guest today, Dr. Jotham Suez, is doing fascinating work on this topic. He's Assistant Professor of Molecular Microbiology and Immunology and the Public Health Johns Hopkins University.

Interview Summary

So most everyone knows of the microbiome, but not everybody knows exactly what it is and how it works, so I'm hoping we might start with a quick overview of the microbiome. Could you help us with that?

Sure, so I would say there are three really important things to know about the microbiome. We know that there are trillions of microbes, bacteria, and viruses living in our body. What everyone should know is that most of the systems in our body require these microbes for their proper development and proper function throughout our lifespan, so without these microbes, our immune system, and even our brain, would not develop properly, and if the microbiome is perturbed, this can lead to development of various diseases. That is the first thing. Already this implies that the microbiome is amenable to change, which is actually something that is attractive facet about the microbiome. If we know that the microbiome is involved in the pathogenesis of various diseases, then we can use that to our advantage, and we can think of way to change this microbial community to help protect us against disease, or even treat diseases in which the microbiome plays a role in the pathogenesis. The third thing that we should all think about is that the microbiome is some sort of a fingerprint. Each one of us has a unique microbial community in their body, and we can use that person-to-person difference in the microbiome on one hand, to predict disease risk. This is because some people would harbor the microbes that make them prone to diseases. We can also use that to tailor various drugs or various diets, or various therapeutics, to that community, because we would be able to say, based on your microbiome, how you would respond to a certain therapy or a certain diet. Heterogeneity in the microbiome plays an important role in personalized medicine.

Thanks for helping establish how important the microbiome is, and also, how it can be affected in both positive and negative ways. So in that sense, what got you interested in the impact of artificial sweeteners on the microbiome?

Yes. I think it was the person-to-person heterogeneity, and how that can lead to differential responses to diets or therapeutics. Just like you said, there have been decades of studies on efficacy of artificial sweeteners or potential safety concerns about whether they are helping us lose weight, helping us maintain healthy blood glucose levels, or they are actually doing the opposite. The studies are really all over the place. You would see studies that support a beneficial impact and studies that demonstrate detrimental impact. We were wondering as we started this research, if it's possible that this heterogeneity in outcomes of the studies is related to heterogeneity of the microbiome. Is it possible that some people are negatively impacted and some people are positively impacted, whether this is related to the differences in their microbiome.

That's a fascinating area, and interesting to think that the same substance may have much different effects on people. So how have you gone about studying this yourself, and what have you found?

We started very naively. I started when I was still a PhD student. I went to the supermarket, I purchased sachets of the most common artificial sweeteners that are out there, and we added that to the drinking water of mice. We saw that mice drinking these artificial sweeteners developed glucose intolerance, meaning they had poorer response to a simple sugar, which is how you would predict or diagnose pre-diabetes or diabetes in the clinic, for humans. We were able to show for the first time that sweeteners can actually cause negative impact on the metabolic health of an animal. What was more interesting is that we saw that these sweeteners also changed the microbiome of the mice drinking the sweeteners. What we've done then is take the microbiome of the animals that were drinking sweetener and we transplanted these microbes into mice that don't have any microbiome of their own. Just by giving them the microbes of mice that were drinking sweeteners, these mice also had a poorer metabolic response. We were able to show for the first time that the impact of sweeteners on the microbiome can result in a negative impact on our metabolic health. After a lot of experiments in mice, where we proved beyond any doubt that mice should not drink artificial sweeteners, we were really wondering what would be the impact on humans.

We started a study in healthy individuals, so people that are not overweight and are without diabetes. We asked them to supplement their diet for two weeks with common artificial sweeteners, so sucralose, aspartame, saccharin, or one natural non-caloric sweetener stevia, and we followed up on glucose tolerance and also on their microbiome before, during, and after the exposure to the sweetener. We saw that two sweeteners, saccharine and sucralose, had a detrimental impact on their glucose tolerance. So just during two weeks of exposure to the sweetener, they had poorer responses to glucose. That would already put them on the path to potentially developing pre-diabetes and diabetes. We saw that all four sweeteners altered the microbiome. Again, when we took microbiomes of these people and transplanted them into germ-free mice we saw that the stronger the impact the sweetener had on your microbiome - that means that you would have a poorer metabolic response when you transplant these microbiomes into mice. This was really showing that there are person-to-person differences in the responses to sweeteners, and this depends on how much a microbiome is impacted by the sweetener.

That was amazing summary in a short time of really complex and fascinating science. It's interesting that some sweeteners are having a stronger effect than others, which I guess makes more sense, because they're not all chemically alike. Is it possible to know when you get an effect on something like glucose tolerance from the use of the sweeteners, whether the microbiome is the main mechanism, the only mechanism? How does it fit in there when you start thinking about the impact of sweeteners on something like the glucose tolerance?

That is a really great question, and I think the short answer would be that we don't know for sure. There have been multiple other groups that have been studying the impact of sweeteners on metabolic health or other parameters related to our health that have found fascinating mechanisms that are not related, or at least, not directly related to the microbiome. So for sure, sweeteners can have a broad impact on our body, not just for their impact on the microbiome, but what we are seeing, actually, is that's the impact that they have on the microbiome is sufficient to produce detrimental impact on metabolic health without any other measurable impacts, at least, in our studies.

Many, many people have been using these artificial sweeteners in one form or another for many, many years, and in some cases, they're introduced into the food supply in ways that people may not even be aware of. Is there any way of knowing what happens if animals or humans have used these for a long period of time and they stop? Does whatever the impact on the microbiome reverse itself?

That's a fascinating question. In the short term, that is something that we have measured in our studies, and others have done similar works in animal models. In a study like what we have done, which is two weeks of exposure, then one week of follow-up, you see some reversion of the microbiome to what it was before the exposure to the sweetener. But we should say that these individuals were recruited to the study precisely because they're habitually not drinking artificial sweeteners, so their body saw sweeteners potentially for the first time. So then if they immediately stopped after two weeks, in that scenario, we can say that the microbiome reverts. What happens after years of exposure to sweeteners, that's a study that we're definitely interested in doing, or I would be really happy to see the results if some is already doing such a study, but I am not aware of long-term studies where people just stopped taking sweeteners and then their microbiome was profiled.

My mind is sort of firing with ideas of ways to study that question, but it's heartening to know that at least in the short term, at least some of the whatever damage is done starts to revert. That's very good news for people who have been using these products who choose to stop them for one reason or another, there may be a benefit to the microbiome. Let me ask about children. So many parents, they're concerned about the effect that the sweeteners might have on their children. Is anything known about this?

Yes, I think this is a good point in the conversation to talk about the various types of evidence that we have about the detrimental impact of sweeteners. If we look at associative studies, most of these studies would find some sort of association between drinking artificial sweeteners and a negative impact on weight or on diabetes risk. So the associative studies are, for sure, pointing to a negative impact, but they don't provide evidence that the sweeteners are causing these negative impacts. So they might be a result of, you know, the changes in weight or the risk of diabetes rather than the cause. And then when you go to studies that actually provide causality, so these would be, for example, randomized controlled trials when you give the individual the sweetener then see what happens to their metabolic health, these types of studies are all over the place in terms of benefit versus risk, both in adults and in children. So unfortunately, there is no good answer to that question. There are studies that show a risk, but even studies that show a benefit.

Even if there is risk from the artificial sweetener, some people may feel that the benefit, in terms of weight control, is more important, and they might say, "Well, I'm willing to accept the risk because of the benefit," but we've heard from others that whether these products actually help people control their weight is in question as well. What do you think about that topic?

Yes, so what you would do when you have all of these studies that show even opposing results, and you try to find the truth, you would do a meta-analysis. When you perform meta-analysis on specifically the question of impact on weight, you find a very modest beneficial impact on weight. And even then, the quality of the evidence for that impact are low. Even if there is a benefit, it's very mild, and the evidence for such a benefit are not very strong. I think that's why organizations such as the World Health Organization have recently said that this may not be the best strategy for assisting individuals to lose weight.

You mentioned that the two compounds that had the strongest effect on the microbiome were saccharin and sucralose. Is that correct?

In our study, yes.

So saccharin, I'm not sure how much that's used in the food supply still. It may be there, but it's been around forever. Maybe I'm wrong, but I figure that it's been displaced by lots of newer advances. But sucralose, which I think is marketed under the brand named Splenda, is a much more recent development in the field. It's interesting that that's having a negative effect too. So do you think that there's reason to believe that those two would be substances to avoid?

I would say that you would never want to make public health decisions based on one study. I would say that that goes both ways, I think. I wouldn't advise avoiding saccharine just based on one study, and I wouldn't say that aspartame and stevia are safe just based on one study. I would say that others have found negative impacts for aspartame and for stevia that we have not seen very strongly in our study, whereas others have found both negative and neutral, or even beneficial effects for sucralose in other studies. So I would not make recommendations based on just our own study, but considering everything that is out there, I would say that all four sweeteners that we studied, and others, including Ace K, that we have not studied in a recent human study could pose a risk for some individuals. Unfortunately, right now, we don't have any good tools of predicting who would be those individuals, so it's a question of whether people should take that risk or not.

Thank you for being appropriately cautious with the result, because as you said, the work is relatively recent, but why I'm really happy you're working on this topic. So summing this all up, what do you think is most important for people to know?

I think, at this point in the research, and just recently, another group provided really interesting evidence about a different sugar substitute, erythritol, also posing a risk for cardiovascular disease, at this point in the research of artificial sweeteners and sugar substitutes, I think we cannot say that these substances are innocuous. They can pose a risk for at least some individuals, and we and others are definitely working hard on being able to help people know whether or not they are in those risk groups. But then the question is what can people do? I think what people should definitely not do is switch back to sugar. I think that if the evidence for the impact of artificial sweeteners are still something that requires further research. I think that the detrimental impacts of added caloric sugars in our diet, in our beverages, are beyond doubt linked to detrimental impacts on our metabolic health. So people should not switch back from diet soda to regular soda, that's for sure. But we and the industry alike should find ways of reducing the intake of sweeteners, and both caloric and non-caloric sweeteners in our diet to levels that hopefully don't pose as great a risk as what we are currently consuming.

Bio

Dr. Jotham Suez is a Feinstone Assistant Professor at the Johns Hopkins Bloomberg School of Public Health. Dr. Suez's work on non-nutritive sweeteners was instrumental in understanding how these popular food additives can counterintuitively disrupt glycemic control. During his graduate work at the Weizmann Institute, he demonstrated that sweeteners are not inert and can alter the gut microbiome, and causally linked those impacts to impaired glucose tolerance. He further showed that in humans, the microbiome mediates individualized responses to sweeteners, potentially underlying the conflicting literature on their impacts. Similarly, Dr. Suez's research on probiotics offers an opportunity to resolve the contradictory literature on their efficacy. His work highlighted the microbiome’s importance in modulating probiotics colonization and downstream impacts. Inspired by these discoveries, Dr. Suez is fascinated by the potential of harnessing microbiome heterogeneity in precision medicine and personalized nutrition. In 2020, Dr. Suez received the NIH Director's Early Independence Award.

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Processed food industries are thriving in developing countries, despite government commitment to eradicating non-communicable diseases, prevention programs aim at reducing obesity, type two diabetes, and sugary beverage consumption. What's more, political leaders in some countries are reluctant to regulate the marketing and sale of these products, particularly among vulnerable groups, like children and the poor. Like me, you might be asking yourself: why? Our guest today is the author of a new book, "Junk Food Politics: How Beverage and Fast Food Industries Are Reshaping Emerging Economics." His name is Professor Eduardo Gomez, Director of the Institute of Health Policy and Politics, at Lehigh University.

Interview Summary

Let's begin with a basic question, what prompted you to write the book?

Great question. It really started, I remember almost the day, when I came across this article written by the New York Times in 2016. This article started to talk about the rise in influence of the sugar industry in the US, and how they were shaping evidence about the connection between the consumption of sugar and heart disease. For many years in the past, that connection was never emphasized when it came to national dietary recommendations. This New York Times article really revealed how powerful and influential these industries were in shaping the evidence and policies on the linkages between sugar and heart disease, and our consumption of these products.

At the same time, I was doing research on obesity policy in Brazil, comparing Brazil to the US, and why Brazil was doing better in the areas of nutritional information, prevention, and awareness about childhood obesity. I also saw that obesity cases were still increasing in Brazil despite these prevention efforts. At the time, I was also starting to work in Mexico and saw similar policies in Mexico being implemented on prevention and awareness, and national dietary guidelines. But still, we saw a rise in obesity, a rise in adolescent diabetes. So those two things - the evidence about how industries manipulate data and dietary guidelines - and then how luncheon programs are really not achieving their goal of reducing childhood obesity in adolescent diabetes. Those puzzles really motivated me in writing this book to really delve deeper into this question. That really required not a journal article, but a book that would do an in-depth historical case study analysis of several countries, and to document and do interviews on how these industries are working with government. And, how government also works with industries in this area of trying to address childhood obesity, and type two adolescent diabetes.

So how did you go about collecting data for the book?

I did a qualitative comparative method, which is a bit different, as you know, from most people working in public health and epidemiological studies about childhood obesity and diabetes. That entailed a comparative historical analysis of several similar case studies. I chose cases in the emerging economies that, I think, reflected the biggest problems with obesity and diabetes in their region. But the goal of the comparison, was really to accentuate similarities between cases, and, also, the vast differences and uniqueness of the cases. I then went about doing the research through document analysis of several different sources, books, articles, policy reports, media news, talking about the issue, both in the English language, and also in the countries of Brazil and Mexico, the Spanish and Portuguese language. I did interviews with activists and researchers in several of these countries, although not all of them. I think bringing together all the different qualitative evidence was very effective in trying to thoroughly address this issue. It's a topic that has not been discussed that much. Bringing together the multiple evidence pieces took a long time.

It produced a wonderfully rich book with lots of interesting information from different sources around the world. I, for one, really appreciate what you've done. So in the book, you have very detailed case studies, as you mentioned, of a number of countries, in particular countries such as Mexico and Brazil, India, Indonesia, China and South Africa. Let's talk about a few of these countries, and then, perhaps, we can return to something that you alluded to a moment ago. That there are quite striking similarities across the countries. So what did you learn about Mexico?

I had lived in Mexico for several years doing research there, and the fast food culture and industry, and the consumption of soda, is extremely high. Compared to the US, Mexico's per capita daily consumption of soda is highest, arguably, in the world. Coca-Cola played a major role in that. Coca-Cola was in Mexico for many, many years, and the NAFTA Free Trade Agreement facilitated the arrival of Coca-Cola, and of many other kinds of ultra-processed foods and industries, into Mexico. Mexico is one of the world leaders in childhood obesity and type two diabetes. The government did, for many years, a good job of raising awareness to this issue. The National Institute of Public Health in Cuernavaca, for example, did fantastic work elevating the issue, convincing the government that something needed to be done about this ongoing health problems, especially among children and the poor.

But what I found is while there was legislation being implemented, it was, a lot of times, delayed, and those policies that were created, such as limiting the presence of sodas within schools, were not really effectively enforced. A lot of parents reporting to schools that their children were still consuming soda products. Of course, everyone knows about the soda tax that was implemented in 2014 in Mexico, becoming the first in the world to have a national soda tax. That's been a very effective effort. But there are several years in which this was debated and delayed, and for many years industries resisted improvements to the food label, which was, eventually, recently accomplished. But all of this started to point to the power and influence of major industries and their interest group.

One thing that I learned in this case is that industries also engage in several partnerships with government to try and take away the focus from regulations and improving food labels, for example. And one partnership is working with government to introduce the importance of exercise in schools. And it's something that we'll see, also, in the case of China. And so that has taken attention away, in addition to the lobbying efforts, and funding science and research sort of questions, from the efficacy of a soda tax. But one thing that was very important is that presidents also matter, and their relationships with industry. One president that really stood out was President Vincente Fox, who was a former Coca-Cola executive for the region. And that relationship facilitated industry's influence within government, and in connecting with politicians in influencing policy over years. But then later, subsequent presidents, like President Enrique Pena Nieto, worked with Nestle to address hunger eradication programs in Mexico.

So these partnerships with industry, while they are admirable in trying to eradicate hunger, they also, at the same time, bring legitimacy to these industries. This facilitates their ability to influence policy. Those was some of the key lessons that I found in Mexico.

So moving to a different part of the world, and, of course, to a different political system, what did you learn about China?

China has seen a burgeoning growth in consumption of soda, and also fast food chain establishments. We've also seen a huge increase in childhood obesity, and adolescent type two diabetes. But was really striking about this case, is that the government has done a great job, not only of increasing awareness about the challenge, but emphasizing the importance of exercise as a primary way to try and address the issue and why this particular approach. Instead of regulation limiting sales and access to foods for children and the poor, in trying to emphasize this idea of exercise. Now I found that through the International Life Sciences Institute (ILSI), Coca-Cola, and other industry, had an influence. The ILSI found partners within the Ministry of Health, who created the ISLI of China, and through these partnerships, in these connections between I-S-L-I and major health officials, the idea of emphasizing exercise as a solution started to infiltrate, and really shaped government legislation. I cite the excellent work by Susan Greenhalgh at Harvard, who documented a lot of how this was happening. At the same time, we saw industries partnering with government, and government officials emphasizing sports and exercise as an approach. But surprisingly, there was really no effort to introduce regulations on advertising and marketing. Similar to what we've seen in the US, no effective food regulations or mandates on quality of sugar and products. That really was startling, given the huge problem that China's having with childhood obesity. But again, government partnerships with industry on eradicating poverty and achieving economic growth, certainly doesn't help, and overlooks the need to introduce regulations, and sees industry as a partner in trying to achieve China's broader efforts on poverty reduction and economic development.

We're certainly starting to see some themes emerge in the stories that you're telling. So let's go to the third continent. What did you find in South Africa?

South Africa is a very interesting case, where, again, like these other countries, you've seen a rise in obesity and type two diabetes. It's been very challenging because culturally, being overweight has been seen as a sign of health for some. Being thin, being associated with diseases, such as HIV, AIDS, or tuberculosis. So, one of the major hurdles that governments, and activists, have also been trying to address, is information about the health implications of being overweight. And then also the increasing public's knowledge about type two diabetes. Similar to the other cases, you saw government efforts, beginning in 2015, to address the national obesity issue. But there are very, very few effective policies introduced, such as regulations on advertising and marketing. These have basically been introduced as plans and ideas, with no concrete efforts yet. The government relied on self-regulation, where industries pledge not to market their products to children, and to be more responsible in that. Also, there have been no regulations on sales of these foods in and around schools, and no improvements in labels. Why has that been the case? Again, industry has been very involved through policy partnerships, working with government to emphasize, again, exercise. Companies, like Nestle, have done a very good job in providing nutritional education and training to schools. While admirable, these partnerships have distracted the government from pursuing needed regulations, and trying to address these issues, seeing that these industries are partners, and seeing no real need to introduce these regulations. But again, at the same time, presidents matter. You've had presidents with very strong connections to industries. The current president, for example, having been in consulting profession, direct ties to fast food industry. And they've seen these industries as a critical partner in addressing economic development, but especially job security, and job growth, and seeing them as a need to be there in prospering. But, at the same time, you've also seen a civil society that is starting to emerge, but has been challenged by industry's relationship with other nutrition researchers and activists, and not being able to work and create a broader mobilization effort to address this issue. %he activist community is just now starting to emerge. They don't have as many allies in society that they can work with. As we saw in China, that civic activist movement has been just very slowly emerging. That's been limiting as well.

These comments, so far, are consistent across countries. Focusing on physical activity, for example, diverting attention away from industry influences and regulations that might affect them, weakening regulations, and things like that. What do you see as the main themes that are weaving through this picture?

There are several themes. One is policy partnerships - industries partnering with government, and how this helps industry convince policy makers that regulations are not necessary. Those studying commercial determinants of health and nutrition, we all know this, but this has been especially prominent in the emerging economies. Another, is corporate social responsibility activities. There have been so many cases, wonderful efforts, that major soda and food industries are doing to increase education, nutritional awareness and training, even food regulation, and quality of food For example, with street vendors. But again, these CSR activities are taking away, and distracting from the need for regulations, while, at the same time bringing legitimacy, and social legitimacy, community legitimacy, to their product. Another major theme is that these corporate social responsibility activities, for example, sponsoring or providing support to NGOs, that contributes to dividing society. So, when industries partner with certain activists, or NGOs, that question the importance of particular policies, or libertarian principles, of having the right to eat whatever food that you want, whenever industries partners with these researchers and activists, it takes away from the number of activists, real activists, working on the issue can partner with. There are many cases where I interviewed activists are saying that, they don't have as many allies that they can work with, because of these other people. These nutrition researchers working with industry. So that was a major issue that came across. Another was institutions. Institutions matter very much, specifically, their ability to include civil societal interest in ideas. In the case of Brazil, I talk about Consell, a national council that was within the office of the presidency. And under the previous Lula administration, civil society had access to the office of the presidency in providing nutritional information, and recommendations for policy. Under the Bolsonaro administration, the Consell Institution was no longer present. But now it has reemerged again. That was the one case where institutions really mattered in guaranteeing access to activists. In all the other countries, these kinds of institutions were not present. A final theme is that presidential politics and policy matters considerably. We often point the finger to industries, you know, blaming them for everything, but this book really shows that we also need to blame presidents for not being more careful in the kinds of partnerships they engage in with industries. Even though their intentions may be admirable in trying to eradicate hunger, eradicate poverty, achieve economic job growth, by partnering with soda and food industries, they're also providing legitimacy to them, and providing excuses, not really to pursue regulations that may harm their prosperity. Those were the main themes that came out in the book.

So a number of things have been tried around the world to counter industries influence. What do you think are some of the most promising?

The most promising are effective regulations on advertising and sales of products. And there are very, very, very few great examples, but one, Chile, has seen amazing progress in introducing restrictions on the advertising of foods, by law, eliminating the usage of cartoons on cereal boxes, something that, of course, we haven't achieved yet in the US. That's been very effective in addressing this issue. I think that these sales and advertising regulations are just the most difficult to achieve, but can really get to the root of the problem, which is decreasing children's awareness, and interest, in food products. Another is incorporating civil society within institutions. The more the governments can provide a venue for activists to have presence within the Ministry of Health, and to actually introduce policy ideas, that can be very effective. I think that that's been, with the exception of Brazil for several years, absent in all of the countries that I looked at in my book. I think that's something that needs to really be taken more seriously. And then another, is investing in civil society, providing more funding for nutrition researchers, activists, and NGOs, that are trying to raise this issue about childhood obesity, but also the commercial determinants of health. That is still much needed area. The Bloomberg Foundation has done great work in Mexico, but we need a lot more in other emerging economies, and lot more support for these activists. These are efforts that can really help to address this issue.

I'm happy you mentioned the Bloomberg Foundation, because, thanks to them, a number of these things have been evaluated, which really helps other countries be informed about what might be effective, and on what might not be. Are there things that are not being done that you would think might be considered?

I do think that it's time that presidents around the world, and other health officials leaders, question their partnerships with industry. Question if it's really effective. I believe that there should be more of an effort to not have industry involved in nutrition policies, non-communicable disease policies, and, especially, policies that focus on childhood obesity. I think the case of China really showed that that can be a major problem. I think that one, political leaders need to take more leadership in reevaluating the effectiveness of these partnerships, and if they're appropriate. Another is that laws on regulations of conflict of interest need to be well established. Really, in none of the cases that I looked at are there federal laws and regulations on if industries can contribute money to nutrition conferences, sponsoring of nutrition conferences. In Brazil, they are now starting to address this, but in other countries, this has not really been addressed yet. This is unacceptable when there are industries that have conflict of interest, and are supporting nutrition scientists and researchers. One of the things that really needs to be done is increasing government, or foundation, support for nutrition scientists in these emerging economies, so they are not interested in working with industry. Finally, there just needs to be a lot more of a government commitment to civic inclusion in these kinds of policies. We all know the civil society matters. Of course, government officials will always say, of course, you know, we're listening to civil society. But the evidence on to what extent activists have access to national institutions and policy, is very, very scarce. I'm just not convinced that governments are doing enough to include activists into their national policy discussions in these emerging economies. With the exception, I think, of Mexico, now, hopefully, with Brazil, the other emerging economies that I talk about in the book really have not achieved, and I think that needs to be addressed. These are the issues that really need to be addressed going forward.

Bio

Dr. Eduardo J. Gómez is an Associate Professor and Director of the Institute for Health Policy and Politics at Lehigh University. A political scientist by training, his research focuses on the politics of global health policy, with a focus on emerging middle-income countries. He is the author of three books, the latest being Geopolitics in Health: Confronting Obesity, AIDS, and Tuberculosis in the Emerging BRICS Economies (Johns Hopkins University Press, 2018). Dr. Gómez has published his research in a myriad of peer-reviewed journals, as well as policy journals and major news outlets. His new book, Junk Food Politics (Johns Hopkins University Press, 2023), critically examines the rise and political influence of soda and ultra-processed food industries in developing nations, with a focus on NCDs among children and the poor. He is also leading several other major research projects focusing on the politics of NCDs, such as type-2 diabetes and obesity, in Mexico, Brazil, and Indonesia. Dr. Gómez is also a Commissioner for the Rockefeller Foundation and Boston University Commission on the Social Determinants of Health. His research has received external funding support from the Rockefeller Foundation, Oxfam, George Soros, and Tinker Foundations.

Prior to his arrival at Lehigh, Dr. Gómez was an Associate Professor (UK Senior Lecturer) at King’s College London, Assistant Professor at Rutgers University, and pre-doctoral visiting scientist at the Harvard School of Public Health. He has also previously worked for the RAND Corporation, the World Bank, and the Inter-American Dialogue. Dr. Gómez is also a veteran of the United States Air Force and is a former Term Member of the Council on Foreign Relations. He received his PhD political science from Brown University, MA in International Relations from the University of Chicago, and BA in Foreign Affairs from the University of Virginia.

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The average American family of four loses roughly $1,500 annually, not eating the foods they purchased. This uneaten food, at best, ends up in a compost heap or goes to household pets, or worst, this wasted food ends up in the trash, a total loss. Of course, no one wants to waste food, but there is often a disconnect between what people know they should do, as opposed to what they would do. This podcast is part of a series on food waste. My colleagues, Agricultural Economist, Brenna Ellison of Purdue University, and Penn State's Applied Economist, Linlin Fan, and I, asked people to tell us what food waste prevention measures they would support. And we asked which strategies they thought would work. The study was published recently in the "Journal of Cleaner Production."

Interview Summary

Norbert - Brenna, I'll start with you. What are some common reasons that households waste food?

Brenna - Thanks for the question, Norbert. As we all know, because we've been working on this topic for quite some time together, there are lots of reasons why a household might waste food. Some of the big ones that we know contribute to household waste, are misunderstanding date labels. So Norbert, I know you've done some research separate on this, but if you're a consumer in the grocery store you might see "used by," "sell by," "best by," "best if used by." Lots of different terminology, none of it particularly well regulated. Only baby formula has regulations on how date labels are used. So there is definitely misunderstanding on how to apply those date labels and if they are signaling something as unsafe to eat. We also know that households struggle with planning and food inventory management. So often, I am even guilty of this. I'm a very optimistic planner when it comes to cooking for the week. But the reality is, when it's Wednesday and I'm tired and just want takeout, then you over optimistically planned your food. We also know that US households in particular, are sometimes guilty of over purchasing because they have a good host mentality. You always want more to less. You definitely don't want the issue of running out. And then similar to misunderstanding date labels, there's often concerns over food safety. And so, you know, when we think about people and their personal cost-benefit calculations, if there's a concern that something might make you sick, you might prefer to throw that out rather than incur the cost of missing work or childcare or things like that. So those are just some of the reasons. Certainly there are plenty more but I think that's probably a good starting point.

Norbert - Brenna, I really do appreciate this. I am the food safety person in my household. That is really my title. And there are just times when I have thrown things out because I just didn't know. I wasn't going to risk it. So I appreciate those comments and it seems like this is a challenge that all of us are facing. There are probably some ways that we can actually help manage this. So Linlin, I want to turn it to you now. In your view, how can we begin to reduce some of this food waste at the household level?

Linlin - There are some research showing there are ways to effectively reduce the food waste. For example, like Brenna just mentioned, we can streamline the date labeling terminology, and the industry have begun to take steps to address that. For example, the Consumers Brand Association, representing the major food manufacturers in the US, and Food Marketing Institute, representing food retailers, have begun to encourage their industry members to adopt "best if used by" for food quality, and "used by" for food safety. Another effective way to reduce food waste is larger-scale consumer education campaigns to inform consumers on issue of food waste, and also how to reduce their own food waste. Improve household planning behaviors around shopping, meal preparation, using a shopping list before you go, eat before you shop, these are all effective ways to help reduce food waste and better prepare for shopping. There are more opportunities offered for diversions, for example, composting. Those are several ways that could help with household food waste.

Norbert - Linlin, thank you so much for that. What I hear from you is this idea that there can be things at the macro level or at the governmental level, where we could change some things about how we regulate date labels. You said that industry is already doing some of this work, but there have been a couple of instances where Congress has introduced bills to actually regulate those labels for all products, not just for infant formula. There are things that we as individuals can do. So I'm really appreciative of you sharing the wide variety of ways that we can see a reduction in food waste, looking at the household, all the way up to actual federal law. Linlin, I want to continue on with you and ask you to share with our listeners more about our recent study on what food waste reduction efforts US consumers support? Could you tell us a little bit more about that?

Linlin - Sure. Our study assessed the public support for nine food waste solutions, including changes in food packaging, portion size, standardizing the data labeling system, selling imperfect produce in retail stores, making donations easier, using uneaten food to feed animals, implementing composting in communities, consumer education campaigns on food waste, and tax food waste. So we sent an online survey to a nationally representative sample of US respondents, and asked them about their support for, and perception of effectiveness, of each food waste solution I just mentioned. We found that making donations easier and the standardization of data labels, were the most supported food waste solutions.

Norbert - I must admit, I was really intrigued when we looked at the numbers. Very few people wanted to see taxes on food so I'm not surprised by that. It was interesting to see the things that they would be willing to accept as possible policy. Brenna, I'm intrigued because there was another part of this study. Will you tell us a little bit more about how support for a particular strategy relates to the belief that that strategy will work?

Brenna - So in general, we found pretty high levels of support for most food waste reduction options. To the tune that large majorities, with the exception of taxes, said that they might or definitely would support those policies. However, there is a bit of a gap when they say these same policies will be effective. If we look at just the most supporting and the people who believe the policies will be most effective, we're talking in the range of like, 15 percent-ish difference. People are generally more willing to support a policy than they believe it will be effective. There is a bit of a gap. This isn't too surprising if we look at practical examples we've already seen. Particularly as it relates to animal welfare, we see a lot of policies being passed where people want better animal welfare regulations, for, let's say, chickens related to living space. But then, when it comes to practice and we have to buy more expensive eggs, people are less willing to do that. That is something that we saw when California passed their Animal Welfare regulations. At least from an academic perspective, we call this the vote-buy gap or the claim-action gap. In general, we want to support things like reducing food waste because we all know it's undesirable. But in terms of our willingness to change behavior, that's a little bit harder to shift.

Norbert - Thank you for that. I think it's really important for us to appreciate this. I realize that we get really excited and we can be very passionate about certain causes. But when we actually have to do it, when we have to live that out, it's sometimes hard. I know that's true for all of us and so I'm grateful to hear that. I think it's something that, as policymakers begin thinking about these issues, need to take that into consideration. I'm hopeful for what we can do further. That's my question for both of you. As you watch the evolution of research on food waste, especially at the household level, take place, you know, what are some important questions that remain? What do we need to do more research on? Linlin, why don't you start?

Linlin - Yes, sure. There are a lot of questions to be answered. This is still a active area of research. So first, how can we better measure food waste at the household level on a large scale? There are several models, but still people are trying to figure out a better, more accurate, and easier way to track the food waste at the household level on a large scale. Second, I've mentioned several ways to reduce the food waste, but what's the most effective way to reduce food waste at the household level, and how does it vary with household circumstances and attributes? Those are all interesting questions for future research.

Norbert - Great. Brenna, what about you?

Brenna - Well, I definitely agree with the things that Linlin said, and I would just add the personal space that I'm increasingly interested in, is the intersection between food waste and nutrition. So we know that the US generally has a food waste problem, and we also have an obesity problem that are both linked to maybe having surplus or excess food. Yet when we think about them from a policy perspective, we don't generally talk about them together. I think we need to spend a little bit more time thinking about the nutritional consequences associated with food waste, and how do we get people to kind of behave in a way that's optimal to both nutrition outcomes as well as waste outcomes.

Norbert - I do believe that both of these topics are really ones that are important to us. I appreciate the challenge of trying to evaluate what actual food waste happens and trying to understand the interventions that are most effective, and particularly ones that don't cost as much but also leads to the greatest outcome. And then Brenna, the work that you're talking about, linking food waste and concerns around nutrition and wellbeing, are also really critical. So thank you both for all of those responses, and really, thank you for participating in this podcast.

Bios

Brenna Ellison is an Associate Professor and Undergraduate Program Coordinator in the Department of Agricultural Economics at Purdue University. Dr. Ellison's research focuses on how people make food choices, particularly how information and other environmental factors impact those choices.

Linlin Fan is an applied economist at Pennsylvania State University with interests in food policy and nutrition. The overall objective of her research is to understand how various food policies affect people's food choice, health and welfare. The findings of her research provide important insights into current policy debate on food prices, food security and food waste.

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Today we're looking at food waste and loss on an international scale. Did you know that over 1/3 of the world's food is lost or wasted? In low- and middle-income countries, over 40% of food loss occurs before a crop even makes it to the market. This food loss undermines efforts to end hunger and malnutrition. Wasted food contributes 8 to 10% of global greenhouse gas emissions. Addressing this challenge is critical to global food security, nutrition, and climate change mitigation.

Interview Summary

Norbert: Ahmed, let's begin with a question for you. Can you tell our listeners why USAID has decided to prioritize addressing food loss and waste?

Ahmed: Thank you, Norbert. Food loss and waste is increasingly a part of our global agenda, whether we are talking about food security and nutrition, economic growth, or climate change. As you mentioned, 30 to 40% of food produced is either lost or wasted throughout the farm to consumer supply chain. Many of USAID partner countries lose up to 35% of their food annually at multiple points. In the field due to spoilage and damage, while being transported or stored, and when it goes unused by consumers. Nutrient-dense foods, such as fruits, vegetables, dairy, and meat are highly perishable and often lost due to bruising or spoilage, thus decreasing nutrient-rich foods in the market. These losses equate to one out of every four calories intended for human consumption, enough to feed 2 billion people. According to the World Resource Institute, just a 25% reduction in food loss and waste across the world would decrease the food calorie gap by 12%.

On the climate mitigation side, emission from food loss and waste create nearly 8 to 10% of all greenhouse gas emission. If food loss and waste was a country, it would be the third largest emitter. The global food crisis requires us to think about accelerated pace of change, and in many ways food loss and waste is a low-hanging fruit. The investment in time and energy to grow it are already made. Now we are maximizing its benefit. There really is a huge opportunity. Food loss and waste is a triple win. It will improve nutrition and food security. It will improve income for small order farmers, but also for others all along the supply chain, so it can be a force multiplier for job creation. It is a great entry point for our agenda for improving opportunity for women and youth, so it has an equity component, and it is important for addressing climate crisis.

Brenna: Nika, turning to you. I understand that part of your role at USAID is to produce a podcast called "Kitchen Sink Food Loss and Waste." What was the rationale and objective of creating the podcast, and what are your plans for the future?

Nika: The monthly USAID "Kitchen Sink Food Loss and Waste" podcast was an idea born from the USAID community of practice to increase awareness and promote knowledge sharing among USAID staff, implementing partners, and development professionals. The podcast began with a 101 episode, explaining what food loss and waste is, why we should care, and how we can reduce it. We have episodes featuring experts speaking on technical topics ranging from the role of the private sector and youth in reducing food loss and waste, to solutions that include post-harvest handling innovations and cold chain. In a special December 2022 episode with USAID's Dina Esposito, Bureau for Resilience and Food Security, together with Senior Climate Advisor Ann Vaughan, the episode explores USAID's prioritization of food loss and waste, and the triple win opportunities inherent in food loss and waste programming, that engages women and youth while emphasizing nutrition.

We are now available wherever you listen to podcasts. Each episode has an audio-only format, as well as a video recording that can be found on YouTube. We hope to reach a wider audience, including organizations, private sector members, and individuals interested in reducing their own food loss and waste. We have some exciting upcoming episodes with different formats, including a food loss and waste storytelling episode with a dramatic reenactment similar to "This American Life," and case studies for missions.

Ultimately, it is our goal to increase the frequency of episodes to two per month, and to continue to feature high-level speakers and technical experts, including our inter-agency colleagues. The podcast has proven to be a great way to connect internally and externally, and has sparked excitement and interesting conversations. I love receiving emails from individuals I haven't previously interacted with because of their interest in the podcast. And we're always open to suggestions for topics and speakers, so I encourage anyone listening to reach out. The podcast is a new medium for us, and one that has not only been successful in raising awareness, but has also been quite fun to work on.

Brenna: Norbert and I have been doing this for a little bit, and it is really fun to talk to other people about food loss and waste, and thanks so much for sharing what you all are doing. It seems really fun to listen to a dramatic reading about food waste, so I'll have to watch for that in the future. Ahmed, turning to you now. Could you talk about what USAID is doing internationally to address food loss and waste and incorporate climate and methane mitigation?

Ahmed: Thank you for this question and I'm glad you asked it. At the UN Food System Summit last year USAID announced its commitment to address food loss and waste, including investing $60 million over five years in new research contributing to critical evidence-driven solutions to reduce food loss and waste. This includes support for Feed the Future, the US Government Global Hunger and Food Security Initiative led by USAID. The Feed the Future Innovation Lab for Post-Harvest Loss Reduction is working in with collaboration in Ghana to locally produce technologies that will thoroughly dry and safely store grains for future use. Technologies like this are critical as more than 750,000 metric tons of maize are lost each year to rot and disease across the country contribute to over half million metric tons of greenhouse gases. The Women Poultry Association has adopted these technologies to help them overcome those harvest challenges. With the proper drying and the storage of maize enabled by these technologies, farmers and association member, Josephine Evans, has been able to increase her flock of birds from 1000 to 50,000 over five years. Successes like these have helped farmers endure a historic climate change related maize shortage and continue providing animal source food to maintain food and nutrition security.

Additionally, the Feed the Future Innovation Lab for Food Processing and Post-Harvest Handling has been doing some exciting work with youth in Kenya, linking youth groups with agro-dealers to incentivize youth to sell food loss and waste reducing imports such as hermetic bags and moisture meters to smallholder farmers who were underserved by existing input supply chains. The Innovation Lab and their Kenya partners worked with over 300 youth and did a randomized control study to look at what was most successful. Youth were given a small amount of imports, for example, bags to sell to farmers. Youth with existing assets like motorcycles or small businesses made net profit of $75 a month, while youth with less assets only made $10 more a month and were less successful in sale. Figuring out how to make sure we can help uplift youth at all income levels will be important. These examples highlight how food loss and waste initiatives can be beneficial for growing the income of women and youth along with improving nutrition.

Additionally, we also invested supplemental funds provided by the US Congress in response to the global food security crisis. Part of these supplemental funds were used to fund food loss and waste partnership facility. It's currently open for application by small and medium enterprises in Bangladesh, Kenya, Nepal, Nigeria, Niger and Tanzania. These countries have been hard hit by Russian invasion of Ukraine and have high-level food loss and waste. So this targeted and timely investment can make real difference. Through the market system partnership, food loss and waste partnership facility, businesses can apply for matching grants that will increase the uptake and scaling of technologies and management practices that reduce food loss and waste with any emphasis in nutrition.

As USAID continues to invest in food loss and waste effort, we'll continue to link our work to other sectors. Food loss and waste is not just a climate adaptation initiative but also an important knock in effect for a climate mitigation, especially as reducing food loss and waste reduces methane emission. I think this is one of the most exciting co-benefit that also gets the broader community and world excited about reducing food loss and waste. Methane is emitted when food brought in the field and transport at market which happens there is not proper storage and of course when food is wasted and thrown out by consumers or wholesalers. According to the IPCC, methane accounts for 30 to 50% global warming. The United Nation Environmental Unit estimates that food loss and waste is associated with methane emission near 50 metric ton per year. Additional measures like a shift to renewable energy and reduction of food loss and waste can reduce methane emission by 15% by 2030. So if we can cut methane emission, as called for by the Global Methane Pledge, by at least 30% from 2020 levels by 2030 which could eliminate over 0.2 degrees warming by 2050 and really buy us more time to deal with other gases that are contributing to climate crisis and making the world a more dangerous place.

Brenna: Thanks so much for sharing those opportunities with us, Ahmed and all the progress that's already being made in this space.

Norbert: Nika, let's turn back to you. What is USAID doing to keep food loss and waste as a development agenda priority?

Nika: Thanks, Norbert. Happy to share how USAID is ensuring that food loss and waste remains a priority. We recently launched a food loss and waste community of practice, which brings together our Feed the Future Innovation Lab research partners, private sector businesses, the World Bank and Foundations, along with USAID staff in DC and in our missions to exchange ideas, identify priority focus areas and advance new partnerships. We also have six food loss and waste, "upstander missions." So named because they will no longer be bystanders to food loss and waste, but are ready to take action to advance this agenda within their food security portfolios.

At last year's COP27 climate conference there was not only an agriculture theme day, there were also six pavilions on food and an important emphasis on food systems featuring several food loss and waste panels. COP28 will include even more focus on food systems, which will create exciting momentum for food loss and waste. We would love to see food loss and waste as a standalone session or initiative at COP 28.

The US government has joined The Food is Never Waste Coalition, working with Champions 12.3 to halve food waste by 2030 and to reduce food losses by at least 25% with a goal of creating more sustainable and resilient food systems. USAID engages with our inter-agency colleagues including USDA, EPA, and FDA to promote strategic engagement on food loss and waste issues. We have several exciting international food loss and waste workshops in the planning phase for this year.

Of course, we are trying to amplify our messages and promote knowledge management, including through the USAID Kitchen Sink Podcast and by hosting food loss and waste theme months on the Agrilinks website to share learnings and success stories. Country specific data can really help move the needle forward. We're excited to be working with IFPRI, who has done a deep dive on the economic impacts of reducing food loss and waste. While there are some caveats to the research, cutting food loss and waste in half in Nigeria, for example, could increase GDP by one to 2%, while decreasing poverty and hunger by 4.4%. That's huge and that will get the attention of finance ministers and other policymakers who are essential to making changes.

Norbert: Wow! Thank you for that response and I'm so impressed by the systemic view that you all are taking both in terms of looking across the food supply chain and how your agency works with other agencies across the federal government and also other international organizations. That's really wonderful work. I would like to learn a little more about the link between food loss and waste and the food safety agenda.

Nika: I'm glad you brought up the food systems approach because that is definitely an emphasis at the agency and food safety is of course, part of that. I joined the agency as an AAAS Science & Technology Policy Fellow in the food safety division. So, the linkages between food loss and waste and food safety are near and dear to me and as we say in the food safety division safe food is saved food. In a world where as many as 830 million go to bed hungry every night and 420,000 die from unsafe food every year, we cannot afford to lose food due to poor post-harvest management and contamination. Moreover, nutrient dense foods, such as fruits, vegetables, dairy and meat are often highly perishable and lost due to bruising or spoilage, thus decreasing the availability of nutrient-rich foods on the market. Just a 25% reduction in food loss and waste across the world would decrease the food calorie gap by 12%. Improving cold chain logistics, storage facilities and food processing technologies can improve food safety and reduce food loss, improving agricultural led economic growth. Technologies to reduce food waste can also help improve food safety and shelf life. For example, practices or technologies that improve post-harvest handling and processing, transportation and cold chain can improve food safety and reduce food loss and waste due to spoilage. Food that is lost or unsafe cannot be sold. Leading to losses in revenue and impacts on food security and nutrition due to decreases in the amount of food available. Improving food safety systems improves food loss and waste efforts directly and indirectly while increasing access to nutritious food.

Bios

Nika Larian is a Food Loss and Waste Advisor in the Center for Nutrition within the US Agency for International Development (USAID) Bureau of Resilience and Food Security. Dr. Larian is passionate about the intersection of nutrition, food safety, and climate sustainability. Nika is the producer of the USAID Kitchen Sink Food Loss and Waste Podcast and Co-Chair of the Global Nutrition Coordination Plan (GNCP) Food Safety Technical Working Group. Previously, she was an American Association for the Advancement of Science (AAAS) Science and Technology Policy Fellow at USAID, working as a Food Systems Advisor. Nika received her Ph.D. in Nutritional Sciences at the University of Kentucky in 2019. Her doctoral research explored the effects of environment pollutants on human health, namely diabetes and obesity. Working at USAID, she has provided technical assistance and policy guidance on US Government nutrition strategies and engaged with colleagues across the interagency.

Ahmed Kablan is a Senior Science Advisor, Center for Nutrition/Food Safety Division/Bureau for Resilience and Food Security/USAID. Dr. Kablan manages several research programs in the area of Nutritious and Safe Foods that includes the Food Safety Innovation Lab, Post-harvest Loss Reduction Innovation lab. Dr. Kablan leads the Nutrition Center’s efforts on Food loss and waste, food safety and nutrition research; member of the Interagency Risk Assessment Committee (IRAC), member of the Interagency Committee on Human Nutrition Research (ICHNR), member of the external advisory boards for the Partnership for Aflatoxin in Africa (PACA), the Food Systems for Nutrition Innovation lab, The Golden Rice & the Food Safety Innovation Lab. Dr. Kablan is a co-lead of the USAID Food Loss and Waste (FLW) community of practices, representing USAID on the UNFSS Food is never a waste Coalition and member of the interagency food loss and waste working group. Dr. Kablan leads the center for nutrition efforts on climate change and food systems and is a member of the USAID climate change technical working group and the USG Climate Change, Food Systems, Nutrition Security, and the Interagency Climate Change and Human Health Group (CCHHG) under the U.S. Global Change Research Program. Dr. Kablan has wide technical expertise in nutrition, food Safety, nutrition-related non-communicable diseases, double burden of malnutrition, metabolic syndrome, food safety & public health.

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There has been increasing attention to the issue of food insecurity among college students. Estimates vary, but to provide some perspective, one report found that a staggering 30% of all college students experienced food insecurity at some point in their college careers. In response to the COVID-19 pandemic, the US temporarily extended the Supplemental Nutrition Assistance Program benefits to college-aged students. But now this pandemic help is set to expire, impacting more than three million college students who have relied on this program for food. Today we speak with Heather Taylor, a former US delegate to the United Nations, and now managing director of Bread for the World. Having experienced severe food insecurity as an undergraduate student at Georgetown University, she now advocates for SNAP expansion for college students and other marginalized groups facing food insecurity.

Interview Summary

This is a really interesting topic and an important one because so many people are affected. I know recently there have been more surveys, more awareness to the issue and so finally people are beginning to pay attention. I know judging from the response at our own university, that universities are paying attention to this too. But let's talk about the bigger picture of this: how the benefits at the national level are important. Tell me a little bit more about your work with Bread for the World.

Bread for the World is a faith-based organization that works alongside community groups and congregations across the country to urge primarily members of Congress to pass legislation that addresses hunger and poverty, both here in the United States and abroad as well. We spend a lot of our time equipping community groups so that they are empowered to speak with their members of Congress and talk about issues that are impacting them on the ground.

I mentioned in my introduction that you experienced food insecurity yourself as a college student. How has that impacted your work today?

It really underscores the conviction and the passion that I have around food insecurity, including the way in which it impacts college students. It's such a critical time in one's life, if one is blessed to have the opportunity to attend college, to shape their future, their career path. It's essential that students are nourished and that they have the time necessary to invest in their studies, in some cases extracurricular activities, to perform well and to be able to compete in the market, to contribute to society as a whole. I have experienced firsthand how difficult it can be, what a struggle it is to worry about working on top of investing some 60 to 80 hours a week in one's studies and classes alone, to worry about where one's next meal is coming from. It's really put me in a position to hopefully speak effectively firsthand about what one's experience may be. But also, about what some of the practical solutions are to address food insecurity that individuals, and in this case college students themselves may be experiencing today.

That this problem occurs among college students might come as a surprise to some people because they think kids go to college, they pay for tuition and they pay for room and board and they get fed meals in their dorms and things like that. How does food insecurity come about?

So a lot of times the financial aid, be it student loans or other grants, goes toward college tuition, but not necessarily meal programs. Students are given options to choose meal programs. Some may be three to five meals per week. That was typically the program that I selected, not necessarily 14 to 21 square meals which is what is necessary to ensure that students are not food insecure. That is because these individuals simply may not be able to afford these meal programs. Secondly, while they may not be able to afford them, they could under certain laws be eligible to receive SNAP benefits, but oftentimes students aren't even aware that they may be eligible. While they may have access to certain programs, like federal work study programs that are advertised when students are filling out FAFSA forms, for example, information around the SNAP program may not be as readily available. Because again, any support that they may receive through loans or grants is typically going toward tuition, perhaps books and other necessities, then food security is still an issue that is at stake.

Very helpful background. I know in addition to that, there are large numbers of individuals who don't live on campus, like those who are attending community colleges or graduate and professional students who may not be living in dormitories and don't have meal plans and things like that. It's easy to see how so many people might be affected by this. Let's talk about the SNAP changes at the onset of the pandemic. What can you tell us about that?

Sure. As a result of the expansions that were made available at the onset of the pandemic, students eligible for SNAP benefits could receive up to an additional $95 a month. This is a decent amount that can help put a dent in someone's monthly food bill on a regular basis. The second important change that was made as a result of the expansion is that students who were eligible for SNAP, because they were eligible for the federal work study program did not necessarily have to participate in the work study program in order to get the SNAP benefit. Again, this is important because before the pandemic, students who participated in work study if they were attending school more than halftime they had to work at least 20 hours a week. We know through various studies that typically students are investing three hours in study time for every credit hour that they are signed up for in a given semester. Many students are enrolled for 12 credit hours. That means that they are studying approximately 36 hours on top of their 12 hours of classes. And so we see how they're already investing a significant amount of time and then required to work an additional 20 hours. And so when we're looking at students who are spending some 50, 60 hours and in my case personally, because I had to register for 15 credit hours, up to 80 hours a week. It creates a highly stressed environment for students to work in. At the same time, they're expected to compete, they're expected to make good grades, they're expected to be on par with their peers who may have other support systems in place. The pandemic benefit expansion allowed students to participate regardless of whether they tacked on an additional 20 hours to their already 40 to 60 hour work week was an essential benefit. This is one that we at Bread would like to see continue.

You mentioned some of the hurdles for college students who could potentially utilize SNAP benefits, the work study requirement is one. Are there others the college students have to face?

The work study is one of the essential requirements that they have to face. There are some exceptions. For example, if a student has a differing ability or another term might be a disability. There are some exceptions, but they're so specialized that we want to make sure that students who may be on their own, may be low income themselves, not receiving any support from their families are able to still access the benefit without having to partake in this requirement.

• What's known at the moment about food insecurity among college students?

There are studies that were actually taken right before the pandemic. One in particular done by Temple University showed that nearly 167,000 surveyed, 40% of these individuals experienced food insecurity. And we also know that of these fewer than one in five were accessing SNAP. Again, it speaks to the lack of awareness and how severely underutilized the program is.

You've painted a really striking picture of the number of people affected and how seriously it can affect their lives. You mentioned several really important things. One is just the stress of not knowing whether you'll have enough food or having to have so many requirements imposed on you, work requirements, study requirements, getting food requirements can really add an awful lot of extra pressure to what's a pretty pressured time of life anyway for people. And then adding to that, what you mentioned at the outset that an under-nourished person can't learn and function as well as somebody who's well-nourished is really is very serious issue. What do you think might be done?

The hope is that some of the expansion that was put in place, specifically in correlation to the pandemic, that this would continue, that students would still have the opportunity, those who are eligible, to receive up to $95 a month. When we think about inflation and when we think about how high food prices are, we know how necessary this is. While the benefit may suddenly expire in a couple of months, inflation will not necessarily disappear. Food insecurity that was already high before the pandemic will still continue to persist. We know that some 40% of individuals who attend college come from low income families. So the need is still there. What we would like to see is that the availability of this amount of up to $95 a month would continue. We would also like to see the hourly work requirement be dropped. Those who are eligible for federal work study should not be mandated to work an additional 20 hours a week when they're already investing 40 to 60 hours a week in a given week in their studies. And so we want to ensure that they can invest their time, their energy in their studies, in their schoolwork, what they are there to do, and that they have the energy, that they have access nutrition to be able to perform well.

Those things sure make sense. Let me ask you one final question. You mentioned that only a fraction of the students who are eligible for SNAP are actually enrolled in the program. Are there efforts underway that you're aware of to just get that number higher so that students are made aware they're eligible and they have some coaching or assistance on how to sign up?

To my knowledge, there are no efforts and there's no requirement in the law to make students aware. So this is one of the changes that we are advocating for, that schools would be required by the law to ensure that all students are made aware of the program, what the eligibility requirements or criteria may be so they can access it because it is available to them.

That sounds like something where the colleges themselves could be a big help. They provide lots of guidance to students on all kinds of things. And boy, this could be one thing where colleges could really take the lead in letting the students know about these benefits and providing some help to get people signed up. I'm not aware of any places doing that, although they might very well exist. But if they are out there, it would be good to create a model that could be replicated in other places.

Exactly. As I understand, there are a number of student groups now that may help to make students aware of food donation programs, of food banks. I was informed recently that some schools allow students to donate some of their meals that they already purchased through the school program to their peers. While these programs are helpful it means that students, their food security is contingent on the generosity of their peers, that their access to nutrition is contingent on food that is made available through the food bank system. We know in recent years because of the pandemic, also because of inflation that it has been difficult for food banks to keep stocked up and to also have the number of volunteers that are necessary to distribute. Again, we support these programs, they are important, but alone they do not have the ability to really put dent in hunger like a federally supported program does. We know that the SNAP program is the most effective anti-hunger program in America. It is our moral responsibility to ensure that our young people as they are eligible, have access to this program as well. It's important to know that students who are food insecure are 43% less likely to graduate than their food secure peers and 61% less likely to get an advanced degree. When we think about helping to ensure students ability to succeed personally, but also their ability to contribute to our society and economy, it makes strategic and moral sense to ensure that they are food secure.

Bio

Heather Taylor oversees Bread’s public policy and program divisions and operations as Managing Director. She is passionate about developing communications and advocacy strategies to organize and inspire faith communities, policymakers, and partners to engage in our mission to end hunger. Heather spent her career as a dedicated advocate lifting the voices of people who experience racial, gender, and economic injustice. She previously led organizations to increase access to legal and social services, as well as protect the rights and dignity of historically marginalized populations. She advocates to secure the economic rights of women in Sub-Saharan Africa as a fellow at International Justice Mission, a Christian nonprofit seeking to protect people in poverty from violence by transforming justice systems; and twice served on U.S. delegations headed by the UN Commission on the Status of Women to promote women’s political participation in emerging democratic societies. Heather holds a J.D. from the University of Iowa, a Master of Divinity from Wesley Theological Seminary and a B.S. from the Georgetown University School of Foreign Service.

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In February, 2023, the US Department of Agriculture announced plans to streamline and modernize WIC - the Women Infants and Children Program focused on supplemental nutrition. We'll talk about the future of WIC today with Stacy Dean, the Deputy Undersecretary for USDA's Food, Nutrition and Consumer Services.

Interview Summary

So you play a key role in these really important programs. So let's start by describing why modernizing WIC and SNAP - especially regarding the shopping experience is so important.

I'd be happy to. I think we should start with what are these programs just to level set. SNAP used to be known as food stamps and it is our country's largest food assistance program. It helps about 42 million people and 22 million households afford groceries. We provide that benefit through what looks like a credit card or a debit card and we call it electronic benefit transfer or EBT. And WIC, of course, is a program supplemental to SNAP that offers specific foods for pregnant and postpartum women, infants and toddlers. SNAP can be used to purchase any food in the grocery store, whereas WIC is a specific prescription food package. So your question about why is moving to online shopping so important? I think the bottom line is this administration really believes government services must be designed and delivered with a focus on the actual experience and needs of people they serve. The way Americans shop and pay for food has evolved in recent years and we have so many choices now as consumers. We want to make sure that those choices are extended to households who are using SNAP or WIC to pay for food.

Just the vast numbers of people that are touched by these programs is really impressive. Even a small change in the way the program is administered would have a big impact because so many people are affected. Let's talk a little bit more about the shopping experience. I gather there is a tension now to how customers can move to a more digital experience. While that might seem like an easy thing, it's a pretty big deal, isn't it?

That's right. Moving to online shopping, but more importantly online payment, has been a little bit sticky. But, we are so pleased with our retail partners who have helped us make this work. The real issue is does the store have a platform to order food and then a platform to accept payment. A lot of the stores who participate in these programs don't have that available. So, we've been trying to work with them to make sure that they're ready to take payment through electronic means.

That can make a big difference in people's lives. I can imagine convenience, some people not having access to transportation to get to stores, people who are homebound, ill. There are a lot of people that could have this effect the way they shop, isn't that right?

That's absolutely right. We want to make sure that our program participants have choices. You gave some great examples of how they might deploy those choices keeping themselves safer maybe by wanting to pick up the food and not go into the store. That was incredibly important during the pandemic. Another issue is SNAP participants are incredibly thrifty shoppers. The ability to search around for the best price point and the best quality is really important. If you have limited transportation, if it costs you money because you have to take a cab or pay a friend to get to the grocery store, you want to make sure that trip is going to be really worthwhile. Online shopping offers that as a basic enhancement and allows I think our benefit dollars to stretch even further.

You mentioned one barrier to the online shopping and it's just that the systems may not be set up for various food vendors. Are there other barriers online shopping for WIC and mobile payments on SNAP?

SNAP online shopping has been an option. It was originally a small option starting in about 2020 and it has really grown. But WIC is going to be a little bit different because in the WIC programs, states manage the relationships with retailers. Whereas in SNAP, it's USDA that manages that relationship. We've got to work with each of our state and tribal governments who operate WIC. They have to turn around and create those payment relationships with our grocers. So imagine your Kroger or Publix or some other large chain, you've got to work out individual payment relationships with each of the states that you operate in. That will probably flow us down a little bit, but there's incredible enthusiasm for offering this option. I would imagine the first few states will be a little tricky and then hopefully they will sort out how to make this work and we will see it move quickly across the country. Another barrier that is worth pointing out is that there are lots of stores across the country, particularly small, independent-owned businesses who don't have an online shopping platform. We are really trying to do a lot of work to figure out how we make sure we bring them in and that we're supporting them because we don't want large stores with an online footprint crowding out small independent stores.

I can understand the enthusiasm. Has there been discussion of how the food vendors might change the way they do things as a program this large might come online? Let's fast-forward to that time when this program is available. Would you see potentials for the vendors to change the way they market their foods, the way they price their foods, the way they deliver their foods? Do you think anything might change on their end that might affect people's experience?

There are two ideas that come to mind. As I mentioned, the WIC food package is a prescription package. It's designed specifically for the age of the child or whether the mother's pregnant or postpartum. So right now, if a shopper's moving through the store, they've got to move through the whole store and find the individual WIC foods. Wouldn't it be fantastic if you were ordering online and there was just basically a WIC room with everything right there and you wouldn't have to sift through and find items? I think that would add incredible convenience to the program. In SNAP, retailers have the opportunity to offer incentives or discounts on certain foods like fruits and vegetables. You could imagine if the retailer knew through an online forum that a shopper was a SNAP participant, it could really highlight the discounts around healthy foods, which would improve the shopping experience, I think.

That would be so helpful. I could even see potentially some entrepreneuring tech people finding a way to alert shoppers to where things are cheapest, given that there might be multiple places a person could ultimately shop online. If you want to buy food A, this online tech thing might be able to tell you that that food costs this much at this store and that much at that store and that might make the shopping experience even easier. I'm just thinking ahead, but I wonder if something like that might not be possible ultimately.

Well, I'd love that in my own life. I think that would be great to offer to our program participants. I think another enhancement that I would love, we haven't yet embarked on this journey at USDA, but we have this incredible tool called MyPlate that helps translate the dietary guidelines into recipes and shopping lists. All of the advice we offer is targeted to a budget consumer, someone who's buying food with our program benefits. I would really like that to be something that helps people in the shopping aisle or while they're online, right? This sort of interactive example - hey, I want this recipe, where are the food items? And again, it would be pulling those budget conscious choices for our consumers. There's a lot of opportunity for us to improve the shopping experience for our program participants.

The SNAP program has already seen advancements in this online shopping sphere. How successful has that been?

It's really been remarkable. In March, 2020, we had about 35,000 SNAP households shopping online across the whole country. When the pandemic hit, USDA and states knew that they had to accelerate the rolling out of the online shopping pilot. Today, we have about 4 million households are shopping online or about 9% of SNAP purchases overall are happening online. That's a tremendous growth over a short period of time. Of course, there were all kinds of innovations and changes during the pandemic provoked by the emergency and this is one that I think is an incredible enhancement and we want to see grow even more.

Well, that's pretty impressive growth, as you said. Why isn't it higher than 9% though? If this is available, why aren't more using it?

I don't think that's that far out of line with the overall norm for all consumers. Many shoppers still in fact shop at their local grocery store and most of our redemptions are happening at big grocery stores, big box stores. It's probably the case that many participants have that kind of convenient shopping available to them. But for those who don't, online shopping is a tremendous enhancement.

Just a little bit from my own personal experience. When the pandemic came about and I started using delivery services like Instacart for having groceries delivered, when I was able to shop at stores again and started comparing prices to what was available online and what I was paying at the store, it was more online, like five, 10, 15% even in some cases. Is there any way to prevent that problem occurring so that people who do choose to shop online might not have to pay more than people who are going to the actual store? I mean, of course there's the built-in cost of having things delivered, but beyond that, the store was also charging more.

Well, again, I put a lot of faith in our program participants. They are very savvy shoppers and they are living on an incredibly tight budget. I'm pretty sure they're going to be shopping where prices are the best for them. You were comparing maybe your local grocery store to online in your personal experience, but it's also true for some of our program participants, right? They may only have a not particularly well-stocked convenience store in their neighborhood or they may live in a very remote or rural area where there's one store and it's pretty far away. There's just different context to their choice than what you or I might be doing.

Bio

Stacy Dean was appointed by President Biden to serve as the Deputy Under Secretary for USDA’s Food, Nutrition, and Consumer Services where she will work to advance the President’s agenda on increasing nutrition assistance for struggling families and individuals as well as tackling systemic racism and barriers to opportunity that have denied so many the chance to get ahead. Prior to joining President Biden’s Team at USDA, Dean served as the Vice President for Food Assistance Policy at the Center on Budget and Policy Priorities (CBPP). She directed CBPP’s food assistance team, which published frequent reports on how federal nutrition programs affect families and communities and developed policies to improve them. In addition to her work on federal nutrition programs, Dean directed CBPP efforts to integrate the delivery of health and human services programs at the state and local levels. Before joining CBPP, she worked as a budget analyst at the Office of Management and Budget. Dean earned her B.A. and master’s degree in public policy from the University of Michigan.

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Artificial sweeteners, known more recently as non-nutritive or low-calorie sweeteners, have been a source of great hope. What could be better than enjoying sweetness in foods but without the calories? Sucralose, xylitol, stevia, saccharin, aspartame, there are a lot of them out there. You may add them to food yourself, you may consume them in beverages, and if not, there’s a good chance they’ll show up in foods that you buy. But, do they work and are they safe? Few know this area like Dr. Richard Mattes, distinguished Professor of Nutrition Science at Purdue University. 

Interview Summary So Rick, thanks so much for joining us. You’ve done pioneering work on this area and there are a few people better positioned to discuss this topic, so I appreciate you joining us today. So let’s start off with why do we need these sweeteners at all?

Well, I think the primary driver here is concern about the consumption of nutritive sweeteners – sugars. It is the case that often sugars are consumed in foods that provide limited other nutritional value. So they add calories without nutrients. And then given an environment where there’s concern about weight gain and obesity, there is a reasonable assumption that we can reduce sugar intake without compromising nutritional status. So, it’s a good target for interventions to manage body weight. Low-calorie sweeteners, as you pointed out, are one approach that can be taken to reduce sugar intake without compromising the sensory qualities of foods. I think it’s very well accepted that the sensory qualities of foods are really the primary driver of food choice. We as nutritionists would like to believe people make food choices based on nutrition. We recognize the importance of cost and convenience. But the reality is if a product does not have the right sensory properties, people just won’t consume it. We have to pay attention to the sensory properties of foods. Added sugars are presently contributing about 13% of daily energy intake – so that’s a very high percent without contributing a lot of nutrients. To give you a little more perspective, at the 75th percentile in the US population, that translates to about 400 kilocalories a day for males, about 300 kilocalories a day for females. If we use a 2,000 kilocalorie diet as sort of the standard, which is what’s used on food packaging labels, that represents 20% for males and 15% of energy on a daily basis. It’s very, very high. Now, the Dietary Guidelines Advisory Committee from 2020 reviewed sweeteners and their relationship to body weight. In their modeling analyses they concluded that people can really only take in something on the order of 5 to 6% or so of energy from added sugars without going into positive energy balance. That is taking in more energy than we need and as a result, putting ourselves at risk for weight gain. That is based on what it would take to obtain all the necessary nutrients in the diet if we make smart food choices. There’s very little discretionary room for added sugars. As a result, low-calorie sweeteners are a way to reduce total sugar intake, again, without compromising sensory quality.

That makes good sense and those numbers are really quite striking. Can you give us a little bit of a sense of how much these low-calorie sweeteners are consumed and how they show up in the food supply?

Well, the primary source is through sweetened beverages, but there is increasing use in solid foods as well. They are ubiquitous in the food supply, I think that’s safe to say, but low calorie sweetened beverages are the primary source.

There’s been concern that these low-calorie sweeteners can disrupt carbohydrate metabolism and result in greater hunger and food intake. What do you think about that?

Yes, this has been very extensively studied and my interpretation of the literature is that they do not disrupt carbohydrate metabolism. We know that when people consume nutritive sweeteners sugars, that they are absorbed, the blood sugar rises. That elicits the release of insulin as a way to get the sugar out of the blood and into our cells. When blood sugar levels drop and insulin levels are relatively high, that’s viewed as a sort of metabolic signal that we should be hungry and be interested in eating again. However, my reading of the literature shows that low-calorie sweeteners do not elicit a rise in insulin, do not lead to a drop in blood sugar and as a result don’t generate a hunger signal. But even if they did that, the question is, does a rise in blood sugar or a drop in blood sugar or a rise in insulin after a typical meal really serve as the driver, or the primary mechanism for generation of hunger signals? There’s an experimental approach called euglycaemic clamp. We don’t need to go into all of the details, but suffice it to say it’s an approach that allows one to independently manipulate the level of glucose in the blood or the level of insulin in the blood. When those studies have been done, they demonstrate unequivocally that independent changes in glucose do not alter appetitive sensations, hunger, nor do independent manipulations of insulin. They undoubtedly change following a meal, but they are not the cause of the generation of hunger signals.

So this gets right at the heart of a key question. Some people are saying that, when you consume these artificial sweeteners, they rev up the body in a way that makes you want to eat. You’ll then consume as many calories as you might have if you’d been consuming sugar or maybe even overdo it. But you’re saying there’s not a biological basis for that in science.

That’s correct. I think where there is credibility to that scenario lies more in cognitive or psychological dimension. When people use a product or a food that is reduced in energy, and we require products that we purchase to label their energy content and often claims are made about them being low energy when they are, people are overly optimistic about the energy that they save when they consume these products. So they may then may be more inclined to indulge subsequent to that and overestimating the amount of energy they saved, they can indeed offset the benefit of substituting a low-calorie sweetener for a nutritive sweetener and result in higher energy intake. But that is not a biologically-driven phenomenon. It therefore requires more education in terms of how to use low-calorie sweeteners to better effect, rather than it being a biological basis that is kind of out of people’s control.

If people are consuming diet beverages for example, and they’re getting accustomed to a high level of sweetness because they’re consuming these throughout the day, does that generalize to other parts of their diet? Might they then like other things sweeter than they might have otherwise or have sort of a drive for these things?

I think where there is credibility to that scenario lies more in cognitive or psychological dimension. When people use a product or a food that is reduced in energy – and we require products that we purchase to label their energy content and often claims are made about them being low energy when they are – people are overly optimistic about the energy that they save when they consume these products. So, they may be more inclined to indulge subsequent to that and overestimating the amount of energy they saved, they can indeed offset the benefit of substituting a low-calorie sweetener for a nutritive sweetener and result in higher energy intake. But that is not a biologically-driven phenomenon. It therefore requires more education in terms of how to use low-calorie sweeteners to better effect, rather than it being a biological basis that is kind of out of people’s control.

That seems like a really important question to nail down, doesn’t it? Because what you say about salt and fat and the dairy products and things makes all the sense in the world. I know I’ve experienced myself with low fat dairy products compared to when I was a kid and people were drinking high-fat versions of milk and things. So if that’s true and it does apply to sweetness, then you’d think the artificial sweeteners would be counterproductive because they keep people consuming sweet and not getting used to less of it over time. Does that make sense?

That’s a most interesting question and highly relevant right now. So there is a reasonable body of science on the effects of exposure to sensory qualities and the preferred level of that quality in foods for salt and for fat. If one consumes high salt levels, foods with high levels of salt and saltiness, they generally come to like and actually prefer foods that are high in salt. If you’ve gone on a diet that limits sensory exposure, it’s not the amount of sodium actually consumed, it’s the sensory exposure that determines this. If you limit sensory exposure to salt, you can actually come to prefer low salt foods. The same is true for fat. Probably many people have exposed themselves to low fat dairy products, for example, and over time actually come to prefer them to the higher fat versions. But the story for sweeteners is still very much unknown. There is a small amount of evidence based on short-term studies with small sample sizes that would suggest that scenario holds, at least in kids, but the largest and probably best-controlled study to date fails to find an effect of exposure to sweetness on the preference for sweetness of foods. In contrast, they find that it alters the sensory perception (that is the intensity of sweetness) but not the preference or the liking of sweetness. So the jury is still out on that scenario.

Let me ask one of the bottom line question:  Are low-calorie sweeteners associated with lower or higher body weight?

Yes, that’s the logical conclusion. The question is whether sweetness is indeed different from salt and fat and how exposure effects work.

Okay, good to know. We’ve been talking about these sweeteners as a group, but if we start to separate them, do the different ones have different effects on the body?

So there is ammunition for different perspectives on this question. The epidemiologic data, that is the data based on surveys, pretty consistently shows that there is a positive association between consumption of low-calorie sweeteners and indices of adiposity, body fatness, things like body mass index or body weight or waist circumference. However, the evidence also in my opinion quite convincingly and strongly shows from randomized control trials that consumption of low-calorie sweeteners is associated with lower indices of adiposity, BMI, body weight. In the sort of hierarchy of scientific rigor, randomized controlled trials are viewed as stronger than these cohort studies, these survey studies. In my opinion, the strongest science shows that they’re associated with lower body weight rather than higher.

I’m really happy you brought up that study because it’s clearly a landmark study. It’s nice that you’re being modest about it, but boy, it sure opens the door to some very interesting and important questions. I appreciate you doing this study and describing it today. If these compounds are having different effects because they’re different biologically, which would make sense that they wouldn’t all behave the same once they get inside the body. I’m assuming the same thing would probably be true for safety concerns. I know over the years, there have just been lots of things in the press about worries, about safety of these products. What do you think about that? Do you think these concerns are merited?

So this is a very interesting area because we tend to speak about all low-calorie sweeteners as though they were kind of one thing. And it’s true, they all impart sweetness with very little or no energy. But, does that mean that they all have the same effect in the body? We know, again, from other kinds of chemicals that that’s not the case. For example, salt, sodium chloride, tastes salty, but is associated with elevation of blood pressure. Potassium chloride also tastes salty, but the potassium is associated with lower blood pressure. The fact that they share a sensory property doesn’t mean that they have the same physiological effect. Yet we view all these different low-calorie sweeteners that have entirely different chemical structures as though they’re the same thing. I think that the time has come to look at them individually. We conducted a study with Kelly Higgins as the first author, and compared four low-calorie sweeteners and their effects on body weight. People consumed these on a daily basis for 12 weeks. We monitored body weight, as well as things like hunger and appetite and so on, but the most important endpoint was body weight. One of the groups consumed sugar. We expected that if we asked people to consume sugar on a daily basis that they would gain weight and indeed they did. The interesting finding of the study though was when people consumed saccharin, they also gained body weight and at a rate that was comparable to the sugar. In contrast, when they consumed Splenda, they lost body weight. By the end of 12 weeks, there was a significant difference in body weight between those consuming Splenda and those consuming saccharin. So, what this suggests is that there may indeed be substantive differences in how we respond to these different commercially available and widely consumed sweeteners. I want to emphasize that this is the one and only study that has addressed this issue and we should never believe a single study, no matter how well done it is, until it’s replicated. I think this is an intriguing hypothesis. I think there is logic to viewing them as potentially different. Again, they all have different chemical structures, but this requires verification.

I guess because these products are used by so many millions of people, you’d think if there were negative effects, we’d know by now. But on the other hand, there are some of these products relatively new to the market compared to others like Splenda. And if this may not have immediate effects but long-term effects after somebody’s consumed them after many years, we may not know yet, I’m assuming. But it sounds like from your reading of the science, there are no negative effects of these at this moment.

Two levels of response to that. First, I’m not a toxicologist, so you should be cautious in interpreting my perspective on it. But these sweeteners have been highly studied by the regulatory agencies of many, many nations, the European Union, the US, Australia, Canada, Japan, around the world. And uniformly, they have concluded that when used within reasonable amounts, they are safe. And of course, that stipulation, when used in reasonable amounts, may be open to debate among people with different views in this area. But it’s a qualification that would be used for any food or any nutrient. Any nutrient consumed at excessive levels becomes a drug and has effects very different from its role as a nutrient. So it’s not unusual to put that qualification on such a claim. However, yes, they’re different chemicals. They should be evaluated independently. As a particular sweetener is petitioned for approval, regulatory agencies do review the science for its safety independently. So for the commercially available products, I think it’s safe to conclude that they are safe, but as new products are developed, they will have to be evaluated on their own merits as well.

Bio

Richard D. Mattes, MPH, PhD, RD, is a Distinguished Professor of Nutrition Science at Purdue University, Adjunct Associate Professor of Medicine at the Indiana University School of Medicine and Affiliated Scientist at the Monell Chemical Senses Center. His research focuses on the areas of taste function, hunger and satiety, food preferences, regulation of food intake in humans and human cephalic phase responses. At Purdue, Dr. Mattes is the Head of the Ingestive Behavior Research Center.  Outside of Purdue he was a member of the 2020 Dietary Guidelines Advisory Committee; is a past-president of the American Society of Nutrition and Secretary of the Rose Marie Pangborn Sensory Science Scholarship Fund.  He has authored over 300 publications. Dr. Mattes earned an undergraduate degree in biology and a Master’s degree in Public Health from the University of Michigan as well as a doctorate degree in Human Nutrition from Cornell University. He conducted post-doctoral studies at the Memorial Sloan-Kettering Cancer Center and the Monell Chemical Senses Center.

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In the United States, over one third of all available food goes uneaten through loss or waste. That is a hard number to ignore when more than 10% of the US population is food insecure. What's more, uneaten food is the single largest category of material sent to landfills. So what is the USDA doing to address food loss and waste? Our guest today is Dr. Jean Buzby, the Food Loss and Waste Liaison in the US Department of Agriculture's Office of the Chief Economist.

Interview Summary

Norbert: Welcome, Jean. It is great to have you. So what do you do in your position as the USDA Food Loss and Waste Liaison?

As the USDA Food Loss and Waste Liaison, I'm using my platform to raise awareness of food loss and waste, its associated challenges that you mentioned, Norbert, as well as the opportunities for businesses and consumers to save or make money by reducing it. I've worked with multiple partners in the corporate, nonprofit, academic, and government arenas to prevent or reduce food loss and waste. I work with colleagues from the different USDA agencies to increase food loss and waste activities within those agencies as well as with other federal partners in particular. We host, throughout the year, webinars highlighting food loss and waste reduction success stories. In recent years, we have hosted interesting USDA Food Loss and Waste Innovation Fair.

Norbert - That's wonderful. As I remember, you were one of the earlier folks out there really using USDA data to begin thinking about what food loss and waste looks like. We really thank you for the work that you've done to begin this work.

Brenna - Jean, that actually leads us into one of my questions. The USDA is a big agency with really broad responsibilities. Can you tell us a little bit more about the scope of USDA's work on food loss and waste?

Absolutely. The scope is quite broad. We do quite a lot of research, both in-house and extramural funding, for new food innovations and technologies that reduce food loss and waste. For example, our agricultural research service has over 2000 scientists and 90 research centers across the country. Some of those scientists work to develop new and heartier cultivars, such as the keepsake strawberry, which is flavorful and has a longer shelf life. They also have developed automated infield apple sorting systems that separate low quality from high quality apples at harvest with less bruising damage. And other innovations, such as in packaging. The USDA has the National Institute of Food and Agriculture, or NIFA, which does a lot of the extramural competitive funding that develops new technologies and innovations to reduce food loss and waste. For example, one novel technology is Jelly Ice, which doesn't melt like traditional ice and it can be reused several times. And then ultimately composted when finished. So, it's pretty exciting technology and just one of many. USDA produces education and tools. For example, we have a free FoodKeeper App which provides guidance on safe handling, preparation, and storage of more than 650 food and beverage items. And with this App, you can track storage times for different foods, learn cooking tips, and watch helpful videos, and get information on food recalls. We do a lot of funding through our different agencies. For example, Rural Development has funding, and grants, and loan programs that can provide cold storage infrastructure.

Brenna - Thank you for that broad overview, Jean. I know Norbert and I spend a lot of time thinking about food loss and waste, but you kind of forget all the different things that USDA does to work on that issue. Can you tell us about any other federal agencies that you work with to meet the national goal to reduce food loss and waste in half by 2030?

USDA has an ongoing inter-agency partnership with the US Environmental Protection Agency and the US Food and Drug Administration to improve coordination and communication efforts to educate Americans on the impacts and importance of reducing food loss and waste, and to help get some of these programs going. But these three agencies both have their individual activities as well as collective activities across the agencies that raise awareness and share resources for consumers, businesses, and others. One example of our inter-agency work is the USDA and the EPA have an initiative called the US Food Loss and Waste 2030 Champions program. This encourages the food corporations and businesses to make a public commitment to reducing food loss and waste in their own US operations by 50% by the year 2030, which, by the way, is a national and international goal to make that very ambitious reduction. Right now, we have about 50 2030 Champions, and these include companies across the food system, such as food service organization Aramark, hotel industry leader like Hilton, and grocery giant Kroger. You can learn more about the 2030 Champions by searching for USDA 2030 Champions. If you click on each icon, or the logo of each company, you can see what they're doing in their own in-house activities. It's very exciting and we are actively growing this program

Brenna - I think the number of champions has grown quite a lot so that's great to hear.

Norbert - I really am happy to hear about the various companies that have engaged in helping reduce food waste. Brenna and I have worked on different projects looking at different actors along the food supply chain and their relationship to food waste. And one of the things that we do know is that consumers really are an important part of that challenge for us to reduce food waste by 50%. I would love to hear some of your thoughts of what can consumers do to help reduce food waste?

Absolutely, Norbert. You're right; everybody has a role to play in reducing food loss and waste. A great first step is to be mindful of the food that we discard. We may not be aware of the amount of food we waste over the course of the year because it's a little bit today, a little bit tomorrow, and over time. But an average family of four wastes about $1,500 of food that they purchase and then goes uneaten. That's a big hit to the wallet and small choices add up. But consumers can take mini steps to reduce food waste in their own homes. Such as they can plan ahead; before we go to the grocery store or order online. We can make a list so we don't buy more than we need. You can also love your leftovers. You can pack leftovers in small portions in shallow containers, and mark the contents and date, and then refrigerate it or freeze it immediately. You can even have a leftover night, like every Tuesday is for leftovers. You can also compost and not trash uneaten food. Food in landfills produces a harmful methane gas that's 25 times more potent than carbon dioxide as a climate change gas. It's really important to keep that food out of landfills. You can recycle your food scraps in a home compost bin or a local compost center. But there are many more steps and if you just search online, "USDA food loss and waste," you'll find we have a whole page just for consumers with lots of videos both in English and Spanish, as well as consumer outreach materials. I love the recommendation of "Love Your Leftovers." I'm going to love some later on today so thank you so much for this.

Brenna - So the US has a national goal to cut food loss and waste in half by 2030. So I guess, bottom line, are you optimistic that we'll reach that goal?

Well, it is a super ambitious goal and I really wish I had a crystal ball to know where we will be by 2030. I am encouraged by the momentum that I see by the public sector and the private sector. Both globally and domestically, there seems to be really increased awareness about food loss and waste. I certainly hope it takes off just as recycling did. But it's important to recognize that the food loss and waste challenge itself is going to continue well after 2030. This issue is here to stay with a growing world population, limited resources, like finite amount of arable land and fresh water. And also our growing awareness of the connections between food loss and waste, and the environment. We'll have to continue to address this issue beyond 2030 as well. Some of the key takeaways I'd love to share with you is that food loss and waste is really complex and it's going to take many different solutions from farm to table. There is no silver bullet. These solutions are going to be many, and will include, likely, public-private partnerships, as well as increased consumer education. As I mentioned before really everyone has a role to play in reducing food loss and waste.

Norbert - All great points, Jean. Thank you so much for your perspectives on this issue. One of the things that I took away from this conversation is this is a systemic challenge and it's going to take a systemic approach to help us reduce food loss and waste throughout the supply chain. Thank you for giving us that perspective and also for your optimism. I'm excited about the potential and the work that several of us are doing are all moving towards that goal.

Bio

Jean C. Buzby, Ph.D., is the USDA Food Loss and Waste Liaison in the Office of the Chief Economist. Prior to this position, she worked for USDA’s Economic Research Service for more than 20 years, most recently as the Chief of the Diet, Safety, and Health Economics Branch in ERS's Food Economics Division.  Before moving into management, her primary areas of work as an agricultural economist at ERS were food safety and food consumption research. Jean's food safety research included estimating the cost of foodborne illness, analyzing the legal incentives for firms to produce safer food, and exploring international trade and food safety issues. Her food consumption research was centered on information from the Food Availability Data System. She is domestically and internationally known for her research on the amount and value of food loss at the retail and consumer levels in the United States.

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When I was growing up, people didn't fret much about food safety. Trichinosis from undercooked pork was about all I heard about. But today people hear about much more: norovirus, salmonella, campylobacter, staphylococcus, listeria, and there's much more. So what in the world is happening? Our guest, Timothy Lytton, distinguished university professor and professor of law at Georgia State University knows an awful lot about this. He's the author of a seminal book entitled "Outbreak: Foodborne Illness and the Struggle for Food Safety."

Interview Summary

When your book came out, I was so excited to see it, because there was so much talk out there in the general world about food safety, but to have somebody with a kind of your legal background take this on and put it all into a single volume, I thought was extremely helpful. So let me begin with a basic question. So how did you get interested in food safety and why do a book on it?

You know, our political world is largely characterized by an ongoing debate about people who favor government regulation against people who favor letting free markets run their own course. I found this debate somewhat unsatisfying. I'm really interested in a lot of ways that government activities and market activities interact. In fact, in most contexts we have not really two alternatives, one between government regulation and the other free markets. But instead, we have a complex interaction between public and private efforts to try and govern health and safety problems. This really is characteristic of what I would call complex regulatory systems. They involve at least kind of what you might think of as three legs of a stool. On the one hand, you have government regulation, you have private governance, supply chain management, and other things that companies do to protect health and safety. You have liability, lawsuits and liability insurance. These three legs of the stool really are interactive and they together comprise what I would call a complex regulatory system. And food safety's really a great example of this and I think it was for me an important way to try and illustrate to people that our regulatory world is a lot more complex than the choice between government regulation and free markets.

There are a lot of places where business and government interests are at odds and government needs to keep a watchdog eye on business and make sure that they behave in ways that are consistent with the public good. You would think that government and business interests would align, that it's not in a business' interest have an unsafe food product that goes out there because all kinds of bad publicity and litigation and things like that can happen. So is it not true that there's alignment of goals?

I think there's alignment of goals. I think it's also fair to say that sometimes there's a difference of opinion as to just how aggressive or ambitious food safety regulation ought to be. On the one hand, industry tends to be a little bit more cautious. They may be worried about costs for food safety advances that may be unproven and government may be very nervous about making sure that consumers are properly protected they may be a bit more aggressive. I think one thing that is important to keep in mind is that even though there are those tensions, there's a very powerful interdependence between the efforts of government regulators to try and advance food safety and the efforts of private industry supply chain managers. In fact, a lot of the standards that grow out of the system are standards that have come out of collaboration between them. So for example, standards for agricultural water quality that help reduce the microbial contamination of water that is used to irrigate crops. Those originated in technical committees that were put together by industry associations, but those technical committees included members who came from government regulatory agencies. By the same token, when government came around trying to develop guidance and regulations to govern agricultural water quality, they called on industry in the notice and comment period. So the same group of experts have been really working over the course of the last two and a half decades on water quality standards. They've been doing it in different institutional venues, sometimes in industry technical committees and sometimes in the government's notice and comment process and sometimes in informal ways at conferences where they also meet and merge with academics. But, there's an enormous amount of collaboration that comes out of this ongoing conversation that is occurring in these different institutional venues.

Thanks for that background. I'd like to ask you about the system's approach to food safety that you proposed. But before we do that I'd like to ask kind of a broader question about where we stand with food safety in the US. So the industry is quick to claim that US has the safest food supply in the world. Is that really true? And how big of a problem is food safety in America?

You know, it really depends on how you measure it. The CDC estimates that each year from foodborne illness there are 3000 deaths, 128,000 hospitalizations, and 48 million cases of acute gastroenteritis. That really means serious enough illness to include diarrhea or vomiting or nausea that would be strong enough to keep a person out of work for a day or away from school. Now when you think about it in terms of deaths, that is 3,000 people a year who die from foodborne illness or foodborne-related illness. That's much less than something like tobacco which is close to half a million, or obesity which is closer to quarter million, or auto accidents which is about 34,000. In that context, the number of deaths from foodborne illness is relatively low as public health problems go. On the other hand, if you think about the 48 million episodes of acute gastroenteritis each year, people being sick enough to really have to knock off a day of work and in some cases getting much sicker than that, that's an enormous number. That is one out of six Americans every year. That is far more than the number of Americans who are injured in falls, car accidents, cutting, cycling, poisoning, and fire burn injuries all put together. It is orders of magnitude larger than those other things. So in that sense foodborne illness is a significant public health problem. And since we dedicate resources to things like falls in the home or car accident injuries, we probably should also be paying attention to food safety.

As you think about trends and look at the drivers of food safety, the way farming is done in the US, the way food is transported and those sort of issues, are you expecting that the challenges will become even more serious as time goes on, or are these being reined in?

I think that things are moving in two different directions one of which is difficult for food safety and one of which is advantageous. On the difficult side: the industrialization of food; the mass production; the large and growing global markets; and the increasingly complex supply chains where we're getting a lot of our produce from around the world This makes the problem much more difficult because there is just a farther reach that regulations would have to get to in order to help protect consumers from the risk of contamination. Also the ability to track and trace back the root causes of contamination just becomes more difficult as the food system becomes increasingly global. On the other hand, there are a number of important advances in technology. In particular, advances in technology that relate to surveillance and tracing. The ability to actually isolate and create a DNA fingerprint for different pathogens that are harvested from people who are sick or are harvested from investigations where contamination might occur, and that allow public health authorities to actually discover and spot outbreaks as they occur more frequently. And also increasing sophistication in tracing them back to their root causes. That growing technology, that ability to spot and trace back the source of foodborne illness, I think, is probably something that is getting better and better over time.

That's good news to hear and fascinating description of this. So you talk about a system's approach to food safety. What do you mean by that?

When we think about food safety, what we want to do is realize that instead of just pushing on one of these legs of the stool - more government regulation or for less government regulation, greater industry vigilance or less industry vigilance, greater liability or increasing liability insurance for growers or other food producers - we need to think about how these things are interrelated. We need to think about how we can help them complement each other. So for example, it may be the case that what we want to do is relieve the government of its burden, to some degree, of inspection because the government just doesn't have their inspection resources, it needs to cover all of the food industry and it struggles to do so. On the other hand, retailers who sell the food actually have a global and robust system of third party audits and that is driven by economic incentives and it has a much farther reach than government. We might find ways to rely more on that and government can then shift its resources away from things like inspection, which is really doesn't have the resources to do comprehensively and spend more of its money on surveillance of foodborne illness, so we can spot outbreaks when they occur, as well as tracing investigations to figure out what are the root causes of those outbreaks. That requires a governmental infrastructure at the federal, state, and local level and on some levels increasingly at the global level, that really only government can put together and overlook and oversee and develop. And so these are ways in which we can think in a system's approach, that instead of just looking for government to do everything or industry to do everything we can sort of divide the different types of tasks that are required, to create a robust food safety system and look at the ways in which these different branches of the system can complement each other.

Let's look beyond our own borders and talk about how other countries address these issues. How does the US measure up to what other countries are doing?

We don't really know the answer to that question, we don't really know how well the US is actually doing. It's extremely difficult to figure out whether or not any particular regulation or intervention works. In fact, that's really the story of a lot of different regulatory areas, food is not different in this way. We spend an enormous amount of money on developing and implementing regulations, but very little money in trying to figure out how effective they have been or whether they've been efficient or whether there are better ways to do them. Those questions are very difficult to answer and they are enormously expensive. As a result, we don't really know how well the US food safety system is doing. That becomes a similar problem when we look at places like Germany or England or Japan to figure out, well, how well are they doing? It's pretty hard to measure that as well. So there's not even something to compare here. I think a lot of people have general impressions about whether food is safer in one country or another and this will depend on the sector. Food safety in meat is different than fluid milk and it's different than fresh produce or poultry. I think it's a difficult question to answer and I think you hear a lot of opinions about this, but most of those opinions are not really, I don't think, grounded very clearly in the kinds of careful measures we would need to have in order to have good reliable answer to that question.

I'd like to underscore something you just said that it's hard to know whether the food safety regulations that we have actually work. So why is that the case and what do you think are some of the greatest challenges facing the food safety system today?

It's just a very curious thing. When I was doing my research, I would ask people how well is your system working and they couldn't tell me. If you ask someone in industry, we put in a million dollars into marketing, what do we get for it? They will be able to come back to you in a year and tell you for the million dollars you put into marketing, in the budget, we got X number of sales. We can do the same thing with quality control. We give you a million dollars, what did we get for it? A year later they'll come back and say, "Well we had X number of fewer defective products." But when you ask a company executive we give you a million dollars for food safety last year, what do we get for it? They can't really tell you. They give you some vague story about how they have improved the culture around food safety and institution. The same is true with government officials. When I ask people at the USDA, you know how well are your food safety inspections going? Have they improved the quality of American food safety? They really couldn't even begin to answer that question. One of the top officials at USDA told me, "Gee, I'd really love to know the answer to that question." I think there are a couple reasons why. One is it's very hard to measure how much illness there is, of the estimates of 48 million episodes, that's really, you know, a projection based on statistics. Of those 48 million episodes only 800 involve identified outbreaks. So, we only have 800 that we actually are counting. Of those, there are only about 300 identifiable food vehicles and of those, there are only about three to four cases where we can trace back to the root causes. So, we don't even know where the foodborne illness is coming from, even if we have a rough estimate of how much there is. It's also hard to know what caused the illness because we don't have root cause analysis or it's very rare. We don't know whether or not a particular intervention fell short or really made the difference. It's very difficult to figure out what the different levels of illness connected with a particular food are. We can make a food safety change but we don't have any way to measure on the public health side whether or not illness has been reduced as a result of that. When illness rates go up or down, we don't really have a way of tracing that back to where the failure's occurring in the system. We can't connect particular interventions to improve food safety with particular public health outcomes in terms of reducing illness.

You know, it's amazing how complicated this is, because when you're a consumer and you go to the store, you go to a restaurant and you buy something, you just assume it's going to be safe. And there are a whole bunch of people that are paying attention to that and making sure that that is so, but it's way more complicated than that. So interesting to hear you lay that out. So let's talk about what you think effective reforms would be. I'd like to ask about one thing in particular, in this context, where some people have called for reorganizing federal food safety regulation under a single federal agency which kind of makes sense instinctually, wouldn't it make sense instead of having destroyed the things going on, that all take place under one umbrella? I know you have some reservations about that. Could you explain?

Sure, I'll just start with this idea of a single food safety agency. This is a proposal that has been put forward in every single presidential administration, Democratic and Republicans, since the Truman Administration. It's basically the idea that if we can rearrange the bureaucratic structure of food safety, we can reap efficiencies and do a better job. I think there are a number of reasons to be skeptical of this particular approach to fixing the food safety system. First of all, there's very widespread lack of support from Congressional oversight committees. Congressional oversight committees and industry are basically connected with particular agencies. There are about 15 federal agencies currently that deal with food safety and each one has its own oversight committee in Congress. If you were to consolidate that, you would reduce the power of each of those congressional representatives to actually serve the interests of their constituents. It would make it harder for industry to sort of exercise influence in government. As a result, there's really not much support in Congress for this sort of consolidation. Second, it would require a massive and complex statutory overhaul. The food safety laws of this country go back to the late 19th century. They're involved in many difficult and complex and large statutory laws and they all are put together in a complex system. And I can't imagine the Congress getting involved in that level or scale of a statutory overhaul what it would take to consolidate this all in one agency. Furthermore, the agencies have different expertise and culture. So USDA is populated largely by people who do animal veterinary science and they look at beef production and poultry production. FDA's populated by microbiologists and they look at a lot of things related to water quality and safety and food production. These are just different technical skills and so reorganization would be very difficult. And finally, I would say that there's no evidence from other countries that have done this and a number of countries have done this, that they have reaped any public health benefits from this. We do know it would cost an enormous amount of money at the front end, but we don't have any indication that it would actually save us any money or be more effective at the back end. I think we would do a better job, rather than consolidating and rearranging the bureaucracy, to do a better job of knitting it together and creating cooperative task forces and more interaction between agencies. There's actually a lot of this already. There are joint task courses that have membership from USDA and FDA and the CDC and the other agencies involved. And I think that that growing coordination is probably a better approach to the food safety system than trying to consolidate. When we move away from that, I think there are probably three things I would focus on in terms of advances that would be good reforms for us. The first is to focus more government investment on outbreak investigation, to put more money into the CDC's surveillance systems for foodborne illness and the inter-agency cooperation that goes into investigating outbreaks. We need more information in order to know whether what we're doing is working and one way to generate that is better surveillance at the public health side and better investigation. Second thing I would do is I would rely more on private resources for oversight of that system. That is to rely more on private auditors and on liability insurance and the liability system to try and put pressure in order to have food producers more compliant with food safety regulations as opposed to spending a lot of government money on what's really become quite an inadequate inspection system. And the last thing I would stress is that we want to look for opportunities for feedback and learning. We want to be more experimental in the way that we think about food safety, try something out and then build into that a way to evaluate whether we think it works and whether or not we think it's an efficient way to go about advancing food safety in that way. Only if we generate more information, we'll be able to do things that we have greater confidence are safeguarding consumers as opposed to what we're doing now, which is largely just shooting in the dark.

Those things make a great deal of sense. So let me close by asking you kind of a broad summary question. You're really on top of this, of course, as you see trends like in public opinion on these issues, on actions that are being taken by the administrative and legislative branches of government, what industry is doing, is there a reason to be hopeful that things are moving in a good direction?

I think there are two sources of hope at least. One is that we are seeing steady technological advances in the ability to fingerprint DNA of foodborne pathogens. Those technological advances are sort of moving along and as they move along, they are spinning off better ways to spot foodborne illness outbreaks when they occur, more effective and efficient ways to investigate the root causes of it. And they are also creating new ways of thinking about how we can intervene in food production to try and create opportunities to reduce microbial contamination after it occurs or before it occurs. So technological events I think is a great source of hope. There are really a lot of very smart minds working very hard in a number of fields to try and improve food safety. The second thing I think that's a source of hope is the maturation of liability insurance. This is not something that most people think about very much. But when you think about big public health problems of the last century - things like urban fires in the 19th century and things like car accidents in the 20th century - liability insurance became a major driver for safety reforms in those two areas. Liability insurers basically collect premiums to ensure when those accidents happen and then they try and figure out ways not to have to pay out when the accidents happen on the insurance policies. So they get into the safety business. Many of our safety features associated, for example, with fire safety measures in our houses, in public buildings, as well as the type of things that our cars have in terms of safety equipment are driven by the liability industry trying to look for ways to reduce risks so that they cannot have to pay out when there are accidents. I think those types of markets are emerging in food safety. Increasingly we see food safety liability insurers getting into the business of trying to help companies figure out how to comply with the state-of-the-art in food safety.

Bio

Timothy D. Lytton is Distinguished University Professor and Professor of Law and currently serves as Associate Dean for Research and Faculty Development at Georgia State University College of Law. He teaches courses in torts, administrative law, and legislation. His research focuses on tort litigation and the regulation of health and safety. Lytton is the author of several books, including Outbreak: Foodborne Illness and the Struggle for Food Safety (University of Chicago Press 2019), which was a finalist for the 2020 ABA Silver Gavel Award, Kosher: Private Regulation in the Age of Industrial Food (Harvard University Press 2013), Holding Bishops Accountable: How Lawsuits Helped the Catholic Church Confront Clergy Sexual Abuse (Harvard University Press 2008), and the editor of Suing the Gun Industry: A Battle at the Crossroads of Gun Control and Mass Torts (University of Michigan Press 2005). Lytton has B.A. and J.D. degrees from Yale University. He is licensed to practice law in New York, Ohio, and Georgia, and in 2018 was elected to membership in the American Law Institute.

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According to the Environmental Protection Agency, food is the single largest category of material sent to landfills in the US, where it emits the greenhouse gas methane. It would be a win for climate if food waste could instead be transformed into commercially valuable products. Today, we're talking with two researchers who are working out the feasibility of just that. Welcome to the Leading Voices in Food podcast. Our guests for today are sustainability and energy science researcher Thomas Trabold of the Golisano Institute for Sustainability at Rochester Institute of Technology. And second, we have food science and technology researcher Ned Spang from the University of California Davis Food Loss and Waste Collaborative.

Interview Summary

This podcast is cosponsored by the RECIPES food waste research collaboration, led by American University and funded by the National Science Foundation.

Norbert: So Ned, how does wasted food contribute to climate change?

Ned: That's a great question, Norbert, and something we should be thinking about when we are talking about food loss and waste. Really, at all times. As you said in your intro, there is a close connection between food waste and greenhouse gas emissions along the pathway of methane. When we dispose of wasted food in a landfill and it gets covered up with dirt and other waste, it creates an anaerobic environment. Microbes that thrive in that environment break down the organic material and release methane to the atmosphere. So, if we can divert organic waste and food waste from landfills and put it to productive use, we avoid that methane being released to the atmosphere. Another way I want people to think about food waste releasing greenhouse gases or being related to climate change is thinking about it from a food systems perspective. Because the other thing we need to keep in mind is that it takes a lot of resources, and effort, and investment, frankly, to get food from the farm to your table. So, if we think about growing a tomato, for example, we need to put fertilizer into the soil, which requires a lot of energy to create that fertilizer. We need to run tractors over the field. We need to harvest. We need to store the crop. We need to refrigerate the crop, and we need to transport that crop. All of those steps of the food supply chain require energy inputs. If we are using fossil fuels, that is leading to carbon dioxide emissions as well.

Norbert: So this is a really big issue. It seems like it's what happens once the food is in the landfill, but there are all these other places where there can be climate challenges throughout the supply chain. So this is a critical point: to not only think about the end, but also all along the supply chain. Is that a fair assessment?

Ned: That is exactly right. I think that is the piece that really makes food waste such a challenging issue. There are so many pieces to the puzzle. Food losses and food waste can occur anywhere across the food supply chain. It's not just with the consumer. We have losses in the field, we have losses at distribution, we have losses in storage. So just as there are resource inputs at every step of the food supply chain, there are also losses at every step. And so when we think about solutions, there is not going to be just one single solution. We have to think about many different solutions and the role of many different stakeholders as we bring food from farm to table.

Brenna: Thomas, if we can take a moment and turn to you, how can we turn food waste into something of economic value? And, how does that transformation help mitigate climate change?

Thomas: I'm glad you asked about economic value, because to really facilitate change in this area and valorize food waste, we really have to think about how to make that economically viable. That's ultimately what's going to drive sustainable change. We've done a lot of work in food waste at different scales. I would say the number one thing we need to do to convert that waste into something of economic value is to understand the nature of the waste itself. For example, we need to know how much is generated and where is it generated. Is it generated in large quantities in a few locations? Or, as is the case in household food waste, it's generated in relatively small quantities at millions and millions of different locations. Is it generated at a constant rate throughout course of the year, or is it more seasonal? Ned mentioned crop born food waste. Well, that's going to really occur at a more seasonal rate than, say, household food waste which is generated more uniformly over the course of the year. And we also have to know what are its characteristics. Food waste that is generated in, say, a food processing plant tends to be rather homogeneous, and that material will have a larger number of potential valorization options. Conversely, food that's generated in, say, a university cafeteria is by nature heterogeneous. So it's going to be more difficult to define viable valorization pathways for that kind of material. And how all these valorization options can help mitigate climate change is number one - keeping that material out of the landfill so it can't generate methane - but then also by mitigating or offsetting other sources of greenhouse gas emissions. For example, if we take food waste that's currently going to the landfill and divert that to an anaerobic digester, now we're using that material to generate a gas that can offset fossil natural gas use. So we're combining the benefit of methane reduction, but also generating bio-based gas that can offset fossil natural gas. So combining all these different benefits can enhance the economic viability of the overall system and help us mitigate climate change.

Brenna: Those are really helpful examples, and just good illustrations to help you think about the different ways we need to think about food waste. I thought about when I was doing food waste research in university cafeterias, and it is very heterogeneous. Although I will say there was an absurd quantity of ketchup, from what I remember while physically sorting the waste. I was just going to bring that up. I really appreciate the illustrations. Those are very helpful, different ways to think about it.

Norbert: I'm interested, are there other kinds of products that you can make out of wasted food?

Thomas: Oh yes, and this is where we spend a lot of our focus - looking at different options for converting food waste into different products. Of course, if food waste can't be used to feed human beings, which should always be our first objective, there's certainly animal feed. But we've done some research looking at the example of university cafeterias. We've found that the mixed food waste from our cafeteria to RIT, based on its characteristics, is actually well suited as fish feed, if you go and look at the specs on typical commercial fish food. Beyond that, of course, we often think about composting. And composting is a great option, because we're taking the inherent nutrients in the food waste and returning those to the soil, and that's going to help facilitate the next generation of food products. The challenge with some of these options, and compost in particular, is that you have to look at the entire supply chain. If you're generating lots of food waste in the middle of an urban center, do you really have an outlet for compost? Is there really a market for the compost? Certainly if you're in more of a rural area closer to the center of food production, there will be an obvious outlet for your compost. But in an urban setting, that may not be the case. Other products that can be generated from food waste, certainly energy is a big one. There's lots of interest now, and this is an area where Ned and I are collaborating on anaerobic digestion. So we can take the food waste and, by the same biological process in the landfill, generate methane gas, which can be used to offset fossil natural gas and other fossil fuels. We can also use that material in fermentation processes to make, say, ethanol or butanol for vehicle fuel, or even organic alcohols that have many many industrial applications. Beyond the animal feed, compost, and energy options, another area where we're really focusing our research is biochar. So if we take this organic food waste material and process it at high temperature, in the absence of oxygen, we're creating a very stable carbonaceous material we call biochar. The interesting aspect of that material is it effectively sequesters carbon for very long time periods, hundreds or even thousands of years. So now when we use that material in manufactured products, such as, say, concrete, now we're converting that food waste into a material that can sequester carbon for long periods of time. And, offset other materials like fly ash, let's say, used in conventional manufacturing processes. So again, I would just emphasize that to look at different options for valorization in different products, you really have to understand that complete supply chain, and understand your markets. Because that is going to really dictate the scale that you need to work to utilize that food waste material.

Norbert: Ah, that's really fascinating. Thank you for sharing those options.

Brenna: So Ned, Tom hit on some of the technologies, in terms of aerobic and anaerobic digestion, and then this cool new biochar, which I was not as familiar with. But can you add on a little bit where we are, in terms of technology to convert wasted food into economically viable products?

Ned: There's a lot of great examples of some smaller pilot projects and people exploring different options, which is fantastic. But if you think about it in terms of utilizing this technology and society at scale, we still have a ways to go to really make holistic change in how we think about food waste and how we treat it. There are roles here for policy. Here in California, we've put in an aggressive policy: Senate Bill 1383. And the goal of this larger bill is to reduce short-lived climate pollutants. But one of the short-lived climate pollutants is methane. And we actually are specifically targeting organic waste here in California, and we're trying to divert 75% of organic waste that previously went to landfill to more productive uses. 75% by 2025, which is a very ambitious goal. So that means that we have to start getting these technologies deployed rather quickly. We would be using a lot of composting, a lot of anaerobic digestion, and we'd need to build out that infrastructure to really handle 75% diversion. We also included a component that we want to recover 20% of edible food that's currently going to landfill. And so I think this is an important way to think about food systems, again, when we think about food waste, is that we're not just trying to deal with this as a waste product, but can we think about it still as food? When we say wasted food, it doesn't mean that it's not edible anymore. In fact, a lot of this wasted food is perfectly edible. So let's think about ways we can keep as much food as possible in the food system before we rely on some of these technologies that treat it more as a waste. If we sort of zoom out, I do want to think about it sort of at that scale. What's the role of policy, how do we spur investment in a lot of these technologies that Tom mentioned, and how do we really make change at significant scale?

The other way I want to think about the technologies is that many of these are well known. Some of them are pretty well known, but not yet widely adopted, and some are really emerging. Tom mentioned two probably of the most well-known pathways, which is animal feed and composting. Two things that we've been doing for as long as people have been eating food: we have been diverting some of our leftover food to animals, and we've also been returning it back to the soil as compost. So certainly there's more opportunity to divert food from landfill to those two pathways. Anerobic digestion that Tom mentioned has been known for quite some time in Europe. It's widely used. Here in the US, we're a few years behind, but we are looking to expand the use of anerobic digestion. And, there's a lot more investment in that space. An interesting question for anaerobic digestion, this is one of the research topics I work on, is what is the right scale of anaerobic digestion? Is it better to have large centralized facilities that we transport waste to over longer distances, but we get the economy of scale of a large treatment facility? Or is it better to have distributed small scale anerobic digestion? Where we can bring the food waste, it doesn't have to travel as far, there's a lot of food waste in urban areas. Perhaps we can embed some of that treatment directly in the urban landscape to reduce the transport of this material over great distances. One other known but not widely adopted technology is upcycling. So this is getting back to the using edible food. So, a juicing company. And they're taking all these great fresh fruits and vegetables, and juice is coming out of one side of the juice press, but a lot of this great nutritious fiber material is coming out the other side of the juice press. And we can actually use that; We can incorporate that into products. Another example is making beer. We have a lot of great grain material left over after the fermenting process for beer. So there's companies out there that are using these byproducts and actually returning it directly into the food system, as chips, as granola bars, you name it. There's a lot of excitement in this area. It's been identified as a growing food trend the last few years, and we're starting to see a lot more of these products actually on the retail shelves.

One more pathway, which is really some truly emerging technologies that are focused more on extraction, so looking again at byproducts and trying to extract high value products. These can be things like antioxidants, or nutritional supplements, things like oligosaccharides, which are known as a prebiotic. So the food to feed your probiotics in your gut to ensure a healthy micro flora in your gut. All of these things can be extracted from different food byproducts. One example we're working on here is extracting both of those things, antioxidants and oligosaccharides, from grape pomace. So whenever you're making wine, you're expressing the sugars and liquid out of the grapes to convert into wine, but you have a lot of the leftover skins and seeds, known as grape pomace, and we're working on ways to valorize that material.

Brenna: Thanks for sharing all of those pathways, Ned. California is typically ahead in terms of policy, so I really appreciate you sharing what you all are doing on the West Coast. A note on the upcycled food, I do think that's a really interesting pathway, and I study a lot on consumer food labels, and so I know there are increasing studies trying to understand what consumers might be willing to pay for foods labeled as upcycled. But I've also seen, I believe it's a yogurt brand. They have a label that, I think says it's certified rescue fruit, certified rescued food maybe. So I think that's kind of been an interesting development that we see in the retail setting.

Ned: Yeah, and I think we'll see more of that as time goes on. There's a lot of creativity, and we even did an upcycled project with our students, and I've never really seen their eyes light up and get so excited about this, because they love to make new food products, and that's always exciting. But this little extra piece of having this sustainability component and this extra challenge of working with something that hasn't been traditionally seen as an ingredient really got them so excited. And it really caught on here on campus. In fact, we've been running sort of a challenge every year on upcycled food products. I think the last three of five business competitions we've had at the business school here on campus have been people presenting upcycled food products. So it's not just the sustainability component. There's a great story behind it that I think really catches people's imagination.

Brenna: Super interesting. I would love to connect more on teaching notes.

Norbert: That is wonderful. Both you, Ned, and you, Tom, have talked about new products and new ways of doing this, but there's an important issue. And Ned, I remember you mentioned this particularly, that there's an infrastructure concern here. And so my question to both of you is what kinds of infrastructure would need to be in place to make food waste streams economically viable for commercial product manufacturing?

Ned: That's a great question, and I think I might just take the opportunity to zoom out again to think of this at a high level. There's lots of different particular infrastructures for the technology we talked about, but if we think about it in terms of domains, I would say we need the physical infrastructure. And by that I mean composting facilities, anaerobic digestion, even labs to think about some of these emerging technologies, opportunities for extraction and upcycling, et cetera. But we also really need that informational infrastructure that Tom was talking about at the beginning of the hour here. We just don't have a great picture of where the waste is, and what the waste is, and how much, and when. And all of that information is going to really allow us to have better opportunities to come up with viable decisions about what to do with this material. So that's part of the focus of the project Tom and I are working on, is not just looking at the technologies, but thinking about how we can improve access to information and the information we need to really open up opportunities for others. Because there might be great ideas out there, but people might not be able to estimate how much they can scale that idea. How much tomato pomace is there if I have a solution for tomato pomace? And when is it available? How far would I have to travel to go get that material, and at what cost? We just don't have that information. So I think really coming up with a database that starts to track this information would be incredibly helpful. We still suffer from the out of sight out of mind when we think about waste. You know, we think about the primary products, and we're very good at measuring those things. But as soon as we don't see value in a material, we don't tend to track it. So that's a place I think we need just as much investment in thinking, is that informational infrastructure as well as the physical infrastructure.

Thomas: I would add a couple of thoughts, and Ned had touched on these earlier. One is just thinking about the scale of some of these systems. Traditionally, as engineers, we always learned about scale up. Everything has to be bigger. If you want to get your unit cost down, it's got to be bigger, bigger, bigger all the time. However, we're now looking at a scenario where maybe things at, say, a community scale make more sense for a variety of reasons. One is, at a community scale, the people that actually generate the waste can benefit from its valorization. Let's say for example, we can develop anaerobic digestion systems that are suitable for, say, a neighborhood of 25 or 50 homes, or a large apartment complex. Now the residents who are generating food waste that can be converted into methane can now actually benefit from that material, maybe offset their own energy usage. The other advantage of doing things at smaller scale is you can more reasonably valorize multiple co-products. For the biochar example I mentioned earlier, that's a pyrolysis system that makes the biochar, and that operates at high temperature. Well, that's an exothermic reaction. So if we were making biochar at a community scale, you could also use that waste heat to heat the homes. So if we can start looking at community scale deployments that can valorize multiple co-products, I think we can move a lot of these technologies forward and also eliminate some of those transportation impacts that are really running counter to some of the benefits. If we're transporting food waste a hundred miles, we're generating a lot of greenhouse gases to do that, and we're eliminating some of the benefits that we're trying to realize in the first place. The other infrastructure need that I did mention early on, we need to figure out the logistics. The technologies that are out there for converting food waste into useful products, they're generally pretty well known, been done for hundreds of years. The real challenge is how do we collect, and pre-process, and move around all of this food waste that, again, at the household scale, is generated in fairly small quantities, but at many, many, many individual locations. So how do we develop the systems to economically and sustainably collect that material and make it available for upcycling and to value added products?

Norbert: Thank you, Tom. It sounds like what you're suggesting is this idea of having to rethink the way our food system works, both in terms of how we've thought about waste, but also thinking about waste as something local, which is an interesting idea that I think coincides with people's interests in local foods, that there are ways of capturing the cost of that, but also capturing the benefits. And Ned, I really appreciate your comment about not only just physical infrastructure, but information. Creating new databases, new ways of sharing what is actually being developed in terms of food waste, and making sure that that's available to the people who can actually use that.

Bio

Thomas Trabold teaches courses in the fundamentals of sustainability science, sustainable energy systems, sustainable mobility systems, and green chemistry. His primary research focus is in the development of alternative energy technologies including fuel cells, bio-fuels, and waste-to-energy processes. In 2014 and 2015 he was nominated for the Richard and Virginia Eisenhart Provost’s Award for Excellence in Teaching, and in 2007 he earned the General Motors McCuen Award for “Neutron Imaging Facility and Methods for Fuel Cell Water Visualization.” His students say he has a system-level perspective informed by fundamental understanding and experiential knowledge. When Dr. Trabold isn’t in the lab or classroom, he enjoys soccer, basketball, trail hiking, biking, and gardening.

Ned Spang’s research focuses on characterizing and optimizing the efficiency of linked water, energy, and food resource systems. He is particularly interested in applying methods for measuring and monitoring these systems and their interrelationships in high-resolution and across multiple scales, both geographic and temporal. He further seeks to understand the influence of external markets, technological innovation, and policies on this integrated food-water-energy nexus. His recent publications explore the linked relationship between water and energy resource systems, the drivers and environmental impacts of on-farm food losses, and an in-depth review of the academic literature on food loss and waste.

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Today we're speaking with coauthors of a new report by the Center for Law and Social Policy, entitled "A Community-Driven Anti-Racism Vision for SNAP." Senior policy analyst, Parker Gilkesson, and community organizer, Tamika Moore, argue that although public benefits such as the Supplemental Nutrition Assistance Program provide critical care and support for families with low incomes, they also reinforce racism and structures of oppression.

Interview Summary

As I was mentioning to both of you before we started recording, this is a really interesting perspective, and it needs to be aired more. I'm glad we're playing a role in that. Parker, let's begin with you. Can you tell our listeners, what you're hoping to accomplish with this report?

Parker: So I was a social services worker for the State of North Carolina, and that is where a lot of my thoughts around policy, particularly pertaining to public benefits, arise. I saw so much while working there. I recognized that the systems in place often are framed as race neutral. They are set up to help people, however, there are multiple barriers put in place that particularly harm people of color. It was really important to me when I began my journey at CLASP, to figure out how we could bring along folks who have deep expertise. People who actually have received and been recipients of the program themselves. They are the experts. And so, that is what led me to bring together folks to create the Community Partnership Group, who wrote this report along with us, and which Tamika is a part of. It's super important to really set the tone for community driven vision for what the SNAP program can be. Obviously, just based on different systemic roots, the program currently, innately, is not anti-racist, even though it does help people and helps people of color as well. We talk about multiple barriers in the paper, what we want to grow, what we want to eliminate, we want to make better, so that it better serves people and moves on the journey to becoming more anti-racist.

Let's talk in a little more detail about something that you just mentioned, which was the importance of the partnership between your center, the Center for Law and Social Policy, the staff there, and people with direct lived experience of people in the communities that are most affected by these programs. And you've created something called the Community Partnership Group. So can you tell us a little bit more about that group and why is it so important?

Parker: So the Community Partnership Group is a diverse collective of activists from across the US. They partner with us, other nonprofits, administering agencies, and policy makers, to ensure that whoever they're working with, the work is grounded in the expertise of people who are directly impacted by poverty. This group is small but mighty. We work together on multiple issues. Tamika works on youth issues. We have other folks who work on housing. We've been meeting together over the last two years. It was definitely something different for a CLASP to embark upon. It had not been done before, where we wanted to deeply engage with folks to really shape our minds around what policy changes could look like. And to do it in a way that wasn't transactional, that wasn't, "We're just going to consult with you all on this one off project." Or, "We are just going to create something and bring it back to you all for your advice," versus helping them to be a part of the process. I'll push it over to Tamika to talk a little bit about her experience with this.

Tamika, I'm glad that we can hear from you on this. So what are your thoughts on this issue of a partnership and working together with a group like CLASP?

Tamika: It has been nothing short of incredible. They are extremely supportive. Our entire group is extremely supportive. I've been a part of the Community Partnership Group since its inception in 2020. I do youth empowerment work as well as anti-hunger work. I am a lived experience expert, someone that has gone through and used these programs, and been street homeless, and lived in my car, and I've utilized these programs over a course of several years. I don't anymore. But I have plenty to say about them and how these different programs and different pieces of legislation that affect these programs can be updated and changed to actually benefit the people that's supposed to benefit. Being a part of this and having this partnership with CLASP, with everyone else in the CPG group, has been an incredible journey.

It's really nice to hear from both of you that this partnership is working so well. These partnerships don't happen all that often. It really takes, I know from our own experience, a lot of work by all parties to make these successful. So congratulations for doing something pretty unique and important. So Tamika, back to you. Could you share some historical examples of what you see as institutionalized racism built into the SNAP program?

Tamika: We can find institutional racism across the board when it comes to the SNAP program. From different neighborhoods that need the SNAP program and that are impacted by different policies that block individuals from receiving SNAP benefits, such as the drug felon ban, to gatekeepers that are hired and are supposed to approve, disapprove the benefit to the participant. These individuals, their training, affect the lives of people that they're supposed to be assisting. The foods that are available in these neighborhoods, what's available and accessible in the neighborhoods that mainly receive SNAP benefits, which are obviously disproportionately, black and brown communities, communities of color. Not having access to hot foods, which is just a policy issue in and of itself. But not having access to nutritious foods, like fruits and vegetables, in these neighborhoods that receive the SNAP benefits. Not receiving enough of a SNAP benefit to even benefit the way that you're supposed to and be able to feed your family, is another one. There's just so many different ways that this affects the SNAP policies and SNAP benefits.

Let me ask you a follow-up question about that. You've given a lot of examples and I really appreciate that. Can you tell us a little bit more about how individuals experience interacting with the system? How does it make people feel to interact with such a system, and does this affect people's willingness to engage with the SNAP program? Or does it affect, you think, the number of people who are eligible, who enroll in the program? What's it like?

Tamika: A hundred percent. I can say from personal experience. I was homeless for a period of time before I applied for benefits myself because there's such a stigma attached to receiving these benefits. That you're lazy, that you don't want to work, that you're a bum or a whatever other derogatory terms. I'm sure you've heard them, we all have. Or you're on drugs, or you're an addict of some kind. Anything and everything. But that's simply not the case. I wasn't on drugs, I didn't have any children, no one could say, "Oh! You know." But there's such a stigma attached to it, it keeps a lot of people from applying. And then when you do apply, you're in this place where there's so many people that are needy, that are in the position that you're in. And it's a re-traumatizing system, to have to tell someone your story, first of all, that you don't know. Tell them what's going on in your life, and actually admit to the fact that you can't provide for yourself and that you need help. But to have to go from that person to another person, to another person, to another person, and actually hope that these people care. They're dealing with a number of people throughout the day, so it's stressful on them as well. But to actually talk to somebody that cares about what's going on in your life, that wants to help you, which is not something that happens often. Unfortunately, I was homeless for seven months before and I went through three social workers before I got to someone that actually told me how I could help myself. This is why I call them gatekeepers. Because they are the individuals that ultimately have an effect on whether you receive this assistance that you need so badly, or whether you don't and you continue to struggle.

It's not a great process. It needs to be updated, it needs to be streamlined in every state so that you don't have to be re-traumatized every time you have to go in there. You don't have to re-qualify. Every time you have to re-qualify, you have to worry about losing your benefits. You're threatened by letters and stuff that you receive when it is time for re-qualification. I mean, it is so hard to explain without becoming relatively emotional, but it's a terrifying process when we're supposed to be helping people. These are our people, and we're supposed to be helping them and lifting them up. Instead, we're threatening them every step of the way. If you lie about this or if you misspeak about this, there's public charge associated with so many different parts of this process as well. And you're just like, "I don't know what to say." So you don't say anything, and you don't get the benefits that you could have gotten. There's so many different parts of this. It's just not a great process. It's not a fun process, it's not a good process. It needs to be revamped.

Tamika, I appreciate you sharing that, and I'm sorry that I've asked you to relive it yet again. But it really helps, I think, paint a picture of what it's like to interact with a system like this and how traumatizing, re-traumatizing, and difficult it can be. So thank you very much for sharing that. Parker, why don't we dig into the report recommendations? Can you describe to our listeners, what you believe the key points in the recommendations are?

Parker: We have multiple recommendations that fall into different buckets. The main thing that we want, is that SNAP should absolutely be available to all who need it. Meaning, remove any barriers for folks who like Tamika mentioned earlier, who have been formally incarcerated students, immigrants. Even some indigenous populations who receive another food program that's full of canned foods and not fresh foods, if they received at that month, they aren't able to receive SNAP. That's not fair. Also, residents of Puerto Rico. There are multiple different policies right now that prevent different groups of folks from being able to receive benefits. So we want to make sure that it's available to all who need it.

We also want to make sure that it's sufficient enough to meet the needs of community members. So we want to make sure that, number one, we protect the Thrifty Food Plan. Although it's the lowest level food plan, they just reevaluated it last year, and we want to protect that. We know that there are multiple legislators that want to come against it. We know that the SNAP program does help folks, and we want to protect the good changes that have happened. But we also know that we need to increase overall SNAP benefits. Right now, currently per person, it is around $5 per day. $5 per day, so that's around a dollar and 33 cents per meal. I don't know anywhere that you can get a meal for $1.33 cents. So folks are having to make difficult decisions about what type of food they want to provide for their families. We think about food policing, and telling folks they can't buy sodas with their SNAP benefits, or they can't buy sugary foods, or they can't buy chips and all these different things. But the reality is that, to stretch someone's SNAP benefits to make sure that their families feel full, we can't talk about nutrition, and we can't talk about healthy foods without talking about increasing the benefits. Because at that point we'll be blaming people for the difficult choices that they have to make, instead of recognizing that the SNAP benefits just aren't enough for a sustainable diet. Not only in terms of the cost of food, but also in terms of culturally appropriate foods. In different communities, whether it is Caribbean, African, Latino communities, we use different spices, we use different beans and flavors, and different things that also cost a lot of money. And so, oftentimes the diets that are used to estimate the average cost of food are Eurocentric diets. And so we have to move away from the idea that Eurocentric diets are the only diets that are healthy. That's not necessarily true. When we look at the more culturally diverse diet, and we add those foods as we estimate the cost, that will help SNAP benefits to go up as well.

In thinking of different dietary needs and different things of that nature, we also want to expand bonus funds for accessing fruits and vegetables. So currently there are multiple programs. One that we talk about specifically in the paper is a farmer's market benefit where if you have a farmer's market in your area, you can use double benefits to purchase from the farmer's market. However, farmer's markets are seasonal. Farmer's markets sometimes for different communities are extremely difficult to get to. And so, if we want to encourage fruits and vegetables, and the purchase of them with the SNAP program, we should encourage that by using this benefit across all grocery stores.

And one of our major, major, major recommendations, is about hot foods. This is one that many folks in the anti-hunger community, don't necessarily jump into but it was super important. The group was really serious about us taking this on to really talk about how the SNAP program should allow people to buy hot and prepared foods. Because it is something that is necessary for folks who have experienced homelessness, for folks who may live in housing where they don't have a working stove. There are so many different situations that we've heard of through doing our research and talking to folks, where if they were able to purchase hot foods with the SNAP program, it would completely and totally change their lives. So I'll let Tamika jump in here, to talk about our recommendations with hot foods, and also just talking about subsidies, in terms of fruits and vegetables.

Thanks, Parker. I appreciate it. There are a lot of very concrete ideas among your recommendations. So Tamika, what would you like to highlight about the report?

Tamika: So I'm going to start with hot foods, speaking with direct personal experience with street homelessness while I was receiving benefits. I'm first going to address just how dehumanizing it is to tell someone that if you don't have a stove or a kitchen, that you don't deserve a hot meal. That's basically what the current SNAP policy is insinuating, right? Because if you don't, you can't. It's ridiculous to think that someone is homeless and out in the cold in the wintertime, and they can't go and get a bowl of soup from the corner store or from a grocery store, if they have access to one, or somewhere like that. Or a hot dog or just something that's hot to warm your stomach. Food should be treated and accessed as a basic human right no matter the disposition of it. And that's just the fact of the matter. Could you imagine someone telling you that you can't have something hot to eat just because they don't want you to use the dollars that they're giving you for that? It's incredibly dehumanizing and ridiculous.

And then also as a homeless person, you really can't budget the same way that you would if you did have access to a fridge, or a refrigerator, or a stove. You can't go and buy milk because there's nowhere to put it. Or eggs, or rice; nowhere to cook it. Pancake mix - nowhere to cook it. These are all things that you could use to stretch those dollars for yourself and your family. You can't do these things. So you actually end up spending more money having to go to corner stores and buy whatever it is that they have at the corner store that you can eat that day rather than being able to cook something for yourself, or buy something that is hot for yourself. One of my colleagues talks about the frozen chicken or frozen turkeys at the grocery store where you could buy a roasted one for $7, maybe 5$, $7 something like that, that's already cooked. But you can't buy that. But then you can buy the frozen one that's $14. It's just not cost effective either. And like Parker just highlighted, that is what you're limited to with the SNAP funds.

As a single person in the United States, the benefit right now is about $192 or less. The USDA estimates that for a single person, a single person in the United States, it's $230 to $420 per month. So the benefit is not enough to sustain you. We know that. Just for a single person, not enough to sustain you. Now going to the corner store, you're reduced to those foods, which we know is not nutritious in any way. And like I said, more expensive in the long run. Furthermore, it is re-traumatizing to have to go to the store or corner store, whoever or wherever you're going every day, to ask them to heat something up for you too, because you don't have access. Being homeless is already a daily battle, mentally, physically, emotionally; a battle. You're constantly having to fight negative thoughts and feeling unworthy. Having to go and ask someone to heat up food for you because you can't do it for yourself, it just amplifies those feelings.

I'm so happy that you're able to lay some of these things out, because these are not stories that everybody has heard.

Tamika: That's one of the reasons why we're hearing why it's important to have someone's perspective that has experienced these things. It's important to have people with lived experience in the room when you're creating policies that affect the individuals that actually experience these things. This is why. This is why. It's a different effect. If you have never experienced that, I don't feel like you should be writing a policy that affects someone that does, especially not without direct input from someone that has.

Bios

Parker Gilkesson is a senior policy analyst with the Center for Law and Social Policy’s Income and Work Supports team. She specializes in work support programs for people with low incomes and focuses on the Supplemental Nutrition Assistance Program (SNAP). Parker is a subject matter expert in social policy, benefit eligibility, human services delivery, racial equity, community partnership, and state and local policy regarding SNAP, Temporary Assistance for Needy Families (TANF), and Medicaid. She has been quoted in TIME Magazine, New York Times, National Public Radio, The Hill, and many more. Prior to joining CLASP, Parker began her career as a human services specialist in Mecklenburg County, NC. In this role, she worked directly with people to determine their eligibility for Medicaid, TANF, and SNAP. Parker earned a Master of Public Policy degree, with a concentration in public administration, from Liberty University and a bachelor’s degree in health education, maternal and child health from Howard University. Parker believes all policies should be grounded in the wisdom and experiences of those directly impacted by them. Therefore, she has worked to co-create a community of shared learning that highly regards lived experience as necessary expertise in the quest toward equitable policy solutions. Parker is passionate about systemic change that addresses root causes to eventually eradicate poverty and inequities in the health and social welfare of our nation’s residents.

Tamika Moore is a New Jersey native who has spread her passion for youth empowerment through her non-profit organization VisionWorkz. Her mission is to help guide, inspire, and empower LGBTQ youth to see their true potential and value. She pushes to provide healthy and safe avenues for teens and adolescents to release their emotions on a creative and functional basis. Tamika has traveled the East Coast delivering her global vision of bringing the input of young people to the forefront for legislative changes involving education, programs for teens, and poverty. Tamika contributed to the LGBT curriculum in New Jersey and believes in helping to establish core values like financial literacy and professional development to help kids feel secure about themselves and their future.

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Today's podcast is part of a series on food waste. When farmers produce more of a product than people are willing to buy, or when the demand for a product falls unexpectedly, food is wasted. What role do agricultural policies and politics play in creating and perpetuating cycles of supply challenges? Our guest today is Dr. Garrett Graddy-Lovelace of American University. Garrett is an agricultural policy expert and she studies the problem of food gluts through the lens of social sciences, international affairs, history and analysis of USDA data.

Interview Summary

This podcast is co-sponsored by the Recipes Food Waste Research Network led by American University and funded by the National Science Foundation.

Norbert: Garrett, from your perspective, why do you think a historical policy analysis is useful in discussions of contemporary issues of food waste and loss?

It's a crucial question. The current situation of wasted food is uniquely contemporary and it's unprecedented, but its root causes have long roots. On one hand, there's a complicated but telling geography kind of spatial aspect to the wasted food fiasco we're in. We have vast global supply chains with pinch points of precarity. There are so few processors to butcher and process such vast quantities of meat. So few mega ports for all of these millions of shipping containers. So few companies owning all these markets and so few grain storage facilities for these mountains of corn and soy. So it's a spatial situation. But, it is also a historical situation. There are conditions and incentives driving commodity crop production and overproduction right now that have deep roots in US history, in global history, even in colonial history. So historical perspectives are crucial to help tell the why and the how. The current situation in configuration might seem natural or inevitable, but unpacking how we got here helps us understand, dismantle and reconfigure the policies, political economies and paradigms that got us in to this mess.

Brenna: Those are really interesting perspectives, Garrett, and I'm looking forward to hearing more. So since we are on the topic of policy now, how do you think Ag policy and particularly the Farm Bill has shaped or created food waste?

Good question. So the broader World Trade Organization began in the mid '90s and it's an extension of the general agreement on tariffs and trades, which was the Bretton Woods's Post World War II, World War I set of international governance paradigms. It really liberalized agricultural trade and arguably neoliberalized it. And so it set in motion a whole situation that we're in now which deregulated national and federal government policies around supply coordination, supply management. So from the mid '90s on, you've got a set of policies around the world that really opened up trade. But, it also opened up the incentives to compete with each other around the world. So farmers were competing with each other in this arguably race to the bottom of farm gate prices, which incentivized cycles of overproduction that we're in now. The policy shifts that happened domestically, and all of these countries around the world, emerged from the paradigms of the mid '90s. The WTO and the broader focused on moving enormous quantities of commodity crops around the world in a comparative advantage model. But it ended up creating enormous quantities of food circulating around the world that then is very conducive to supply chain gluts and to pinch points where there are blocks and a precarity that we're in now.

Norbert: Thank you for that. I would love for you to point out one particular historical policy that you think is critical for us to understand this.

The elimination of export subsidies was crucial and many of the intentions behind what ended up becoming the WTO were actually about decreasing dumping. So the anti-dumping measures are so crucial as a broader paradigm and a governance goal. But as you know better than others as Ag economists, the loopholes allowed for some countries like the US to continue overproducing a certain commodity crop and then offshoring it through complicated ways that were not explicit subsidization of exports. So the ending of export subsidies is a universal good, but it did not end the broader problem. And obviously, this is a exceptionally complicated topic, but the broader question of policy needs to be contextualized within political economy. So there's a set of political economies at work that we're in now, which gives inordinate power to private industry in terms of input suppliers and in terms of commodity crop purchasers. As a result, the situation we're in now is that you have a handful of firms who are price setters and they can really decide the price of inputs and the farm gate price of various commodity crops. And the broader configuration is that farmers are squeezed around the world with expectations and incentives of expensive input purchases, annually purchased inputs, and then farm gate prices that don't cover the cost of the production. So that's a political economic situation. The question is what's the role of policy? I think what's interesting for me and for Norbert and for others in our research team is that there's a long history of policies, governmental policies particularly in the United States, that have attempted to protect farmers from this squeeze. This treadmill of buying more inputs and trying to sell more and growing more to cover the cost of what they've invested in that particular season. And, it lends itself to overproduction unless there's a way to mitigate that kind of treadmill cycle of overproduction. So, the policies that we're interested in began in the 1920s and the 1930s which we'll talk about with the Agricultural Adjustment Act. They really were ended in the WTO in a convoluted way in the attempt to end trade distortions. There was a way in which the corporate interests or the private firms gained even more power and say in the broader trade and agricultural economics and practices around the world. I think the WTO is so fascinating because the intentions behind it are truly important. And many of the measures like the anti-dumping and the ending of subsidized, explicitly subsidized exports which are so deleterious, so destructive to local farm economies around the world were mitigated, but the loopholes have grown. And actually the disparity between kind of corporate interests and the private firms and farmers themselves, small and medium-sized farmers has grown even more egregious. So, the role of policy in that I think is what we're analyzing today.

Norbert: Garrett, you've done archival work looking at agricultural policy from the Agricultural Adjustment Act, the original Farm Bill legislation from 1933. What has inspired you to see food waste and loss as a critical issue?

It's a great question. The Farm Bill in its current iteration enables and exacerbates wasted food. But it would be, I think, reductive to say it causes it and stop the analysis there. So, this kind of takes some historical analysis. We're going to go back to the archives, but before we do, we kind of think about the 20th century. Over the course of the 20th century, the Farm Bill has become a behemoth mechanism for disposing of surplus commodity crop production. So if you think about Title I, Commodity, and Title II, Conservation, those actually have at their origin - the beating heart of the Farm Bill - an attempt to prevent another great depression economically, that's a commodity title, and another Dust Bowl. That is the environmental impacts of overproduction, Title II, conservation. So there was a supply management coordination attempt to end overproduction and end the price fallout of overproduction woven into the heart of Title I and Title II. Once you get to Title III which is Trade, and you go back to the archives, the justification for Title III was move this surplus. We've got to get rid of this growing pile of surplus. The Commodity Crop Corporation, the broader CCC arm of the government is trying to mitigate overproduction by buying the surplus and getting it off the backs of the farmers. But then it had a huge kind of glut. So trade was a matter of offshoring and offsetting the food aid and the food trade in the 1950s and the 1960s. And then frankly, Title IV nutrition, which has all of these noble crucial intentions of feeding the people actually is a surplus disposal mechanism as well when you look back at the archives. And even Title IX which is Energy, has a surplus disposal mechanism of corn in moving it into bioethanol. So the Farm Bill has kind of hidden overproduction through these surplus disposal mechanisms and not been able to prevent it. And then of course, we get into where we are now where why doesn't the research title fund investigations into wasted food interventions? Why aren't there discussion of composting systems or ecological biodigesters to divert methane from landfills in the research title? So right now, it's more what the Farm Bill doesn't do. It doesn't curtail excessive monopolies in the agrifood sector. It ends up subsidizing them. It doesn't provide nearly enough for regional adaptive supply chains or markets which are much more adaptive to shocks in the system like Ukraine or climate change. So the Farm Bill doesn't do what it needs to do, but it's not the root cause of wasted food.

Brenna: Those are really interesting points that I think many of us at least from an agricultural economist perspective don't necessarily talk about in that way. One thing I wanted to follow up is you mentioned the current Farm Bill doesn't really do much to address food waste. I think the most recent Farm Bill did establish the food waste and loss liaison to try to kickstart some food waste reduction initiatives. So I'm curious just to get your thoughts, would you say that that effort is not nearly enough?

Yes, it's such a good question. So the Miscellaneous Title is the best thing happening in the Farm Bill. All the farmers know and the practitioners and the activists and the scholars. And so, there's an optimistic way you could look at this and say there are such innovative, broadly far-reaching exciting pilot programs tucked into the Miscellaneous Title or even into the Horticultural Title around farmer's markets, around racial justice, around food waste prevention, wasted food prevention. But on a macro level, it's tucked into the Miscellaneous Title, oftentimes with discretionary funding, not mandatory, so you have to fight for it each five years. And the appropriations get divvied out, so it's not rock solid in terms of mandatory appropriations. And so there are wonderful pilot programs that began in the 2018 Farm Bill, frankly, directly because of scholars and activists and civil society clamoring for it. But on the macro level, the bulk of the Farm Bill itself is status quo in terms of commodity crop overproduction when you really kind of see where it's going and it's largely going to ethanol or to concentrated animal feeding operations, CAFOs, or to highly processed additives for foods that aren't nourishing. So yes, it's exciting that there are these micro provisions and there's these pilot programs that are so exciting tucked away into the Miscellaneous Title, but arguably the scale of the problem that we're in now demands a much more transformational approach to the Farm Bill.

Brenna: Thank you so much for weighing in on that. I was excited to hear your thoughts.

Norbert: Garrett, I know that you are committed to social justice, especially around food and agriculture. What is the social equity lens to food waste and loss that you think is important for people to consider?

Thank you for that. So wasted food is a tragedy of squandered farm work, top soil, water, energy, shipping containers, and single-use plastic wrapping. All of the labor, all of the time going into food that ends up becoming methane and egregious climate greenhouse gas. And so I think when we look at this situation, there's an issue of wasted resources, but there's also the injustice of the people who are doing much of the work along that supply chain to get that food to people's table themselves can't afford food. So the inequity, the acute injustice of food insecurity next to and even within the system of wasted food is a disaster. But, it's also defining of a failure of governance and a failure of our research institutions. There are so many smart people in the US, so many expensive labs, so many great research infrastructures and networks. Surely there's a way to coordinate these smart minds into analysis and interventions that prevent wasted food and that move agricultural production to where it needs to go, to hungry mouths and to people's plates and to remunerate food producers fairly for their harvests. So the urgency of wasted food has become one of the defining parts of my research and my teaching in my scholarship. In terms of the history of this, I was fascinated with how surplus is not used as a term. This is something that Norbert and I are researching. Ag economists and Ag policy experts don't use the words overproduction or glut or surplus these days. But if you go back into the archives, it is such a ubiquitous problem that in the archives, it's called the Farm Problem. It's actually just called the Farm Problem and it's the problem of overproduction. And so, a little bit of history here, World War I, there was a whole incentive structure by the US government to feed the allies over in Europe and win the war through wheat production. So all of these farmers in Europe and throughout the Middle East who were part of World War I were in the trenches. They needed wheat. So, the US ramped up wheat production. It actually incentivized farmers to go out into the prairies and dig up those deep-rooted prairie grasses and plant wheat, single season wheat. And prices were good. And so, what do farmers do when prices are good? They grow more. And so, there was more and more production in 1914, 1915, 1916. Then the survivors of World War I crawled out of the trenches, went back to their farms and grew their own wheat. Then there was too much wheat on the global market and prices started to go down. What do farmers do when prices go down? They grow more. So all of a sudden, US farmers were madly ripping up prairie grasses, deep rooted prairie grass, planting more wheat. There was so much wheat on the global market in 1918 that it crashed the prices. There was an agrarian economic crisis in the US in 1919 and 1920, and farmers went to DC and said, "Please help us end this cycle of overproduction. We're competing with ourselves, with each other, our neighbors, and it's suicidal." And so that began the broader political movement to have supply management with the price floor for farmer viability and a way to not overproduce and destroy the soil, which is what led to the Dust Bowl. By the time you get to the Agricultural Adjustment Act of 1933, you've got a whole system of supply management which was in place. It was dysfunctional. It was not perfect. It largely helped White male farmers and it had some other issues to excluding tenant farmers who were largely Black farmers in the deep south, but as a principle to stave off the ravages of just kind of capitalism unfettered in agriculture, it was important to think about as a precedent. And so, cut to 1940s, 1950s, 1960s, by the 1970s, it's really eroded the supply management and by the 1980s, 1990s, it's gone. By the 1996 Farm Bill, there's hardly any supply management or price floors left. I think what's interesting for us is that there's a powerful precedent from a governance perspective of ways to mitigate cycles of overproduction. Now we're in a situation where there's not only no mechanisms from a policy perspective to mitigate overproduction, it's enabled and totally forgotten. There's really an amnesia about these parody policies, these price floors, these supply managements, these non-recourse loans, these quotas, which again, were not perfect, but they were an honest recognition that you have to have some protection. Otherwise, the corporate buyers and the broader political economy will just drive down the farm gate price and the farmers individually will just overproduce to try to get out and exacerbate the problem. I think looking at the historical origin of the Farm Bill helps us have clues as to how we could update it. How we could expand it. How we could make it more fair for a broader diversity of farmers. How it could apply to much more diverse crops than just these eight commodity crops, these kind of handful of commodity crops that it was designed for. So how could parody pricing and supply management be updated for ecological production, nourishing food production for a whole new generation of BIPOC farmers? I think we're thinking about that history as inspiration for agricultural policies moving forward that coordinate supply and demand more wisely frankly.

Brenna: Those are really interesting perspectives. I had no idea about the Farm Problem language use and I'm really curious to hear more about what you and Norbert are doing and look forward to seeing those results in the future. I was wondering if you could tell us a little bit more about what food waste and loss looks like from an international perspective and what are some of the policies abroad or globally that you think contribute to the wasted food that we see today?

It's a great question, Brenna. I'll preface by saying there are myriad international perspectives. So I certainly don't want to presume to speak on behalf of these international perspectives, but I'll also say that one cannot address this issue from a national perspective alone. One never could, but particularly now because the US agricultural policies and practices and the actual food stuffs and the climate emissions are deeply connected to those around the world and vice versa. There's a dominant political economy that is really impacting farmers and fishers around the world. It's really fascinating that the millions of different agricultural, aqua agricultural food systems around the world are now related to each other through price setting that is globalized and through supply chain pressures. Even at this point, Ag extension and national governments are all working very closely with or for a few set of agro-corporate firms. There is this incredible interconnectedness and interconnectedness sounds great, but in this context, it is an interconnectedness to a set of private industries - Cargill, Archer-Daniels-Midland, Walmart, PepsiCo, Monsanto, Bayer - input suppliers and corporate buyers. They have inordinate influence on national governments and agricultural extensions and ministries of Ag around the world. And philanthropy - the Bill and Melinda Gates Foundation - which is technically a philanthropic organization, but has deep ties to private industry from the standpoint of Microsoft data and agricultural data. Which is, frankly, as farmers say around the world, "my data is worth more than my product." There's an enormous political economy of agricultural data at work right now. So there is an interconnectedness around the world that we need to analyze.

There's also a set of political economies and paradigms around the world that are very powerful. A model of development that is so pervasive around the world is that there is, underdeveloped or developed, there is a paradigm or an expectation that farmers around the world will want to and need to industrialize their respective farms. And that expectation, that model or that paradigm demeans or denigrates a whole set of agricultures around the world that are small scale and that are low input and that are biodiverse and that are not export oriented. That are oriented toward feeding local farmer's markets or local village markets or local families or networks. So there's a systemic devaluation of farming practices that are oriented toward local or regional production that have agro-biodiversity at their heart, that have semi-subsistence or low input agricultural models at their heart. A systemic glorification of very high input, intensive export-oriented commodity crop monocultural overproduction. So that paradigm makes its way into Ag extension agents, makes its way into philanthropic donations, makes its way into agricultural aid, agricultural development funding. And that paradigm is global. Every village around the world is either internalizing the inferiority of their small-scale production and their biodiverse production or resisting it, frankly. There's a whole global movement that's resisting that paradigm and says actually a climate-resilient future would need to have agroecological production grounded in Indigenous and African diaspora foodways. A lot of culturally-specific, place-based agrarian knowledge, which is not necessarily export-oriented though it could be, but is more geared toward feeding or nourishing local villages or communities or networks. There is a whole global movement of farmers and farm coalitions that say why denigrate that as underdeveloped? Why not celebrate that as actually the future of climate-resilient, climate-just agroecological production.

Brenna: Garrett, I know that you are committed to social justice, especially around food and agriculture. So what is the social equity lens to food waste and loss that you think is really important for people to consider?

So thank you for that. I'll say the first one is that there is food insecurity. There's hunger in the system that's producing wasted food and that, as I've said before, is a tragedy and an injustice and a failure of research and governance to think through how we can prevent that. And, how we can move nourishing food to people who need it and while remunerating the farmers and the food providers and the fishers for the beautiful work of feeding people. So that's the most acute level. But I also want to say, getting back to history, I know that's one of the themes of today, looking at histories of policies are so important. The archives have so much to teach us. But also elders and farmer elders around the world have so much to teach us. So oral history is a methodology that I love and I respect and I use and particularly Indigenous and African diaspora and immigrant elders in the US who have such knowledge of agrarian practices, of agroecological production, of seed saving, of foodways, of nourishing foodways, of climate-resilient foodways. Those sets of knowledges have been frankly systematically devalued by academia - by my institutions - as underdeveloped or as passe or as irrelevant. But in fact, as climate crisis encroaches, those knowledges of how to forage in the forest, how to grow nourishing gardens, how to grow agrobiodiverse farms, how to raise livestock breeds, heritage breeds, these knowledges that have been devalued frankly along gender and class and racial lines need to be celebrated. There's an epistemic inequity at work in our current situation where the real knowledges of how to grow nourishing food and provide nourishing food have been devalued when right now we need those knowledges more than ever. So there's a whole reevaluation and reclamation of agrarian place-based agroecological knowledge that I think will help us, not just prevent wasted food and really re-localize and re-regionalize supply chains and markets and economies and ecologies, but also help us provide nourishing food for communities in a climate-resilient and climate-just way.

Bio:

Garrett Graddy-Lovelace researches and teaches agricultural policy and agrarian politics. A critical geographer, she draws upon political ecology and decolonial studies to research agricultural biodiversity conservation, agrarian cooperatives, land use decisions, and domestic and global impacts of US farm policies. This includes community-based research-action with grassroots groups on the Farm Bill (see disparitytoparity.org project). Her forthcoming book, The Power of Seeds & Politics of Agricultural Biodiversity, is with M.I.T. Press. She is co-PI for a SESYNC-NSF Pursuit, entitled "Diverse Pathways to Nourishment: Understanding How Agricultural Biodiversity Enhances Food Security, Sovereignty and Nutrition" and Senior Personnel for AU's $15M NSF RECIPES grant on Wasted Food. She was awarded the inaugural Provost Associate Professor title, the 2022 School of International Scholar-Teacher of the Year Award, and the SIS Excellence in PhD Mentoring Award. Graddy-Lovelace co-founded and co-leads School of International Service's Ethnographies of Empire Research Cluster, and the nation-wide Agroecology Research-Action Collective. She is a Faculty Affiliate for AU's Antiracist Research & Policy Center and Associate Director for the new Center for Environment, Community & Equity. Additionally, she works on and for open knowledge and Indigenous data sovereignty.

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School meal programs provide children with needed meals, snacks, and even take home foods throughout the world. These programs have a tremendous impact on children's overall nutrition, physical, and emotional development, and their academic performance, as you can imagine. Much can be learned from a project that is entitled The Global Survey of School Meal Programs. Today we will be speaking about the second such survey with Global Child Nutrition Foundation Research Coordinator, Ayala Wineman, from Michigan State University.

Interview Summary

Well, this is a really interesting topic, and a lot of people don't think beyond the borders of the US when they think of school meals, but this really is a global issue and the place where countries can learn from one another. So let me ask you first, what is the Global Survey of School Meals, and what do you hope to accomplish with this work?

The Global Survey of School Meal programs is a survey that is administered at the country level. It is designed to gather information about school feeding, in a manner that is very standardized, very consistent, in how the information was collected. Before the Global Survey was introduced in 2019, the data landscape on school feeding was very fragmented, very spotty. You would find good information about school feeding for one country, but not for another country. You could find good information about what is happening with school feeding for one year, but it would then not be updated. And, you'd be able to find information much more easily for programs that were implemented by international development partners, like the World Food Program. But, it was much more difficult to find information about programs that were implemented by national governments. So with this kind of fragmented data landscape it was hard to understand what was going on across all the different countries, and also hard to see how things were changing over time. The Global Child Nutrition Foundation introduced the Global Survey of School Meal Programs in 2019, in order to address this knowledge gap.

The survey asks for information about a whole range of topics. So in every country it asks for information on the numbers and characteristics of beneficiaries, the avenues through which school feeding programs procure food, the modalities through which they distribute food to the children. It asks about funding, about the extent of government involvement, related health and sanitation interventions. In the second round of the survey, which was conducted in 2021, it also was able to ask about the impact of the COVID-19 pandemic. The database is intended to be updated every few years, so the rationale for the survey is to produce this data as a public good, to help country governments recognize gaps in their own awareness of what is happening with school feeding in their countries, and to guide them in remedying those gaps. The data set is available upon request, and information is also available on the GCNF website at gcnf.org.

So I'm imagining the fact you did this in 2019 and then again in 2021 had something to do with COVID, is that correct?

The goal was always to have this be updated periodically, because we want the data to be useful for tracking trends over time. And also to measure impacts of shocks, to measure how school feeding programs are affected by shocks - it doesn't have to be COVID-19, it could be anything else - and how school feeding is evolving over time. We will be doing a third round of this survey in 2024.

Good, that'll be really important. So what is the process of administering a survey designed to be answered by the country governments?

I'm more accustomed to surveys that are administered to households or individuals. So for me this has been a really unique format for a survey. We have a data collection period which lasts about six to eight months, and we have an amazing survey team that's positioned throughout the world. Everyone on the team is assigned a portfolio of countries to invite to participate in the survey. Most countries agree to participate, and assign one person the responsibility of completing the survey on behalf of the government. Now the survey asks for information at the level of the country, and also at the level of each large-scale school meal program that's operating in the country. Once they have gathered all the information together, they submit the survey. There is some back and forth, in order to clarify anything that wasn't clear, or perhaps doesn't add up in the survey submission. We really intend for the governments to own their responses and to take responsibility for knowing what is happening with school feeding in their countries.

What are some of the key results from the survey?

The survey is very rich, but I can pull out just a few highlights to share with you. In 2021, we received responses from 139 countries. Together, these represented 81% of the world's population. We received responses from every region and from countries at every income level. 125 countries had at least one large-scale school feeding program. The first key result is that at least 330 million children received food through school meal programs. The share of children who are of school age, who benefit from school meal programs, was 27%. This did vary across different regions of the world. The highest rate was seen in Latin America and the Caribbean, where 55% of school-aged children receive food through their schools. And notably in low-income countries, just 10% of school-aged children benefit from school meal programs. In high-income countries, 47% of children benefit from school meal programs.

Over the previous three years, the aggregate number of children that receive school food increased by about 7%. In sub-Saharan Africa, 71% of countries reported a positive trajectory in school feeding numbers.

We found that programs serve, on average, 6.9 different food categories, things like greens, or dairy, or fish. Not surprisingly, the diversity of the food basket, or the menu in school meal programs, varies across regions. So the diversity seems to be, on average, greatest in Asia, and it is least in sub-Saharan Africa. It's also higher in high-income settings, and lower in low-income settings around the world. As just one example, there's a 75 percentage point-gap in the share of programs that served fruit in school meal programs, in high versus low-income settings.

Thanks for that background, really helpful to know. Let me ask you a few big-picture questions. You mentioned the word "procurement" along the way, which interests me a lot. Through procurement, institutions can express statements of what they're trying to accomplish by where they buy their food.

Yes, procurement is a really important topic in school feeding. We definitely hear a strong narrative of programs that desire to focus on domestic procurement, especially in settings that have historically relied on in-kind food donations from international donors. There is a stated desire to shift towards sourcing food from domestic sources. There is also a stated desire to procure food from small-scale farmers. It is more likely to hear that objective in lower income settings, where presumably, agriculture is a greater part of the economy.

It is nice to hear you say that, because procurement can be a pretty big deal. It sounds like kind of a boring topic, but in fact, if you think about the amount of food that institutions purchase, so institutions like hospitals, or even prisons, government agencies, schools, of course in this case, it is a lot. So, if there are broad social statement issues being made, about we care about the environmental impact of food, or we care about supporting local farmers and things like that, those decisions can have big ripple effects through the food supply, because so much food is being purchased in those contexts. It sounds like what you're saying is there's increasing interest in this around the world. Is that right?

Absolutely, there is increasing interest. It is also interesting to consider how procurement for institutions, such as schools, can perhaps shift food systems towards more diverse production. If schools demand more vegetables, they become a market for farmers to produce more vegetables. There is potential for the food system itself to diversify. I don't think this is a topic that has been studied enough. I don't think there's enough evidence on the impact of institutional procurement on food systems, on economies and agricultural development, but it's definitely a stated objective of programs.

No, I agree with you on that. I'm not an expert on the topic of procurement, but my impression that there's not enough work on this is consistent with yours. So let me ask you this about your work. What did you see with COVID? We've done some podcasts ourselves on what happens with schools during COVID, what happened elsewhere around the world, with school food programs and COVID?

What we saw was that school meal programs, although they faced a huge challenge, they also were able to respond with agility. So a good number of programs, indeed, they did temporarily cease their feeding operations when schools closed, but when the schools opened, the feeding programs were able to make adjustments. For example, they shifted from targeting students to targeting their whole families, in terms of how food was distributed. Shifting from in-school meals or snacks, to take-home rations, that were either available to be picked up at school, or even delivered to students' homes. We also saw that the COVID-19 pandemic seemed to bring greater attention to, and appreciation for, the role of school meal programs. As just one example, in Italy, the pandemic made clear the importance of school canteens. And now, there's more of a discussion around funding the programs through taxation. So that's been an interesting, positive outcome that emerged from the pandemic.

Bio

Ayala Wineman is the Research Coordinator for the Global Child Nutrition Foundation (GCNF) and a Research Associate in the Department of Agricultural, Food, and Resource Economics at Michigan State University (MSU). She holds a M.Sc. and Ph.D. in Agricultural, Food, and Resource Economics. She has been engaged with GCNF and the Global Survey of School Meal Programs © since 2018. Her research relates to broadly to food security and agrifood transitions, primarily (but not only) in sub-Saharan Africa.

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Food packaging can make shopping a pretty difficult process. Packaging can be a blitz of marketing strategies, where fact and misdirection are hard to distinguish. Plainly put, food labels are often confusing for consumers. So what is the Food and Drug Administration doing about this? We're happy today to have Dr. Susan Mayne join us. She is the director of the Center for Food Safety and Applied Nutrition at the FDA. She has done a lot of work on this topic.

Interview Summary

Well, let's jump right in. The FDA already has a definition for the "Healthy" claim on food packages. So why does it need to be updated?

You're right. We already do have a regulatory definition for healthy, but it's outdated and we need to update it to align with current nutrition science and the Dietary Guidelines for Americans. So for example, current dietary guidelines focus in on the importance of eating healthy dietary patterns and food groups that comprise them, the type of fat in the diet rather than the total amount of fat consumed, and limiting the amount of sodium and added sugars in the diet. The proposed definition is really consistent with that focus.

What are some examples of foods that could change from healthy to unhealthy or the reverse under the new definition?

Some examples of foods that could qualify under the new definition include things like healthier oils, like olive oil, and fatty fish like salmon that, under the older definition, had too much fat to qualify. Trail mix, for example, could also qualify as long as the ingredients don't make it too high in added sugar. When the previous definition of healthy was put out, we didn't have added sugar in the regulatory definition for that. Yogurt is another food that could qualify, but a lot of yogurt is highly sweetened so those products would need to meet our proposed limit for added sugar to bear that healthy claim.

This could be really big news and a lot of important foods could shift categories. Let's talk about what this means for the actual words on package that a consumer might see. So if a food, before it would qualify for healthy claims and still does, or one now all of a sudden goes into that category, what kind of things can the company say? What kind of words would show up on a package?

Our proposal here is to use that same term, "healthy," that can be used on food package labeling as it has been able to be used for the last couple of decades, but just give it a new meaning. And so one is the actual claim: "healthy." The other thing we are doing at the same time is we are doing research on a healthy symbol that could also be used on a food package. And the thinking here is that symbols on the front of the pack could serve as a quick signal again for consumers who are trying to make choices about what types of products could help them put together healthy dietary patterns. Once this definition is finalized, companies could use the term, the claim, they could use the symbol if we finalize a symbol that would go along with it. And again, these are meant to be quick signals for consumers for how they can help choose foods to build healthy dietary patterns.

Now let me ask a little bit about the science of these kind of things. Given that there's so many things that are being said on packages, do consumers pay attention to these kind of things? Does it matter whether a product says "healthy" or not? Is there some risk that people, some people at least, will assume that if the word "healthy" is on it, it's not going to taste as good? How does this all work out in terms of impact on consumer purchasing decisions?

Consumers definitely pay attention to claims and things that are on food packaging. When we finalize the updated definition for healthy, we also want to do some consumer education so that consumers really understand what this healthy claim would mean. So from our perspective, the updated definition that we have proposed means that foods that would bear that claim contain a meaningful amount of food groups that we're trying to encourage as part of the dietary guidelines. A meaningful amount of, for example, fruits and vegetables or whole grains or healthy oils or dairy, those are all food groups in the dietary guidelines. And those foods also would not have too much sodium, saturated fat, or added sugars. So, we would want to do education around that. But consumers can understand that choosing foods that bear that claim can help them put together healthy dietary patterns consistent with our dietary guidelines.

So one, theoretically, could deduce all this information from the existing nutrition facts panel if one were to spend enough time looking at it. So why would it be helpful for consumers to have this additional information?

One of the differences between the proposed definition for healthy and the nutrition facts panel is that the nutrition facts panel conveys really important information, but it's nutrients only. With the updated definition that we have proposed, that's giving consumers that these products contain a meaningful amount of a food group. And there is an additional piece of information that consumers would have, once we've updated the definition of healthy, that this contains a meaningful amount of the food group. What that means is you're getting all those nutrients that come along with that food group, including things that might not be included in the nutrition facts label.

I'm imagining, as you proceed with this, that you involve various constituencies in the discussion. Scientists, obviously, who work on it, consumers, the food industry, etc. I'm interested in the challenges that the food industry faces in this. Are there things in particular that are important to them in this context?

As we finalize this, there will be significant engagement. Even the proposed definition was following significant input and engagement. We held a public meeting on healthy before we ever came to this proposal. So now that we have a proposal out, we have a public comment period and we encourage people to comment, I know we'll get extensive comments coming in, and then we have to take into consideration all those comments before we finalize the definition for healthy.

Thank you for giving that description. I guess the ultimate hope here is that a change in labeling practices will in turn affect consumer decisions about what to purchase and what to eat. And this, in turn, will have an impact on health. Is there reason to hope that that causal chain will actually take place?

There is, and we know that food labeling can be a really powerful tool for change. It empowers consumers with information that they can use to choose healthier diets. That can be really helpful when people are comparing similar food products. But it's powerful in another way. In addition to helping consumers make good choices, labeling has the potential to make foods healthier because it provides an incentive for food manufacturers to reformulate. Our goal is to create a healthier default so that all food options get healthier. This is critical in our work to help create healthier diets and reduce diet-related disparities. So we do know about the power of labeling and one great success is our influence in virtually eliminating artificial trans fat from the food supply. After trans fat was added to the nutrition facts label in 2006, it led to an 80% drop in intake of artificial trans fat through consumers choosing different options and industry reformulating. We have since taken additional actions, and these artificial trans fats have now essentially been removed from the food supply, likely averting tens of thousands of cases of heart disease and stroke. We've also seen the restaurant and fast food industries are offering lower calorie options after we required calories on menus and menu boards. And as a third example, added sugars are now on the nutrition facts label, and we have already started to see industry introducing new lower sugar options and we're seeing the population's intake of added sugars declining. But there's still more progress needed here. But, I think those are key examples of the power of labeling to get to a healthier food supply and better public health.

I'm really happy you brought up trans fats as a precedent, because that really was a huge victory and it involved the elimination of something altogether. And I remember, at the time, the industry said it would be terrible for them because they wouldn't be able to find alternatives and consumers wouldn't like the taste of the reconfigured products. But none of that turned out to be true and it probably reassured the industry as well as protected the health of the public. That was a great success story and it'll be interesting to see how it plays out with other things, like added sugar and salt. It's really nice that you're working on that and I really appreciate you talking about some of the things that FDA is doing. And thanks for your work as a public servant, I really appreciate it.

It's my pleasure. We are very committed to public health and nutrition at FDA, and these are some of the tools and some of the approaches we're doing to get to just that.

Bio

Susan Mayne is the Director of the Center for Food Safety and Applied Nutrition (CFSAN) at the Food and Drug Administration (FDA). In this position, Dr. Mayne leads the Center’s development and implementation of programs and policies related to the safety and labeling of foods, food and color additives, and cosmetics. CFSAN’s responsibilities also include fostering the development of healthier foods and ensuring that consumers have access to accurate and useful information to make healthy food choices. An internationally recognized public health leader and scientist, Dr. Mayne received a B.A. in chemistry from the University of Colorado. She earned a Ph.D. in nutritional sciences, with minors in biochemistry and toxicology, from Cornell University. Dr. Mayne has conducted extensive research on food, nutrition, and health. She is author or coauthor of nearly 250 scientific publications and her work has been cited more than 17,000 times.

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When you hear the words food waste do you think about forgotten leftovers? In the journey from farm to stores to the dinner table, some food is lost during the processing and transportation and at home some purchase food simply goes uneaten. How can transportation science help reduce food waste and loss and make the food system more resilient and climate friendly?

Interview Summary

Norbert: Welcome Callie and Celeste, it is a real pleasure to have you. Both Brenna and I are agricultural economists. You folks are engineers. So we are curious how did you come be working on food waste and loss? Callie, let's start with you first.

Callie: Thanks Norbert, and thanks so much for having me. I've been really fascinated by waste in general for a long time. Like what makes certain products and certain things valuable to people so that they'll hang onto them and what makes us throw away other things. And for a long time I was studying sort of high tech waste like electronic waste, used lithium ion batteries, old solar panels or even plastics packaging. One of the things that I learned from that is that there's so much resources and there's so much value still contained in the things that we traditionally think of as waste. Whether it's gold in the circuit boards of those old cell phones or it's the chemical energy that can be converted into fuel energy contained in the carbon bonds of plastics. But, one of the challenges that I discovered in working with these different systems is that people don't really connect to them very immediately or very viscerally. When we discard something like a phone it sort of goes away and we don't really see what happens. However, I discovered that when people think about food, it's extremely visceral. That was spinach that you bought at the grocery store with the best intention of eating, and it sort of hurts when you throw it away. It hurts your pocketbook as well as it makes you feel really guilty. So I got into food waste hoping to bring this perspective of value recovery and value retention to the food system. But, doing so in such a way that really connects to people. So looking for technologies and user-friendly solutions where we can first of all try to keep food from being discarded. But then if it is inevitably discarded how can we use best engineering and technology practices to actually recover the energy, the water, the nutrients that are contained inside instead of sending those to landfill.

Norbert: You really are playing off the old idea of one man's or one person's trash is another person's treasures. I appreciate that. And you're right, food does have this deep connection to us from a lot of different perspectives we don't like and we have been taught over and over again not to waste food. So I do appreciate how you were able to take what you've learned in other spaces to the food space. So thank you for coming into this conversation. I'd like to turn this over to Celeste. Your work began in areas around food access and now exploring food waste and loss. What interests you about this societal challenge?

Celeste: So I really fell into the field of food waste. As you know, my background is in transportation and I've always been really interested in the societal impacts of transportation. A lot of my work focuses on equity and accessibility metrics related to transportation. I was working in the food access space before coming into food waste. I kind of first got interested in food access actually from a student of mine who for their senior project wanted to know which food insecurity or food desert metrics should they be looking at for their senior project. We started looking at how different parts of Baltimore indicated different areas of food insecurity. So that's really how I got interested into food. What has been the most interesting about food waste is that transportation is important to all aspects of the food supply chain and just the scale of the problems can be so different. We can think on a worldwide scale, a national scale regional and household level. For me household level has always been I think the most interesting when it comes to food waste questions. I've always been very interested in choice in how people make choices whether it be transportation or food purchasing habits and also how those two work together.

Norbert: Thank you Celeste for that. And I would say the first time I thought about transportation and wasted food or food loss was the challenge that food manufacturers have once a product, especially something like a fresh vegetable or fruit, leaves the farm. If it starts to go bad what are some alternatives to manage that potential loss as the product that's being transported from the farm to the packing house and from the packing house to a food manufacturer or retailer. And that there are real challenges of actually redirecting product once it leaves the farm. It's really exciting to hear how you think about that. Not from the farm gate necessarily but also to the final consumer. So thank you for the work that you're doing.

Brenna: Celeste, if we can continue with you the work you have done focuses a lot on transportation and waste management. Can you tell us more about how your research has informed the ways that we need to think differently about wasted food as a household or a farming problem?

Celeste: Sure, I'll speak about it mostly from the household level. One of the things that first came out of my previous work is that everybody values having choice and agency in their food purchasing. I don't think that we often model those choices when we're doing transportation modeling for example. I think that's still important when it comes to food waste. In my previous work I talked with a lot of people during my focus groups about how they're making the decision of what stores to go to, how often and why. What we found were that households were balancing tough decisions when it comes to limited budget, quality of food not being equal everywhere, which really gets at some of the supply chain issues and making difficult trade offs between how often to shop versus how much they're able to purchase. I think some of those lessons learned translate to food waste particularly when we talk about rescuing food how we go about rescuing food for example do we just provide boxes where people don't have a say in what those boxes are? Are we matching wasted food to the demand and the needs of people? So I think a lot of the lessons learned can translate well into the food waste space as well.

Brenna: I really appreciate those perspectives, Celeste. And appreciate that agency discussion as well. Norbert and I actually have a recently published paper on the tradeoffs households make between the frequency of grocery shopping and the food waste that they incur. People definitely have pretty strong preferences for the amount of transportation they may put in going to and from the store in a given time period. Callie, shifting to you is there anything you want to add related to this topic?

Callie: One of the things that Celeste pointed to is the complexity of this challenge. While we may see quite a large percentage of food waste happening at the household level, that waste is really magnified once we look all the way up the supply chain. And transportation plays a key role at every step of the process. Not only in the transportation of food to the downstream markets, but then the collection the transportation, the aggregation, and all of the choices that then these stakeholders make at a broader scale. So say a grocery store or a restaurant decides to engage in food waste diversion and recycling behavior then the transportation becomes a key part of that. Food is heavy, wet and kind of stinky. So it's a little bit of a unique challenge for transportation in that we both want to pick it up and transport it regularly to a place where it can be recycled but that transportation can be really expensive. So this is another challenge where it speaks to these broader questions about infrastructure because then you have to start deciding where can I put locations to site recycling food waste to energy locations? How do I actually collect the food waste from what places am I going around in my truck and picking it up? Where do I take it and then how do I use the products that come out of that? Because once you have taken food waste and say you've put it through a composting process, and you have the solid compost that comes out. Or perhaps you put it in an anaerobic digester and you have bioenergy in the form of natural gas or electricity that comes out, all of those products then have to be transported back to places where they can be used. So transportation really does infuse the entire system even if sometimes it means we're transporting things other than food itself.

Brenna: That's a really important point and it does add up in between each stages of supply chain and then sometimes back again, once we have these new products and then transforming them and moving them back to where they can be used again. Celeste, if we can continue with you, what are some of the transportation challenges that contribute to wasted food?

Celeste: One of the things we deal with in transportation is just it's a uncertain science, there's always some built in uncertainty with transportation and when we're talking about items that are perishable like fresh food, that is what results in a lot of food waste because they are buffering for that uncertainty and travel time. One of the big challenges is how do we reduce uncertainty and have more reliability in our transportation system? That's becoming more challenging as land use changes. We're seeing farming being more consolidated food is being produced further from where people live as well as just our cities were decentralizing which makes transportation even more difficult. Some of the biggest challenges related to transportation really linked to changes in land use patterns as well as the production of food and how we can kind of bridge those gaps together with transportation. In the near term rising gas prices is definitely a challenge and it'll be interesting to see what impact that has on the food supply chain and to customers as well.

Brenna: That is a really important point. I can imagine where some efforts maybe to recover and recycle foods may be stagnated if transportation costs are too high. Thank you so much for that perspective Celeste

Norbert: Hearing this conversation makes me think of something you said earlier, Callie. And it's this idea that previously you've worked on how to manage waste of science and technology products. There might be gold the circuit of a cell phone or something. But, when you talked about food waste you talked about heavy wet products and ultimately I thought of products that are of relative low value and given that there are rising costs in terms of transportation related to fuel costs how do we balance this? How do we get this relatively low value product on a per unit basis given that there is these high costs associated with transporting them? What do we need to make that equation work out?

Callie: That's a great question, Norbert. This is the perfect opportunity to bring in what we call life cycle thinking. So not just looking at the end of the pipe or at the last part of the problem when this waste is inevitably generated, even if we've put in place efforts to try to prevent or reduce it or divert it upstream, some waste will inevitably result. It's not just about the cost and benefits of that process of managing it but really thinking systemically over the whole supply chain. The food that we're talking about ultimately was produced in such a way that consumes significant amounts of energy, water, and nutrients. We pump a lot of electricity, a lot of fossil fuels, a lot of land, nitrogen, phosphorus and water into the production of food. So all of that is opportunity for us to recover that value at the end of life. The food itself contains much of those resources. It contains a significant amount of carbon, nitrogen, and phosphorus. These are things that we might normally have to obtain from more environmentally intensive process if we're extracting them from nature transforming them into a form that we need for agriculture. And so then when we think about what would happen otherwise to the food if then we move downstream, if we aren't recovering the food at end of life or doing some other activity to reduce or donate surplus food before it becomes waste then we also have this huge cost of the landfill. Depending on where you live in the United States the cost of land filling products varies significantly. In some places it's pretty expensive and that's because landfill space is scarce. And it's also in recognition of the fact that there's a huge climate cost of landfilling, when the food enters a landfill environment where it's anaerobic or in other words oxygen free. It degrades in such a way to where methane is the primary product and if that methane is not captured at the landfill that has a climate impact 25 to 30 times more than carbon dioxide. So we can also think about attaching a cost or even a social cost of the carbon impacts that come from the landfill.

So when you look at this systemically you can think about food waste as a real value recovery and value retention process, in such a way that those costs associated with making it happen are worth it. When you look at the life cycle cost of the food system you can think about using this process to recover some of those initial embedded impacts and the initial embedded carbon, water and nutrients in the food as well as to prevent the downstream cost of unavoidable and unconstrained climate impacts from land filling food waste. But I would also say that for many companies and for many actors in this space they also see a value in food waste recovery. Many households are deciding to try composting for themselves or to work with a community compostor because they value the ability to produce that compost and use it in some way at home. Similarly, businesses are looking at some opportunities for food waste diversion that actually save them money. It may end up actually being cheaper to divert this material and use it in such a beneficial way to recover some value from it than to pay to have it hauled to this landfill instead.

One of the really cool areas that we're looking at is one in which we can think about decentralized solutions in parallel with centralized solutions. Our conventional waste management model has been to collect material within a relatively constrained area and then haul it to some location where it can be processed or landfilled afterwards. There are all kinds of new food waste recovery technologies that are emerging where they can actually be put in place at the point where the food waste is being generated. So this might be a small-scale digester, dehydrator or compostor being embedded right there at the restaurant or at the point at which the waste is generated. Now those can be still very cost sensitive for some businesses but there's some cases when they actually make more sense economically than alternatives.

Norbert: Thank you so much for that. That really adds some clarity to this issue of how do we valorize food waste. And what I've heard from you is that one of the ways of thinking about this is it's the avoidance of the cost associated with processing or throwing away that food that there can be significant effects on society, on the climate by having this product go into a landfill. We can avoid some of that and we can actually capture some value that there are different actors along the supply chain or different supply chains that could benefit from this. So thank you for that, that's really helpful. Along this line I'm interested to hear your thoughts Callie on other ways to improve the transportation infrastructure or the management of food waste that can help us prevent this possible wasted food.

Callie: When we think about minimizing and managing wasted food we really want to take this full circular economy perspective. Circular economy focuses on recovering and retaining value from products rather than thinking about it as waste management. So it's a real change in paradigm first and foremost. And within this circular economy framework we might first be looking at minimizing waste like designing waste out of the system by some of the things that Celeste is shared about ensuring that we actually get food to people who are going to consume it in ways that they want to, in a way that works for their choices. Then, if there's some excess food or surplus food, food that's in the wrong place at the wrong time, then we can think about diverting that through rescue and recovery operations. Transportation clearly plays an important role there because again, you have that sort of narrow time window to get food from one point to another where it can be used effectively. Then finally, in terms of closing the resource loop by this valorization process there are a lot of open questions there that I don't think we completely have the answer to. This again speaks to the importance of a systems perspective. So first and foremost, determining what the optimal strategies are for collecting waste. If I'm a food waste collection business what company do I start with? Where do I pick up waste first? How do I optimize the training of the people who are employed and engaged in this activity? Because if food is not separated effectively at a source and contamination like plastic packaging or other materials in the food waste stream that can really throw a wrench downstream when we try to recycle it. So there's some questions there about optimal methods for separation, segregation and collection of the food waste. And, there's all these open questions about the siting and the scale of the technologies we would use to actually treat it.

I mentioned earlier this question between small scale decentralized and large scale centralized systems. Another thing to layer on that is then the optimization of the markets and the transportation and the siting of the product uses. So one of the most common and promising methods that we're looking out for food waste recycling from commercial not necessarily households but the upstream suppliers is anaerobic digestion. Because in this case we're taking that anaerobic environment with oxygen free environment where the food degrades into methane, methane's the primary constituent of the natural gas we use for heating and driving and other things in our energy system. We can certainly take that energy and put it back into use if the food waste recycling facility is located near a transmission grid or near a pipeline where the compressed natural gas can be injected. But on the flip side, there's other products that come out of that, like a liquid digestate stream, which has some of those nitrogen and phosphorous nutrients still there. Now this could be land applied on farm fields but it is also really expensive to collect this liquid, transport it and then apply it into different areas. You have to be cognizant of the ecological impacts of applying this to land, especially if you are near freshwater resources that may already be vulnerable to agricultural pollution. I don't know that there's really a clear pathway of a one size fits all recipe for setting out these food waste ecosystems. But, I think there are a lot of open questions about the best way to optimize this system in different regions and parts of the country because everywhere has different sort of local infrastructure, ecological resources and transportation available. That's one of the most exciting parts of researching this is, is trying to figure out the right solution at the right place.

Norbert: Wow, thank you for that. That's really helpful. I'm grateful in particular for this idea of reframing our thoughts about waste management and how to think about that differently changes the way we actually approach these issues. We're at the end of our time but I wanted to raise this question to Celeste because Callie I think you've addressed this to some degree, but feel free to jump in. How do we want to make sure we include the environmental impact in the work that we are doing in reframing waste management? Are there some important things that have been left out? Should we reconsider? I would love to hear your thoughts on this.

Celeste: When it comes to food waste, one of the things that really is important is that it is an interdisciplinary field. Often I find as we talk about the role of transportation in food waste is that everybody recognizes that it's an important component of food waste but often it's a separate conversation. So listening to Callie in particular, she highlighted the importance of making sure that transportation is being included kind of as a decision variable in our models. That transportation is not just an afterthought as one of the costs associated with transporting food. When we really embed transportation into the decisions that we are making related to food waste it naturally has a positive impact on the environment as well. One thing that I am curious about is the role of new transportation technologies in the future. Our field is evolving quite rapidly with autonomous and connected vehicles drone deliveries and things like that. In the future there will need to be research to look at what new technologies can do in the field of food waste.

Bios

Callie Babbitt is a Professor of Sustainability at Rochester Institute of Technology’s Golisano Institute for Sustainability. Callie's research group aims to create circular economy solutions to recover value from waste streams - including food waste, consumer electronics, plastics, and lithium-ion batteries. Research at RIT is focused on creating innovative technologies, business models, policy initiatives, and consumer engagement efforts to reduce the amount and environmental impacts of food waste while at the same time creating economic growth and maximizing efficient use of resources.

Celeste Chavis is an associate professor in the Department of Transportation and Urban Infrastructure Studies at Morgan State University. Her research focuses on transportation operations, safety, and performance metrics for multimodal transportation systems through an equity lens. Her research focuses on accessibility measures (including food access), public transit operations, pedestrian and bicycle safety, and travel behavioral modeling. She is a registered professional engineer in Maryland.

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In September of 2022, the White House held the first conference focused on hunger, nutrition, and health, in 50 years. The convening served as the Biden-Harris administration's call-to-action to end hunger, and increase healthy eating, and the physical activity among Americans, by the year 2030. But how successful was this event in actually catalyzing a national strategy? We'll hear perspectives on this from Dr. Susan Mayne, Director of the Center for Food Safety and Applied Nutrition at the Food and Drug Administration.

Interview Summary

Susan, I've respected your work for so many years. First, as a scientist - we were together on the faculty at Yale for a number of years. And now you work in government too. So it's really nice to hear the word "perspectives." So let me ask this as the first question. What do you think was the best thing that came out of the White House Conference?

From my perspective, it really drew a huge focus on the problem that we have been facing for a long time. The epidemic of diet-related chronic diseases, and how having good nutrition really can help reduce those diseases. As you know very well, this is something I've been working on for my entire career. What the White House Conference did is it really put a focus on that, provided inspiration and commitment to action, associated with this White House Conference. There were two very important deliverables that came along with that. The first one is a roadmap of actions that the federal government can take. In the “all of government” approach to end hunger and reduce diet-related diseases, while reducing disparities. The second deliverable is really a number of other commitments that others have made to really tackle this problem. I think we see this as a really great opportunity to accelerate the efforts that we have been trying to do, to get to a healthier food supply, and turn the tide on the epidemic of diet-related chronic disease that we have in this country.

Let's talk about what the FDA can do in particular. There aren't many people out there who probably know the full portfolio of FDA activities around food, because there are a number of them. So how do you think FDA can make a difference with this goal to end hunger, and to prevent diet-related diseases?

Yes, there are many ways the FDA can make a very big difference, and we have several deliverables in the White House strategy that really take advantage of two things that we do. One is through our labeling authorities, and we can discuss some of the labeling authorities and how those can really help turn the tide on diet-related chronic diseases. But we're also working to have a healthier food supply for all, using tools outside of our labeling authorities. It's really that combination of things that we can do, and how that can be leveraged by other federal agencies, so that we can be part of the solution. Obviously, FDA can't solve this problem alone, this is a multifaceted problem. The problem of diet-related chronic disease, it requires multifaceted solutions. But FDA is proud to be part of the federal workforce that's really trying to impact this problem of diet-related chronic disease.

When you mention "a healthy food supply," in the context of FDA, some people would automatically think "That's all about food safety, let's make sure we don't have foodborne illnesses." That's, of course, important, but you're talking about a different thing: the long-term health consequences of food. FDA has a role there too, I'm suspecting?

Yes, we do. And our title, the name of the center that I lead, is the Center for Food Safety and Applied Nutrition. So nutrition has always been a foundation of what FDA does, and much of our work actually intersects the two together. And I'll just give you one example is the work we are doing on food safety, for example, to get to better produce safety, so we have fewer outbreaks related to produce. That's also critically important for our work on nutrition, because we want consumers to have confidence in fresh produce, consume more of it, to be more consistent with what the dietary guidelines recommends, and that instead will improve nutrition. So food safety and nutrition are both interrelated in the work that we do at FDA.

If the goal is for people to be able to eat healthier foods, part of that is people knowing how healthy foods are. So how do you work on that issue?

Well, a couple things to emphasize, one is that education is critically important. And, when it comes to education around health and nutrition, we partner with the US Department of Agriculture, the Centers for Disease Control and Prevention, in a lot of these educational efforts to educate consumers, to make sure that they know what healthy eating should look like. But interestingly, another piece of this is that if you ask consumers where they go to, and who they trust for nutrition information, they will frequently tell you that their most trusted source is their doctors. It's also important, not just that the federal agencies are working on this, but medical professionals also really need to be educated about nutrition, so that they can help their patients. We have produced some continuing education models for physicians on food labeling, and how they can use that to counsel their patients. I would like to see more nutrition incorporated into the medical exams and board certifications. So we incentivize more nutrition training for physicians, and some of these concepts are built into the national strategy on nutrition, released around the White House Conference.

You've mentioned food labeling several times, and when people think about food labels, they naturally think of the ingredient label, and they think of the nutrition facts panel that's on the side, or the back of packages. But there's been talk over the years about the possibility of some sort of a labeling system on the front of the package, which would be a quick guide for consumers to understand how healthy a food might be overall. I'm just not aware of where discussions stand in FDA about that now, and I'm hoping you might bring us up to date.

Happy to. You know, we look at food labeling holistically. There are different claims that we regulate on food labels, things like a healthy claim that currently exists that we've been working to update. Those are claims that we regulate. You asked specifically about front-of-pack labeling. As part of the national strategy on nutrition, we did make a commitment to work on developing a front-of-pack labeling scheme that could help consumers make those types of decisions quickly, through front-of-pack labeling. So there are many labeling tools that we have, whether it be claims around healthy, dietary guidance statements, front-of-pack labeling. In addition to the nutrition facts labels and ingredient statements. Those are all pieces that can really help inform consumers about the foods that they are purchasing.

You have to look around the world at these front-of-pack package labeling systems, there are lots of different types. I mean, some are like a stoplight program, with red, yellow, and green symbols to indicate how much overall nutrition, or unhealthy things that food might have. Others talk about specific ingredients. Is there a consensus around the field now about which of those systems might be most effective and helpful to consumers?

So, one of the things we've been doing is really looking at that international landscape. We have learned a lot about what different countries are doing, and what those countries have learned about the various systems. As part of our commitment to develop a front-of-pack label system in the United States, we are learning from the vast international experience that is out there. We are in early phases of this, but I can assure you that FDA's work will be informed by what's happening in the international landscape. At the same time, we are interested in how our own consumers respond to different front-of-pack labeling systems. We have begun, and completed, a first-round of consumer studies. We have a consumer studies branch in my center where we test how consumers interact with various labeling systems. So we've completed some qualitative research, some focus groups, and we're looking forward to additional consumer research that would help guide us being informed by our own work, as well as what's happened in other countries, in terms of a potential path forward for the US.

I'm really happy to hear that, because that kind of work in the United States needed to be done in the kind of big way, you're probably able to do it. So I'm really happy to hear that news. So if you come upon a system that you feel might work best in our own country, what's the process for actually having something like that on packages? I mean, does Congress need to approve? Is that something the FDA can do on its own? What sort of route might it take?

I can't foreshadow specifically which route we would take, but FDA will issue guidance, or regulations, in terms of where we would be going. Under any scenario, it's important to us that we get public comment on anything that we would be doing. So for example, we could issue a proposed rule on a particular labeling pathway, that would then go through a public comment process before we would make anything final. A key part of all of this work is extensive stakeholder engagement, and that means hearing from a number of different stakeholders; our consumer groups, the academic sector, the industry, to provide information into our process. There would be multiple places where we get input for any system that we would be moving forward. It obviously would involve extensive public comment before we would finalize the next steps.

It'll be really interesting to see what happens with that. And ultimately, what we might find on the front of packages in the United States. Let's return to the national strategy. The national strategy discusses all of the government response. You mentioned before connecting, with CDC, USDA, other parts of government. Are there some examples you could give us about how different government agencies can work together to make progress? How that might work, and what kind of issues might be involved?

Sure, with regard to some of our own work, for example, we're not only using our labeling authorities, but we've also taken other steps to have a healthier food supply. I'll give you one example, and that's our work to reduce sodium in packaged foods. We have issued targets for industry to level the playing field, and gradually reduce the amount of sodium in the food supply. Our sodium targets hit not only packaged foods, but also restaurant and retail as well. What we've done in the national strategy is we've talked about how other government partners can leverage FDA's sodium work. For example, the VA, the Veteran's Administration, they are planning to increase procurement of lower sodium foods consistent with FDA's targets. We're also partnering with HHS administration for community livings administration on aging, to help older adult nutrition programs. That they would provide lower sodium options consistent with FDA's targets. USDA has been using FDA's targets as they're working to reduce sodium in school meals. This is an example where FDA can take an action, and it can be leveraged and amplified, including through the power of procurement through the federal government, to get to a healthier food supply for all.

I'm really happy you mentioned "procurement," because you're right, that can be very powerful, and the government has so much sway in that respect. This is the final question, let me just follow up on this sodium issue, because I think it's really an interesting one. Consumers might hear the term "lower sodium," and think that means lower taste. I think the strategy that some people have discussed is that the diet became high in sodium without people really knowing so much that it was happening. People just got accustomed to a very high level of sodium in their day-to-day foods. But that if it gradually got reduced, it would happen in a way that consumers wouldn't even notice each little decline, because it would be gradual. But they'd become re-calibrated to a new standard that they would find just as pleasant, it would just be lower in sodium. Is that kind of the way the thinking goes?

That is a key part of our sodium strategy. What we heard from the food industry is that if they tried to reduce sodium in foods to promote better nutrition that consumers might recognize that those products tasted different from other foods that had not been reduced in sodium. That in order for us to make progress, we needed to level the playing field, so all of the industry was reducing sodium incrementally at the same time. The reason this can work is because sodium is an adaptive taste, and so we can all adapt to these lower sodium foods. Consumers wouldn't even notice these minor adjustments as you begin to ratchet down the amount of sodium in the food supply. These changes can help, gradually, across a population, have really important health benefits.

Bio

Susan Mayne is the Director of the Center for Food Safety and Applied Nutrition (CFSAN) at the Food and Drug Administration (FDA). In this position, Dr. Mayne leads the Center’s development and implementation of programs and policies related to the safety and labeling of foods, food and color additives, and cosmetics. CFSAN’s responsibilities also include fostering the development of healthier foods and ensuring that consumers have access to accurate and useful information to make healthy food choices. Mayne received a B.A. in chemistry from the University of Colorado. She earned a Ph.D. in nutritional sciences, with minors in biochemistry and toxicology, from Cornell University. Prior to joining the FDA in January 2015, she spent nearly three decades at Yale University, where she held an endowed chair as the C.-E.A. Winslow Professor of Epidemiology. Her distinguished career there included two leadership positions: Chair of the Department of Chronic Disease Epidemiology and Associate Director of the Yale Cancer Center. She completed two consecutive terms on the Food and Nutrition Board of the National Academy of Sciences, and a five-year term on the Board of Scientific Counselors for the U.S. National Cancer Institute.

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Did you know that each year the average American family of four loses $1,500 to uneaten food? What's more, consumer food waste is the largest category of waste sent to landfills. When food is wasted, so is the land, water, labor, and energy that were used in producing, processing, transporting, preparing, storing and disposing of the discarded food. So why does household food waste and plate waste happen? We have two guests today to help us explore this topic. First, Dr. Roni Neff from Johns Hopkins University. Roni studies wasted food, food system resilience, and climate change through a public health lens. Second, we have Dr. Brian Roe from the Ohio State University. Brian focuses on food waste and behavioral and consumer economics.

Interview Summary

This podcast is co-sponsored by the Recipes Food Waste Research Network Project, led by American University, and funded by the National Science Foundation (2115405).

Norbert: So our first question is to you, Roni. Could you help us understand why food goes uneaten, and why do you avoid using the term food waste.

Roni: Great questions. So I'd like to give a simple answer, but the reality is that waste of food is caused by a whole mess of reasons, all intersecting and reinforcing each other. It's become part of the fabric of how we operate as a society. It's part of the functioning of our food system, and it's our way of life. That makes it challenging to address, and it's also what makes it very interesting. So Brian and I were on a National Academy of Sciences panel recently that closely reviewed the literature on consumer waste of food. We actually identified 11 distinct factors that shape it. Let me summarize it in two main buckets. First, our food system pushes us to waste through upstream policy and marketing factors that provide us with an overabundance of food. They encourage us to buy or take more than we need, and they leave us with misperceptions about what food is good quality and safe to eat. The second is that even as we don't like wasting food, with everything else that we care about, it doesn't necessarily rise to the top of our minds or priorities. So we waste because we forget, we change our plans. We choose not to eat foods we don't want. We take the path of convenience. I don't say that to blame or shame us, because we all do it, and our society and our norms push us there. And if you think you don't, try tracking what you throw out for a week and you'll see it. But also, shame isn't productive. The trick is to put in place strategies to help us.

I want to say one other thing about drivers from a public health perspective. In consumer surveys that we've done, the top two reasons that people give for throwing out food are concern about food safety and concern about eating food that's good quality. Of course we don't want anyone eating unsafe food, but actually the food is often perfectly safe. And sometimes the problem is a lack of knowledge of how to tell it is okay or risk aversion. Date labels play an important role, and we need a national standardization. But also its messages. We in public health have pushed this idea that freshness is the way to convince people to eat healthfully. That's a disservice. When it's cooked into a meal, you often can't tell the difference if it was frozen, if it was a little wilted, it tastes just as good and it saves us money. Let me also answer your question about why I avoid using the term food waste. I prefer the term wasted food because it puts the emphasis on the idea that this is food, it's not waste. If we catch it before it's too late, we or someone else could eat it. And especially as we get to talking about recovering food that's good for people to eat, it's food, and using the word waste can be harmful.

Norbert: I really do appreciate that definition. That helps us reframe how we think about this challenge that we face and how we can do something differently.

Brenna: Brian, let's transition to you for a minute. Can you tell us about the economic decision people make when food is wasted?

Brian: It's not actually just one decision, right. If we think just even at the household level, it's a whole bunch of decisions. There is this great article a few years back by Laura Block and some of her co-authors, and she talked about the squander sequence, which I think is a very apt description of what's going on, even in small segments of the food supply chain like the household. We're thinking about our own situation. We're thinking about the first economic decision, how much food do I bring in to the home at any given point. And you know, there's a big fixed cost. You're getting yourself organized. Maybe you're taking yourself to the store, you're setting up your online food delivery. So you're making decisions and tradeoffs about do I buy a few more items, a few larger sized items, et cetera. You have to make tradeoffs about how much to acquire and bring into the home. Sometimes we lean to the side of safety and buy a little bit more food than we need. And then we're in our homes, we have all this food there, and we're thinking about how much do I prepare, and who's going to be at the table in a particular situation. And again, we're making tradeoffs about what types of food do I want to prepare, how much do I prepare, is that item, like Roni was saying, is it on the cusp of having a date on its label that's getting close, do I add that or not. So there's decisions being made there about how much to actually put onto the plate. And then there decisions about do I finish my plate or I'm trying to lose weight as well. So maybe I don't eat all the food on my plate, particularly if I'm at a restaurant, and they serve me very large portions. Then I have to make decisions about do I want to wrap that up and bringing that home with me. Or if I'm at home, is there enough there to actually put into the refrigerator. And then of course we're sitting there, it's Thursday night, and maybe friends stop over and want to go out to dinner with us. But yet we had food there sitting in the fridge that we were planning to prepare. And we have to make those decisions about tradeoffs, about the spontaneity of the moment, and kind of the perceived fun of that versus what do we do with the food that we've already have that might then go unused in our refrigerator.

So there's this whole sequence of decisions that have to be made, and we're always being tugged by risk aversion, whether we want to make sure there's enough food, it's safe enough, whether we want to not embarrass ourselves socially by not having enough food on hand. Then there's the convenience of, rather than dealing with all those small bits of leftover in the fridge and whether we can do something clever with them to make those interesting, or just pack it in and order a pizza instead. So there's just all this whole sequence of decisions that have to be made.

Brenna: That's really interesting, Brian. I know in our house there are lots of layers of questions in terms of how we go through our food, so thank you for saying that in a bit more detail so people understand deciding to waste is not typically a simple decision on the part of consumers, but it's one hopefully we can impact. That brings me to my next question. There have been a number of interventions suggested to reduce food waste. Which ones do you think would be most effective?

Brian That's a good question, and I don't think there's overwhelming evidence yet, as we've talked about amongst ourselves, and we know there's just limited good data out there upon which to make these decisions, and even less data to help us evaluate past interventions. But as I've thought about this, and I kind of think about that whole squander sequence that we just talked about, and I kind of reflect on some modeling that economists have done in the past thinking about sequential decision processes. There's this idea of a weakest link technology, where it's the weakest link that reduces the ability for us to do well. So in the case of food waste, you have to not only do one decision appropriately, but every point in that process of bringing the food into the back of the house until it gets into somebody's stomach you have to execute in order for that food to actually be ingested and therefore not wasted. In those models, what's shown is that those last steps are sometimes the most crucial and the most valuable to making sure that the end goal - that is getting the food eaten rather than wasted - takes place. I think focusing on helping consumers at the very end of that process is very critical. And I've seen this very clever intervention that was put out there by, of all people, Hellmans. They're a Unilever company and they make the mayonnaise. They have this very clever kind of gamification where they do a “fridge night.” They kind of challenge people to go into their fridge and make one more meal with the food in their refrigerator each week. They've got an app that supports it, and it helps build confidence among consumers to be able to go boldly into the refrigerator and create a recipe that they think will be used and useful and enjoyed by their family. So I think being at the very end of that process is important - so you can make mistakes earlier in that big squander sequence, but there you can kind of play catch up at the end and put together something that will be used and reduce waste at that front. So that's the one that's really struck me recently as being very intriguing and I'd love to see even more evaluation of that intervention and how it works out in the field.

Brenna: Absolutely, I'm very curious to know how many people are using that app. It's an interesting concept.

Roni: Yes!

Brenna: Roni, what perspectives would you like to add in terms of effective food waste reduction interventions?

Roni: Sure, so I would echo all the things that Brian said, and I'll take it from the opposite end. On the one hand, there are things that are very kind of simple and direct. The flip side of that is that there's a lot of evidence from a lot of domains of behavior change for a very multifaceted type of intervention and hitting it from as many angles as possible at once. So a lot of the countries where they have been having really good success, often there's consumer education combined with policy change, and people are hearing about it in schools and they're hearing about it in communities. So as big and as broad as we can get in terms of how we intervene, it seems like we might be most likely to help shift the lever at a broad perspective as well.

Norbert: Thank you for this conversation on interventions, the ways that policy makers, organizations, communities can actually make a change. So Brian, I have a question for you. You have talked about this example of the gamified app, of sort of like a "Chopped" version online, but I'm wondering how do researchers evaluate if these interventions actually work, and what kind of measurement is really needed?

Brian: Yeah, and just for our listeners who don't know, Norbert and Brenna do awesome research in this area as well, and are very good experts on measurement as well. So you'll be familiar with a lot of these approaches, and Roni as well, but yeah, measurement is always a trick. Because people really don't like to mess around with the things that they no longer want. So measuring waste is always a tricky endeavor and there are different ways to go about it. You can do the very kind of nitty gritty, and try to collect it maybe at the curbside, or maybe convince consumers or processors to collect it in their own buildings, and then have you and your research team go out and dig through it and measure it and weigh it in all sorts of ways. That can be very effective. In the household setting, sometimes, though you don't get everything because things go down the sink or into your pet's bowl, or maybe into a compost bin that goes someplace else, so sometimes you miss things there. You can also beg people to measure their waste blow-by-blow, day-by-day through some type of diary. We can try to do things to help them ease the burden of doing this, maybe with a photo-based app or something like that. Or you can do what a lot of people do, and I do some of this myself, which is to ask people to remember types of food and the amounts of food that they wasted over a particular period, perhaps over the course of a week. That can be very effective. But typically, people are forgetful or might be a bit shy about reporting things that they've wasted. So a lot of studies suggest that typically people underestimate the amount of waste that they create when using that approach. So there's probably no perfect approach to doing this, but just understanding the pros and the cons, the strengths and weaknesses of each of those measurement approaches is kind of critical for the researcher to understand what's the best way that they can go in and evaluate an intervention or get a baseline or understand trends over time.

Norbert: Thanks Brian. I have got to say this sounds so messy. And yes, I mean literally messy, going in through people's trash, but you really made a really compelling point about how difficult this is, and that there are an array of ways that researchers have tried to measure this. Where do you think concerns for how people want to be perceived fits into this difficulty of measuring, when asking people or trying to even measure physical waste, when people know that they're being evaluated?

Brian: Yeah, there can be what's known as reactivity to a measurement approach. The sociological Heisenberg effect, if you will. And so that's where some of the passive measurement approaches, such as doing curbside audits of an entire neighborhood for example. So you don't have to worry about privacy concerns because you've mixed 40 different households together in one collection of garbage gives you a baseline so that then when you go to the household level, you can kind of estimate the amount of underreporting or reactivity that might be there. There's some tricks of the trade to be able to back out how much under reporting there might be.

Norbert: Roni, I want to shift gears a little bit, and I want to understand how is wasted food a critical question at the intersection of nutrition, climate change and household economics?

Roni: Great question. So climate change and food security, including nutrition security, are at the top of our list of our most pressing global challenges. As food prices keep rising, households are feeling this strain. So we care more and more about what we can do to stretch the food dollar. The beauty of focusing on wasted food is that it's one single lever that moves the needle on these multiple issues. It's not the solution to any of them, and there can be trade offs, but let's look at the potential impacts.

From a climate perspective, the International Governmental Panel on Climate Change estimated last year that about eight to 10% of our total global human-caused greenhouse gas emissions are coming out of wasted food alone. Not only is it impactful, but wasted food supports the urgency of rapid reductions in greenhouse gas emissions. Experts have focused particularly on methane, which is one greenhouse gas, and it's short-lived and it's powerful, and it's key in wasted food, because it comes both from our food production and from food that's decaying in landfills. So cutting waste of food has been recognized as a key climate strategy because it helps us get to that rapid reduction.

When it comes to nutrition and food security, there's this intersection because the same strategy, in many cases, can address waste of food and improve food security. So for example, some shared risk factors for poor nutrition and waste would include large portion size and oversupply. Then, when you think about like efforts to bring in healthier food like in school meals, unless the food tastes good enough, the kids won't eat it. So you lose on both nutrition and waste. Then as we turn to household economics, as was mentioned in the introduction, we're spending about $1,500 a year for a household of four on food that we're not eating. So preventing that waste extends our food dollar. Also knowledge that we might, waste of food could also, it does also lead some households to not purchase healthy or perishable foods, especially if they have lower incomes. So it advances nutrition to have strategies to reduce that waste. So one other reason why wasted food is a critical question at the intersection of all these issues is that many of the solutions that advance change on these issues are politically fraught. Generally speaking, wasted food is not. Left or right, like none of us like waste. Everyone is a fan of saving money. So I see where working on wasted food is an opportunity to address these issues with less of those kinds of political challenges and many collateral benefits.

Norbert: Roni, thank you so much for that commentary on the political nature of addressing this. I mean, that is something that lots of people can get behind, and I appreciate how politically fraught our moment is, and I appreciate the way you framed this, and I'm really grateful for you raising the concern of families from low income households and the challenge of food waste and nutrition access and food security. Thank you so much for bringing those together, because I think that's an under-discussed topic. So Brian, I want to hear your impression or thoughts about the intersection of nutrition, climate change and household economics. So how do you see wasted food as critical to that question around that intersection?

Brian: Yeah, Roni touched on so many great points there. Some others I'll amplify are that, yeah, really, it's an accessible topic that people can connect with on many different levels, whether it be the nutrition, whether it be on the environment, climate change, whether it be on municipal issues. Nobody likes to build more landfills. Nobody wants to be by a landfill, and what is 20% of most landfills, it's typically wasted food. So even at the municipal level it can be something of a rallying point, and something that provides meaningful benefits at that level. At the system level, I think another thing that goes unappreciated is we talk about nutrition, and most people want to focus on, for example, food recovery that is taking food, that might have not found an immediate home in the food system, recovering that, and then redirecting it to others in the food system that might need it. More fundamentally, if we can right size the food system, if we reduce our wasted food from say the one third that we see now down to even 20%, that means we can also push down food prices at an aggregate level. That really helps nutrition, because we know families in need who have difficulties finding the food they need, oftentimes it is a financial issue. Bringing down food prices through reduction of waste can have large positive implications for everybody, including those who are really struggling to meet their financial needs and get stressed by their food budgets. So I think those systematic issues are really something we have to appreciate as well.

Bios

Roni Neff is an Associate Professor in the Johns Hopkins Bloomberg School of Public Health’s department of Environmental Health & Engineering and Center for a Livable Future. She received her AB from Brown University, ScM from Harvard, and PhD from Johns Hopkins. Previously she worked for 10 years in public health practice and policy at the community, municipal and national levels. She edited the widely-used textbook, Introduction to the U.S. Food System: Public Health, Environment, Equity. Her team has just published the guidebook, Food System Resilience: A Planning Guide for Local Governments, developed in partnership with 5 U.S. cities.

Brian Roe is the Van Buren Professor in the Department of Agricultural, Environmental and Development Economics at Ohio State University. Roe attended the University of Wisconsin – Madison where he received a bachelor’s degree in Agricultural Economics. Roe went on to receive a Ph.D. in Agricultural and Resource Economics at the University of Maryland. Prior to his employment at Ohio State, Roe worked on policy issues surrounding food safety and health information disclosure as a Staff Fellow at the US Food and Drug Administration in Washington, DC.

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The COVID-19 pandemic deeply impacted the US food chain and has heightened attention on nonprofit food pantries and soup kitchens. Today's guest argues that sometimes the people most in need of food face the most challenges in getting it because of food pantry operating procedures. Our guest, Alana Stein has conducted research on these issues at the University of California at Davis.

Interview Summary

I'm really happy you could talk to us about these important issues because these food banks and food pantries and other enterprises like this are really important at any time but especially when there's a crisis on the food system like the pandemic created. So let's dig into the work that you've done on the barriers to assistance. Now you published a paper recently in the journal "Social Currents" about this. So could you explain to our listeners how you went about doing your research?

The research for this project actually took place before the pandemic and started as a public scholarship project at the request of the food bank. They wanted to know more about the barriers people experience trying to access their services and particularly for people experiencing homelessness. I did over 200 hours of participant observation at the programs of the food bank working as a volunteer, focusing my observations on two produce-focused distributions that the food bank operated. I also did 21 in-depth interviews with food assistance clients, focusing primarily on interviewing people experiencing homelessness.

It's interesting to think about these qualitative methods of interviewing people and what can be learned from them. So given that you did these in-depth intensive interviews, what are some of the barriers that you found in accessing these food assistance programs?

So the food amounts really varied from week to week. The clients who came through the distribution first had a lot more choice about which foods they could take. This meant people started waiting in line the night before to try to get the earliest spots in line. Sometimes clients would be offered 10 loaves of bread. Other weeks, clients wouldn't be offered any bread at all. So clients really faced a lot of variability and not knowing what types of food they would get or what sorts of food would be available and the amounts that would be available. Not everyone could even eat the bread to begin with, such as if people had gluten intolerance, and some people also had diabetes, which was really forcing them to watch how many carbs they were taking in.

Some of the people also faced barriers with their lack of kitchens. A lot of times, these produce-focused distributions would hand out items like large squashes that were supposed to be a lot of the food that people were receiving. But people experiencing homelessness who didn't have a kitchen weren't able to use the squash. They weren't able to prepare it. It needs to be cooked and needed to be cut. Other issues even when things were more readily available to eat, such as yogurts were sometimes available, is people without kitchens didn't have spoons or utensils to really help with eating. You could ask volunteers for a spoon. That wasn't something that was regularly advertised, but you had to know to ask, and also, sometimes, the volunteers still said no.

Particularly in California's hot summers, it was also difficult for people to store the food, particularly if they didn't have access to refrigeration, and it was just difficult to get your food from a weekly food distribution without having access to food and times in between. There were also barriers around the scheduling and locations of the distributions. So most programs occurred during standard business hours and were only open for a few hours a month, which made it difficult for clients who worked or had other time constraints to access them. Clients had difficulty getting to distributions that were located all over town and then carrying the food with them, especially if they did not have a car. Clients also had trouble accessing information to learn about food distributions and changes to them, and the places that did have information on distributions, like the social services office and food bank website, often were outdated. Some of the distributions also had a heavy security or police presence. So one of the locations for the food distribution I observed was directly across the street from the police office, and you actually had to go under a sign that said probation in order to access the food assistance. People from groups that have historically been targeted by the police, such as people of color and people experiencing homelessness, were more affected by this barrier. Some of the distribution sites also weren't wheelchair accessible. All these barriers were just things that really compounded and impacted people.

In your paper you mentioned that many people face not only a single barrier but many barriers, and you just kind of put this into a coherent picture in just a little bit of time. It's really very daunting, isn't it? These issues that people face, and like the issue of the police presence, I hadn't even thought about that. That sounds very significant then. Sounds like, again, we get back to that issue that I mentioned in the introduction that the people who may most need the help may face the most barriers, and that's pretty much what you found in your paper, wasn't it?

There are a lot of barriers involved in accessing each program, but for the people who had the most need, they often needed to access multiple programs in order to meet their food needs since they couldn't just meet their needs with the available food from one program. So trying to access multiple programs in and of itself added barriers. But then, people with dietary restrictions and who lacked regular access to a kitchen, particularly people experiencing homelessness, couldn't eat, store, or prepare many of the foods, which made it even more important to arrive early to have the greatest choice and to attend multiple programs. However, when people experiencing homelessness tried to arrive early the night before the distribution, they ran the risk of attracting police attention for being in a place where overnight camping was not allowed. As people faced other hardships in their life, they struggled to be able to access the programs. Another example, one woman who was housed I interviewed struggled to attend the distributions when she had to take her brother to chemotherapy. She took a chance each week on whether or not she would make it in time to get any food because the program didn't allow them to set aside food for people, even if they attended regularly and had other barriers to coming.

Well, these are agonizing choices people face, aren't they? So in your paper, you mentioned the concept of operationalized inequity in this system. What do you mean by that?

When I'm thinking about operationalized inequity, I'm thinking about how the programs are structured and how these programs structures were not set up to accommodate different circumstances. If we think about treating everyone equally, we give everyone the same exact treatment. But, if we think about treating people equitably, we're really meeting people where they're at and recognizing the hardships that they face, the historical inequalities that they faced. So even though there was some choice, everyone roughly was treated the same at these programs, but that didn't mean they were treated equitably. And in the cases where volunteers did use discretion and make exceptions for people, they often did not do so in ways that accommodated the clients that were the most in need. They often did so in ways that accommodated the clients that they said were their favorites.

So if nonprofits are in business to serve people in need, why are some of them operating in this way?

So most food banks focus on the amount of food that they distribute as a key metric. This encourages food banks to focus on distributing more pounds of food each year rather than really focusing on how they can better serve populations that face the most hardships. So rather than taking people's actual circumstances into account, programs were more built on assumption that they could have a one size fits all model. There's a cultural assumption that often underlies this narrative, and that's the assumption that if people really need the food, they will find a way to make it work, but that's a really problematic narrative. It doesn't account for the many other hardships that people face. People aren't generally one-dimensionally facing food insecurity. They're also facing many other hardships that go along with poverty, and it takes away people's dignity and does not recognize the basic human right to food.

There are so many daunting issues that the organizations need to face in this and that individuals face in accessing what these organizations have to offer. So what are some of the ways that come to your mind about how these food pantries might better serve the clients?

While I focused on one food bank, other scholars who work in studying food banks have recognized many of these same barriers to accessing food assistance and organizations across the country. So I really encourage food assistance organizations to think about how their programs are structured and the barriers that clients may face, particularly the most disadvantaged clients. Another way to potentially recognize more barriers is to include the voices of people with lived experience with food insecurity and other hardships in program design. Food assistance organizations should also think about how they can build flexibility into their programs while also training staff and volunteers about biases and discrimination so that this flexibility is applied equitably. One good thing that has come out of the pandemic is that food assistance organizations have realized so many new ways that they can structure their programs rather than just continuing with the ways things have already been done. I've been excited to see home delivery programs and programs that provide clients with cash and vouchers, allowing them to have more choice and options. I think the pandemic really showed food assistance organizations that they can change to accommodate clients' needs and do things in ways that didn't seem possible before the pandemic.

Bio

Alana Haynes Stein is a Ph.D. Candidate in the Department of Sociology at the University of California, Davis. Her research uses theories of political economy, stratification, and organizations to study inequalities in the food system. In her research, she pulls on the methods of ethnography, in-depth interviews, geospatial analysis, content analysis, and network analysis. Alana’s dissertation focuses on the resources, practices, and decision-making of U.S. food banks during the COVID-19 pandemic. The research focuses on understanding how the privatization of food assistance and food bank networks impact access to resources. Her mixed methods dissertation employs geospatial analysis to examine food bank resources in relationship to demographic characteristics, and she uses in-depth interviews with food bank leaders coupled with archival research to compare the programs and practices of different types of food banks.

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Today we're speaking with Roland McReynolds, Executive Director of the Carolina Farm Stewardship Association which is a member-based farmer-driven, non-profit organization based in Pittsboro, North Carolina, that helps farmers and consumers in both North and South Carolina grow and eat local organic food.

Interview Summary

So why don't we begin with this. Can you help listeners understand what the Carolina Farm Stewardship Association does?

So our vision is a sustainable regional food system that is good for all consumers, good for farmers, good for farmworkers, and good for our ecosystems. So to achieve that vision, we work with farmers and with communities to advocate, educate, and build connections that support sustainable food systems in the Carolinas, centered on local foods and organic agriculture. We do that by working and consulting directly with farmers to help them implement organic practices in their operations and to help them expand their market opportunities. We work with food hubs and other sorts of food businesses to strengthen their operations so that they can become reliable market outlets for small farms and improve their competitiveness and ability to connect with values-driven buyers. We provide education and training both for farmers and the public. For instance, we host the largest organic farming and food system conference in the Southeast which this year is actually taking place in downtown Durham, November 6 through 8, 2022. We also run a farm incubator facility in Concord, North Carolina to help new organic farmers learn the trade and become successful in moving into organic farming as a career. We do consumer outreach, such as our Piedmont Farm Tour event here in the Piedmont Triangle area in North Carolina and K-12 agriculture education. We do a lot of advocacy educating state and federal policy makers on the needs and concerns of sustainable farmers. And, training people at the local level on how they can be effective advocates for healthy and just food systems.

Thank you for that description in this sort of remarkably broad portfolio you have. I can imagine how busy you folks are! But let me ask a question of kind of a national scope. Are there other organizations like this around the country, and is there a coalition of such groups?

Absolutely. Many states have sister organizations, like Carolina Farm Stewardship Association, serving their communities and their regions. One national umbrella group that we're a part of is the National Sustainable Agriculture Coalition, which acts as a lobbying voice for our sector in Washington DC. Their members span all the way across the country. So similar types of organizations that we work with are in states everywhere, like the Northeast Organic Farmers Association in New England, Community Alliance for Family Farms in California, and everywhere in between.

So let's go back in time and speak about how the association got started. So what were its origins, why did people think there was a need for this, and who are the members?

Essentially, it was a group of organic farmers and gardeners who got together back in 1979 seeking to practice organic farming, and to gain opportunities to learn about how to grow organically. And who wanted to see a food system that was re-centered on communities and relationships and shifted away from a commodity mindset of the cheapest food grown using practices that were focused on extraction from the natural world. These were farmers and gardeners who wanted to work with the natural world and work with their neighbors to create a different vision for a food system. This is the late 1970s, and this was during the "Get Big or Get Out" mindset in agriculture. In fact, existing agricultural institutions, universities, companies, were really actively hostile to organic. It was really to create that peer-to-peer learning opportunity for farmers across North and South Carolina that CFSA originally began. Over the years, the initial project of the organization actually came to be an organic certification agency. Back before there was the green organic seal that we have in the grocery stores today, the organic label was something that was locally defined. There wasn't a national program. So these farmers got together and decided and collectively created organic standards for helping them to manage their farms in a way that was beneficial to the environment that promoted healthy living soils. And over time, as we've expanded, and as the movement has expanded, those farmers recognized the need for policy advocacy and policy change to promote more sustainable food and farming systems, and to expand our services so that we can encourage and promote new farmers to get into organic agriculture and local food.

Now that you explained the origins of the organization, I was first going to say it was the beginnings of a trend for people and farmers to become more in touch with one another through things like farmer's markets and local produce programs and farm-to-school programs, things like that. But it wasn't a new trend. It was sort of the restoration of what existed before when people were more in touch with the farmers who grew their foods, and that connection between farmers and their communities is a really interesting one. And I'd love to hear your thoughts on the role that farmers can play in addressing economic and social justice issues in their communities.

Absolutely. A really great example of how the sustainable agriculture and sustainable farming community in the Carolinas is doing just that today is our FarmsSHARE Program which was developed as a COVID response by Carolina Farm Stewardship Association back in 2020. Initially, we saw with the pandemic and the public health controls that were being put in place, saw restaurants closing and especially those farm-to-table restaurants that were buying food from small local farms in our region and across the country. So those farmers all of the sudden lost a market, and they already had crops in the ground ready to sell, and the restaurants were laying off their workers. And, you know, this predominantly is people working in the kitchens and in the service industry who tend to more likely come from oppressed backgrounds, and they didn't have money because their jobs were getting cut off. So our FarmsSHARE program initially was created to provide CSA-style boxes from those small farms to those restaurant workers who were unemployed, or underemployed, as a result of the pandemic. Thanks to some very generous funding from the Blue Cross Blue Shield Foundation of North Carolina, CFSA was able to buy that food from those small farms. They then worked with local food hubs to have it packed, and then the food hubs delivered the food to the restaurants that they used to sell to so that the workers could have this free, fresh, healthy food. As the pandemic has evolved and revealed to a wider population, the realities of food insecurity in our communities across North and South Carolina, FarmsSHARE evolved to address people throughout society who are in need of fresh, healthy food. So the way FarmsSHARE works right now is that we provide funding to food hubs for them to purchase food directly from small farms, package that up, again, into CSA-style, (Community Supported Agriculture) boxes. And then take that to food pantries in their own communities and senior centers in their own communities so that small farms are, through this program, feeding people in need in their backyards. This is a great example of what happens when we marshal many small farms to work together to address the injustices in the food system in their own communities, and bring healthy food made in harmony with nature to the people that deserve it.

Well, it's a great example of ingenuity. It's a great example of the resilience of a local food system and how people can come together in times of crisis, and the FarmsSHARE program you talked about is really interesting. Do you think that the lessons have been learned about how these food systems can be resilient so if something like this happens again, let's hope it doesn't, but if it does, that we'll be able to respond even more quickly and effectively?

I think we have an opportunity to help people learn that lesson. I mean, there's no doubt we have seen examples of fragility of the national and international food systems as a result of COVID, and we've seen examples of local food systems being resilient. As a professor and instructor, you probably appreciate that learning doesn't just happen from experiencing it once. We have to keep pushing and keep sharing those examples. This is really where the role of policy becomes vital in terms of ensuring that our society learns these lessons. The Farm Bill is coming up, which is the massive five-year legislation that Congress brings about every few years that guides food and agriculture policy in this country. That is a crucial opportunity for advocates of resiliency in our food system to make sure that these lessons actually get ensconced in policy. That policies that direct and incense the production and distribution of food in this country are built to be resilient instead of to be commodified.

Well, so let's talk about the Farm Bill. We'll turn our attention a little bit from the local picture to the national one. So this is an enormous and enormously complex piece of legislation and, as you said, it's coming up for renewal. So what do you think the legislation can do to help support local and regional food systems, and what do you think the policy reforms might be for the 2023 Farm Bill?

It really is a crucial opportunity, and one of the places that can start is in food procurement policies within USDA programs. So when it comes to food purchasing that the government does for relief to address food insecurity, the primary metric for making those purchases, is how cheap is the food? We need to change that mindset. We need to change policy to allow for these systems to prioritize community development and supporting farmers as well as supporting communities. So, for instance, there is a proposed bill that's out there in Congress right now, the Fresh Produce Procurement Reform Act, that is an example of policy that we'd like to see incorporated into the next Farm Bill that would lower the barriers for small farms to participate in these feeding programs. And would allow the agencies that run these programs to make decisions based, not just on getting the cheapest possible food and calories for people who need it, but to actually allow them to get fresh and healthy food and do it in a way that builds community instead of extracts from communities. That's a crucial area of reform. Incenting, agroecological and conservation practices, and promoting more research on organic practices is also something that is a critical opportunity in this upcoming farm bill. There is so much that farmers do that is shaped by the policies that the farm bill puts out. The Farm Bill, as it exists right now, eliminates most of the risk for very large farms to just grow corn and soybeans, and to not worry about the environments. Changing those incentive structures, making it possible, and in fact, desirable for farmers to work in harmony with nature as a primary focus and as a primary benefit of their operations has to be a part of the kind of reform that's needed.

Bio

Roland McReynolds has served since 2007 as the Executive Director of the Carolina Farm Stewardship Association (CFSA), a member-based, farmer-driven non-profit organization based in Pittsboro, NC that helps farmers and consumers in the North and South Carolina grow and eat local organic food. He is an attorney, receiving BA and BS degrees from the University of Missouri-Columbia, and his JD from the UNC-Chapel Hill School of Law. Roland directs CFSA’s programs and policy advocacy work at the state and federal level, and has served on the USDA’s Fruit & Vegetable Industry Advisory Committee; the Policy Committee of the Organic Farmers Association; the National Sustainable Agriculture Coalition’s Organizational Council; and the Advisory Boards for the North Carolina A&T State University College of Agriculture and Environmental Science and the North Carolina State University Department of Crop and Soil Science; among other boards and committees. Carolina Farm Stewardship Association is the oldest and largest organic farmers organization in the Southeast. CFSA hosts educational conferences and events on sustainable agriculture and local food systems; provides training and direct technical assistance to local organic farmers; runs a training farm for new organic growers in Concord, NC; coaches food councils on effective policy advocacy; and represents organic and local food systems stakeholders with state and federal legislators and agencies. In response to COVID, CFSA has been operating a program called FarmsSHARE, a CSA-style food box program that addresses food insecurity in the Carolinas by purchasing food from small farms at a fair price and distributing that food to people in need through a statewide network of community-based food hubs. For more information about CFSA, visit www.carolinafarmstewards.org.

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In 2017, two Black former activists, Karen Washington and Olivia Watkins, met at a conference. Sharing their frustrations about the lack of financial assistance available for Black farmers, the two decided to create the Black Farmer Fund as a new way to nurture Black community wealth and health by investing in Black agricultural systems in the Northeast. In today's podcast, we will talk with Olivia Watkins, President of the Black Farmer Fund.

Interview Summary

I'm really excited to start getting into the conversation. We mentioned a little bit in the introduction about your connection with Karen Washington. So can you tell us about the impetus for the creation of the Black Farmer Fund?

It was really created out of a community ask that we were hearing over and over again. There's so many great organizations out there that work in policy, education, that work in bringing farmers together, and that work in creating self-determination for farmers, and so many farmers themselves that are doing great work in their businesses. But, there was not a financial institution that existed that was able to provide this type of assistance for farmers in a way that they felt like they could trust, and in a way that was safe and culturally appropriate. There are lots of historical evidence to show that where there is high levels of discrimination in some of the major agricultural lending financial institutions. So, we decided to be able to figure out how we can offer an alternative to some of the realities that exist today.

So thinking about those gaps that you are seeking to fill, and acknowledging the cultural and historic realities of those gaps, so those issues of trust, those issues of safety, and those issues of culturally appropriate connection and access to capital, what are the goals of the Black Farmer Fund?

This is a great question, because we just went through our theory of change, where we are continuing to refine what exactly is the change that we're trying to see, and how will we know if we made that change happen. But, in terms of what the reality is that we want to create, we're seeing there are Black people that are in right relationship with land, in a healed relationship with land and food. We're also seeing that's happening through centering ancestral wisdom, practicing community-led decisions, and building out collective power and autonomy. Really, we want to be able to see a thriving and racially just Black food system. The main bucket of our work is building community wealth, and so that is making sure that we have networks of Black agricultural businesses that are resourced. That there is money flowing into Black agricultural communities so the people are well equipped with other sources of assistance that they need. And making sure that we have the tools, and systems, and people to do that, and making sure that those tools and systems, especially in our operations, mirror how we operate externally into the world. One of the things that's really hard for a lot of organizations is the messages and the abundance that we are putting out into the world oftentimes isn't reflected internally in the organization. I don't think that's really any organization's fault, that's the reality of the systems in place. But, there are ways that you can shift that in order to make sure that staff feel supported and held in organizations. That there are processes to make work go smoothly, that there's increased transparency, and that there are different places for people to be able to influence and have autonomy in the outcomes of an organization. I think that is pretty rare, but it's becoming more so required in order for organizations to really embody the change that they want to see in the world.

I love that framing of your theory of change as it relates to your explicit goals. I think about one of the things that you said that feels core to all of those goals, which is that right relationship, whether that's internal or external, or the land, connection to food, connection to capital, what community wealth looks like. So it feels as if that's so rooted in your values, and I know that the Black Farmer Fund is explicit about its values. I was hoping you could share with us what your values are, and just a few examples of how you operationalize those values?

I appreciate this question, because oftentimes, we are not asked about internally, what goes on in the organization in order to produce the work externally. So, we have six values. At the beginning of the organization, we had, like 12, but we wanted to whittle it down and consolidate our values and put specific principles or behaviors around how we would be expressing the values in the world. So the first one is called love. And, with our value of love what that looks like for us is being able to prioritize relationship building, gathering around food, and expressing gratitude in any interactions that we have. And, generally having a culture of care and concern for one another on our staff and our board. So the way that we interact internally as an organization is from the lens of we really care and respect one another, and check in on one another when folks are feeling overwhelmed or need support with work. And, to always make excuses to relationship build and have a good meal, ideally, produced by some amazing Black cooks. Also, to have site visits and community workdays where we bring people to the land of our farmers to be able to put their hands on the land for us. To bring food with us, to bring community, and really show that love for the work that they do and the appreciation and gratitude that we have for them as they continue to do this work.

The second value that we have is community-centric. So, this to us means that we are creating opportunities for Black agricultural businesses to have decision-making power within Black Farmer Fund. This is really important for us as a community-led organization. It's important to have some elements of community governance, and community governance is a really wide spectrum. But for us, it meant having an Investment Committee that has Black food business entrepreneurs and organizers on it who are making the decisions. And, in order to make that real versus just being an advisory board, we legally shifted the power from the Board of Directors to the Investment Committee, so that way, the Board of Directors wouldn't have the power to veto any of the decisions that the Investment Committee made.

The third value is abundance. So it's showing up authentically and honestly in the organization and with people, and being able to speak of success for our communities. I think it's really easy, when you're dealing with a really complex problem that's been generations long, to be in a scarcity mindset. So how we operationalize this is in the way that we do our financial modeling, and make investment decisions, and in thinking about what's the risk of not investing. Typically, a lot of lending institutions would not invest if the risk is super high, or would not give money if the risk is super high. But we're trying to do the opposite, because oftentimes, the businesses that are considered highest risk traditionally are offering the most impact to communities.

The fourth value is wisdom. So we really value wisdom, we value elder knowledge and counsel, we value intergenerational leadership, we value Afrocentric leadership. Just all the different, I guess, non-traditional leadership sources, are really important to our organization. So we make sure that this diversity happens across any decision-making committees that we have, across our staff, across our board, to make sure the knowledge that those folks from those different categories are reflected into how we make decisions and move as an organization.

The fifth value is accountability. It's important, and especially as we're working in community, to make sure that we are accountable to community, and make sure that community feels accountable to us. Making sure that we show up as a dependable organization, that we are disciplined, that we're effective, but then we're also clear on why decisions are made. If there are any conflicts, being able to have processes in order to address those. The biggest accountability piece for us lately has been being able to have a clear matrix of how power is distributed across the organization. So the Black Farmer Fund, we have hierarchy in our organization, and we have different pockets of horizontal leadership. Being able to name where that power is, and where and how things are influenced in our organization, it not only makes it transparent for everybody in the organization, but also provides opportunity to be able to shift things if they're no longer working - because it's clear.

The final value is financial sustainability, which is an important value to us because we are a financing institution, and we are community-centric. We really value being able to provide non-extractive financing for farmers, and being able to maintain the highest standards of our fiscal responsibilities to all of our stakeholders. To make sure that we're doing right by everybody as we continue to steward resources into our communities, and make sure that we're not doing harm with those resources. So this looks numerous different ways that are mainly pretty standard, but I think transparency is the biggest piece. So making sure that as many stakeholders as possible understand what's going on financially in the organization. That people are educated and empowered on what financial best practices are, even if they might not be in the finance or investing team. So just bringing folks along with us in this journey of being able to distribute wealth into our communities.

Olivia, I feel like I've heard you mention so many different things that I would love to dive into so deeply. There are several aspects of the values that are dynamic in terms of how they show up in each of the values. I heard a lot around transparency and flexibility. I love this idea of redefining risk. I don't know if there's anything in terms of each of those themes you might like to speak to just a little more deeply, that resonates with you and your team at the Black Farmer Fund?

Yes. Across the board, a thread that weaves through all these different things is prioritizing the wellness of our staff and our team. We are a very new organization, a young, scrappy organization, and we've accomplished so much within the past couple of years. We've been able to distribute over $600,000 in loans and grant capital to businesses, distribute other pools of capital, like $60,000 to nine Northeastern ag businesses that we don't work with now but hope to work with in the future. We provide emergency relief. We provide technical assistance. There are so many things that we do in our organization and that we've been super successful at. It takes a lot of hard work and dedication and passionate people in order to make that happen. Something that comes up a lot, especially in new organizations, is dealing with burnout or intense workloads. We want to make sure that as we're continuing to do our work, we can build our organizational capacity. We are doing that because there's just a general care and concern for staff and wanting to make sure that people don't feel burnt out and have space and time to rest and process. But I think another thing, as well, that we've been learning about from one of our facilitators who's been our wellness facilitator, is that we deal with vicarious trauma every day. We're dealing with a group of people that have been and currently are marginalized, people who experience hostility every day, on the land, from neighbors, who have financial troubles, who are isolated. We interact with folks who are dealing with really real issues and serious problems on a day-to-day basis. That vicarious trauma can pass on to staff and make it really hard to carry out our work. So I think wellness and rest has been a really important thing. We have different PTO practices that are a little bit more progressive. We're currently developing a sabbatical policy. We always try to find any reason to give people time off to process what they are working on in the organization, and make sure that folks feel well-rested to continue this important work.

That's beautiful. I love that the Black Farmer Fund is so rooted in that culture of care and concern, and, when you named specifically the excuses to relationship build. But really, this role of the Black Farmer fund, the explicit goal of getting dollars to Black farmers, but what it sounds like, is how to do that from a space of healing. Clearly, there's outcomes that you have in getting money to Black farmers. I think a lot of organizations think about connecting folks to capital from the perspective of a transaction, and it sounds like you think about this from the process of relationship. An authentic relationship, both internal and external. I'm wondering, with that grounding in relationship and that grounding in a culture of care and concern, if you'd have any guidance to offer to organizations who might not have started the framework of connecting their outcomes to their values, but might be in a space of seeking to retroactively operationalize their values. What advice might you offer to organizations that are in that space?

Yes. I think something that we've learned along this journey is that values can be interpreted in many different ways. So Black liberation, for instance, means something different to everybody, and that's okay. But what does it mean to BFF, and, what does it mean to that organization that's looking to have that as a value? What are the specific ways that we know we will be operating within a framework of Black liberation, and even what are the specific ways that are clear that we're not operating in that framework? So having a clear understanding of what's important to the organization, and how to define it or not define it, I think has been really helpful. That has been an ongoing and an iterative process to define every year, what's important to us in terms of values, changes, and shifts. It evolves and continues as a iterative learning process. So making sure that all staff are involved in the development of and the defining of what the values means I think can help organizations go down that path.

Thank you so much for that. I think that transformative aspect of what this is, and that really understanding of WHAT any organization might be not just seeking to do but HOW they seek to do that. Both WHAT and HOW the organization chooses to center is going to be so imperative for all of us as we're really thinking what might our food system look like when we're centering those who are most directly impacted. Before we close today, I just want to ask if there's anything else that you'd like to explicitly note about the Black Farmer Fund, and the amazing team and network of farmers with whom you work.

Yes. I'm really honored and super proud. I'm honored to be working with the people that I have been working with to date to make this happen And I'm really proud of how far we've come as an organization, and also all the work that my colleagues have done in order to contribute to this initiative. The stats that I listed, were surface level in terms of what we have achieved so far. I think, moving forward, we're looking to increase that impact we have been making. That includes being able to continue to provide technical assistance and hosting skill shares for the larger community. We are also excited to expand our investment pipeline from New York into the Northeast. Last year, all of our investments were in New York, and now they will be in the Northeast. We're just excited to continue to figure out how we can develop as an organization, collective responsibility for the organization, and what that will look like. What are the different circles of people who will be a part of influencing how we will go about doing our work.

Bio:

Olivia Watkins is a social entrepreneur and impact investor. For the past seven years, she has financed, developed, and operated environmental and social projects across the US. She currently serves as a co-founder and President of Black Farmer Fund, a non-profit impact investing organization creating sustainable and equitable food systems by investing in black farmers and food businesses of NY. She also serves as a board member for Sustainable Agriculture & Food Systems Funders and previously for Soul Fire Farm Institute. Prior to founding Black Farmer Fund in 2017, Olivia worked in several production roles at Soul Fire Farm Institute and Kahumana Organic Farms, leveraging her environmental biology background to manage and grow environmentally regenerative and socially impactful business operations. Olivia has an MBA from North Carolina State University in Financial Management, and a BA from Barnard College, Columbia University in Environmental Biology. She was also recognized on the 2021 Forbes 30 under 30 Social Impact list and The Grist 50.

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Pioneer, path breaker, field builder. These are all descriptions that apply to our guest today, Dr. Marion Nestle. Marion Nestle is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health emerita at New York University. She has been a major force in food policy for decades, partly because she is a brilliant communicator and a prolific author. Her groundbreaking book, "Food Politics," has been published in several editions. Another book, "Unsavory Truth: How The Food Companies Skew The Science of What We Eat," is a classic. And this just begins the list. But today we're talking about Marion's newest book, which is a memoir called, "Slow Cooked: An Unexpected Life in Food Politics". It offers an unprecedented look into the life, the thinking, and the passions of one of the top figures in the field.

Interview Summary

You've had an amazing journey to get to where you are. People know a lot about what you've done at the point where you became an academic started publishing, and things started showing up in the field, but an awful lot happened before that that led up to the academic part of your life. I'd like to have you tell us a little bit about that, if you would.

I called the book "Slow Cooked," because it took me forever to develop a career. In looking back on it and in writing this book, I realized that I was a woman of my time. I grew up in the 1950s when expectations for women were extremely low. Women weren't expected to do anything except get married and have children, which I did. I was fulfilling societal expectations. I worked very hard and was pretty unhappy about all of that because doors seemed so closed. I grew up in New York, and my family moved to Los Angeles when I was 12. I went to an academic high school where everybody went to college, but you were not expected to do anything or to use your college education to create a career. You were expected to find a husband, get married, and have children, and that is what I did.

So then what led you from that to the academic world?

Well, I wasn't very good at being a housewife, and I found it hard to be home with young children all the time. I had a lot of growing up to do, and my poor kids and I grew up together. But I stayed home with the children for a couple of years and it was not a happy experience. I think that was the time in my life when I was close to being clinically depressed. I had friends who said, "You have just got to go back to school." Well, I didn't know what else to do. I thought that was probably good advice, I had very good grades as an undergraduate. So, I was able to get into a graduate program and went back to school when my children were six months and two years old and somehow survived that. Looking back on it, I don't know how I did. That was the beginning of a long, slow progress towards a career. I went to graduate school because I wanted to make sure I had a job at the end of it. I trained to be a laboratory technician and got a job when I finished college. But even in graduate school, I didn't take what I was doing very seriously. I wasn't treated as if I was a serious student. I was told that the only reason they were giving me a fellowship was because no men had applied that year. I thought, "Well, nobody's going to take me seriously, I'm not going to take myself seriously either. I'm just going to do this." And at the end of it, I knew I would have a job.

So what happened that got you interested in academic life, and food issues in particular?

The transition was on my first teaching job. I went to Brandeis University as a postdoctoral fellow. By that time I was divorced and remarried. My husband had a job in Boston. I got a job as a postdoctoral fellow with Brandeis. That led to what I call the swimming pool epiphany, which was a realization in a moment that I could not have an academic career as a bench scientist and handle two young children at the same time. There were women who could do that, but I was not one of them. I was a bench scientist, and working in a developmental biology laboratory. My kids had swimming lessons at Brandeis on Saturday morning. I stayed home with them, because my husband had his own job. He was an assistant professor at Harvard, and he had to work on weekends to keep up with his work. One day there was a much longer swimming lesson for some reason, so much longer that I thought, "Well, I'll just go to my lab. And there won't be anybody there, and I might actually be able to get a little work done." I walked into my lab on a Saturday morning and everybody was there, everybody! The lab director, his wife, the lab technician, the graduate students, the other postdocs, everybody was there except me. I didn't even know that people were there on Saturday morning. I thought, "Oh, okay, this is why everybody treats me like I'm not getting any work done." And, "Oh, okay, THIS IS WHY I'm not getting any work done." That was the end of my lab career. I started looking for a teaching job right away. I knew I couldn't do it. So I took a teaching job at Brandeis, and learned how to learn, which was very useful. On my last year at Brandeis, I got handed a nutrition course to teach. As I like to describe it, it was like falling in love and I've never looked back.

That is so interesting. And What happened after Brandeis?

Well, after Brandeis, my husband got a job at UCSF in San Francisco. I went along as an accompanying spouse, not really realizing the terrible political position that I was in - because I had gotten a job because I was my husband's wife. The job seemed fantastic, I was a halftime associate dean for human biology programs, and then the other part of my time I was teaching nutrition to medical students. I was able to keep that going for eight years, until it and the marriage fell apart at the same time. Then I went to public health school, and actually got credentialed in nutrition. I did a master's in public health nutrition at the University of California, Berkeley. And then, when the UCSF job ended, I went to Washington for two years with a very fancy title: Senior Nutrition Policy Advisor in the Department of Health and Human Services. There I edited the 1988 Surgeon General's report on nutrition and health.

That was a landmark report. But there's a question I'm dying to ask, what was it about nutrition that made you fall in love with the field?

Oh, it was so much fun! It was so much more fun than molecular biology and cell biology. For one thing, the papers were so much easier to read. When I first started teaching undergraduate nutrition, I could give undergraduate students original research papers in nutrition and they could critically evaluate those papers - almost without knowing very much about science. They could see that the number of study subjects was very small, that the studies weren't very well controlled, that there were all kinds of other factors that could've influenced the outcome of those studies. I thought this is just the best way of teaching undergraduate biology I could think of, because everybody could relate to it in a very personal way. It was really fun to teach. Still is.

You're a very gifted communicator. So I can imagine how you would enjoy teaching. You've had an interesting journey through the nutrition field itself, having started at kind of the basic level, with a biological background, teaching about research papers in the field, and then transitioning to having this major focus on the policy side of things. I'm imagining that time in Washington you just discussed was pretty influential in that. Is that right?

Oh, it certainly was. You know, I took the job because I was told, "If you're interested in nutrition policy, this is the place to be." I was in the Office of Disease Prevention and Health Promotion, which is responsible for a large number of very important public health initiatives. And I thought the Surgeon General's report was really worth two years of my time. I ended up writing most of it, and certainly editing a great deal of it. It was an education in how politics works. I had come from Berkeley, where we didn't really understand the difference between Republicans and Democrats. We thought both of them were mainstream, and didn't really get it. Oh, I learned the difference very quickly. It was an education in how Washington works; what you can say and what you can't say; how you get things done politically; how you try to work across bipartisan lines, but how difficult that can be. Also, I met people in agencies who ended up being extremely helpful in later stages of my career. If I had a question, I knew who to ask. I was on committees, I was just really involved in a great deal of nutrition-policy activities in Washington during that two-year period. It was a very steep learning curve, and one that I consider immensely valuable.

And was it during that period where you came to develop a richer view of the influence of food industry on the way food policy decisions are made?

On the first day of my job in Washington, I had just arrived from California. The director of the office I was in explained that even if the research showed that eating less meat would be better for health, the Surgeon General's report could never say "Eat less meat." Because that was a politically impossible statement. The Department of Agriculture would complain to Congress, and the report would never be able to come out. That was, as I am fond of saying, no paranoid fantasy. It was absolutely true. An enormous part of my job in Washington was to fend off the Department of Agriculture official who was most interested in making sure that the Surgeon General's report did not say one negative word about red meat. And of course, it didn't. It said, "Eat less saturated fat," and you were supposed to know that saturated fat is a euphemism for meat.

The role you played was really phenomenally important, and that document that you worked two years on was really very important at the time. So what did you do after that?

Well, I discovered quite early in my time in Washington DC that I was not suited for a Washington DC career. I tend to be outspoken and say what I think, and that's really not acceptable in those circumstances. I was constantly getting my boss in trouble for things that I said. I discovered quite quickly that in addition to the Republican and Democrat split in Washington, there was a split between people who liked New York better than Washington, and those who liked Washington better than New York. I quickly discovered that going to New York would be going home, in a sense. I started looking for jobs in New York right away. After a year or so, the job chairing the Home Economics Department at NYU came up. I applied for it, and happily got it.

Boy, that term - home economics - really brings you back, doesn't it?

It does, and I thought it was hilarious, because here I was with a degree in molecular biology, and another one in public health nutrition. I was coming to chair a Department of Home Economics. Couldn't believe they still existed. I had been hired to change the department into something more appropriate for the 20th, if not the 21st century. And I didn't realize how hard that was going to be. But it was actually the only job I got, so I was happy to do it. It was in New York; it was in The Village; it was at NYU. Which was, at the time, kind of a third-rate institution, but with a commitment to improve dramatically. Which it did very, very quickly, over the next several years. It was very exciting to be part of that development. And of course, eventually the department shifted from home economics to food studies and nutrition, which is what it is now.

When you bring up home economics, it reminds me of being in high school in South Bend, Indiana, where the girls went to home economics classes and the boys went to shop class and learned to do woodworking and things. What a difference there is today.

I was happy to learn how to cook. I think they should bring cooking back. It's a great thing to know how to do, and it certainly improves the quality of food that you eat at home. That's where I learned to cook - in home economics, in junior high school. But the home economics department that I inherited had 25 different home economics programs run by five faculty. It was so absolutely amazing, and there was much work to be done to kind of clean up some of that. Fortunately, I had a lot of administrative help, because the university was improving rapidly, and it wanted that department to improve too.

You're so right about cooking and how important the skill it is. I do a lot more cooking these days than I do woodworking or using a drill press. I wish I could have gone with the girls into that home economics class back then.

Well, I wish I could've gone to the shop, I would've loved to know how to fix cars.

Ahh, there you go. So at NYU, you created, I think, what was the first university program in food studies, is that right?

The first one called "Food Studies." There was a program at Boston University in gastronomy that had been kicked off by Julia Child and Jacque Pepin, but I knew that gastronomy would not work at a rapidly-improving university that took its academics very seriously. But there were, at NYU, a great many programs with "Studies" in their title. And I thought if we had food studies, we could get away with it. And we did. We were very, very fortunate in being able to do that, because a program in hotel management that the department ran was being taken away from us and transferred into another school. And it was an extremely lucrative program, and everybody felt very sorry for losing the income from that program. And so, when we came up with the idea of food studies, once people got over the initial question, "What's that?" And we were able to explain to them that food is a multi-trillion-dollar-a-year industry; the major public health problems in the world are connected to food; agriculture is connected to food; climate change is connected to food - in fact, practically any problem you can think of is connected to food in some way. Then we were permitted to go ahead and do that. We were very, very fortunate in creating a new field, because the "New York Times" wrote about the program the week after New York State approved it. The most amazing thing happened! We had people in our offices that afternoon holding up copies of the clipping and saying, "I've waited all my life for this program." In a sense, we created the program that many of us wish we could've taken when we went to school, because it's a program about food and culture. It now has agricultural components in it, although it didn't at the beginning, but it does now. It's kind of food and everything. Our students love it, they all come into the program wanting to change the world through food, and I'm greatly in favor of encouraging them to try to make the world better through food. I think it's a great way to do it.

I found the same thing in my teaching. The students are so keen on these issues, they get more sophisticated and knowledgeable every year. Interest in food and climate change, like you said, is just booming. And boy, it's really heartening to know that there are so many young people interested in taking on this issue. And thanks to you and others who started those early programs that really paved the path for everything that exists today. Let me ask you about your book "Food Politics", which is really a classic. What inspired you to write that?

I had gone to a meeting at the National Cancer Institute in the early 1990s, and it was about behavioral causes of cancer, mostly cigarettes. This was my first meeting with the main anti-smoking physicians and scientists who were taking extremely activist positions against smoking. They did slideshows, and the slides showed cigarette-company marketing in remote areas of the world: the jungles of Africa, and the high Himalayan mountains. One of the presentations was about marketing to children, and showed pictures of the Joe Camel ad everyplace where kids hang out. I was kind of stunned by it. Not because I didn't know that cigarette companies marketed everywhere, and marketed to children. I did know those things, but I had never paid any attention to it. I had never systematically thought about it. Cigarette advertisements and advertising was so much a part of the landscape at that time that it was unnoticeable. It just kind of disappeared into the woodwork. I walked out of those presentations thinking, "We should be doing this for Coca-Cola!" We nutritionists should be looking at the companies that are marketing products that are not particularly healthful, and looking at how they're doing it. So, I started paying attention. I started looking at food-industry marketing, fast-food marketing, soda marketing everyplace I went. And I started writing articles about it. In the late 1990s, I had a sabbatical coming up, I needed a sabbatical project, and by that time I had figured out that NYU valued books. I had been trained in molecular biology, where the only thing that's valued is original research in very prestigious journals. But NYU values books, it's very humanities-based. So, I thought I could take those articles and put them together into a book. That's where "Food Politics" came about. It was a little bit more complicated than that, but that was basically the origin of "Food Politics".

It is one amazing book, and it had so much influence on generations of students, and researchers, and advocates. And I thank you for writing it. It really has had a big impact.

Well, thank you for that. I have to say, I thought I was just stating the obvious.

Well, obvious to you, maybe, because you had the insight to look into these things before other people did. You really were a pioneer there. A lot of people believe that the job of an academic is to do their research, do their scholarly work, do their teaching, and then that's it. Not to go out and try to change the way the public thinks about things, talk to the press, try to change policies, and do things like that. The thought is, once you stray into that territory, you're biased toward a certain point of view and you lose your objectivity as a scientist. Now, I certainly don't believe that's the case, and boy, if anybody epitomizes that sort of philosophy, it's you. How did you sort that through in those early days, as your work was moving into the advocacy arena?

Well, I think there were two things that happened. One was that I went into a department that did not have laboratories. So laboratory science was out of the question. I had to find something to do as an academic where I could publish in scholarly journals. And yet, I wasn't doing original kinds of research, so I had to solve that problem. But the other was the miracle of NYU: they hired me as a full professor with tenure. I had tenure! I could do anything I wanted without fear of reprisals, or without fear of being fired because I was saying something that would offend someone. I have to say, never in my 30 years at NYU did anybody ever suggest that I keep my mouth shut. So it was absolutely the right place for me, and, I guess, the right time. But I had, I guess, they are biases. I had them for the beginning. I think it would be better if people ate more healthfully. I think it would be better if we had a food system that was better for climate change. I think it would be better if people ate diets that reduced hunger, and reduced their risk of chronic disease. I think those are values that are really important. To be able to do work that promotes those values made perfect sense to me. You know, I realize that I'm looked at as incredibly biased. I never get appointed to federal committees, and I have not been invited to the forthcoming White House conference, because I'm considered much too controversial. I've always found it ironic that people who work for food companies or who think that food-company marketing is perfectly appropriate are not considered biased. That's the world we live in.

You know, it's interesting how the academic world construes the concept of impact, and journal articles, and how many times people cite your articles. The outside world might look in on that definition of impact and just think it's ludicrous. You think of impact in a different way, and I do as well. If you're able to harness the work that occurs in the academic world in order to create the kind of social changes that you're talking about you really are kind of maximizing the potential of what exists inside the academic world. Do you agree with that?

Oh, absolutely, it's publish or perish, and I quickly discovered that food studies was a wonderful umbrella for the kind of work that I wanted to do. And it valued books, it values articles, opinion pieces. I mean, the way I describe my work is I write heavily-footnoted editorials. These're opinion pieces that're backed up by large amounts of science. I think that's a valuable contribution. I'm not able to measure the kind of impact that I have. I have no idea what it is, and I don't know how to measure it. But I'm doing the kind of work that feels good to me. I'm doing work that I feel good about and I feel is worthwhile. I hope that other people will pick it up, and that students will follow in footsteps. And one of the reasons for writing the memoir was to encourage students, no matter what field they're in, to get some idea that they can do these kinds of things, it's okay. You can get paid for it!

That's not to mention changing public opinion or putting pressure on political leaders to do things outside of industry influence, and things. You know, it reminds me of an op-ed you and I wrote together in the "New York Times" some years ago, on the World Health Organization and the stance it was taking on sugar. Those things need to be made public, people need to know about those. And sometimes academics are in a pretty good position to highlight some of those really important issues.

Oh, absolutely, and all of that research skill that we have, all of those references and citations give a credibility to the kind of work that we do that is pretty unimpeachable. You know, I'm often attacked for my opinions. But never on the research that backs them up, which is kind of interesting. You may not like what I say, but I've got evidence to back it up.

Yes! Speaking of attacks, over the years, I've had so many of these sort of things. Some really nasty and threatening and some a little more humorous. I remember somebody once sent me a letter that said they wished a pox on my house. I wasn't sure what I was to do with that. Like, I mean, should I go to Home Depot and buy a pox detector? I didn't really know what to do. Heck, you must've had a ton of that kind of stuff. Has that ever bothered you?

Well, you would be amazed at how little of it I've gotten. I mean, there was one right at the beginning when "Food Politics" came out, there were a lot of attacks. "Doesn't she know anything about personal responsibility," and "Who is she to tell people what to eat," and that kind of thing. And then the famous letter from a lawyer saying I maligned sugar by saying that soft drinks contain sugar, when I, of all people, should've known that they don't contain sugar, they contain high-fructose corn syrup. Which I thought was hilariously funny, because high-fructose corn syrup is a form of sugar. But nothing ever came of it. I've heard remarkably little overt criticism or that kind of thing. What I have heard from people is I talked to one person who said he was hired by a soda company to track every single thing I was writing and then develop positions that the soda industry could use to refute what I had said. But I didn't know anything about that until that confession later on. I was kind of amazed. He got paid to do that! Yeah, I thought that was pretty good.

That's so interesting, so you're creating jobs. Back to that time you were in government, working on the Surgeon General's report, you were noting a lot of influence by the food industry on nutrition guidelines, nutrition policies, etc. If we fast-forward to today, do you think nutrition guidelines, nutrition policies, are less influenced by the food industry?

Absolutely not. Of course they're still influenced. You can look at it in the dietary guidelines. They still talk about salt, sugar, and fat. They don't talk about the foods that those substances come from. They're still very cautious about advising less of any particular agricultural product, because the pushback is enormous. The meat industry is enormously influential over government policy. I mean, we have government agencies that are captured by corporations. We see this in many, many fields, but it's certainly true in food. Everybody is worried about the FDA these days because of its cozy relationships with food companies. I just did a blog post this week on user fees. I don't think the FDA should be getting its money for doing inspections of food corporations from the corporations it's inspecting. They can't possibly do that in an independent way. The Department of Agriculture has long been infamous for working for the meat and dairy industries. The food industry likes the perks it gets, doesn't want them changing, and it uses the political system in the way that all corporations use the political system. I think there's more recognition of food-industry influence over what we eat and how we eat, and that's very gratifying.

Are there things you think could be done to lessen this influence, if you could wave the magic wand?

Yes, get rid of Citizens United to start with, so that corporations can't buy elections. I think there's a lot we could do. I think we need an agricultural system that is focused on public health, not on growing commodities that feed animals and fuel automobiles. I think one of the greatest travesties in the food system is that 30 or 40% of United States corn is used to make ethanol. That's just shocking. In a world in which food is a really big issue, we should be growing food for people, not for automobiles, and not nearly as much for animals. You know, and I think there're all kinds of policies that would promote public health in a way that we really need promoting. We need universal school meals; we need a healthcare system, that would be nice; and we need an agricultural and food system that is focused on reducing hunger and reducing chronic disease, particularly obesity-related chronic disease, which the government doesn't want to touch. Because touching it means putting some limits on what food companies can do. I don't think that food companies should be permitted to market junk food, especially to children.

Bio

Marion Nestle is Paulette Goddard Professor of Nutrition, Food Studies, and Public Health, Emerita, at New York University, in the department she chaired from 1988-2003 and from which she retired in September 2017. She is also Visiting Professor of Nutritional Sciences at Cornell. She holds honorary degrees from Transylvania University in Kentucky and the Macaulay Honors College of the City University of New York.

She earned a Ph.D. in molecular biology and an M.P.H. in public health nutrition from the University of California, Berkeley. Previous faculty positions were at Brandeis University and the UCSF School of Medicine. From 1986-88, she was senior nutrition policy advisor in the Department of Health and Human Services and editor of the 1988 Surgeon General’s Report on Nutrition and Health. Her research and writing examine scientific and socioeconomic influences on food choice and its consequences, emphasizing the role of food industry marketing.

She is the author, co-author, or co-editor of fourteen books, several of them prize-winning, most notably Food Politics: How the Food Industry Influences Nutrition and Health (2002); Safe Food: The Politics of Food Safety (2003); What to Eat (2006); Why Calories Count: From Science to Politics, with Dr. Malden Nesheim (2012); Eat, Drink Vote: An Illustrated Guide to Food Politics (2013); and Soda Politics: Taking on Big Soda (and Winning) in 2015. She also has written two books about pet food, Pet Food Politics: The Chihuahua in the Coal Mine (2008) and Feed Your Pet Right in 2010 (also with Dr. Nesheim). She published Unsavory Truth: How Food Companies Skew the Science of What We Eat, in 2018. Her most recent book, with Kerry Trueman, Let's Ask Marion: What You Need to Know about the Politics of Food, Nutrition, and Health, was published in September 2020. Her forthcoming book with University of California Press is a memoir to be published in 2022.

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In July, 2022 food giant Kellogg lost a court challenge of the United Kingdom's high sugar cereal rule. The multinational food company had argued that the UK government's inclusion of their serials among and I quote, less healthy foods is unfair because it doesn't take into account the milk that is usually added to the cereals. The UK court dismissed the claim and is enforcing regulations, is limiting the promotion of foods that are high in fat, salt and sugar in UK supermarkets as part of their efforts to curb obesity. Here to speak with us today about the implications of this ruling is Anna Taylor, executive director of The Food Foundation in London.

Interview Summary

So let's start with this. Can you explain the ruling that Kellogg objected to and then what the ruling itself makes happen?

Sure. So in the UK we've been having a series of measures being gradually introduced to try and prevent obesity, particularly childhood obesity. And one of those sets of regulations were around controlling the promotion of unhealthy foods in two aspects, one, controlling the position which those products hold in the supermarkets and particularly regulating the high impact parts of the shop. Things like the checkout or the isle end and controlling whether or not foods that are high in fat, sugar salt could be placed in those locations. And the second aspect was applied to a similar set of foods around whether they could be sold to customers in volume based promotion. So like multi buys where you would two get one free, that kind of idea. These regulations are being developed and they are applied to a sub series of categories of foods which contribute a lot of calories and sugar to children's diets. So things like biscuits and crisps and pizza and chocolate and so forth, and also breakfast cereals and only products within those categories that are classified as being high fat, sugar and salt food, using what the UK has as a nutrient profile score, would be eligible for these restrictions. But, Kelloggs sued the government on the grounds that the breakfast cereals that it sold were actually served with milk, and therefore the nutrient profile score should be applied to a whole meal. IE, the cereal and the milk included, which would have tipped many breakfast cereals into not being classified as high fat, sugar and salt foods. However, the court ruled against them. They took the government to court on four counts, and all four counts were rejected by the court. And obviously the public health community were very relieved that that was the outcome, the ruling was really unequivocal in explaining the consequences of an unhealthy weight for children, what that means for their long term health and the links of course between sugar consumption and calorie consumption and the knock on impacts on obesity and excess weight. We were all delighted with the outcome.

So I'm assuming, because the industry bothered to take this to court, that they're expecting this to harm their sales. Is there any sense of how impactful this might actually be?

The impact assessments in the UK come into this as billions, in terms of public health, savings to the health service, savings to social care costs and so forth. But I think in the UK, to some extent, we're a little bit of an outlier; certainly across Europe, in that we buy a lot of food on promotion. About 40% of what we buy tends to be on promotion and the modeling and the work with expenditure data seems to suggest that that leads us to buy 20% more calories than we otherwise would. So this whole connection between promoting things, particularly foods which can be stored easily at home and where you think - well, I can get something extra now - and sort of in anticipation that you won't eat it immediately. In fact, with these foods, because of their close connection to our appetite and the fact that they don't suppress our appetite as much mean that we eat them more quickly. So we end up then buying more and the companies call this the expandability of the category. It is a food category that if you put it on promotion, you can actually expand the size of the market essentially. So it's not surprising that companies are pushing back. We were just emerging from the pandemic, and the Department of Health and Social Care was under immense pressure during the pandemic. We had seen a huge spike in childhood obesity in the UK through the first year of the pandemic. So this was a strategic move by Kellogg's, but I think there wasn't a lot of support for it in the media - perhaps this is the best way to say it.

This is heartening on a number of levels. First that the original regulation was passed. Then second that it prevailed in the court and third that the projections of its impact are so great. Another way that things like this can sometimes be historic is that they open the doors to other such action. I'm thinking, for example, of in the United States when New York city was the first jurisdiction to require calories on restaurant menus. A lot of people, including me and my colleagues, fought hard for that - not knowing really what the impact would be on people's dietary choices. But thinking it was historic because it was a sign that a City Health Department, in this case in New York, expressed jurisdiction over the long term consequences of food. Not just the short term food safety type things that health departments usually get involved in but the chronic conditions produced by long term consumption of things like sugar, fat and salt. So it was historically important in that sense. And I'm wondering if this ruling and the way the court came out on this might be similar in some ways, that it could open the door to other things in the future that could be equally or even more important.

The decisions around these kinds of regulations in the UK are made through the political process, government, parliament and so forth. I think we haven't yet seen a lot of evidence sort of referencing back to the court ruling in making a case for even stronger measures to be introduced in the policy frame. In fact, we're seeing at the moment, that this is reflection of the sort of politics in the UK at the moment. We've actually seen this week that our new prime minister, who came into power the week before last, has requested a review of a whole slew of obesity prevention measures that have been introduced in the UK. Including these ones around promotions. In fact, the regulations on promotions that were due to be introduced on multi buys have been already delayed a year on the grounds of the cost of living crisis. I think it still feels here in the UK that these measures are fragile, that the narratives around nanny state and the role of government intervention in the food system, the sort of private realm is still very politically contentious. It's become a kind of wedge issue if you like, for a much bigger debate about the size of government and the role of the state, food has become a sort of way into that much bigger political conversation. I think we'll know in time how significant the ruling was. It would've been extremely significant if you had gone the other way, because you can imagine, for example, you might say, well, I sell chocolate spread. You normally eat it with bread. And therefore my chocolate spread ceases to become an unhealthy product. And furthermore, things like advertising restrictions and so forth will no longer apply to it. You can imagine it opens a floodgate of potential precedence to the use of the nutrient profile model to classify foods as being less healthy or more healthy. So that would've been incredibly damaging and would I think have had a very detrimental set of sort of long term consequences in terms of how you design policy around the food environment. So I think we've yet to see the real positive impact of it but I think it's probably very fair to say that had it been a different ruling, we'd be already seeing much more severe negative effects of it.

Thanks for that context, it's very helpful especially seeing it in the broader political context, which is exactly what's happening in our country as well. So let me ask this, so efforts by many parties are usually needed to bring about outcomes like this. And I'm wondering in the case of this action in the UK, what happened either visibly or behind the scenes to make this possible?

There's a huge amount of work that goes on, both in the public sphere with the public around, I suppose trying to create a bigger political space for government action in obesity prevention. To some extent, that work really got ahead of steam in the lead up to the introduction of the sugary drinks tax that came in the UK. And, around which there was a sort of major documentary which Jamie Oliver did and which was sort of tipping point I think for public engagement and a recognition by parents that sugar was really hidden everywhere. They felt in some ways manipulated by the system and unaware of the ways in which sugar was appearing everywhere. Suddenly it got a kind of potency in the public realm, which I hadn't had to date. We are very steeped in now, in the conversation about, well, how do we make sure that these measures are protected, that they're not rolled back and indeed that the government feels emboldened to take further steps. That's everything from huge amounts of engagement with parliamentarians right across the political sphere. I imagine in many places as I said before in the UK, this is an issue that people very instinctively think they don't want the government telling them what to eat. Nobody does. They see these kinds of interventions as if it were the government telling them what they need to eat. And so we're doing huge amounts of work with MPs around how we frame these issues in the context of long term health of the nation and the economic productivity and so forth. There's work with parliamentarians, there's work with the public. We do quite a lot of polling work to understand how the public are feeling on issues and tracking that on an ongoing basis, huge amounts of work with the media trying to make sure that there's a sort of drum beat of evidence and stories and real life experiences, which bring attention to the issue. The political economy around these issues is really, really difficult. It's hard for government to act in these areas. The implementation of some of these regulations is tough. Trying to define an isle end in a supermarket becomes the business of teams of civil servants. You know, this is not easy stuff to actually implement. The potential workarounds by businesses are so massive and loopholes and unintended consequences, it's a difficult area to also actually design the right types of regulations. I think we're making progress but it always feels sort of two steps forward, one step back, that kind of sense of stuttering progress really. And if you look at it in a long term frame, then sure, we are on the right track but the urgency of the issues are now so intense that we're just not moving fast enough.

Thanks for that background. So just as the final question, what additional policies are priority for you right now?

At the moment, we're focusing on trying to get the commitments which the government have made not get rolled back. So included in this are, as well as promotions, regulations around advertising of junk food up to 9:00 PM on television broadcast. So sort of blanket ban on advertising of junk food up until nine o'clock in the evening on TV and online. So that's at the moment planned, but delayed. We don't want it to be ditched. We are also putting a lot of energy at the moment into trying to get a set of measures in place to protect the very poorest households who are really struggling in the context of the cost of living crisis. We've got rising levels of food insecurity. And we know at the moment that the food system really if you've got very little money, your options for eating healthily are narrowed even further. And so we're trying to get the government to invest in expanding things like free school meals and preschool programs so that children from disadvantaged backgrounds at least have a guarantee of one decent meal a day.

Bio

Anna Taylor has led The Food Foundation as the Executive Director since 2015. Prior to this role, she worked within the foundation’s Department for International Development. Anna has worked at multiple international organizations such as Save the Children and UNICEF, and has been at the forefront of international leadership on nutrition, supporting programs in a wide range of contexts in Africa and South Asia. Anna also previously worked for the UK Department of Health. In 2014, she was awarded the OBE for her work to address the global burden of undernutrition. She did a MSc in Human Nutrition at the London School of Hygiene and Tropical Medicine in 1994. In May 2017, Anna became a member of the London Food Board to advise the Mayor of London and the GLA on the food matters that affect Londoners. She is a Board member of Veg Power and an advisor to the International Food Policy Research Institute. She served as Chief Independent Adviser to Henry Dimbleby for the development of the National Food Strategy published in 2021.

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Soul food has played a critical role in preserving black history, community and culinary genius and has also been a response to centuries of food in justice. Today we're speaking with author, Dr. Christopher Carter about these new book entitled, "The Spirit of Soul Food." Chris Carter is a professor of theology and religious studies at the University of San Diego and also a pastor in the United Methodist church.

Interview Summary

Chris, I can't tell you how much a pleasure it is to talk to you again. You were a very important figure in a meeting we held at Duke University with experts from around the country on food and faith issues. It made me appreciate more than ever how much work has gone on, how rich the thinking is in this area and how important work of this type is. It's really nice of you to join us.

That was an amazing conference for establishing connections. And, just as you said, seeing that there's so many people that are connecting food and faith on a broader level, it was just really exciting.

I'm glad you found it that way. So let's talk about your book. So you began your book with a really interesting statement and I'm quoting here, "I did not want to write this book." Tell us why not?

Yes, that is definitely an odd way to start a book that I have been working on for about 10 years. For me, it was really more about this particular version of the book. I had submitted a few earlier drafts throughout the review process and while they were all received well by the publisher, some of the reviews were coming back not as good as I would like them to or not as well appreciated as I thought it could be. There was something missing. I think one of the reviewers noted they felt as though I was being too critical, particularly the food ways of black culture and the ways in which I was being critical. And that wasn't my intention, as a black man I'm talking about the food my people eat. I'm from Louisiana, Mississippi and so my culture is very much steeped in the book. What I realized was that in order to do justice to my arguments and to fully explain how my reasoning has evolved, I had to be vulnerable. I had to talk about my own experience growing up impoverished, and talk about the experiences of my grandfather growing up in the Jim Crow south as a migrant farm worker. I had to talk about the experience of my paternal great-grandfather who was Spanish and was an overseer in the ways in which they had a particular kind of position of power in plantation. It required a lot more vulnerability than I initially wanted to disclose. I think the book is richer for it, and it allowed me to weave compassion in the book in a way that I think is unique. But, that's not the book I set out to write, Kelly. It definitely pushed me in ways that I anticipate and I'm grateful for it but definitely was not easy.

Well, I for one very much appreciate the fact that you took the risk and went and wrote the book. I think it is a really important contribution. So let's talk a little bit more about what you address in the book. So one of the things you do is you wrestle with a complicated relationship between food and agriculture and black culture. So what if anything did you discover in your own research for this book that changed the way you think about this intersection?

I think one of the most powerful things for me that discovered in this research was the fact that Africans were enslaved because of our agricultural acumen. That was really world changing for me. Growing up, you know, my grandfather had a garden, but it really was like a small farm in his backyard. My family migrated from Louisiana, Mississippi, respectively, to Michigan and they lived in a tiny town called Three Rivers. He had this pretty good size backyard because everybody had lots of space on properties because we were in the country. So I grew up with a particular kind of appreciation for how to grow food but not necessarily knowing that that's a part of or associating it with my identity in any kind of positive connotation. In my research and visiting plantations down south, I was able to connect with the scholars and residents at a few of these particular plantations. What I learned were the ways in which plantation owners were very specific in the tribal affiliation of the slave they were trying to purchase to it depending on the product they were growing. That just utterly transformed my notion in understanding of agriculture and spirituality that I'll talk about in a moment, because I think I grew up with this impression that black people were enslaved because of our physical capacities. I think that's a lot of what the myth is: that we're very strong people and that we can have a high level of endurance. We can work really hard, or whatever. This idea that we were enslaved because we had a particular kind of skill set and knowledge and acumen that otherwise would have prevented the colonizers from actually being able to produce food really was in a unique way like empowering. It helped me realize the traumatic relationship we can have to agriculture and to growing food within the black community because of the history and legacy of enslavement. That enslavement in and of itself, or plantation work in and of itself, is just a part of the story, but it's not the only aspect of the history and legacy of food and agriculture for black community. That was important. It tied to spirituality in as much as what I have come to also realize, that the ways in which the particular kinds of foods we eat - many of them are distinctly West African. They are kind of celebratory practices. We have come from this kind of tradition as well and that we have inherited these and they've been passed down. There's this way in which food has been this binding agent for us to preserve parts of our culture and identity in the midst of a particular kind of marginalized existence in America. That has allowed us to, the words of my ancestors to make a way out of no way. So that really did, I think, change the way I thought about that intersection because I no longer had to think about it as purely oppressive. I could see the liberatory nature found within our ability, reclaiming our ability to connect to the land, to grow food and to be serious about our food ways. That is a way to me to do honor to my ancestors now having done the research and written the book.

That is absolutely fascinating. And, it reminds me of the book, "The Underground Railroad" by Colson Whitehead where he talks about some similar things, about the importance of agricultural expertise among the people who are enslaved.

I absolutely love that book and you are 100% spot on. Particularly in the very beginning of the book, for those of you who haven't read, he talks about the fact that many of the enslaved had their own little gardens. The gardens were on the side of their cabins where tons of people stayed. Those were crucial for them to be able to provide food for themselves, and also some sense of identity and sustainability. So that's an excellent connection that you're drawing that I kind of whole heartedly support it.

In your book you chose to make a theological argument for food justice. So why did you decide to include religion? I know it is obviously important in your life and your profession, but why do you think religion belongs in this sort of discussion? What's the primary theological issue that prevents Christians from various backgrounds, conservative or liberal for that matter, from making food justice a central part of their ministry?

There are a couple of reasons why I decided to include religion. I think the first one really is that as a person who thinks theologically. I am an ordained United Methodist Elder, I'm currently a pastor at Westwood United Methodist Church. So it's hard for me to disentangle those identities. I think just from the way in which I interpret the world. And so one is just to be transparent about the ways in which I'm even approaching the topic. But, also talking about race in the ways in that do require me to talk about religion. So much of the construction of race in America is tied to the role religion played in not only helping to facilitate the creation of racial categories, but to assigning them a particular kind of hierarchy that grew out of a theological hierarchy. So for me, if I were going to talk about some of the moral issues and moral challenges within our current food system, I kind of had to talk about religion because religion was a big aspect or really important part of how we got to the problem in the first place. That leads naturally to the second part of your question: the kind of primary theological issue. It really is what I was just mentioning in terms of how religion was used to justify this kind of oppressive hierarchy of being. And by that I mean the ways in which we give certain forms of being human more privilege, right? So whether it be male privilege over female privilege black over white or able bodied over disabled. I mean all the other various ways that we go about being human. Among the challenges, I think we have the primary challenge with respect to taking environmental justice or food justice seriously from theology is we have a broken. The technical term is theological anthropology. That's just a fancy way of saying our understanding of what it means to be human is radically disconnected from the land. Our understanding of the relationship between God and humans, humans and humans, and humans and non-human nature is fractured. We have prioritized this way of being human that separates us from anything that's material, right? That separates us from anything that is necessarily connected to work. And so when you say what it needs to be an ideal human is to be a kind of upper middle class, white Anglo-Saxon, protestant, heterosexual male - if that's your ideal version of being human, then all other people are going to strive to model those particular kinds of ways, right? Of being in the world and seeing them as the ideal. So that doesn't allow for the plurality of the human experience. Really my argument tries to take seriously the Eucharistic call that's in Christian theology - this idea that either male or female, June or Greek or slavery or free - we're all created in the body of Christ. And to exclude someone from the body of Christ by putting these boundaries on the ways in which they have to be human is an affront to the idea of Eucharistic solidarity, the idea that we are all part of the same body of Christ. The challenge that I try to cross in the book is, how do we understand and develop a new way of being human as modeling our lives after Christ? I talk about this idea of being human as practice or in Methodist terms, as I said I'm a Methodist pastor, we call this sanctification or Christian perfection. It is this idea of being human as a process, a goal, something we're always striving towards rather than it's just assumption that it's just the way we are, right. So it's really about preserving and aiming towards particular kinds of ideals of solidarity, ideals of love and ideals of interconnectedness that I believe can transform the ways in which we engage the world particularly from ecological and food perspective.

It is my impression you're speaking about this mainly from a Christian point of view. And one thing that was interesting from that conference that we both attended on food and faith several years back was how there were pretty distinct similarities across religious traditions and the way food, helping people in need with food and things like that existed. Those similarities were really fascinating. It seems to me, but I want to see what your opinion on this, that more and more people are aware of this. They are more aware of the connections between food and faith in general, but specifically how it applies in the different religious traditions. Do you see that interest and awareness increasing as I do?

I do. I will tell you probably my second most popular class at the University of San Diego is my introductory course called Religion and Food. Now on one hand, it's popular because it's probably the only class where you're going to get to do a lot of cooking. Some students really love to cook. So for them they are like, "hey, this is great. Part of the class is going to be eating food, sign me up, you know." So that's one part of it. But, I think underneath that what students realize, I have students multiple religious traditions, and I talk about how we use food to make meaning. How eating food is a meaning making practice, right. Through their food, they are able to then explain and construct their own identities and where they come from, with their particular stories, their ethics and their values around what they are eating or what they are not eating and why they eat in these particular ways and how it's tied to their traditions. I think there is a growing appreciation for food in American culture and particularly the spiritual dimensions when it's made explicit to people. They understand it almost immediately because we all have certain things we eat every holiday, right. We all have certain things that we eat because this is how grandma used to make it. And that is sacred, righ?. There's something sacred about that. So it's helping them tease that out a little bit so they can begin to understand how it connects with their broader sense of self. It's a really exciting course. And to your point, Kelly, I think people are really starting to understand how this connection is spiritual in regardless of our religious traditions.

It's good to hear your perspective on that. So back to your book, so you end your book by suggesting three theologically grounded principles for eating in ways that align with values of love, justice, solidarity, and interconnectedness. Can you share a little bit more about those principles?

This for me is kind of the culmination of the whole project. I try to identify as a practical theologian and obviously that is just a fancy way of saying, I don't want to disconnect my academic work to the realities of what's happening on the ground with people. I think it's part of the reason I still am a pastor. So, I try to make arguments and suggestions that I think people actually can apply. The first principle that I talk about is what I call soulful eating. That is really eating in a way that recognizes and takes seriously the kind of theological, moral commitments we are to have with non-human animals and non-human nature. So that means taking this kind of assessment of where do we procure our food from? Like where does it come from? Who is growing it? Are these people being paid fair wages? Are they being treated humanely? Taking seriously as the fact that if you look at factory farms and where those plants are located, how they just do so much ecological harm, particularly to communities of color and poor and rural communities. What I suggest as soulful eating really is a way that tries to eat in a way that does no harm, right. I argue for, at its best, that for me this is a kind of practical veganism, right? This is a way of trying to opt out of systems that we know cause harm not only to our planet, but to people, right. That the people that either work in these places or the people impacted in those environments who live by those factory farms are disproportionately harmed. How can we opt out of those systems? I recognize that is not possible for everyone. Again, I grew up impoverished, so that wasn't possible for me. And so I talk about trying to, in the second part, give justice for food workers. How people who are of privilege work towards creating the kind of capacities and spaces to provide means for people who are low income and poor, to access food in ways that does justice not only for them, but also to those who grow the food. So by this, I mean things like what Heber Brown is doing at the Black Church Food Security Network is a perfect example of the work I think religious organizations can be doing, where they connect with farmers to basically have more or less these kind of food hubs, right. The church literally becomes a hub where people can come and purchase food where there is low overhead because the point isn't to make a bunch of money, the point is to provide a service. So that they're getting more than selling their food to just a grocery store. You want to make sure that you're compensating the employees that run the business, right, the drivers and whoever, and other than that, that that's really it. It is really about keeping things low cost as possible because you are keeping the dollar, it's staying within that community that's marginalized quite honestly. Whether it's doing that, whether it's stopping at a CSA or a Co-op, those are some of the ways in which we can talk about eating in ways that addressed justice for food workers. The last one is caring for the earth. That ties together with the other two, in as much as again how might, particularly if you're looking at churches for instance, how might we turn church land into farmland. Like again, I grew up in semi-rural West Michigan. Our church had literally has acres of grass that we mowed. What could we also do with that land? Even if we didn't necessarily want to farm it, you know, we could have hired someone or let someone actually do something with that to actually grow food and provide food for the community. It doesn't necessarily have to be food for people. It could be a cash crop. I mean, there are multiple ways in which we could use our land more efficiently. I think this needs to be thought and taught in schools of theology, especially, so clergy can make this connection. Understanding the ways in which again this is kind of a spiritual practice. All this to me is bound together through the lens of cooking. I talked in the previous answer about the importance of cooking for me. I think it has a spiritual practice for us to really tell our stories, to demonstrate our values, so that people can begin to understand who we are and whose we are by the things that we eat and kind of reclaiming the kitchen as a sacred space rather than thinking about cooking as a kind of chore, which often I think in American culture we're taught to move so fast and get things done really quickly. If we slow down, I mean, I do this with my three-year-old son. I include him in the kitchen when I'm cooking probably three to four days a week. I talk to him about his great-grandmother he would never have a chance to meet when I'm making something that she taught me how to make because I want him to know her through this meal and to carry on that particular kind of tradition. Those are the three practices, probably the thing that always gets people jumped out is the veganism stuff. I try to do a good job of explaining in the book that it is much more of a practical veganism that doesn't recognize that everybody can't do it. It is much more about a goal of trying to eat in ways that do no harm. That really puts the burden on organizations and people like myself to provide the framework so people can eat in ways that align with their values so they can actually have access to good healthy food.

Bio:

Christopher Carter is an assistant professor of theology and religious studies at the University of San Diego. He is also a pastor within the United Methodist Church and has served churches in Battle Creek, Michigan, and in Torrance and Compton, California.

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Today, we're speaking with geologist David Montgomery, co-author with Anne Bikle of a new book called "What Your Food Ate." Very interesting title. David is professor in the College of the Environment at the University of Washington and earlier had been awarded a MacArthur fellowship. You may already be familiar with him through his acclaimed book called "Dirt: The Erosion of Civilizations." Dr. Montgomery has long argued that the root of good health begins with dirt, a factor that we ignore at our peril.

Interview Summary

Well, I really admire your work, and this work in this area is so important. We've recorded a number of episodes around the issue of regenerative agriculture, and it's been impressive how much interest there is in this topic, which I think, only a few years ago, wasn't very well known to most people but now is becoming more part of the general discussion, which I see as a very positive development. Let's begin with your interest in dirt. So what is the condition of the Earth's dirt?

Well, sad to say, not very good in terms of our agricultural soils in particular. That's something as a geologist, that's what got me interested in soils is looking at the long history of human interaction with our landscapes and soils and ended up writing a history of farming about how it had degraded farmland around the world over the course of centuries. The short answer is that we have degraded something between about ¼ to 1/3, probably, of the world's potentially viable agricultural land to the point where it's not terribly useful for agriculture. The UN's 2015 Global State of the Soil report concluded we are losing about a third of a percent a year of our ability to grow food on this planet due to ongoing soil loss and degradation. So the physical erosion of the soil and the degradation of its fertility as manifests through the loss of soil organic matter. And, that 0.3% a year number doesn't sound like a big deal on a year to year basis. But think about that over the rest of this century, and it adds up to almost another 1/3 of the world's farmland taken out of production at a time when we really need all hands on deck or all acres on deck, as it may be, to feed the world as our population keeps growing. So, we face a fundamental challenge this century of how to sustain agriculture on a degrading resource base. Our other choice is to think about trying to improve, enhance and restore the soil. That is where regenerative agriculture comes in and where my interest has really grown beyond just looking at the sad experience of past civilizations that degraded their land. And to thinking about possible solutions that will allow humanity to continue intensive agriculture to feed the world well into the future.

So what are some of the factors that have driven the erosion and the degradation?

One of the biggest factors that contributed to the loss of topsoil in societies around the world was tillage, the act of plowing. That seems a little odd to hear at first because isn't that something that farmers do? It helps to provide weed control. It helps to prepare a seed bed for planting, but it also leaves the ground bear and vulnerable to erosion by water and wind until the next plants come in, whether it's a crop or whether it's weeds. If you leave the ground bare and vulnerable, you get the erosional situation like we saw in the Dust Bowl where great clouds of dust blew off the American Midwest when we plowed up the plains when the next drought came in. The same kind of thing happened in slower motion in societies in the past, mostly in response to rain rather than wind, but erosion that proceeded faster than the rebuilding of the soil gradually stripped off the top soil from regions around the world that people depended on to grow their food. And in the modern world, we can actually degrade soil faster with the combination of tillage, the over application of synthetic nitrogen fertilizers, which also contribute to decline in soil organic matter, and the concentration on monocultures can also reduce the release of exudates that plants produce and drip into the soils to feed microbes around their roots. That combination is all resulted in degradation of soil organic matter and the loss of topsoil, soil erosion in many parts of the world. So the very foundation, if you will, of modern conventional agriculture, intensive tillage, lots of agrichemical use, and monocultures has helped to undermine the native fertility of the farmland that future generations globally are going to depend on for their food. So one of the questions I've been wrestling with and how I got into looking at regenerative agriculture was how could that process be turned around? How could we actually sustain intensive farming and not degrade the land? Is it possible to actually engage in intensive farming that could improve the health of the world's soils? That started to turn me into an optimist when I ran into farmers, interviewed farmers, and studied their farms where they had indeed done that.

It is impressive to hear those stories. We've had a number of such farmers doing podcasts, and it's very inspiring to talk to them. So let's just take one piece of what you said, the use of tillage. You hear the term no-till farming. What does that mean? What does that look like?

• [David] Yeah, so that would be farming without plowing, and so the challenge is how do you get the seeds into the ground? How do you prepare a field for planting if you still have the remains of last year's crop on it, the so-called crop residue? Over the last century, people have invented new and different farm implements and machines, and there are no-till planters that can actually put seeds down into the soil in narrow little trenches that get good contact between the seed and the seed bed but don't require essentially inverting the soil. They don't rip it all up. They just disturb a little narrow slot to actually get seeds in the ground. What that also allows is keeping the residue from a prior crop as essentially a mulch. If you knock it down, if you kill any weeds that were there physically and knock them down, crimp their stems, you can convert them into mulch that can help keep moisture in the soil, but it also protects the soil from erosion. No-till farming is a way of farming that minimizes the physical disturbance of the soil, and you need different equipment to do it and a different mindset to do it, but it's very feasible to do, and there's lots of different ways to do it. Some farmers use a lot of herbicides to control their weeds in no till. That is the conventional way to do it, but there's others who are pioneering different techniques that don't require the use of a lot of herbicides to do no till. The basic idea of no till is to minimize the disturbance of the soil, and why is that important? Because it enhances the beneficial aspects of soil biology. It allows the natural soil ecology that really evolved in the last 450 million years since plants colonized the continents to work. Soil microbes have these partnerships that evolved between plants and life and the soil that are mutually beneficial. And if you disturb the soil physically, you disturb a lot of the fungal partners that crops are trying to invest in with some of their early growth.

I know the regenerative agriculture approach wasn't called this going back hundreds of years but been used by populations around the world, including Native Americans, but if we fast forward today, do you think that this holds promise for being done on a broad enough scale to really make a social difference?

Yes, I really do. What is different today is that in the past, these practices of crop rotations and of planting legumes in and amongst crops to get nitrogen into the soil, those are not new ideas. They have been traditional ideas in many societies around the world because they worked to help sustain the fertility of the soil. But, what I think we really have the opportunity to do now is to combine some of that ancient wisdom with the modern technology that allows us to do no till at scale. And, to minimize our use of not only physical disturbance from adopting no till but also to minimize the chemical disturbance that comes with the overuse of synthetic nitrogen fertilizers and pesticides. Combining the modern technology with ancient wisdom can allow us to basically expand the realm of regenerative practices to very large-scale farming because unless we all want to become farmers, we're not going to be able to do small-scale regenerative farming and feed the world. Even though most of the world's population is fed by small-scale farmers, those of us in the westernized world relying on very few people to feed very many of us. I've been on regenerative farms that are up to 20,000 acres in the US; big, large mechanized farms that have done an amazing job at rebuilding the fertility of their land. I've also been on very small-scale subsistence farms in equatorial West Africa that are regenerative that have done an amazing job at rebuilding the fertility of their land. Those three general principles of minimizing disturbance, growing cover crop, always keeping living roots in the ground to provide exudates to feed the microbes, and to grow a diversity of plants. That recipe is a combination of principles that different kinds of practices would need to be used on large farms or small farms or high tech farms and manual labor subsistence farms, but the general underlying philosophy of cultivating the beneficial life in the soil underpins all those. And that's how I tend to look at what I would call regenerative agriculture, are farming practices that are tailored to the size of the farm, the environment, the climate, the crops that farmers want to grow, the technology they have access to, but that prioritizes building the health of the soil as the foundation for the farm.

It's nice to hear such a positive outlook on this. You are painting the picture saying that it can be done. Do you think it can be done in a way that can compete cost wise with traditional approaches to farming?

Absolutely, and that was a big focus of what I wrote about in "Growing a Revolution." If you could tell a farmer that you could cut their fertilizer costs, cut their diesel costs, cut their pesticide costs as much as in half, they all start looking at you like going, "Yeah, tell me more. How would you do that?" That's one of the key attractions, I think, of regenerative agriculture. Once the soil is restored to a healthier state, you don't need as much fertilizer. You don't need as many pesticides, and you don't drive tractors around as much if you're doing no till. What are three of the biggest costs on modern farms in north America? Well, fertilizer, diesel, and pesticide. And so if you can teach farmers a different way of farming that starts with a different way of looking at the soil and adopting a different series of practices that allows them to harvest as much while spending less to do it, it's a recipe for a more profitable farm. And for what I've seen in the experience of the pioneering regenerative farmers that I've interviewed, once they've restored fertility to their land, their yields are comparable to, if not better than, their conventional neighbors, and their expenses are less. That's what started turning me into an optimist on this is I've seen a lot of growing interest in farming communities simply because farmers are pushed to the wall and looking for ways to cut costs.

That's so exciting to hear that, and then, of course, at some point government could subsidize these sort of approaches to make it even more cost effective because of the environmental benefits.

There are all kinds of add-ons in terms of benefits, less offsite nitrogen pollution, greater on-farm biodiversity, enhancements to rural economies, and also differences in what gets into the food that we grow that could potentially benefit human health.

I have a million questions to ask you. We've talked about the vitality and health of the soil. Let's talk about the vitality and health of what's being grown in the soil, that is the nutrient quality of the foods. In the book, you note that produces significantly less nutrient dense than in the past. How much is this true, and how less dense is it?

Yes. That's a great question. So one of the things we really delved into in "What Your Food Ate" because it is a central question to thinking about, well, does soil health mattered to human health? And the conclusion we came away with in diving into the peer reviewed literature and doing some of food testing of our own, was that there's three key areas where the nutrient density, shall we say, of food has suffered over the last half century. And that's in terms of mineral micronutrients, phytochemicals, and the fat profiles of our meat and dairy. So how does that work? Well, in terms of mineral micronutrients, a lot of plants partner with fungal communities in the soil to actually trade sugars and fats and proteins. Plants will drip those out of their roots to feed microbes in the soil in exchange for those microbes, particularly fungi, giving back things like zinc or copper or iron mined from the soil. It's literally an underground economy but where both partners benefit from the exchanges, and conventional agricultural practices disturb those relationships. We're not talking so much about the major nutrient composition of foods as much as the micronutrients. Plants have different gene pathways where if they're grown in very nitrogen-rich environments, they shut down their exudate production. So they stop feeding their microbial partners. Their microbial partners aren't on the job to give them the mineral micronutrients that they need and that turn out to be very important for our health, too, when we eat them. Plants also make what are known as phytochemicals in response greatly to environmental stimuli, some of which are microbes in the soil. And so the communities of life around their roots are actually key partners in terms of making things that we don't often consider nutrients in the nutritional sciences, but they're important for maintaining human health, things like antioxidants, anti-inflammatories. Those are examples of the functions phytochemicals can serve in our bodies, and our farming practices have disrupted them. How much they have disrupted them? There are studies that show differences on the orders of 50 to 100%, others that are more like 20%. Most of the studies and the testing that we did as well make it look like it's more like around 20%-ish. It's modest but very real differences in these compounds that the medical sciences have shown are fairly beneficial to promoting human health in our diets.

So can I assume from what you're saying that there's research now showing that if you use better soil practices a la regenerative agriculture, that the nutrient quality improves?

Yes, it's a nontrivial difference. And the other difference, even bigger, is looking at the ratio of the composition of fats in meat and dairy in terms of the omega-6 and omega-3 fats. To make a very simple generalization, omega-6 fats in our bodies are instrumental in initiating inflammation whereas omega-3 fats are instrumental in quelling or reducing inflammation. It turns out that what we get in terms of the fat composition in our meat and dairy products very much depends on what the cows ate that produce that meat and dairy. Cows that grazed leafy green plants, actually grazing out in a pasture, they eat a lot of omega-3s because that's what's in the leaves of plants because omega-3s are central to photosynthesis. Omega-6s are a very rich in seed sources. They serve different purposes in seeds. Cattle that are on a feed lot diet of seed-derived feeds are rich in omega-6s, and our diet has gone from having just a few more omega-6s than omega-3s in our diet 100 years ago. Now we're awash in omega-6s from that change in our meat and dairy and also the addition of seed oils to processed foods. That trade we write about in the book that translates through, we think, to essentially how so many of us are dealing with chronic maladies that are rooted in chronic inflammation.

Another way to really move this along might be for consumers to begin requesting products that are grown in such a way, and so I'm wondering about your opinion on whether a poll from consumers might help here. Do you think there could come a time when that would be the case?

I absolutely do, in fact. I just noticed in Anne and my own buying habits. So we started doing this research and learning what it was we did along the way, our buying habits have changed. So we're buying 100% grass fed meat and dairy when we can. We've tried to connect with farmers whose practices we really like in terms of the produce we can buy at farmer's markets here in Seattle where we live. Now the average consumer faces a challenge today in terms of what's labeled as what in a grocery store, but it's our hope that people will start thinking more about these connections, start asking questions, ask the produce manager at your store, "What are the farms doing that you're getting the produce from?" I could definitely see a world in the not too distant future where consumers may be armed with the ability to know what the analyses of different batches of produce coming in.

And I wonder if the first movement here might not be from institutions, that a school system or a hospital or the procurement part of a city or county government, if they made purchasing decisions based on nutrient quality and, of course, the practices used to grow the food could make a big difference.

I think that is a tremendous idea that I think could be very impactful, and I think you're right, that that could be where you might see some of the biggest pieces of movement. There is also been some corporations that have been interested in trying to move towards adopting and advertising that they have adopted regenerative sourcing in some of their ingredients. I really see three areas that need attention in terms of advancing regenerative agriculture. Consumer demand is one, as we have been discussing. The inherent farmers' incentives in terms of economics that we discussed earlier is another. The third is in terms of rethinking our agricultural subsidies and policies to actually reward farmers who are rebuilding the health and fertility of their land. Those who are reinvesting in the future of America, quite literally, instead of continuing to subsidize conventional practices that frankly degrade the fertility of the land and the ability of future generations to feed themselves. If we could get all three of those areas lined up working towards the same goal of making what we call regenerative agriculture today the conventional agriculture of tomorrow, that could literally change the world in the coming decades. It's not going to happen fast, but I think it's something that could be done over the course of two or three decades at a time when we really need the change.

Well, especially if the right research got done at the right time. For example, I could imagine going back to school systems. Let's say that a school system changes its buying practices and ends up buying more nutrient-dense foods and then proves that there are beneficial outcomes for the kids, like better performance in school and more attention and things like that. Then you could see a lot of adopters coming pretty quickly.

Yes, I would love to see a lot more research along those lines done. We tried to connect the dots in "What Your Food Ate" from soil health to crop health to animal health to human health, but there's a lot of space between those dots and a lot of work that needs to be done, but it's a very promising area and a new way to think about those connections.

Could we talk about livestock for another minute? You mentioned this earlier, and it sounds like there's a lot of promise using these techniques for livestock production. Most people think of plant production here, but livestock are really important as context as well. Are there places where livestock and plant-based agriculture are interacting with each other in this context?

Yes, some of the farmers I visited were reintegrating animal husbandry into their cropping operations and having their cattle graze off their cover crops and then manure their fields. I came from a position where I had long thought of cattle in particular as harmful to the land through gully formation and erosion from overgrazing. The farmers that I visited who have used cattle to rebuild the fertility of their soils were really grazing in a very different manner, in a different style that enhanced the fertility of their land as a result of reintegrating them. I think one of the big inadvertent mistakes of 20th century agriculture was essentially separating animal husbandry from cropping and encouraging farmers to specialize in one or the other. Now we have the perverse situation where we grow a whole lot of corn using practices that degrade the fertility of the land to feed cattle and feed lots who then are full of omega-6s that degrade our health when we eat them. It makes no sense in terms of large-scale agricultural policy unless you are thinking with the mid-20th century mindset of maximizing efficiency and industrializing and separating those corners of agriculture. What we inadvertently did is we broke some of the biological and ecological connections that helped keep the land fertile and that were result of the integration of animal husbandry and cropping practices. That's another example, I think, of the value of potentially reintegrating some elements of ancient wisdom with modern science to think about doing things a little differently.

Let me end with this question, and I want to see if I'm reading you right. It sounds like if you look at the world's situation with dirt agriculture, it is a pretty dire picture, getting worse quickly, and it could go really badly if nothing is done, but it also sounds like you're very optimistic. There is a lot we know about what can be done, a lot of it is being done, and the signs for the future are positive. Am I reading that right?

I am optimistic about this. I struggle with how much of that optimism is a choice rather than a logical extension of what I know. But I think we know enough now about techniques that can rebuild fertility of the land and restore it that it's feasible to see a path forward where we could do that at scale with very positive results that could also put a lot of carbon back in the world's agricultural soils, which would have ancillary climate benefits. It's not going to solve the climate problem. That's a fossil fuel issue primarily, but it could help. Back when I wrote "Dirt" in 2007, I think it was, there was hardly anybody talking about soil health and the long-term importance of reinvesting in the world's agricultural soils to rebuild their fertility, and now almost every farming conference I go to or get invited to speak at, that's one of the big topics of discussion among farmers. And there's now discussion at policy level in terms of the new Farm Bill that climate activists are interested in. There's a lot of very broad, I think, public support and interest coalescing around the idea that one of the smartest things we could do for the future of our own species and for the health of the planet is to reinvest in the health and the fertility of our agricultural soils.

Bio

David R. Montgomery is a Professor of Earth and Space Sciences at the University of Washington. He studies the evolution of topography and the influence of geomorphological processes on ecological systems and human societies. He received his B.S. in geology at Stanford University (1984) and his Ph.D. in geomorphology from UC Berkeley (1991). Current research includes field projects in the Philippines, eastern Tibet, and the Pacific Northwest of North America. In 2008 Montgomery received a MacArthur Fellowship. His books, Dirt: The Erosion of Civilizations, King of Fish, and The Rocks Don’t Lie have all won the Washington State Book Award in General Nonfiction. Montgomery’s Growing a Revolution: Bringing Our Soil Back to Life, was a finalist for the PEN/E.O. Wilson award for Literary Science Writing. His latest work with W. W. Norton, What Your Food Ate: How to Heal Our Land and Reclaim our Health, published in 2022.

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We've done many podcasts on the topic of regenerative agriculture, which is a conservation and rehabilitation approach to farming and ranching that enriches and restores the environment while also producing more nutrient dense food. Today, we are speaking with Anna Aspenson of the Croatan Institute about the need for financial investment in regional food production, and processing infrastructure, such as meat packing, grain milling and malting and produce canning, or even freezing facilities. Interview Summary So Anna, a recent report that you and others at the Croatan Institute recently released is entitled Investing in Regenerative Agriculture, Across Value Chains. And I thought this was really interesting. And in this report you argue that there's a missing middle as you call it in the country's food processing infrastructure. Can you explain what you mean by this middle infrastructure and why do you advocate for investment there?

Great question, Kelly. When we refer to middle infrastructure, really what we're talking about is anything between the regenerative farm and the consumer. So that can really be anything from a processing plant that cuts, cleans and packages a product. It's the storage of that regenerative product. It can be a company that aggregates for larger volumes to reach larger markets and it is marketing regenerative products and distributing to those retail locations. So grocery store to a school, to a hospital and even the customer's front doorstep.

We talk a lot about the missing middle in agriculture, and that's referring to mid-scale agriculture. We have smaller farms, we have large, more conventional farms and there isn't a lot of regenerative farms that are that mid-scale size. So the missing middle of infrastructure is that it's the infrastructure that helps to widen markets for regenerative farms so that they can reach larger scales. And so that more people can have access to those regenerative products, which are typically flavorful, healthful, and good for the land, good for the environment. We wanted to focus on the investment piece because at Croatan Institute, we focus a lot on pathways to new economies pathways for the economy to work more for human health, for ecological resilience and for social and racial equity.

In 2019, we wrote a report called "Soil Wealth, Investing in Regenerative Agriculture, Across Asset Classes." And that really looked at how we can move more aligned capital to the regenerative agriculture space. But it's not just farms. Regenerative is all about systems and it's all about how farms can work in community and can work for not just the land, but also the general social, relational cultural system that the farms typically lie in, right? We are humans, we live in society, we live in systems. We live in these complex ecological systems. So when we refer to soil wealth, we are talking about soil health, but we're also talking about community wealth and how we can gain more social benefit, more wealth building from regenerative systems.

So wondering if you wouldn't mind helping to paint a picture for us of what a farm like this might look like. So how big would in middle size farm be and what would be some examples of things that such a farm might produce?

So we looked at a number of different regenerative infrastructure businesses and capital providers in this space. We looked at over a hundred, we talked to over 30. So there's tons of examples in the report. But one example that we looked at is a collection of infrastructure businesses in Minnesota. So we looked at companies like Lawrence Meats, Tree Range Chicken, Other Half Processing, and they serve infrastructure for regenerative farms that are grass fed, grass finished ranchers who are creating these regenerative products and need reliable markets to bring those products to consumers. So they all work together in harmony to move those products to the consumer in a way that respects the farmer that makes sure that they're getting the profit and the revenue that they really need to keep their operations moving and expanding.

People are learning more and more about regenerative agriculture, but don't understand those steps that occur after the food is produced and you're helping bring that alive, so I appreciate that. So let me ask another question. So it's natural for investors to want to reduce their risk as much as possible when they're making an investment. What are some of the things that investors should take into consideration about this middle infrastructure space and the companies that surround it, especially when thinking about farms or consumer facing product brands?

Absolutely, part of the reason and the motivation behind this report is that we've seen a lot of interest in investing in things like agricultural technology or consumer facing brands. Those are the types of companies that really work well with the venture capital equity model. They might have higher margins, lower capital expenditures, middle infrastructure is almost the opposite. There's a lot of capital expenditures, lower margins. However, we're seeing that investors are really opening their eyes to impact and not just profit and revenue, which is extremely essential, but also these other benefits that middle infrastructure can provide. And so, some ways to de-risk those types of transactions that investors might be maybe more wary of or less familiar with is to really meet businesses where they are. So middle infrastructure has a lot of unique business models that focus and really bake in those social and ecological benefits and missions. Though investors can work with those businesses to create new and innovative forms of capital that are patient that focus on the long term and can be flexible with where that business is in their stage of development. So one example is this concept that we call integrated capital, which is a term by RSF social finance. And that essentially means that you're using various forms of capital to meet different needs of the business. So anything innovative with debt equity or somewhere in between as well as non-financial resources. So technical assistance, business development, workforce development, policy work, anything that can help really build out that system and help that business make more connections and enrich their business models in order to de-risk those transactions.

So I'd like to ask a question, this may beyond the scope of the work you were doing, but I'm just wondering. Are there signs that consumers are showing an interest on products growing in a regenerative way? I mean, certainly people are using farmer's markets and more people care about organic and things like that. What about the term regenerative in particular? Is it something that consumers know about or people making purchasing decisions based on this?

We certainly have seen an increased interest in regenerative and consumers looking for products that are not just sustainable and good for the environment, but also social and economic benefits of regenerative business. I think that one of the challenges for middle infrastructure is that those farms are really taking in risk and transitioning to regenerative. They're very complex systems that are very knowledge heavy. There's a lot of peer and community learning that is necessary for regenerative agriculture brands and middle infrastructure are a great way to show consumers the benefits of those products in order to increase demand and therefore, infrastructure. There's lots of new labels and brands, and we can expand those markets. Hopefully we'll have more regenerative farms with rich connected value chains.

Isn't it also true that if a farmer takes land that hasn't been used in a regenerative fashion and tries to turn it into a regenerative farm, that that process takes some time and some investment and some risk on the part of the farmer that goes beyond the normal risk of weather and pests and things like that, is that true and is having a solid infrastructure ready for their products once they start getting produced a really important part of the financial security of the farmers?

One thing about risk is that we typically think black and white: this thing is risky and therefore investors might be wary of it because of the lower margins because it's seen as risky. But we've gotten to a point where with climate change and with the increasing challenges and the extremes of climate that we're seeing, we really need to start looking in the long term. So maybe there is short term risk, but it's really helpful for investors to understand that risk and to change the way that they're providing capital in order to think with that long term mindset. The whole purpose of middle infrastructure is to bake in that resilience to increase connections and redundancy so that there is increased resilience.

So in your report, you highlight organizations that have had success as middle infrastructure companies. Can you talk a little bit more about some of these examples?

We highlighted businesses across different types of agricultural crops. East Denver Food Hub, for example, is one that's been incredibly successful in baking in the missions of regenerative. So for example, in the early months of the pandemic, they were able to maintain purchasing contracts that were essentially their original funding for their business and able to provide healthy nourishing regional products for food boxes in the early months of the pandemic. Another innovative business that we looked at is Seal The Seasons out of North Carolina. So right downtown from you all that works in frozen fruit and frozen vegetables. So really what we keep seeing is these really innovative business models that have a mind to niches, to filling in a space in the value chain and working together with their community. I think at the core of that is this idea of relationships and enhanced business contracts that really build out the value in a reliable way.

You know, it's interesting that you mentioned Seal The Seasons because I buy their products and that they're really wonderful. It's nice to see that they've come so far and to see their products out there. And you're really helping show us that having that infrastructure is so important, actually getting these things out into the marketplace. So let me end with this question. What's the final take home message you'd like to give for investors wanting to support regenerative agriculture?

Good question, I think at the core of it, we really want and are hoping that investors can jump in, start somewhere. We've shown through this report, that these types of businesses, although they're unique, although they're innovative, these businesses are profitable and it takes a lot of coordinated effort. But if investors can really embrace that type of cooperative collaborative mindset and start to also work with these businesses in their innovative spaces to create new capital solutions, then we can really start to build these systems that we haven't really had in the US post colonization. We haven't had a food system that is coordinated and built around equitable access to quality foods that generate nutrients for communities and the environments we have to start somewhere. So let's jump in.

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What can be done to reverse racialized marketing of unhealthy foods to Black Americans? What if healthy eating could be seen as a radical act, or even as a form of Black activism and liberation? Today, we're talking about these issues with Dr. Shiriki Kumanyika about a new campaign called Operation Good Food and Beverages. This is an advocacy movement developed by and for Black youth who want to reclaim healthy food as part of Black lives. Shiriki is an emeritus professor of biostatistics and epidemiology at the Perelman School of Medicine at the University of Pennsylvania, and research professor at the Drexel University Dornsife School of Public Health.

Interview Summary

I long admired the work you've done on food and beverage marketing, particularly around the issues of targeted marketing. And then still, you do even more worth admiring and along comes this new campaign that you call Operation Good Food and Beverages. Can you tell us about it?

This campaign is really the culmination of my efforts to do something about the marketing of unhealthy foods in general. But to Black communities in particular, I think first and foremost, it's a call to action to make healthier foods and beverages more available and promoted in Black communities, especially Black youth. It has some educational or motivational elements to it because the call to action is contextualized in a broader message about good food. And, how young people like to have good food, how it makes them feel, and that the messages are in one place on the website. We are more than food companies think we are. You know we're much more than that. So it's a positive campaign. The main elements: our website with various resources, and two social media accounts. One on Instagram and one on TikTok. The main audience is youth, but we also hope to reach parents and others in Black communities Including celebrities and allies of Black communities and anyone who really sees this as an opportunity to send a positive, but somewhat different message to the food sector about marketing of unhealthy foods and beverages.

So before we dive in and learn a little bit more about the nuts and bolts of this, why did you decide to focus on marketing to youth, and in particular, on Black youth specifically?

Well, there are a lot of reasons for choosing youth. I think the most positive reason is the increasing role of youth in various social justice movements, and in raising their voice. There's a lot of energy in the generation that we were targeting here: Generation Z. Those are sort of late teenagers and maybe early college age. So that's one reason. Youth are really great messengers, I think, for a positive message that relates to them and relates to their communities in general. The reason, in terms of food marketing, is that it is kind of a perfect storm. There's a whole body of work that talks about the sensitivity in the adolescent years to identity formation issues, role models that they see, and perhaps a particular responsiveness to ads in Black youth. Seeing themselves positively represented, perhaps and helping in that way with identity formation, but linking this to some of these unhealthy products that they see in the media. So there are really a lot of reasons that Black celebrities are really prominent among people marketing these foods and beverages. And so we thought, considering that these diseases really start at a young age, then we would work with youth in terms of prolonging their lives and keeping their risk factors down.

That certainly makes sense. So tell us what youth will encounter when they interact with this program. What does the program consist of?

So the program consists of a website as the sort of main home base. It's called Operation Good FB, and it is meant to create a very positive picture of foods and beverages that youth might want. As well as mentioning what the problem is, but not dwelling on the negatives of the problem and the negatives of the associated disease burdens. Because we really want it to be very uplifting and positive experience. The social media sites then have similar posts. The youth posts on those sites messages about good food and beverages. And the first thing you see is an opportunity to click and sign a petition. That is one of our key action items. It's directed to the National Restaurant Association. It urges the National Restaurant Association to encourage their members to make healthier options available on the main menus that would appeal to teens. This is building on the progress they've made with healthy options for younger kids through the Kids LiveWell program. So those are the main elements. There are different things that people can do in terms of using social media and so forth, but it's the website, two social media accounts. And the petition is critical for showing that there's a broad base of support for what we're asking.

Oh the petition is a really interesting idea. Would you envision, at some point, expanding it to other parts of the food industry beyond the Restaurant Association?

At this point, I can't say because the petition is asking for the National Restaurant Association to meet with the Council on Black Health, which is our organization that is sponsoring Operation Good Food and Beverages. For that particular association, it's relatively clear what the ask is. It's very concrete. They have a lot of members. Those members have menus that directly relate to children and youth. Because we know through some CDC data about fast foods on any given day that one in every three children is eating at a fast food restaurant. So it's very concrete. For the packaged food industry, which is also relevant, the ask is not as clear. I think we're interested in seeing progress in the other types of foods, but they're not as clearly targeted to youth. So if there's a way to expand it, I would love to do that. But right now, to get action and to season success, we're focusing on the National Restaurant Association and things that they can do. And hopefully they'll be inclined to do.

It makes sense to start with the restaurant sector. It'll be interesting to see over time if the petition has the effect that you hope it does whether other parts of the industry could be brought into the fold as well. So what do you hope will be different if you're successful? What will change?

Well, I have high hopes. I think at minimum, a new conversation that would be picked up widely in the public health and social justice communities, and in the broader consumer communities, this it's not an issue that's talked about a lot in the consumer community and the public health. Messaging, although powerful and well-backed by evidence about the need for change, has just not been that effective in creating changes that would affect a broader audience. So some progress focused on the younger children.

I hope that we could have a new conversation and one that's more positive than we've seen before. Because we think that people respond to positivity. And so if you're always sort of bashing and saying, "This are the problems in the Black community and this is what you're doing wrong," we don't think that that's necessarily going to be effective. So I hope that we can shift the conversation somewhat to what we do want to see - to the solution as opposed to continually emphasizing only the problem. And ultimately, I would like to see what we're asking for. We would like to see the good foods promoted. They're a small part of advertising budgets overall, as I'm sure you know. We would like to see this balance really shift as a part of expressed demand, but also as a part of understanding in the industry that the current practices are really not representing what consumers want to the level that they could. So I think that's what we'd like to see. You know, changing the world is a big deal, but if we can get it started and other people pick it up, maybe some of the celebrities will pick it up and use their celebrity power, then we can have a change in the food marketing conversation and eventually in the food marketing.

Well, you could only imagine the boost that would occur to this if some celebrities got involved. Another question I had as I was doing the introduction for this, we mentioned that Black youth had been involved in developing this program. Can you explain how that process unfolded and how that was important in determining the final content?

Well, the youth involvement is critical. We're working with youth from a group cohort, Smiles MD, which is in Baltimore, Maryland, and it's associated with Johns Hopkins University. And our sponsor was the Bloomberg Initiative at Johns Hopkins. So what they did, they set us straight from the very beginning about what they wanted to see in food and what their generation likes to see in the media. They like positive representations. They have very creative ideas about how to think about this. And as we go forward we are hoping that they can really connect with a larger network with youth organizations holding some web interactive sessions on social media and connecting directly with other youth who can spread the word within this generation even more broadly.

So they've been key because even though I've been studying this issue for a long time, I'm far from Gen Z, and we want to reach that group. And they do see things differently. The social media component is definitely something that they are looking at much more than the traditional media, for example.

Oh, I could only imagine the ingenuity of it must have come from youth getting so engaged in this. So let me ask you one final question. How can people participate if they want to join in and be part of this?

Well, there are many different ways people can participate. We would like everyone to start with the website and take a look at the petition, sign it if they're on board with the ask, which are very positive, use the tips and recipes themselves, but then help to spread the word using social media kit that's downloadable from the website. Spread the word among their networks if they are in touch with youth organizations who could, as a group, really broaden the campaign, post on the social media and so forth, show that there are thousands and thousands and thousands of people who think that the marketing mix could change.

Bio:

Shiriki Kumanyika, PhD, MPH, MS is a Research Professor in the Department of Community Health & Prevention at the Drexel University Dornsife School of Public Health and Professor Emerita of Epidemiology at the University of Pennsylvania. She holds a BA in Liberal Arts from Syracuse University, an MS in Social Work from Columbia University, a PhD in Human Nutrition from Cornell University, and a Master of Public Health from Johns Hopkins University. Over more than three decades, Dr. Kumanyika has led or collaborated on research related to obesity, sodium intake, and other aspects of diet and lifestyle and chronic disease risk reduction. Several of her studies have evaluated behavioral interventions to facilitate healthy eating and weight control in Black children or adults in clinical or community-based settings. Her research during the past 15 years has focused particularly on identifying ways to combat the effects of racialized, targeted marketing of unhealthy foods and beverages on food-related attitudes and practices of Black Americans. Dr. Kumanyika is the founding chair of the Council on Black Health, a research and action network dedicated to improving Black Health nationwide. She is a past president of the American Public Health Association and a member of the National Academy of Medicine.

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What can be done to reverse racialized marketing of unhealthy foods to Black Americans? What if healthy eating could be seen as a radical act, or even as a form of Black activism and liberation? Today, we're talking about these issues with Dr. Shiriki Kumanyika about a new campaign called Operation Good Food and Beverages. This is an advocacy movement developed by and for Black youth who want to reclaim healthy food as part of Black lives. Shiriki is an emeritus professor of biostatistics and epidemiology at the Perelman School of Medicine at the University of Pennsylvania, and research professor at the Drexel University Dornsife School of Public Health.

Interview Summary

I long admired the work you've done on food and beverage marketing, particularly around the issues of targeted marketing. And then still, you do even more worth admiring and along comes this new campaign that you call Operation Good Food and Beverages. Can you tell us about it?

This campaign is really the culmination of my efforts to do something about the marketing of unhealthy foods in general. But to Black communities in particular, I think first and foremost, it's a call to action to make healthier foods and beverages more available and promoted in Black communities, especially Black youth. It has some educational or motivational elements to it because the call to action is contextualized in a broader message about good food. And, how young people like to have good food, how it makes them feel, and that the messages are in one place on the website. We are more than food companies think we are. You know we're much more than that. So it's a positive campaign. The main elements: our website with various resources, and two social media accounts. One on Instagram and one on TikTok. The main audience is youth, but we also hope to reach parents and others in Black communities Including celebrities and allies of Black communities and anyone who really sees this as an opportunity to send a positive, but somewhat different message to the food sector about marketing of unhealthy foods and beverages.

So before we dive in and learn a little bit more about the nuts and bolts of this, why did you decide to focus on marketing to youth, and in particular, on Black youth specifically?

Well, there are a lot of reasons for choosing youth. I think the most positive reason is the increasing role of youth in various social justice movements, and in raising their voice. There's a lot of energy in the generation that we were targeting here: Generation Z. Those are sort of late teenagers and maybe early college age. So that's one reason. Youth are really great messengers, I think, for a positive message that relates to them and relates to their communities in general. The reason, in terms of food marketing, is that it is kind of a perfect storm. There's a whole body of work that talks about the sensitivity in the adolescent years to identity formation issues, role models that they see, and perhaps a particular responsiveness to ads in Black youth. Seeing themselves positively represented, perhaps and helping in that way with identity formation, but linking this to some of these unhealthy products that they see in the media. So there are really a lot of reasons that Black celebrities are really prominent among people marketing these foods and beverages. And so we thought, considering that these diseases really start at a young age, then we would work with youth in terms of prolonging their lives and keeping their risk factors down.

That certainly makes sense. So tell us what youth will encounter when they interact with this program. What does the program consist of?

So the program consists of a website as the sort of main home base. It's called Operation Good FB, and it is meant to create a very positive picture of foods and beverages that youth might want. As well as mentioning what the problem is, but not dwelling on the negatives of the problem and the negatives of the associated disease burdens. Because we really want it to be very uplifting and positive experience. The social media sites then have similar posts. The youth posts on those sites messages about good food and beverages. And the first thing you see is an opportunity to click and sign a petition. That is one of our key action items. It's directed to the National Restaurant Association. It urges the National Restaurant Association to encourage their members to make healthier options available on the main menus that would appeal to teens. This is building on the progress they've made with healthy options for younger kids through the Kids LiveWell program. So those are the main elements. There are different things that people can do in terms of using social media and so forth, but it's the website, two social media accounts. And the petition is critical for showing that there's a broad base of support for what we're asking.

Oh the petition is a really interesting idea. Would you envision, at some point, expanding it to other parts of the food industry beyond the Restaurant Association?

At this point, I can't say because the petition is asking for the National Restaurant Association to meet with the Council on Black Health, which is our organization that is sponsoring Operation Good Food and Beverages. For that particular association, it's relatively clear what the ask is. It's very concrete. They have a lot of members. Those members have menus that directly relate to children and youth. Because we know through some CDC data about fast foods on any given day that one in every three children is eating at a fast food restaurant. So it's very concrete. For the packaged food industry, which is also relevant, the ask is not as clear. I think we're interested in seeing progress in the other types of foods, but they're not as clearly targeted to youth. So if there's a way to expand it, I would love to do that. But right now, to get action and to season success, we're focusing on the National Restaurant Association and things that they can do. And hopefully they'll be inclined to do.

It makes sense to start with the restaurant sector. It'll be interesting to see over time if the petition has the effect that you hope it does whether other parts of the industry could be brought into the fold as well. So what do you hope will be different if you're successful? What will change?

Well, I have high hopes. I think at minimum, a new conversation that would be picked up widely in the public health and social justice communities, and in the broader consumer communities, this it's not an issue that's talked about a lot in the consumer community and the public health. Messaging, although powerful and well-backed by evidence about the need for change, has just not been that effective in creating changes that would affect a broader audience. So some progress focused on the younger children.

I hope that we could have a new conversation and one that's more positive than we've seen before. Because we think that people respond to positivity. And so if you're always sort of bashing and saying, "This are the problems in the Black community and this is what you're doing wrong," we don't think that that's necessarily going to be effective. So I hope that we can shift the conversation somewhat to what we do want to see - to the solution as opposed to continually emphasizing only the problem. And ultimately, I would like to see what we're asking for. We would like to see the good foods promoted. They're a small part of advertising budgets overall, as I'm sure you know. We would like to see this balance really shift as a part of expressed demand, but also as a part of understanding in the industry that the current practices are really not representing what consumers want to the level that they could. So I think that's what we'd like to see. You know, changing the world is a big deal, but if we can get it started and other people pick it up, maybe some of the celebrities will pick it up and use their celebrity power, then we can have a change in the food marketing conversation and eventually in the food marketing.

Well, you could only imagine the boost that would occur to this if some celebrities got involved. Another question I had as I was doing the introduction for this, we mentioned that Black youth had been involved in developing this program. Can you explain how that process unfolded and how that was important in determining the final content?

Well, the youth involvement is critical. We're working with youth from a group cohort, Smiles MD, which is in Baltimore, Maryland, and it's associated with Johns Hopkins University. And our sponsor was the Bloomberg Initiative at Johns Hopkins. So what they did, they set us straight from the very beginning about what they wanted to see in food and what their generation likes to see in the media. They like positive representations. They have very creative ideas about how to think about this. And as we go forward we are hoping that they can really connect with a larger network with youth organizations holding some web interactive sessions on social media and connecting directly with other youth who can spread the word within this generation even more broadly.

So they've been key because even though I've been studying this issue for a long time, I'm far from Gen Z, and we want to reach that group. And they do see things differently. The social media component is definitely something that they are looking at much more than the traditional media, for example.

Oh, I could only imagine the ingenuity of it must have come from youth getting so engaged in this. So let me ask you one final question. How can people participate if they want to join in and be part of this?

Well, there are many different ways people can participate. We would like everyone to start with the website and take a look at the petition, sign it if they're on board with the ask, which are very positive, use the tips and recipes themselves, but then help to spread the word using social media kit that's downloadable from the website. Spread the word among their networks if they are in touch with youth organizations who could, as a group, really broaden the campaign, post on the social media and so forth, show that there are thousands and thousands and thousands of people who think that the marketing mix could change.

Bio:

Shiriki Kumanyika, PhD, MPH, MS is a Research Professor in the Department of Community Health & Prevention at the Drexel University Dornsife School of Public Health and Professor Emerita of Epidemiology at the University of Pennsylvania. She holds a BA in Liberal Arts from Syracuse University, an MS in Social Work from Columbia University, a PhD in Human Nutrition from Cornell University, and a Master of Public Health from Johns Hopkins University. Over more than three decades, Dr. Kumanyika has led or collaborated on research related to obesity, sodium intake, and other aspects of diet and lifestyle and chronic disease risk reduction. Several of her studies have evaluated behavioral interventions to facilitate healthy eating and weight control in Black children or adults in clinical or community-based settings. Her research during the past 15 years has focused particularly on identifying ways to combat the effects of racialized, targeted marketing of unhealthy foods and beverages on food-related attitudes and practices of Black Americans. Dr. Kumanyika is the founding chair of the Council on Black Health, a research and action network dedicated to improving Black Health nationwide. She is a past president of the American Public Health Association and a member of the National Academy of Medicine.

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During the early days of the COVID-19 pandemic in 2020, much of the US was in lockdown. Many people had lost jobs or could not work from home during that time and struggled to pay their bills. Shortages of food and other basic necessities were common. Many people needed help during this time. Charitably-funded volunteer staff organizations like soup kitchens and food pantries suddenly found themselves on the front line of a massive ongoing food relief emergency. Many of them did heroic work. We're speaking today with the co-authors of a new report titled, "The Impact of the COVID-19 Pandemic on US Hunger Relief Organizations, from August and November of 2020." Gizem Templeton is a researcher at Duke University's World Food Policy Center. Alison Cohen, formerly of WhyHunger, is a research consultant on the project. And Suzanne Babb is the director of US programs at WhyHunger.

Interview Summary

So Gizem, let's begin with you. Can you tell our listeners about the survey itself and what WhyHunger hoped to accomplish through this work?

Gizem - Sure, Kelly. So as a research partner for WhyHunger, we wanted to survey hunger relief organizations, which are food banks, food pantries, soup kitchens, as well as hunger advocacy organizations during the pandemic in the summer of 2020. Our goals were twofold. First, we wanted to document what was happening in terms of pandemic impact and response. And second, we were interested to see what programmatic policy and food system recommendations they had for the future. All in all, over 240 hunger relief organizations from 39 states responded to our survey.

It was important to understand the impact on hunger relief organizations because these organizations are mostly dependent on charity donations of cash and food. Their operating budgets change from year to year. And, they're staffed largely by volunteers who tend to be older individuals. So as you can imagine, the COVID-19 pandemic created a range of daunting challenges for them.

You may probably recall the many media stories with photos of long lines of people trying to get food during the summer of 2020. The hunger relief organizations in our survey said that demand for food and other services increased significantly. We heard that people who used to donate money were coming in to get food themselves. And also, that many families were struggling simultaneously with job losses, housing issues, and reduced access to food. Hunger relief organizations did everything they could to stay open. And we saw a lot of innovation to meet the demand, in this survey.

I mean, there is no question that hunger relief organizations gave their all for our society during the pandemic, but in their own words, they also questioned the country's dependence on charitable donations to keep people fed. And survey responses highlight a need to strengthen the national social safety net and to focus on the root causes of hunger.

So Gizem, how did the hunger relief organizations grapple with these tremendous challenges during the pandemic?

Gizem - Yes, so first, all but two of the organizations who responded to our survey were able to remain open. But all of them had to make big changes very quickly to keep up with an almost overwhelming demand for food and new safety practices as more was learned about COVID. And we saw shifts to curbside pickup of food, some home delivery, and a few organizations were even able to offer client transportation for housebound individuals. Some hunger relief organizations made a shift to online ordering.

I would say the biggest challenge they faced was the loss of volunteers due to COVID risk. And they had to suspend some programming as a result of that. Many surveyed organizations said some of their volunteers and staff contracted the virus during this time. Another challenge was not enough refrigeration space for perishable food and storage for shelf stable food as the volume of food coming in increased to meet the demand.

And a big challenge, I would say, the organizations at times struggle with a lack of communication and coordination from the government that would've allowed them to prepare for changes to regulations, safety protocols, and federally sponsored programs like the Farmers to Families Food Boxes.

In terms of what helped them meet the demand, I would say philanthropic funding was key. Charitable funding for emergency food surged during this time and partnerships within and outside of the hunger relief world and increased local coordination were also big contributors to success.

It is clear that the hunger relief organizations did incredible work to support our society during this chaotic time. But we have to ask ourselves, does it make sense in a country as wealthy as ours that so many people had to turn to charity in order to have enough food?

So Alison, in your view, what were the most surprising and the most troubling and even the most hopeful things that you uncovered in the survey?

Alison - Well, I think the survey uncovered both troubling and hopeful things given that the entire emergency food system was thrown practically overnight into crisis mode. Because of the pandemic, we witnessed every single hunger relief organization pushed to its limits. And the ways in which the system was taxed during this time is not surprising given that for many working families, the local food bank has become a kind of free grocery store that helps to plug the holes in household finances year round.

For many decades now, the rate of food insecurity has not fallen below 11%. Food insecurity is, unfortunately, a way of life for far too many households. And as Gizem said, a majority saw an increase in need.

What we need to pay attention to is the way in which this increase in need was confounded by other issues that for many, were not experienced by or visible to hunger relief organizations before the pandemic. For instance, these organizations struggled with the government's response to the pandemic, particularly the inconsistency and unpredictability of the response. The government, of course, was dealing with this magnitude of crisis for the first time itself. More than 70% of HROs said that in order to fill the gaps in government support, they turned to their own forms of communication and coordination with funders, local farmers and growers and other stakeholders, other community organizations.

This survey was unique in that we queried first responders, so to speak, to a food security crisis unlike anything we've experienced in the US at that scale. And our findings in the survey add to the reports and stories in the media, those that we all heard and saw, of the miles long lines of cars waiting in parking lots to receive food and the millions of people who found themselves needing a food bank for the very first time in their lives. And all of that exposed how inadequately we, as a society, are addressing the economic precarity of a majority of American households. And therefore, how in sufficiently we are working to end hunger in food insecurity in one of the wealthiest countries in the world.

But Kelly, it wasn't all doom and gloom. There was a lot of hope, I think, that came through in the survey. And what I found particularly hopeful is that hunger relief organizations overwhelmingly embrace the both end of their missions. That is to ensure that folks who need it get healthy food now and to ultimately end food insecurity. And based on their responses, they have a multifaceted understanding of what it will take to do both and what the role in it should be. And I think that's an incredibly hopeful point and something we should pay attention to.

Well above 60% of hunger relief organizations identified dependence on volunteer staff, dependence on individual and corporate donations as issues to be addressed. They also cited lack of government support and solutions to address the root causes of hunger such as unaffordability of healthy food, low wage jobs, unresilient food supply chains, and they called out as problematic the persistence of inequitable access to healthy food is a manifestation of structural racism in the food system.

But their clarity on where the deficiencies are in the system doesn't end there. They have a strong vision for what they want to see happen and their role in it. These organizations are calling for increased sustainable and more flexible funding so they can get healthy food to people in the most dignified way possible. They're also calling for a stronger social safety net. They want to see the increases that were legislated during the pandemic become permanent features of the social safety net, including universal free school meals. And they're also advocating for snap changes such as more flexibility and broader access. And they're calling for the descaling of government food nutrition programs. Instead, advocating for programs that address the intersections of food security, affordable housing, mental health, living wages, and childcare among other issues.

One respondent wrote in the following response, which was repeated by other respondents in their right end responses as well: "People need living incomes, ones that make it possible to provide both food and shelter. Emergency food network should not be used to prop up an inadequate system of income support."

You know, Allison, as I'm listening to you, it's so clear that this was an enormous challenge with so many implications for looking back on what was done and thinking about the future and what might be done. So it's really helpful to have you talk about some of the permanent changes that could help for us stall or even avoid such a terrible crisis should something like this happen again.

So, Suzanne, let me ask you. The report presents the perspective that the US relies too much on charitable food, but if there's philanthropic support out there for the charitable food system, why is this such a problem?

Suzanne - Well, there are couple of reasons for that. I think, firstly, the charitable food system cannot meet the need. I think then it's important to think about what the charitable food system is based on, and although it has the best of intentions and is trying to fill a need, the majority of the system props up this dysfunctional system that relies on corporate waste. And far too often, these corporate donations are highly processed, filled with high fructose corn syrup, and are lacking in nutrition. And this helps to contribute to increased rates of chronic disease like diabetes and heart disease that disproportionately impact low income and BIPOC people. Also, the corporations that benefit from these tax write-offs in the process are notoriously the low wage employers who don't pay people enough money and whose staff rely on food stamps and charitable food to feed their own families.

Another reason is that the right to healthy and nutritious food is a basic human right and governments bear responsibility to their citizens to fulfill these human rights. But the US has slowly reduced its role in fulfilling that responsibility, and instead have been putting it in the hands of charitable organizations that have been vulnerable, always relying on donations and volunteers. And this is just not a sustainable system.

The US hasn't codified the right to food federally. There's one state, the state of Maine that has done so in their constitution in 2021. And there are other states that are organizing and strategizing to do the same. I think, lastly, it's important to remember that hunger is a symptom of poverty and poverty is a created condition. And the government has played a role in creating this condition and has a responsibility to be a part of the solution.

Thanks, Suzanne. So Alison, let me ask you one final question. The report offers up quite a wide range of recommendations for hunger relief organizations, also for philanthropy and for the federal government. Can you provide examples of organizations who are already implementing some of the recommendations? Could you talk about these and the opportunities that you see for a sustainable change?

Alison - Yes, yes, I'd love to. And I think that's a really important part of the report and there's much more in the report than I can say here during the podcast. So I would encourage folks to really take a look at the report, to hear more details, and to learn about very specific organizations and actions and activities that are happening.

So first, as Suzanne mentioned, yes, there's a historical over-reliance on the charitable food system and that has gotten out of balance. Hunger relief organizations, philanthropy, and the government all have a role to play in correcting that imbalance. Some 50 years ago, these organizations were designed to be temporary and crisis related, but what's emerged is a system that continues to need more and more bricks and mortar to mediate what has become a stagnant and alarming rate of food insecurity. And as we see in the results of the survey, many hunger relief organizations are expanding their strategies to include helping clients get access to government nutrition programs and policy and advocacy to improve federal nutrition programs. And a smaller, but I think growing subset of these organizations are beginning to address root causes of food insecurity such as low wages, poor working conditions, structural racism is a part of their mission.

For example there's a soup kitchen called Neighbors Together that has been operating in Brooklyn, New York for more than 30 years. About 10 or so years ago, they began engaging clients in determining their own advocacy agendas through what they called their community action program. Their participants, all of whom are patrons of the soup kitchen, identified insufficient wages and barriers to safe and affordable housing as primary reasons they required ongoing food assistance. So they organized others in their neighborhood and are currently advocating with the city of New York and the state of New York to implement policies that address housing and wages.

And in Washington State, the state's largest independent hunger relief agency known as Northwest Harvest is working to shift public opinion and change policies and practices that perpetuate hunger, poverty, and disparities while advocating for a right to food framing for statewide policies. They're one of the states that is really engaged in hoping to amend their constitution to include the right to food as Suzanne mentioned earlier.

And one last example, and again, the report contains many others, is the Black Church Food Security Network. Their mission is to ensure food security in Black communities by addressing racial and economic injustices. And they do this by co-creating sustainable local food systems in partnership with Black churches, Black farmers, and Black business owners. It's really remarkable.

So as the COVID-19 crisis continues to reshape public life around the globe, it's not over yet, unfortunately. The results of this survey strongly support the fact that we have an opportunity to organize and protect everyone's most basic human rights, nutritious food. And really, not just in response to COVID-19, but as a springboard to a social and political economy that puts people and planet first.

Bios

Gizem Templeton is a Research Associate at the World Food Policy Center at Duke University’s Sanford School of Public Policy. She earned her PhD in Food Science and Human Nutrition from the University of Illinois at Urbana-Champaign. Her dissertation focused on the use of nanotechnology in peanut allergen and acrylamide detection while utilizing a biodegradable corn-based sensor platform. She is a native of Turkey and has been living in the States since 2011.

Alison Cohen is a former Senior Director of Programs at WhyHunger.org. She has more than thirty years of experience supporting grassroots-led organizations in rural and urban communities around the world in strengthening social movements that address the root causes of hunger. She is currently coordinating a process to build a national movement for the right to food. She holds a master’s degree in sociology from Virginia Tech.

Suzanne Babb is Senior Co-director of U.S. programs at WhyHunger.org. She develops and oversees the implementation of WhyHunger’s domestic strategies: Transforming the Emergency Food System, Black Food Sovereignty and Labor and Economic Justice. Suzanne helps to convene and support regional and national networks and alliances of emergency food organizations working to ensure the right to food by addressing the systemic inequities resulting in hunger and poverty. Additionally, Suzanne supports the growth of BIPOC led food sovereignty organizations, networks and alliances by mobilizing resources and providing technical support to aid in the creation of legislation, infrastructure and institutional structures grounded in equity and justice. Originally from Montreal, Quebec, Canada Suzanne has many years of experience working on community development

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Today, we're talking to Dr. Jasmine Ratliff, who goes by Dr. Jas, and is an applied food systems research and policy specialist, and co-executive director of the National Black Food and Justice Alliance. She believes that your zip code should not determine your life expectancy and that building relationships are essential to creating a sustainable and just food system.

Interview Summary

So let's begin with this. Could you tell our listeners a little bit about The National Black Food and Justice Alliance and some about your work there?

Yes. The National Black Food and Justice Alliance is a coalition of organizations. So we're not just one organizations. We represent multiple others, about 50 now, and we are committed to building Black leadership and Black food sovereignty.

Those are really important goals, and not easy ones to reach for sure. So let's dig in a little bit about how you go about doing that. Let's start with kind of your vision. How do you envision food justice and how do you think about the term food sovereignty?

I work at the Alliance. And at the National Black Food and Justice Alliance, we focus on Black food sovereignty and self-determining food economies, and specifically land justice. And we approach these through a lens of healing and organizing and resistance against anti-Blackness. And all of the work that we do is in pursuit of food justice. So I have a couple definitions. Founding executive director Dara Cooper defined food justice as a process whereby communities most impacted and exploited by our current corporate-controlled, extractive agricultural system shift power to reshape, redefine, and provide indigenous, community-based solutions to accessing and controlling food. And that includes the means to produce food that it is humanizing, fair, healthy, accessible, racially equitable, environmentally sound, and just. That's how I feel about food justice and it leads us right into food sovereignty. So I know you mentioned it's an overall long goal, and we borrow this one from La Via Campesina, but food sovereignty is the right for peoples to define their own food and agricultural systems, instead of food being subject to international market forces - as we all know food is so globalized. So sovereignty is absolutely our ultimate goal and it can't be achieved without confronting actual governance. So we work to ensure that Black people not only have the right, but the ability to control our food.

It really helps to have those definitions. And let's talk just a little bit more about this. So you talked about decision making, needing to reside in the community where the issues are occurring and you mentioned power transfer. Can you just give us some examples of where the system doesn't support these kind of things? Like how is the current system not empower people, and how does it strip people of decision making about their own food systems?

Yes! I didn't actually plan to share this one, but I will. A lot of people refer to your geographic location, and I know in my bio you mentioned this, but your zip code shouldn't determine your life expectancy. And right now that does. We don't have the autonomy to create the environment around us. It's so saturated with capitalism and other things that don't put people first. So I think food apartheid instead of the food desert reference is a real way that people are disenfranchised and not in power. And that's also a definition from Dara Cooper, that it's the systemic destruction of Black self-determination to control our food. This includes land, resource stuff, and discrimination, hypersaturation of destructive foods and predatory marketing in a blatantly discriminatory, corporate-controlled food system that results in our communities suffering from some of the highest rates of heart disease and diabetes of all time. Many, like I said, use the term food desert, but food apartheid is a much more accurate representation of the structural, racialized inequities that are perpetuated through our current system.

Okay, thanks. There's a lot in there that needs to kind of get disentangled. So let's talk about some possible advances in solutions. And I know in this context, food co-ops come up a lot. In your mind, how do food co-ops become a tool for not just providing healthy food for communities but also to make movement on racial and economic justice?

Yes, I think co-ops are about collective power. They're not just a non-extractive way to exchange goods and services, but they're about the collective buying power, the collective political power, and especially the collective people power. It's a way that you can actually, in person, in real life, practice democratic governance. And you can create shared principles and values and shared wealth and authority and it's not concentrated in just the hands of a few, or just the people who are making decisions. And it's not just an economic sense. I really listen to all our members who are in the process of building of even a retail store, grocery, co-op, and it's about a political space. It's more than just groceries. So they're a pillar of our community. And then especially in the Black community, co-ops have always been built out of necessity. I love Dr. Monica White's "Freedom Farmers" book, when she describes Fannie Lou Hamer, when it describes food as a political weapon. We know we can control our food systems and the means of production when we create these places of distribution, and we can use them as a tool to build towards freedom. So I'm excited to be doing that work with the Alliance.

Well, it's exciting to me. And when you talk about food co-ops being more than groceries, let's explore that a little bit more if you wouldn't mind. So if you walked into a food co-op, you'd get a picture of things, groceries, but you're building a picture here that talks a lot more than just those things. So there's community empowerment, there's community engagement, there's wealth creation in the community. But I'm saying these things and you're the one who really knows them. So tell us a little bit more about what's there besides the groceries.

Yeah, there is absolutely community. There's spaces for people to learn together about healthy products. There can be a cooking class attached. When I think about these things, I'm speaking about specific co-ops. One in Dayton, Ohio, Gem City, they have a doula co-op and a health room where maternal health access can be made available. There's also just the vibe. There's the music that you hear. There's the people that you see. It's like not only providing jobs, but it's providing living wage jobs that are able to provide upper mobilization. So it's, like I said, more than groceries. It's a vibe. It's community. It's all the things that you could imagine, but sometimes people outside of the community aren't able to imagine that. Like investors and things. If there isn't a grocery store there for the past 50 years, why would someone bring one there now? But when the community knows that this is something that they need and they're putting their all into it, they'll build it for 10 to 12 years before they even see a store. So I'm excited to actually go into one of the co-ops in Detroit and they're groundbreaking this weekend, so I know that they'll be building it really soon and I can open the doors and be their guest.

So my background is being a researcher and the researcher ordinarily looks at a situation like this and says what kind of outcomes can be measured? And one thing that the researchers might automatically think about would be what are the health outcomes in the community from having healthier diets? But you're talking about a lot more than that, even intangible things like morale of the community, the engagement, the happiness, and then of course there's the economic development. So it sounds like there's an awful lot involved in these efforts, isn't there?

Absolutely. And organizing them, you never know what you'll get when you bring the community together. And beautiful things are born especially when they have control. And it's about participatory budgeting as well and everyone being clear where the funds are going, and it feels good to be a part of something that you can see the effort, the fruits of your labor.

So I'm assuming that your theory on this is that if the solutions for these very significant food problems come from within the community itself, you're going to get more buy-in, better morale, and ultimately better solutions. Is that correct?

Absolutely, right on.

Let me ask a final question about farmers, because they're obviously a really important part of this. Could you talk about the institutional and systemic harm that Black farmers and landowners have experienced and how your Alliance is going about addressing this?

I'm sure a lot of people have heard the statistic about the land that Black farmers no longer have control over. We think back into the 1920s when there were nearly 1 million Black farmers in the United States, and now we're less than 1% of farmers, but more so the land that has been taken away. It's said to be between more than 15 to 19 million acres. And I say land that's been taken away because land has never been lost. You can lose your keys. You can't lose land. It's been Black communities, systemically disenfranchised, and has been this way for decades. And it's interesting to see it continue to play out even today with the debt relief for Black farmers, lawsuits that are still going on. The Alliance is supporting that. But more importantly, we're building an alternative. We're looking to remove land from the speculative market. We have a goal of 15 million acres to do such where it will be in perpetually hands of Black land stewards to continue to build for Black food sovereignty. So that's our resource commons, and that is actually democratically governed by seven of our members on our Resource Commons Council. We're looking to have our first piece of land this year and to continue building and purchasing and removing the land from the speculative market. We are also hosting land stewardship trainings throughout the United States with our members and resourcing them to ensure that we're not only having land to steward, but also having stewards.

Bio:

Dr. Jas is an applied food systems research and policy-based specialist. She partners with academic research teams, anchor institutions, philanthropic foundations, and community-based organizations to identify root causes of and develop innovative solutions to food system challenges. Dr. Jas received her master’s degree in Community Planning from Auburn University and Ph.D. in Integrative Public Policy and Development from Tuskegee University. As a New Orleans native and farmer, she has developed a unique perspective when it comes to food and the effects that it has on communities. Dr. Jas believes that your zip code should not determine your life expectancy, and building relationships are essential to creating a sustainable and just food system.

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Today, we're talking with the President of North Carolina Farm Bureau, Shawn Harding. Farm Bureau is the state's largest farming organization is often referred to as the voice of North Carolina agriculture. In this interview, we'll explore the diverse ways this vital association supports North Carolina farmers and growers. I might also say that there are Farm Bureaus in all 50 states, and from what I understand, North, it's a special pleasure to have Shawn with us.

Interview Summary

I was mentioning before we went live that our center has had a nice relationship with Farm Bureau over a number of years. And one thing that was especially, meaningful to us is with your predecessor, Larry Wooten, and several of his colleagues took us on a tour of farms in Eastern North Carolina. And that was very eye opening and a very moving experience for us to get to talk to farmers and understand a little better. So, I appreciated the work of Farm Bureau before, but especially, after that. So, let's begin. You became President of the North Carolina Farm Bureau nearly two years ago. And anyone in the agriculture world knows a Farm Bureau but others may know less. Would you mind telling us what Farm Bureau does?

Yes, certainly. As you mentioned earlier on, we often refer ourselves as the voice of agriculture because that's what we do. We spread the message of farmers and agriculture. And, you know, what's interesting is our organization started 1936 by farmers who felt like they needed a voice. And in 1936 there were a lot of people on the farm. Now, very few people on the farm, very few people that really understand agriculture. So, we feel like our mission to be that voice for agriculture is more relevant now today than ever before. And we try to stay core to that mission and just spreading the word of our farmers and agriculture and what they do.

I thought I heard that North Carolina Farm Bureau was the second largest in the country. I don't know if that was correct then or still is, but what explains why North Carolina has such a robust Farm Bureau presence?

Well, in 1936 a group of farmers got together and started this organization and really their mission was just to help farmers but also help rural people to any kind of issues they had. And in 1953, believe it or not way back then they were having trouble getting insurance. And so, we started an insurance company. In order to buy insurance from North Carolina Farm Bureau you had to be a member. And so, you joined and you were able to participate in our insurance company. And it was very successful very helpful for our rural families back then. And thankfully, we've been very successful over the years proud of our insurance company. And that's one of the reasons that we have such a large membership in North Carolina. We just crossed 600,000 members for the first time in our state, which does make us the second largest Farm Bureau in the nation. And so, certainly we have many members who have no connection to agriculture but just enjoy and appreciate our insurance company. So, we're proud of that but anyone can join North Carolina Farm Bureau. $25 membership. And if you want to support farmers and support our mission certainly anyone can join. Tennessee Farm Bureau is the largest Farm Bureau, our neighbors to the west. And so, we're looking at how long before we could be number one, but we'll see how that goes.

Well, good luck. And 600,000 is pretty impressive, I must say. So, I'd like to talk about one particular part of the work that you and your colleagues are doing, your Young Farmer program. And I recall hearing from Bert Pitt in Edgecombe County saying that the average age of farmers in North Carolina is around 67. And farming is so critical to the future. I'd like to hear about the kinds of support and recognition that your Young Farmer program offers to newer generations of farmers.

Thank you for asking about that program. It's really near and dear to our hearts. I'm a product of the Young Farmer program. Actually, Larry Wooten was a product of the Young Farmer program. And so, we use it as a leadership development program in our organization, but it's more than just leadership development. Farming can be a very isolated occupation and sometimes you can feel like you're just out there on your own and don't have any support. So, one of the great things, I think, our Young Farmer program does, it brings young people together. As you said, there's not a lot of them in agriculture. And so, it brings them together and they really get to support each other to see, hey, we've got some of the same issues. We're dealing with some of the same things. And so, it's a real support system for our young people in agriculture. And as you mentioned, I mean, that's vital with the age of farmers now, but I'm excited, I'm excited about the future. I see young people getting involved in agriculture that are first-generation farmers. So, I think, I often say when I was coming along, it maybe wasn't cool to be in agriculture, but now it's a very cool and hip thing to be involved in agriculture. And that's exciting to me to see young people coming in that haven't had a history in it.

It's nice to hear that optimistic note in your voice. And boy, that would be great if young people really do come in with a kind of enthusiasm that you're seeing in them. So, that's great. You mentioned your own experience in farming. Could you tell us a little bit more about that? What kind of a farm did you grow up on and what kind of farming did you do yourself?

Sure, absolutely. I grew up in Eastern North Carolina, in Beaufort County. A little town called Chocowinity and my grandfather was farming and my father actually, came into farming in the seventies. And so, we grew up on a farm, typical Eastern North Carolina farm that was a tobacco and grain operation. That's kind of what most everybody did a little bit of. And we were small farmers and just enjoy that life. Went to NC State after high school and studied agriculture. And unfortunately, I lost my father the last year of college. And so, you were talking about the age of farmers and certainly, it's difficult to get started in agriculture as a young person, but I had that opportunity right out of college. And so, started farming early, again, going back to tobacco and grain and doing those kind of things. And working with my brother on the farm. We had a partnership, things were going well. And then we came into the nineties and challenges in the tobacco industry. We had the tobacco buyout that came along in 2004. About that time, my wife had started a little side operation with strawberries and I just I looked at it as an opportunity to change what we were doing on the farm. I saw how many people loved coming to the farm to pick strawberries and learn about what we did in agriculture. And I just thought, I think this is the future. So we stopped growing tobacco. We became a strawberry farm. And then of course, added to the strawberries with blueberries, blackberries, all kinds of fruits and vegetables, and just went direct to the consumer. And thankfully, we were very blessed to be successful in that. The opportunity to be Farm Bureau President obviously, came along and and I thought it was a great opportunity for me but also for my children. I have two boys and back on the farm now that are running the farm. Again, giving them an opportunity to start at a younger age in agriculture, and also giving me an opportunity to do something that I love. And that's lead this organization and talk about farming. So, that's a little bit of my story and how I got to where I am and just love agriculture and love what I'm doing.

At the time we're recording this, we're about to enter the full swing of the strawberry season. So, I was really excited to hear you talk about strawberries. More than that, it's interesting to hear about the transition of your farm and the historical things that shape that. So, let's get back to Farm Bureau. And I know that Farm Bureau does a lot to bring agriculture concerns to policy makers, both at the state level in North Carolina and the national level. And that helps farmers prepare to make the case for North Carolina agriculture. Could you talk about the advocacy programming that you do?

It's really one of the top line things that we're involved in. I mentioned that we're the voice of agriculture and that can mean a lot of different things. As I said, we want to share with the public about what farmers do. And part of that public is our legislators who many have been separated from the farm for several generations and don't really understand modern agriculture. So, quite a task there. And so, we stay involved in that. I'm very proud of our advocacy efforts. The other part I would say on that is certainly we have a lobbying team here at Farm Bureau but what we do, what is special about Farm Bureau is we use the term grassroots operation you mentioned we're in every county in North Carolina. And we encourage our volunteer farmers to advocate for what they do. What we found is when you walk in an office as a lobbyist and then they expect you to be at a certain place, but when you take an actual farmer to a legislator, to a Congressman, to a Senator, they appreciate that. And so, we really challenge our young farmers, our women, all our farmers, all our volunteers, to be involved in advocacy for what they do. And that's what I'm proud of as an organization. Our policies come from our people. So, I sit in this role as President, but I don't set the policy for the Farm Bureau. Our people set the policy. And so, we have a policy development process that we go through every year and they really tell us what's important to them. So, I think it's a really fascinating process that was drawn up many years ago and it works really well.

I can see how farmers would be such important advocacy voices. When we were doing the tour of farms that I mentioned before, we found the farmers to be talented, passionate but also very humble people. So, you can see how they would have a special role in this. It was interesting to hear you talk about that. I'd like to ask you also about regenerative agriculture. We've done a number of podcasts with farmers and others from around the country involved in regenerative agriculture. And they've talked about techniques such as diverse, no-till, rob crow techniques, mob grazing for livestock and other things to improve the environment and produce food at the same time even though to improve the nutrient profile in food and to help be more resilient in the face of changing weather conditions. So, how do you think North Carolina itself is poised to deal with regenerative agriculture and those advances?

I'm, of course, very biased. I believe we have some of the best farmers, in the country, in the world, at North Carolina that are resilient, adaptive and always looking for the right thing to do. And so, when talk about climate change and how agriculture can be a part of that then I think we're at the forefront of it. Many people think about this issue and we all have opinions and things we feel like we ought to do and need to do. And that's great, but I don't think people really think about nobody deals with the climate more than farmers. We deal with the storms, we deal with cold, the heat, everything that comes along with it. So, we're on the front lines of this and certainly, we're ready to look at practices that will help the climate change issue. And I think, farmers are always ready to do that, that with a caveat also, always of saying we have to stay in business. We have to have practices that will keep us on the farm so that we can do the positive things we need to do. But we certainly feel like there's a lot of great research going on right now to say, here's some things that we can do to help reverse this climate change issue and agriculture can play a big role in that. And so, I think our farmers stand ready to be on the front lines of that issue.

That sounds really impressive because you're talking about the influence of climate on the agriculture world and then in turn the influence of agriculture on climate and that relationship arrow going in both directions is such an important part of the overall picture that we're facing in the future. So, it's nice to know that North Carolina farmers, in particular, are focusing on that. And speaking of that, the farm bill is such an important piece of legislation nationally, and obviously, for North Carolina farmers as well. I'd love to hear your thoughts on what North Carolina needs from this important piece of legislation.

Well, certainly when you think about the farm bill that's coming up, we will be engaged in that heavily. Have staff members here that are already working on it now to try to say, you know, what's our priority. I think if we want to talk about priorities in the farm bill and for the last couple of farm bills, I think this has sort of been the direction our country has gone is crop insurance. We've just said, agriculture's such a volatile business to be in with climate again as we talked about and storms that the safety net that needs to be there for our farmers with crop insurance is a really important piece for us. And so, we'll continue to talk about that as we head into this farm bill negotiation, the next bill, because that really is what helps keep our farmers on the farm when these devastating weather events happen. And we certainly feel like that's important for our country. We've all seen what's happened the last few years with just turmoil around the world. And so, we say food policy is good security policy, and so, we need to have a good food security policy. And that starts with keeping our farmers on the farm and being successful. And that obviously, crop insurance is the biggest part of that farm bill that we'll be looking at.

I'm happy you mentioned the vulnerability that farmers face because I think most people who don't dive deeply into agriculture don't realize the number of vulnerabilities that farmers have. There are the weather vulnerabilities we talked about today. There are unexpected market fluctuations. There are complicated relationships with the companies that buy their products. All kinds of things go on in that world that make it a very precarious position that farmers are in. And it's amazing that they're able to tolerate that and still prevail generation after generation. So, it says a lot about the kind of mindset and personalities of farmers doesn't it?

We often talk about it's a love, it is a passion. You mentioned seeing that with some of our farmers and it has to be. I mean, just this year, we've seen prices for inputs rise by three times. And certainly, prices of commodities have risen. And some people are saying, well, that equals out. But what I'm trying to tell the general public is we just tripled the risk that we're putting in the ground. With the seed this spring. We just tripled the risk, the seed, the cost of fertilizer. And we don't know what we'll get out of it. So, that's what agriculture is. You mentioned that it's a lot of volatility, but we do it, we love it. I think most farmers feel like it's their responsibility to help feed the world. And so, we want to continue to do that. So, we appreciate the partnerships and people understanding what we do, but there's a lot of risk in it. Absolutely.

I was impressed on the farm tour we were doing with some of the things that you just mentioned. One, was how passionate the farmers were about their work and how much they felt they were performing a very important service for the world, but also how many generations of a family there tended to be on farms and how the farmers felt that they wanted to turn the farm over to children in better shape than they had inherited it themselves. It was very interesting way of thinking. So, that passion I must really impress you all the time, too.

Absolutely, and as I mentioned my story, I'm sort of living it. I go home now every other weekend, see my boys and the pride they have in growing our things and selling it to local consumers. And there is a pride that goes along with that just to see that, to see your, leaving the next generation in a better place. And that's what our farms and farmers are trying to do to just leave it better than we found it. And that goes with our families. But it also goes with our land. You know, the water the air, the soil, that's how we make our living. So, we're trying to leave it better than we found it.

Bio

Shawn Harding was elected president of the North Carolina Farm Bureau in December 2019. Harding grew up and farmed in Beaufort County. He previously served the Farm Bureau in various roles, including president in Beaufort County, member of the state board of directors and state public policy director. He is a graduate of the Agricultural Institute, part of NC State University’s College of Agriculture and Life Sciences.

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So why is the food history of a community so important? And can Durham's food history be applied to other places? Who owns land, who can grow food and make a living doing so, and who has access to food, any food, least of all healthy food? The answers are deeply influenced by historical policies and practices. These in retrospect, clearly exacerbated, supported, and even created food related calamities, the dual burden communities face of both food insecurity and diet related chronic diseases, such as diabetes and obesity. Understanding these practices is important in creating change. And in understanding that conditions imposed on neighborhoods rather than personal failings of residents explain what we see today.

This is a story about Durham, North Carolina. These days, Durham is famous as one of the South's foodiest towns and known for its award-winning chefs, thriving restaurant scene, and reverence for even the most humble foods served with down-home charm. But Durham, just like the rest of North Carolina, like other states and other countries, has discouraging any high rates of food insecurity. This is juxtaposed to high rates as well of obesity, diabetes, and other diet-related chronic diseases. It is helpful of course, to know how things are now, but a more complex and highly important question is how we got here. Enter history. What can be learned from a detailed historical analysis, in this case of Durham, and how relevant is this information to other places?

The Duke World Food Policy Center worked with historian, Melissa Norton to write a report titled, "Power and Benefit On The Plate The History of Food in Durham, North Carolina". This recording is an abridged version of that report and features documented historical quotes from the relevant periods in history as read by contemporary voices.

Let's go back to the beginning. Durham, North Carolina is the ancestral home of the Occaneechi, the Eno, the Adshusheer and the Shocco indigenous peoples. Before European colonizers came, land was not something that people owned. Instead land and its natural resources were shared so that everyone could benefit.

“To our people land was everything, identity, our connection to our ancestors, our pharmacy, the source of all that sustained us. Our lands, were where our responsibility to the world was enacted, sacred ground. It belonged to itself. It was a gift, not a commodity. It could never be bought or sold.” Robin Kimmerer, Potawatomi Nation.

Durham's tribes and clans supported themselves through hunting, foraging and communal farming. They managed the habitat for fish, fowl and other wild animal populations. They used controlled fires to clear land, had complex farming irrigation systems and created a network of roads for trade and exchange. When European settler colonists came into North Carolina life for indigenous people changed dramatically. At first, they taught colonists how to forage and clear land, what to plant and how to care for crops. The colonists came to North Carolina believed that they had the spiritual, political and legal blessing of Pope Alexander the sixth through the doctrine of discovery. This decree labeled indigenous peoples as subhuman because they were not Christian and treated their land as available for the taking.

“The Indians are really better to us than we are to them. They always give us rituals at their quarters and take care we are armed against hunger and thirst. We do not do so by them, generally speaking, but let them walk by our doors hungry and do not often relieve them. We look upon them with scorn and disdain and think them little better than beasts in humane shape. Though if we're examined, we shall find that for all our religion and education, we possess more moralities and evil than these savages do not.” John Lawson, English settler colonist in North Carolina, 1709.

Settlers forced native people off ancestral homelands and took possession of the stolen land and its resources. As a result, many indigenous people left to join other tribes, some hid in order to remain in the area. And some were forced into assimilation programs or enslaved and shipped to the Caribbean.

Going back to the early colonial settlers, most were small scale farmers who grew corn, fruits and vegetables and commodities such as tobacco, wheat, and cotton for their own use or to barter. As farms grew from the 1500s through the 1800s, colonists brought West African people by force to use as free farm labor. West Africans brought seeds from their homelands and foods such as hibiscus, yams and sweet potatoes, watermelon and bananas and millet, okra and sorghum became a permanent part of the Southern food culture. Food was an essential connection to home, to community and resiliency. Indigenous and enslaved African people interacted and exchanged practical and cultural traditions.

“My name is Alex Woods. I was born in 1858. In slavery time I belonged to Jim Woods. My Missus name was Patty Woods. They treated us tolerable fair. Our food was well cooked. We were fed from the kitchen of the great house during the week. We cooked and ate at our home Saturday nights and Sundays. They allowed my father to hunt with a gun. He was a good hunter and brought a lot of game to the plantation. They cooked it at the great house and divided it up. My father killed deer and turkey. All had plenty of rabbits, possum, coons and squirrels.” Alex Woods

In 1854, the development of the North Carolina railroad transformed agricultural markets. The farming economy shifted from fruits, vegetables, and grains toward large scale cash crops, such as tobacco. The railroad stop in Durham became the center of the city. By the time the civil war began in 1861, nearly one out of three people in Durham county were enslaved. A quarter of the area's white farmers legally owned enslaved people. Cameron Plantation was the largest plantation in the state with 30,000 acres and 900 enslaved people.

To be self sufficient, create security and build wealth. People needed to own land. The federal government passed the homestead act of 1862 to create new land ownership opportunities. As a result in the west 246 million acres of native people's land were deeded to 1.5 million white families.

That same year, the federal government also passed the moral act. This established North Carolina State University in Raleigh as a land grant university to teach white students practical agricultural science, military science and engineering. 29 years later in 1891, North Carolina Agriculture and Technology University in Greensboro was established to serve black students, but the institutions were never funded equally.

In 1865, the civil war ended at Bennett Place in Durham with the largest surrender of Confederate troops. Reconstruction occurred in the subsequent years from 1865 to 1877. During this time, Durham struggled with its own political, social and economic challenges. One of which were the circumstances faced by formerly enslaved people who were freed with no land, no jobs, no money and no citizenship rights. Historians estimate that more than a million freed black people in the country became sick for malnutrition, disease and near starvation. And tens of thousands of people died.

Listen to the words of Martha Allen, a young black woman at the time.

“I was never hungry till we was free and the Yankees fed us. We didn't have nothing to eat, except heart attack and Midland meat. I never seen such meat. It was thin and tough with a thick skin. You could boil it all day and all night and it couldn't cook. I wouldn't eat it. I thought it was mule meat. Mules that done been shot on the battlefield then dried. I still believe it was mule meat. Them was bad days. I was hungry most of the time and had to keep fighting off them Yankee mans.” Martha Allen

In the years after the war, a few people had cash, but landowners still needed farm labor, poor farmers and families of all races struggled. Landowners began hiring farm labor through share cropping and tenant farm contracts.

“The Negros have as their compensation, a share of the crops that shall be raised one third part of the wheat, corn, cotton, tobacco, syrup, peas, sweet potatoes and pork. But the seed wheat is to be first passed back to the said Cameron, the hogs to be killed or pork shall be fattened out of the corn crop before division. The said Cameron is to have the other two thirds of said crops.” Cameron share cropping contract 1866.

Sharecroppers work plots of farmland, and then received a fraction of the crop yield for themselves as payment. For newly freed black people. Many of whom worked the same land, lived in the same housing and worked under the close supervision of the same overseers sharecropping felt like slavery under another name.

In 1868 and 1877 North Carolina passed the landlord tenant acts, which legalized the power imbalance between landowners and sharecropping farmers. For poor farmers there was simply no way to get ahead. And so-called black codes, laws enacted throughout the south in the 1860s and beyond denied black people the right to vote, to serve on juries or to testify in court against white people. With tenant farming, workers paid rent to landowners and kept all the proceeds from the crops.

“We lived all over the area because we were tenant farmers, very poor living on the land of the owner who was of course, white. We used his mules and he paid for the seed and the tobacco and the stuff that we planted. Of course, as I look back now, I know how they cheated us because we never had anything.” Theresa Cameron Lyons, 1868, on growing up in a black tenant farming family in Durham County.

North Carolina politics during this time was dominated by white supremacist ideology and by efforts to keep blacks from voting and from holding political office. In 1896, the US Supreme Court ruled that separate but equal treatment of blacks was legally permissible. This created the legal basis of racial apartheid known as Jim Crow. From 1896 to 1964 Jim Crow laws imposed racial segregation on nearly all aspects of life, including schools, transportation, and public facilities. These laws institutionalized economic, educational and social disadvantages for black and indigenous people, such court sanction exclusion combined with violence and intimidation from white people created severely hostile living conditions for North Carolina's black people. As a result, registered black voters in North Carolina plummeted from 126,000 in 1896 to only 6,100 in 1902.

As the year 1900 dawned, more than half of the US population were farmers or lived in rural communities. Durham County was still largely farmland, but there was incredible urban growth in the early decades of the 1900s. This too had an impact on Durham's food and the community.

Demand for tobacco and textile factory workers was growing in Durham. Although only white workers could work in the textile factories. Both black and white migrants found work in Durham's Liggett Myers and American tobacco factories. Black workers had the lowest pay, most backbreaking jobs in the factories and were paid less than the white workers.

Outside the factories black women had more job opportunities than black men, but as cooks and domestic servants. And they also held some administrative positions. As people traded farm life for the city, they had to adjust to a new way of life. This meant living off wages in the new cash economy and the crowded close quarters of urban living.

Textile mill owners in the East Durham Edgemont and West Durham areas built subsidized mill villages to provide housing for white workers close to the factories. Each mill village had its own churches, schools, recreation centers, and stores.

“Yeah, it was a complete store. They'd have very few wise work in the mills. They would have a man that went out in the morning, they'd call it taking orders. He'd go to all the houses and the woman of the house and tell him what she wanted. He'd bring it back in time to be cooked and served up for what they called dinner, which is of course lunch. And he'd go do the same thing in the afternoon. Have it back in time for a good supper.” Zeb Stone, 1915, a white business owner from West Durham, North Carolina.

Many textile workers had grown up on farms and knew how to garden and raise chickens, pigs, or even cows in their yards. Families preserved extra garden produce and meals for the winter. Home canning became popular and increased during World War I and later in World War II, as food shortages meant rations for canned food. The federal government urged people to rely on produce grown in their own gardens called victory gardens and to share resources with neighbors.

Six predominantly black neighborhoods developed in Durham, along with black churches, schools and businesses, people form close relationships with each other. And even though the yards were often small, many black people also maintained gardens, kept chickens until the local government banned livestock in the city limits in the 1940s. Buying from black businesses meant investing in the whole black community. Community leaders preached how each dollar spent would flow in a wheel of progress throughout black Durham. Neighborhood grocers were owned by and for people who lived in black neighborhoods, here's what longtime Durham state representative Henry Mickey Michelle has to say about growing up in the Hayti area of Durham.

“We didn't have to go across the tracks to get anything done. We had our own savings and loans bank, our own insurance company, our own furniture store, our own tailors, barber shops, grocery stores, the whole nine yards.” Durham state representative Henry Mickey Michelle

Black and white farmers came to Durham's urban areas to sell fresh produce on street corners and created popup farm stands throughout the city. Many came to Hayti, Durham's largest black neighborhood and to the center of black commerce that was dubbed Black Wall Street. Durham established the first official farmer's market then called a curb market in 1911 to connect county farmers with urban consumers.

The federal government helped farmers stay informed of developments in agriculture, home economics, public policy, and the economy. The Smith Lever Act of 1914 launched cooperative extension services out of the land grant universities. In 1914 extension services for Durham County's white people began and services for black communities started in 1917, hoping to draw young people into farming.

Segregated schools in Durham offered agriculture training. Programs for the future farmers of America served white students and new farmers of America programs served black students.

By 1920 farmers comprised 50% of the population in Durham County outside the city core. Nearly half of these were tenant farmers. Arthur Brody, a black man who made his home in Durham had this to say about his family's experience.

“My granddaddy had 50 acres of land. They said he was working for this white family and the man took a liking to him. And back then land was cheap. And that man told him, Robert, what you ought to do is buy an acre of land every month. He gave him $12 a month. So he bought an acre of land a month, a dollar a month for a year. And he bought that farm with 52 acres of land in it. And he built his house out of logs. I remember that log house just as good I can.” Arthur Brody

Black families were beginning to acquire farmland. Although black owned farms were generally smaller and on less productive land than white owned farms. At its peak in 1920, 26% of farms nationally were owned by black farmers.

The shift to industrialized agriculture concentrated on just a few crops, created new pressures for farmers, especially small scale farmers who were already struggling with the depressed economy, depleted soil, outdated farming tools and the constant demand for cash crops, black and white farmers alike struggled with a lack of fair credit and chronic indebtedness. Here is what the Negro Credit Unions of North Carolina had to say about the farm credit system in 1920.

“Perhaps the greatest drawback to the average poor farmer, struggling for a foothold on the soil and trying to make a home for himself and family in the community is the lack of capital. If he buys fertilizer on time, borrows money or contracts to be carried over the cropping season, it is usually at such a ruinous rate of interest that few ever get out from under its painful influence. The man who owns a small farm as well as he who rents one has long been victimized by the credit system.” Negro Credit Unions of North Carolina brochure

In Durham, life still followed the seasonal cycles of farming. There were special times for communal rituals, such as berry picking, corn shucking and peach canning. Mary Mebane described growing up in a black farming community in Northern Durham County in this way.

“Berry picking was a ritual, a part of the rhythm of summer life. I went to bed excited. We didn't know whose berries they were. Nobody had heard about the idea of private property. Besides the berries wild, free for everybody. The grown people picked up high and the children picked low. We children ate them on the spot, putting purple stained fingers into our mouths, creating purple stained tongues while the grown people wiped sweat and dodged bumblebees.” Mary Mebane

Many black Durhamites joined in the great migration of black people to cities in the North and Western parts of the country. More than 6 million black people left the South between 1917 and 1970. Those who stayed found themselves caught between traditional farming culture and an increasingly modernized urban world and black farmers had the further burden of discrimination in federal farm lending programs, which hampered their ability to sustain, adapt and expand their farming.

In the 1930s, the country was grappling with a great depression and the dust bowl. The textile industry was hit hard by the reception and white textile factory workers struggled. Families survived on cheap fat back, flower beans and their own homegrown produce. Through bouts of unemployment or underemployment. Hunger was never far off. Durham's black working class occupied the bottom rung of the economic ladder even before the great depression. Poverty and food insecurity increased to such an extent that black Durhamites were six times more likely to develop pellagra than whites in 1930. Pellagra is a disease caused by niacin deficiency. It was the leading cause of death in the city after tuberculosis. Nurses counseled Durham's black residents to eat green vegetables and fresh milk, but they were told that economics not lack of knowledge led to poor eating habits.

As one black patient remarked: “We would like to do everything you say, but we just haven't got the money.”

During the great depression, the food situation became so desperate that the Federal Emergency Relief Administration and the Works Progress Administration and charities such as the Red Cross began distributing food relief. The supplies staved off hunger to some extent, but black and white residents were both complaining the food wasn't what they would normally eat. Here an unemployed white textile worker in East Durham described his family's struggle with the emergency relief rations during the great depression.

“I go around to the place that the WPA distributes commodities and the last time they gave me four packs of powdered skim milk, five pounds of country butter, three pounds of navy beans, 24 pounds of flour. That was grand flour to mix awful bread. I've tried every way I could think of to cook it. And it ain't been able to do anything with it yet. That stuff just ain't fitting for a dog to eat, but I have to use everything I get. One of the boys gets up early every morning and goes out and picks berries for breakfast. They with butter do make the flour eat a lot better. He wants to pick some for preserves, but we can highly get sugar for our needs right now. But there is something about us that keeps us hoping that in some way, the future will take care of itself.” Unemployed white textile worker in Durham during the Depression

Over time federal, state and local Durham aid efforts shifted toward training and getting people new jobs, but black men and women did not get the same opportunities as Durham's white residents. In 1933, the federal government passed the agriculture adjustment act later known as the farm bill. This legislation raised market prices and paid farmers to rest soils depleted from intensive farming. But this created new problems for small farmers already struggling to survive. Davis Harris reflects on the changes these policies caused in the black farming community of Northern Durham County.

“The federal government started paying farmers to put their soil in what they called the soil bank. At the time the US was producing more grain than they needed. So they asked farmers in order to preserve the land and soil, if they could just let the soil rest. And if you did that for 10 years, the people like me growing up who got public jobs, it was difficult to go back to the farm because you get accustomed to getting paid every month. And to go back to once a year was difficult, almost impossible. And then the farmer's equipment gets obsolete and the facilities get obsolete and there is no help. So I see that as a turning point because you've lost all your resources, your equipment, your facilities, and your workforce, and the farmers are 10 to 12 years older. So a lot of the farmers had to get public jobs so they can get enough credit to draw social security.” Davis Harris

Black land owners also contended with private property laws that put them at a very real disadvantage. Black families had little reason to trust institutions and were far less likely to have a will than white families. So when a property owner died without a legal will, their property passed to all their direct heirs as partial shares. A form of ownership transfer called heirs property. Over several generations property ownership became increasingly unclear as dozens or even hundreds of heirs could own a small share. Heirs were then more vulnerable to land speculators and developers through a legal process called partition action. Speculators would buy off the interest of a single heir. And just one heir, no matter how small their share, and this would force the sale of entire plot of land through the courts. Black farm ownership peaked between 1910 and 1920, and then dropped dramatically due to the changing farm economy, discrimination and coercive means. From 1910 to the 1930s, the total number of farms in Durham declined dramatically. But black farmers lost their land at more than twice the rate of white farmers.

Willie Roberts, a black Durham County mechanic and farmer was interviewed in the 1930s and had this to say about the tensions of the time: “We got some mean neighbors around here. They hate us 'cause we own, and we won't sell. They want to buy it for nothing. They don't like for colored people to own land. They got a white lady, Ms. Jones on the next farm to say that I attacked her. I hope to be struck down by Jesus if I said or did anything she could kick on, it's all prejudiced against a colored family that's trying to catch up with the whites. They hated my father because he owned land and my mother because she taught school and now they're trying to run us off, but we're going to stay on.”

In 1942, many young men were serving in world war II and black agricultural laborers were leaving farms as part of the great migration to Northern and Western states. So the federal government enacted the Bracero Program to address severe farm labor shortages. This allowed contract laborers from Mexico into the country to fill the labor gap. Where you live, determines where you buy food and what food is available. And Durham's black urban residents were grappling with Jim Crow laws and with segregation.

“In all licensed restaurants, public eating places and weenie shops where persons of the white and colored races are permitted to be served with and eat food and are allowed to congregate. There shall be provided separate rooms for the separate accommodation of each race. The partition between such rooms shall be constructed of wood, plaster or brick or like material, and shall reach from the floor to the ceiling…” The code of the city of Durham, North Carolina, 1947, C13 section 42.

Segregation and racial discrimination meant that opportunities for home ownership, loans, and neighborhood improvements favored white people, discriminatory policies and practices also impacted access to nutritious foods and to restaurants and resentment was building.

A black woman recalls her childhood experiences during this time: “When I was a child, the Durham Dairy was a weekly stop on Sunday evenings as part of our family drive, we would park, go into the counter and then return to the car with our ice cream. After my father finished his, we would drive around Durham while the rest of us finished our ice cream. I had no idea as a young child that the reason we took that ice cream to the car was because the Durham Dairy was segregated and being an African American family we were not allowed to eat our ice cream on the premises. I was shocked to learn as an adult how my parents had been so artful in sparing this ugly truth from me and my younger siblings.”

As early as the 1920s, Durham's white homeowners had to agree to racial covenants on their suburban home and land deeds, such covenants explicitly prevented black ownership and restricted black residents in homes, except for domestic servants. This practice was legal until 1948. The National Association of Real Estate Boards code of ethics at that time directed real estate agents to maintain segregation in the name of safeguarding, neighborhood stability and property values. The industry practice known as steering remained in effect until 1950.

“A realtor should never be instrumental in introducing in a neighborhood members of any race or nationality whose presence will clearly be detrimental to property values in the neighborhood…” National Association of Real Estate Boards code of ethics

The great depression stimulated the country's new deal, social safety net legislation, including the social security act of 1935, which offered benefits and unemployment insurance. The Fair Labor Standards Act of 1938 set a national minimum wage and the National Labor Relations Act of 1935 created the right for workers to organize. However, agricultural and domestic workers positions held predominantly by black people during the 1930s were specifically excluded from these programs, losing out on both fair pay and labor protections.

Historian Ira Katznelson wrote extensively about the impact of these policy decisions on the country's African Americans: “Southern legislators understood that their region's agrarian interests and racial arrangements were inextricably entwined. By excluding these persons from new deal legislation it remained possible to maintain racial inequality in Southern labor markets by dictating the terms and conditions of African American labor.”

The federal government also recognized home ownership as one of the best ways to stabilize the economy and expand the middle class. The homeowner's loan corporation, a government sponsored corporation created as part of the new deal developed city maps and color coded neighborhoods according to lending risks, these maps became the model for public and private lending from the 1930s on. In Durham and elsewhere, red lines were drawn around black, mixed race and the poorest white neighborhoods, the effects of redlining now close to a century old had profound effects that are still felt to this day. Over time these maps discourage investment in home ownership and also business development in these areas ringed in red and encouraged and supported these things in white neighborhoods.

By defining some areas as too risky for investment lending practices followed, poverty was exacerbated and concentrated and housing deserts, credit deserts and food deserts became a predictable consequence. Redlining maps also shaped lending practices for the GI Bill Servicemen's Readjustment Act of 1944. The GI Bill made mortgages available to World War II veterans with little or no down payment. And with very low interest rates. The aim was to create financial stability and the accumulation of generational wealth for those who would serve the country through home ownership. However, most homes were in suburban neighborhoods, primarily financed by the federal government. Between redlining lending practices and real estate covenants restricting black buyers, home ownership simply wasn't possible for the vast majority of the 1 million plus black World War II veterans. Between 1935 and 1968, less than 2% of federal home loans were for black people. The GI Bill also did not issue home loans on Indian reservations, which excluded many Native American veterans.

In the late 1950s, Durham received federal money for a local urban renewal program to clear slums and blighted areas through the Housing Act of 1949. The city chose to demolish a large section of the Hayti area, the city's largest and most prominent black neighborhood and home to most black owned businesses. This changed everything. City officials cited the poor physical conditions of Hayti as the reason for demolition. The land was then used to build North Carolina highway 147, a freeway connector.

Louis Austin editor of the Carolina Times wrote in 1965: "The so-called urban renewal program in Durham is not only the biggest farce ever concocted in the mind of moral man, but it is just another scheme to relieve Negroes of property."

Hayti's destruction included a significant part of the neighborhood's food infrastructure, such as grocery stores and restaurants. What was once a thriving and resilient food economy where wealth remained in the community became a food desert.

Nathaniel White, formerly a Hayti business owner in Durham had this to say about the destruction of the Hayti neighborhood: “Well, I think we got something like $32,000 for our business. As I look back on it now, if you're going to drive a freeway right through my building, the only fair thing to do is to replace that building. In other words, I ought to be able to move my equipment and everything into a building. If they do it like that, you will be able to stand the damage. Now, the highway department has a replacement clause in their building, but the urban renewal had what they call fair market value, and that won't replace it. And that's where the handicap comes. Just say, you give them $32,000 that probably would've bought the land or whatever, but it wouldn't put the building back and everything like that.”

In the 1950s, Durham built federally funded housing projects for low income families. But by the late 1960s, public housing in the city was almost exclusively for black people and clustered in existing black neighborhoods. This further reinforced patterns of residential segregation, Durham's lunch counters and restaurants became rallying points during the civil rights movements. North Carolina's first protest was at Durham's Royal ice cream restaurant in 1957.

Virginia Williams, a young black woman at the time was a member of the Royal Ice Cream Nine who staged the protest: “None of it made any sense, but that had been the way of life. And that's the way the older folk had accepted it. And so I guess I was one of them who thought, if not us, who, if not now, when. So the police officers came and they asked us to leave. I remember one of them asking me to leave and I asked for ice cream. And he said, if you were my daughter, I would spank you and make you leave. And then I said, if I was your daughter, I wouldn't be here sitting here being asked to leave.”

In 1962, more than 4,000 people protested at Howard Johnson's Ice Cream Grill in Durham. The struggle to desegregate eateries intensified in 1963, when protesters organized sit-ins at six downtown restaurants on the eve of municipal elections, hundreds of people were arrested and protestors surrounded the jail in solidarity. And in the weeks that followed more than 700 black and white Durhamites ran a full page ad in the Durham Herald newspaper. They pledged to support restaurants and other businesses that adopted equal treatment to all, without regard to race. The mounting public pressure resulted in mass desegregation of Durham Eateries by the end of 1962, ahead of the 1964 federal civil rights act that legally ended segregation.

Although civil rights wins brought about new political, economic and social opportunities for black people, desegregation didn't help black businesses. They suffered economically because black people began to explore new opportunities to shop outside their neighborhoods, but white people didn't patronize black owned businesses in turn.

In 1964, the federal government passed the Food Stamp Act as a means to safeguard people's health and wellbeing and provide a stable foundation for US agriculture. It was also intended to raise levels of nutrition among low income households. The food stamp program was implemented in Durham County in 1966. A decade later the program was in every county in the country.

From 1970 through the 1990s, urban renewal continued to disrupt and reshape Durham central city. As both white and middle class black residents left central Durham for suburban homes, banks and grocery stores disappeared. Textile and tobacco factory jobs were also leaving Durham for good. Thousands of workers became unemployed and the domino effect on home ownership, businesses and workplaces disrupted much of Durham's infrastructure and its community life.

From 1970 through the 1980s, the availability of home refrigerators and microwaves also changed how families stored and cooked their food. Durham already had higher numbers of working women than the national average. As a result, convenience foods, foods from restaurants, prepared meals at grocery stores and microwavable foods from the freezer were in demand.

Like many Americans, Durham residents had become increasingly disconnected from farming and food production, both physically and culturally. Food corporations now used marketing in the media to shape ideas about what to eat and why. The food system became dominated by increasing corporate consolidation and control. And by large scale industrial agriculture emphasizing monoculture. Corporations were fast gaining political and economic power and used their influence to affect trade regulations, tax rates, and wealth distribution.

In the 1980s, the federal government passed legislation that boosted free market capitalism, reduced social safety net spending and promoted volunteerism and charity as a way to reduce poverty and government welfare. These policies negatively impacted Durham's already historically disadvantaged populations. Nonprofit organizations began to emerge to deal with the growing issues of hunger and food insecurity and nonprofit food charity became an industry unto itself. More than 80% of pantries and soup kitchens in the US came into existence between 1980 and 2001.

The H-2A Guest Worker Program of 1986 allowed agricultural workers to hire seasonal foreign workers on special visas who were contracted to a particular farm, but workers did not have the same labor protections as US citizens.

That same year, the US launched the war on drugs to reduce drug abuse and crime. Low income communities were disproportionately targeted when Durham's housing authority paid off duty police officers to patrol high crime areas, particularly public housing developments. Hyper policing, drug criminalization, and logger sentencing for drug related offenses caused incarceration rates to rise steadily. Durham's jail and prison incarceration rates from 1978 to 2015 rose higher than anywhere else in North Carolina.

Here is an excerpt from an interview with Chuck Omega Manning, an activist and director of the city of Durham's welcome program. “Being totally honest, high incarceration rates for people of color is very detrimental to our health. Even in the Durham County Jail, you have a canteen that's run through a private company who only sell certain things like oodles of noodles that are not healthy. And then in prisons, you don't get to eat vegetables unless it's part of your dinner. And even then it's oftentimes still not healthy because of how it's cooked. But if you don't work in the kitchen, you don't get to decide, you just get it how it comes and you pray over it and eat it. But then over time, people get institutionalized in the system. And when they return home, they continue to eat the same way because they're used to it. And the financial piece only enhances that because you have individuals coming home, looking for employment, trying to do something different. And there are just so many barriers even with food stamps. So it almost feels like you're being punished twice. And it's very depressing.”

In the 1990s, Durham wanted more investment in the downtown area. Instead of the factory jobs of the past, the downtown area shifted to offer low paying service jobs and high paying jobs in research and technology. Wealthy newcomers were called urban pioneers and trailblazers and purchase properties in historically disinvested city areas.

Low wage workers today cannot afford new housing prices in Durham, in most cases, or to pay the increasing property taxes. Many people are losing their homes through when increases, evictions and foreclosures. Gentrification has also changed which food retailers exist in the local food environment. Sometimes this creates food mirages where high quality food is priced out of reach of longtime residents.

The North American Free Trade Agreement NAFTA of 1994 also changed Durham and North Carolina. Farmers from Mexico and Central America driven out of business by the trade agreement immigrated to places like North Carolina, looking for agricultural and construction jobs. Durham's Latino population grew from just over 2000 in people to 1990, to nearly 40,000 in 2014, one out of three Durham public school students was Latino in 2014. Today, 94% of migrant farm workers in North Carolina are native Spanish speakers.

In 1996, the federal government made changes to the nation's food assistance security net. It dramatically cut SNAP benefits, formerly known as food stamps and limited eligibility to receive benefits and the length of benefits. In Durham, SNAP benefit participation rate decreased by 14% between 1997 and 2001 despite a 2% increase in the poverty rate.

Durham's Latino Credit Union opened in 2000 at a time when three quarters of Latinos did not bank at all. Over the next 20 years, Latinos developed and operated restaurants, grocery stores and services across Durham. This provided the Latino population with culturally resident food, community gathering spaces and jobs.

Processed foods had become a central part of the American diet by the early two thousands. And the vast majority of food advertising promoted convenience foods, candies, and snacks, alcoholic beverages, soft drinks and desserts. In addition, companies did and still do target black and Hispanic consumers with marketing for the least nutritious products contributing to diet related health disparities, affecting communities of color.

During the great recession of 2007 to 2009, job losses, wage reductions and foreclosure crisis increased the number of people struggling to afford and access enough nutritious food. As a result, SNAP participation rose dramatically in Durham.

In 2008, the farm bill included language about food deserts for the first time. A food desert was defined as a census track with a substantial share of residents who live in low income areas and have low levels of access to a grocery store or to healthy affordable foods in a retail outlet. Today some scholars describe such places as areas of food apartheid. This recognizes the outcomes of past policy decisions that disinvested in disadvantaged populations and locations, the cumulative effects of living under food apartheid have profound impacts on the health, wellbeing, and life expectancy of people of color and the poor.

Here's an excerpt from an interview with Latonya Gilchrist, a Durham county community health worker: “I've suffered a lot in this body for a lot of people it's genetic, but I feel like, and this is my personal feeling based on what I've experienced and my whole family. It's the role of food deserts and the cost of food, not being able to have a community grocery store and what I'll say for Northeast Central Durham or the East Durham area where I grew up, we always had corner stores that sold everything we didn't need. And very little of what we did need. Back when I was a child growing up, potato chips cost 16 cents a bag, and you could get potato chips all day long and all night long, and people could get beer and wine in the neighborhood, but you couldn't find fruits and vegetables until my daddy started selling them on a truck. So diseases come about genetically, but it's increased or enhanced through living in poor poverty stricken neighborhoods.”

Durham foreclosure spiked during the great recession of 2008 and were disproportionately located in historically black neighborhoods. Owners in high poverty neighborhoods have been targeted for high cost subprime loans by lenders through a practice known as reverse redlining. As neighborhoods gentrify and longtime residents get displaced, there is an increasing spatial disconnect between services and amenities and those who utilize them and need them the most. Food, housing and retail gentrification are closely intertwined.

Here's an excerpt from an interview with Eliazar Posada, community engagement advocacy manager of El Centro in Durham: “Gentrification is affecting a lot of our community members and not just affecting the youth, but also the families, unless we can find ways to subsidize housing or find a way to make gentrification not so dramatic for some of our community members. The youth are not going to be staying in Durham if their parents can't stay.”

Durham's people of color and low income people overall have disproportionately high incidents of diabetes. In a 2016 survey in the Piedmont region, 16% of respondents with household incomes, less than $15,000 reported having diabetes compared to only 6% of residents with household incomes of more than $75,000. By 2017 black patients were 80% more likely than white patients to have diabetes in Durham.

In Durham County in 2019, the average hourly wage for food preparation and serving jobs was $10.83 cents an hour or $22,516 annually before taxes. Such wages are all been impossible to live on without government assistance. The fair market rent for a two bedroom housing unit in Durham in 2018 was $900 a month or about $10,800 a year.

Food inequality is a lack of consistent access to enough food for a healthy, active life is caused by poverty, the cost of housing and healthcare and unemployment and underemployment. It is also impacted by the interrelated forces of home and land ownership, political power, economic resources, structural racism, gender oppression, and labor rights. Durham's communities continue to build community solidarity and mutual aid as people lend money, time and other resources trying to make sure everyone can access adequate and healthy food.

In a remarkable feat of resilience the Occaneechi band of the Saponi Nation was awarded official recognition by North Carolina in 2002, following 20 years of organizing and sustained advocacy. They purchased a 250 acre plot of land just outside of Durham County and planted an orchard of fruit bearing trees for collective tribal use. This is the first land that the tribe has owned collectively in more than 250 years.

Durham's black farmer's market emerging from 2015 to 2019 is also a testament to community building through food. The market supports local black farmers and makes healthy eating attainable for individuals living in some of Durham's food apartheid areas. Market organizers are challenging social norms, classism and racism, and believe that healthy living should be possible for everyone.

So why is the food history of a community so important? And can Durham's food history be applied to other places? Who owns land, who can grow food and make a living doing so, and who has access to food, any food, least of all healthy food? The answers are deeply influenced by historical policies and practices. These in retrospect, clearly exacerbated, supported, and even created food related calamities, the dual burden communities face of both food insecurity and diet related chronic diseases, such as diabetes and obesity. Understanding these practices is important in creating change. And in understanding that conditions imposed on neighborhoods rather than personal failings of residents explain what we see today.

A few pieces of this history are specific to Durham, the role of tobacco and textiles, for instance, but most of the fundamental influences on the economic and food conditions are broad social attitudes and practices around race and poverty. And from federal, economic, agriculture and housing policies that have affected urban rural areas in every corner of the country, there is hope from local ingenuity to change food systems and from people in local, state and federal policy positions who are working to reverse inequality and to re-envision the role of food in supporting the physical and economic wellbeing of all people, learning from the past is really important in these efforts.

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Today, we're talking to a change management leader, a person who is advancing social justice through food co-ops. Darnell Adams co-leads Firebrand Cooperative, a new consultancy helping nonprofits, cooperatives, and other socially responsible organizations throughout the US. In a recent article, she wrote for "Nonprofit Quarterly" that a food co-op isn't a luxury item, but the lifeblood of their communities.

Interview Summary

So let's jump right in. You've written that a new wave of leaders is organizing in communities, Black communities, Latinx, Indigenous, rural, immigrant communities, and communities lacking in wealth overall. How have your experiences led your work in supporting economic development through food?

Yeah, it's such an interesting journey I've been on. So I'm going to step back just a minute to say how I landed in the places that I've started to work. Certainly my interest in food is shaped by my experience in the world and my childhood experiences. My mother, who is an immigrant, my father, who's an immigrant - their relation to food and the African diaspora. I grew up understanding what food meant in terms of identity, in terms of nutrition, etc. So I had my own thoughts about food certainly from those experiences, and also had my own business as a caterer for many years. I had that understanding of what it means to be a small business, and launching a business and all of the trials and tribulations of doing that. And in the process of running that business I came to find a location where I could situate that business in a way that was affordable to me using a shared kitchen space that was located in Boston, Massachusetts. Then I really started to develop a broader understanding of some of the economic considerations, not just mine, but many of the producers were having in terms of how to run a viable business, and what supports were needed or missing in their experiences. It's kind of a long story and I won't get into it how it happened, but it so happened that at a certain point, I began a new career as managing director of that shared space kitchen. That was a whole leap in terms of thinking about not just my small catering business, but supporting many businesses, whether they be food trucks, caterers, producers of something that was a shelf staple product or something like that. Many of those business owners were immigrants, many were women or otherwise not having the amount of capital to be able to just open up their own spaces.

Tell us a little bit more, if you would, about the kitchen itself and what kind of work it did?

Oh, sure. So the kitchen, and there are now several across the country, but at that time, there were very few of them. It was a shared space that was initially run by a CDFI - a community development funding institution - who was able to obtain funding to open up a kitchen space knowing that there were many people who wanted to run food businesses, or start a food business, but were unable to because of the cost of actually renting out a space. They needed space to use and that would be inspected by inspectional services and given the green light to work and sell their products. So the kitchen did actually aid some caterers and other people who were working underground in their own houses, not being certified, etc., and therefore not able to expand their business. The idea of shared kitchens is really, really important. Certainly it was the way that I was able to launch my business and able to run it for some years because it was affordable to me. And at that one location was able to grow the business and actually move the location to a bigger space. I have a really long story there, but it's CommonWealth Kitchen in Boston and it is still thriving. They were able to actually buy the building recently, and the space that is still producing quite a lot of businesses that are thriving and also moving into their own spaces. The kitchen is able to give the support, not only just the physical space, but the technical assistance that's necessary to launch a business, to have a business thrive, and then maybe that businesses can move on to have their own spaces. This is really important in terms of thinking about the whole ecosystem of what I would say the food system needs in many communities. But also in terms of what individually someone might actually need in terms of being able to thrive in the food business.

Well, you can see how this would be so powerful as a means of helping people get launched. And a topic that we could talk about another day might be how can these things be put in more places with more support so more people, their businesses could be facilitated by it. But let me turn our attention to the issue of food sovereignty. So I know you've done a lot of thinking about food sovereignty, especially in Black communities. What sort of efforts are you seeing?

Yes, this actually leads me to cooperatives as one of the kind of efforts that I'm seeing in Black communities. And, if we kind of would follow the storyline, in some ways in my experience. The shared kitchen really did open my eyes to the power of collective resources, that no one person in that kitchen was able to afford having their own facility, but together, along with supportive fundraisers, etc., who are able to have a place that was actually thriving and meeting needs. And so upon me leaving that job, I was really kind of struck with what are other ways in which people are creatively thinking about collective capital and all the ways capital can be defined. And there was an opportunity with a food co-op in Boston, the Dorchester Food Co-op that was looking for a project manager to administer some of deliverables for a grant that they had. That was my entrance into the cooperative world, and realized that cooperative economics, an understanding of what people were doing in developing a co-op and all the things that it took, actually really very much aligned with my experience in general. And my philosophy in terms of how people have more entryways, more opportunities to actually take control and ownership of their own economic development. So it's not always groups from the outside looking at a community and then saying, well, we know how funds should be applied or how businesses should be created. Instead, particularly in a cooperative movement, it's the community themselves are saying, we understand exactly what we need in terms of goods and services. We actually will define for ourselves both what leadership looks like and what ownership looks like. So in terms of food sovereignty movement in Black communities and others as well, this incredible growth in terms of thinking - let's look at what joint ownership looks like as a different way to create sovereignty and to keep money in a community. But also money in working in the ways that are consistent with our needs. So certainly food co-ops. Lots of work around land loss, Black land loss for farmers, and creating land trusts. Again, this idea, while not cooperative, is still looking at kind of a collective way of ownership that keeps land off the speculative market. Also just supporting the farmers that are there, both in rural areas and in urban farming. So there is kind of a whole landscape where people are really thinking very deeply and working very hard on all the aspects of food sovereignty, from growing to shopping to workers.

So can you explain some of the opportunities that get created through these kind of efforts and how these opportunities help create social justice?

Yes. This is what's so incredibly exciting and certainly keeps me motivated to work with the folks that I'm working with. The opportunities are pretty broad. And I kind of mentioned a few of these before in terms of thinking about what ownership looks like in a very different way, in which kind of the language of ownership sometimes can get overused. And if you kind of dig deeper, it's not real ownership. So for instance, in terms of food cooperatives, the business is actually owned via shares by its members. In which case, for food co-op, typically that is the community members who are buying a share of the business. Not like being an owner of a quote unquote, a member of a big box store, where you get some money back and you say, okay, well, I'm a member of this club, but you have no ownership. There's no share that is given to you. You're not a shareholder. In the case of cooperatives, certainly you are. And so really kind of rethinking about, like, well, it's not that for goods and services that are might be absent in a community that we need to wait for another entity to come and offer to us what they have, and it may or may not be a match for what we actually really need. But as owners, the folks who are actually going to benefit from the existence of the business, from the profits of the business, by the goods and services that are being delivered, that ownership really does take a whole different sort of meaning that a lot of people are accustomed to. And then there's also the opportunity for leadership also in ways that I think are certainly opportunities that many people may not have had before, and I can certainly speak from my experience that as the project manager of the cooperative, that stepping into that role required leadership and vision in ways that I had not encountered before when I was working for another entity, and I was staff doing what I needed to do, but because it's a grassroots effort, because the systems and the processes, all of that are things that are kind of created by the entity, it meant all the ways to experience all sorts of different levels of leadership and consideration that in many cases would not be something that people would experience.

Right, so, I mean, you're painting a really wonderful picture of how many people in a community can play different roles and develop leadership abilities that are possible through these, so those are some of the opportunities. What are some of the challenges, and what do you think such groups need most?

Right - I'm certainly, you probably can tell by my description of things, very much enthusiastic about the opportunities and the vision for many of these efforts. Particularly the food cooperatives that are happening all across the country in Black communities, and the challenges are also real. So some of that is certainly capital, and I can kind of outline a bit on some of the struggles there and the ways that it can be deployed that would be helpful to some of these organizations. So in terms of capital, one thing is really on some basic level, kind of unknowing in many ways from where groups who might be able to provide capital and even understanding what a cooperative is and how it works. So it's kind of the general idea that, well, cooperatives are out there. I think maybe they sell granola and things, but beyond that, not a kind of deeper understanding of kind of inner workings of a cooperative and how their money might actually be aligned to other social justice issues that they might be funding. So it's like just the awareness and saying, okay, well, this seems to make sense in terms of, yes, if I'm thinking more about nutrition, about any number of things, but say nutrition, food access, economic development, having a better and more refined understanding of what cooperatives offer might actually kind of bridge that gap between the funders and what's needed in order to create a cooperative. Secondly is the amount of time it takes to develop a cooperative, which can be years. It definitely requires a lot of people taking a lot of time that is often voluntary, but can also kind of stretch them out of time that it takes for people to develop these co-ops in their communities because they're trying to fit it in amongst all the other things that they're trying to do in their lives. They're not paid for it necessarily, so I think a certain amount of funding, even just for a paid project manager to kind of move forward what is a complicated business, to kind of shorten the length of time so the delivery of goods and services can happen in a more rapid fashion to actually address some of the issues that we're seeing in Black communities. So that is a couple things there, which is the time it kind of can take, and also lack of capital resources that some of these groups have, and then trying to certainly work around that.

Bio

Darnell Adams, of Firebrand Cooperative, is a dynamic leadership coach, facilitator and business strategist, who has over two decades of experience working with nonprofit, for profit and cooperative businesses. She has been personally recognized in "Bold Thinkers Who Are Shaping Our City'' by Boston Magazine's Power of Ideas and as a Social Innovator by the Social Innovation Forum accelerator program. She develops and facilitates strategic plans, special projects, and workshops, providing expertise and training on an array of topics including implicit bias, power and equity. Darnell has presented to government officials, university administrators, and industry leaders to create social and economic change. Darnell has a Master of Education from Harvard University and is a Certified Leadership Coach.

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Today, we're exploring an agricultural innovation in the state of Qatar in Western Asia. Qatar is a wealthy, densely populated country located on the Northeast coast of the Arabian peninsula and leads the world in liquified natural gas exports. But the country's desert climate is harsh and the agriculture there is challenging. That's where shipping containers, artificial light and vertical farming techniques come into play. Our guest today is horticulturalist Mohamed Hassouna from the Qur-anic Botanic Garden in Qatar. He and his partners at the University of Arizona are developing a shipping container vertical farming model as a way to expand local food production.

Interview Summary

So first let's set the stage for our listeners. Could you describe the agricultural challenges in Qatar given the country's dry climate?

Thank you for your introduction. Qatar, as other countries located in the Arabia peninsula and also in the Arabian states, are facing very harsh weather conditions. Particularly in Qatar, the weather here is hot desert weather characterized by sparse precipitations and high summer temperature experienced with high humidity, high solar radiation and poor soil additionally to strong winds. And this limits the agriculture sector to the months of October to April. Every year, this is the agriculture season here from October to April then the temperature is fine and can allow for producing vegetables. Also the land, the Arab land, suitable for agriculture is very limited. The last inventory here in the state estimated that there is only 60,000 hectares available for the agriculture sector. Also, we have a challenge with water. Water scarcity. The agriculture sector here in Qatar consumes 90% of the available water for the state. A big challenge is also that the agriculture sector consume about 36% of the available water in the aquifer. And as I told you, we have very minimum amount of rain every year. It's about 80 millimeters on average, every year. So production of agriculture in Qatar is difficult.

Well, the picture you paint is really striking and I can imagine those challenges. So what role could your Botanic garden play in addressing food security in the country, closing the food security gap for communities, and also attending to the environment?

Yes! The Qur-anic Botanic Garden is an active member in the community development sector in Qatar Foundation. It takes the issue of community awareness and education from school students to housewife to training even professionals to engage in the investment in agriculture. We established at the Qur-anic Botanic Garden an extra curriculum educational program for school students - from early stage to especially secondary schools students - to learn about the challenges of food security in Qatar, and what are the technologies they can learn. Students are leading the future here in Qatar. Without students being aware about the challenges facing the food security and the agriculture production, we cannot guarantee a future outlook of food security. Also the Qur-anic Botanic Garden has been partnered with Qatar Development Bank, and this is the official bank assigned to develop industry like also agriculture sector. So, anyone from Qatar who would like to take a loan to invest in the agriculture sector, we have the mission to train them on the latest technology of horticulture practices. They can use or they can establish greenhouses or they can establish other modern system for a production of vegetables. Either in their homes or in farms outside. Also Qur-anic Botanic Garden established a hotline for household people. There is now community farming in Qatar. People would like to plant their own vegetables in their home. The hotline is answering all their inquiries about seed selections, seedlings, how to prepare soil, how to make pesticides.

So let's talk a little more deeply now about vertical farming. Can you describe what that is?

Vertical farming involves growing crops in controlled indoor environments with precise lab nutrients and temperatures. In vertical farming, plants are stacked in a layers that may reach several storage unit stories - from personal community scale vegetables or herbal growing to vast building for commercial production of a wide range of crops. Due to the pressure for agriculture land, this makes us look to maximization for food production. Model technology like vertical farming is increasingly something we are turning to for greater crop yield.

I'm envisioning in my mind what the vertical farming could look like. And I'm thinking that in order to produce enough food say to feed a population, you need an awful lot of containers and an awful lot of technology to accompany those containers. Can that be done on a large enough scale?

Before we answer this, we need to go through the pro and cons for vertical farming. If we can speak first about advantages of vertical farming, we can say that vertical farming can ensure crop production year round in desert harsh weather regions like Qatar or other countries in the Arabian Peninsula. And also a controlled growing condition in a vertical farm allow production without chemical pesticides used when needed to deal with any problems from insects. Also, because crops in vertical farming are growing under controlled environmental conditions, they are safe from extreme weather events, such as drought, high temperature, severe winds that also we are facing here. Hydroponic growing techniques used in vertical farming use about 70% less of water than normal agriculture. So, growing the crops indoor reduces the use of tractors and other machinery that also produce a lot of CO2 and this is could be a climate friendly industry. So this is some advantage behind vertical farming that can give us strong signal to say yes, vertical farming can feed a lot of people around the world. Especially in the area that have these two main challenges, availability of vertical soil and a scarcity of water.

Oh, it's so interesting to hear you speak about this. So it sounds like you're optimistic that the technologies can continue to develop and that the vertical farming approach could really help contribute to national food security in your country. But so what do you think are the main opportunities there and what do you think the main challenges are?

Thank you for this question, Kelly. Indeed, I'm optimistic about this industry. Cost of land and building for vertical farming is not easy and it's not also available for all countries and for all people. It needs solar isolation, it needs air conditioners. It needs precise lighting. It needs operation computers. So it needs also specific types of nutrients to be introduced in the cycle of production for fertilization. Here, you bring all the inputs of production cycle. In what you add to the water or to directly to the plants. So the cost is high on the energy side also. You use high amount of energy at a time we are calling everyone to reduce the use of energy and avoid production of CO2. Also, you're aware of expansion of organic agriculture everywhere in the world. So, there are now questions about vertical farming certification. How we can certify or how we can consider merging between organic agriculture and vertical farming. As I said, we use all chemical nutrients in vertical farming to provide the plant with sufficient amount of all of other nutrients required for production. In this case, organic agriculture certification cannot be applied. And scientists in USDA and FAO and many other organization are looking to find a way they can provide a product from vertical farming certified under organic agriculture systems. Two points now, the limited number of crop species in vertical farming. Also, you cannot produce these tall plants that you can grow everywhere or creeping plants that grow everywhere in the field, in the natural field. So you are limited with this layers of a production. So mainly you produce leaves and produce and herbal plants. So we have limited number of crops. Still, also pollination. In natural, we have a bees that make pollinations for the production of vegetables, even for fruits, every, everything. But here, we doesn't have a pollination so we need to go with artificial pollination and this also extra cost to have a special type of bees that you need to put inside the glass houses or inside the building you produce in to secure pollination to complete the cycle of production.

Bio

Mohamed Hassouna is a Horticulturist at the Qur’anic Botanic Garden (QBG), a member of the Qatar Foundation for Education, Science and Community Development. He joined Qatar Foundation in late 2010. He guides and supervises agricultural laborers, coordinating work schedules and performing evaluations, and prescribes fertilizers, pesticides, herbicides and other compounds required for plant care and development. And, he contributes to QBG’s continual education-based conservation programs targeting the Qatari community, especially in the fields of food security, forestation and plant propagation. He is an alumnus of the Advanced International Training Programme on Plant Breeding & Seed Production and Plant Genetic Resources at the Swedish University of Agricultural Sciences in Uppsala, Sweden – Classes of 2008 and 2013. He is finalizing a Master of Science degree in Sustainable Agriculture & Environment and in addition holds a Higher Diploma – Graduate Education – in the same field and a Bachelor of Science degree in Agriculture Sciences & Education, which he gained while studying in Egypt.

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So what percentage of the world's children do you believe suffer from physical or mental stunting due to nutrition and food shortages? How lasting do you think these effects are and what can be done? Today's guest is Sharman Russell, author of the new book, Within Our Grasp: Childhood Malnutrition Worldwide and the Revolution Taking Place to End It. Among the reviews for the book, The Sunday Times of London said "Every page holds a revelation."

Interview Summary

So Sharman, let me begin with sort of a fundamental question. So we led with that issue about how many of the world's children face these hunger malnutrition stunting issues. And you note it in your book that almost one in four children in the world suffers from physical mental stunting in response to malnutrition and hunger, especially in the early years of life. One thing that's noteworthy about your book is that you emphasize successful approaches or solutions to ending this kind of childhood nutrition. A lot of people make note of the problem, but finding solutions is a whole different thing all together. But with this issue being so longstanding and complex why do you think there's reason to be hopeful?

You know, I have been writing about hunger and malnutrition for the last 20 years, and I would never have been drawn to this subject, to this story, if it wasn't a hopeful one. I also happen to think that hope is the best strategy if you want to achieve something. Hope generates action, and hopelessness does not. For me, this sense of hope is about the last 20 years. At the end of the 20th Century, we finally began to understand the role of vitamins and minerals in the human body and in preventing and treating childhood malnutrition. By the turn of the century researchers had developed this wonderful, precisely fortified food medicine, these convenient packets of a peanut buttery paste, that children love, that don't need refrigeration or clean water, that can be given by parents in the home. And at the same time, importantly, we realized there isn't a single approach to ending childhood hunger. Many different things have to happen. Women need to be empowered. Families need good sanitation. They need to be protected from diseases of parasites that aggravate and even cause malnutrition. So we know what to do now. And we also know that for every dollar invested in nutrition, society gets back $16. So we have the motivation. We have the resources. That's pretty hopeful!

I'm really happy to hear the optimism in your voice. But let me ask a question, a lot of hunger is driven now by climate change and, of course, by political unrest and things. So there's the knowing what to do about hunger and what people might be fed to help offset the problem. But what about these things going on outside of the nutrient part of it? Is there reason to be optimistic on those fronts?

Those are real challenges. There's no doubt. We have to remember that nearly a quarter of the world's children are stunted, damaged because of lack of nutrients. Most of them live in peaceful countries. So while war and conflict is horrible, and what we're seeing now is absolutely horrible, most children live in peaceful countries. So those are the ones that we can start ending childhood malnutrition right now. The UN Food Systems Summit, last September determined that an additional 33 billion a year for 10 years on improved food systems could end the majority of hunger not caused by war conflict. And they were talking about all hunger, not just childhood malnutrition. So that's enormously hopeful, 33 billion a year for 10 years! I sometimes use the analogy that Americans are now spending 90 billion a year on their pets and pet products. And I think we should love our pets. Of course, we should love our pets. The important thing is we have the wealth right now to do this.

Right, and you're talking about worldwide expenses. So America wouldn't have to be the only country contributing.

We wouldn't, we shouldn't be. You know, I think the pandemic really showed us how relatively easy and important it is to spend money on public health. And that's what we can do pretty easily!

So many of your books are about nature and the environment. And you say often in, Within Our Grasp, that the goals of the environmentalist and humanitarian are aligned. What do you mean by that?

You know, in the book I sometimes say, I often say we come from the earth. Literally we are made up of the periodic table. We take in food and nutrients, and we turn that into who we are. I also say that in a world of 7.9 billion people, we have become the earth. And, and that's particularly true in terms of population growth. When I was an undergraduate in the 1970s, environmentalists were very concerned about population growth, but I don't think we understood then the connection between that and poverty. Today, we know that when families believe their children are going to survive and flourish, they tend to have smaller families. When women have access to education and employment they tend to have smaller families. Ending population growth is about ending poverty. You know, in so many ways, the environmentalist and the humanitarian want the same thing. We both want clean air and clean water. We both want sustainable agriculture in the form of agroecology and agroforestry. We both can see that if wildlife is going to thrive, the people living next door to wildlife have to thrive. And of course, as you mentioned we both want and demand action to mitigate global warming. Because right now that is causing so much suffering to the very people who contribute to it the least.

You know, it's another optimistic note, isn't it that if the humanitarian and environmentalists can come together, then there's an opportunity for larger coalition strength in advocacy numbers and things like that to call for change. Have you seen any evidence of that kind of things occurring?

Oh, I do, I have. Absolutely, the programs I saw in Malawi were almost always combining the effects on the environment with empowering women with childhood malnutrition, with getting things to market. Really we do understand. And that is the most hopeful thing that this has to be holistic, that there has to be an approach to this that includes all these important factors, and that doesn't just focus on one thing.

You know, another theme of yours is that empowering women is crucial to ending childhood malnutrition. What does that look like?

You know, one example I think would be from a program I saw in Malawi in Southeastern Africa. And I want to say like so many successful programs there, this one was run by Malawians. So they wanted to end childhood malnutrition by creating more prosperity among their smallholder farmers, encouraging them to include more diverse crops and more drought tolerant crops. And that was great. But after a few years they didn't really see a decrease in childhood malnutrition because in making a household more prosperous, this was between the city or in the country, doesn't necessarily help women and children, if women don't have a say in what to do with that extra money. So the reality too, for many women around the world is that they have all the responsibility for cooking the meals, cleaning the clothes, keeping the compound clean. And that's enormous work when you don't have running water or electricity. And they have all the responsibility for the care of children and they have half the responsibility for farming and gardening. So these women are exhausted. They're sometimes too tired to eat properly if they're pregnant or to breastfeed which is so important to the health of the young child. So in this case, this program in Malawi started working at the level of the family. They had this lively form of community theater about sharing household chores and family relationships. They had public cooking classes in which the men participated. Some of this was fun, but it was also hard work. It took time, but eventually it was successful.

You know, it's a very, very positive story. And I'm happy to hear that. And given that you mentioned Malawi, in particular, how is childhood hunger in a wealthy country like America, similar or different to a place like Malawi and other places with less wealth?

Yeah, there are similarities. We have to certainly look at child hunger here in America. I'll just talk about America. Childhood malnutrition here is mainly about children under the age of five being overweight or obese. And that's a form of malnourishment and it can lead to serious adult diseases. And this is true worldwide all over the world we are seeing an increase in being overweight or obese in young children. Here in America, we have some mineral and vitamin deficiencies. The CDC estimates that 15% of American pregnant women are iron deficient. 15% of our toddlers are iron deficient. That's really important because iron deficiency is so tied to neurological development. We have children who are food insecure, who don't know when their next meal will be. I live in New Mexico. During the pandemic one in three children we're at risk of being food insecure. But in poor countries, all of this is so much more serious and life threatening. More than 40% of women and children worldwide are anemic, not just iron deficient. Children can go blind because of a lack of vitamin A. Their growth falters because of a lack of zinc. More than 7% of the world's children are wasted, too thin for their age, more than 22% stunted, physically, mentally. So this is the kind of suffering that we don't see in wealthy countries.

Thanks for that explanation. So let me end with one final question. If you were the czar of this in the United States government, what sort of actions would you take first, let's say?

Oh, wow, if I were the czar. You know, certainly I would increase aid as much as possible. I think of aid more as reparation, especially in terms of global warming. We are so much the cause of the problem, and they're bearing the brunt of it. I would turn to those countries and say how can we help you? You know, there is that idea of decolonizing aid which I believe in strongly. We have to look at them and say, what do you need from us? How can we help? What do you want us to do? You're in charge, these are your countries. How can we serve you? So we can't put conditions on them. We can't make aid serve our purpose.

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Poor nutrition is the leading cause of health issues in the United States, with nearly three in four American adults being overweight or obese, and obesity in children and young people being equally concerning. Today, we're talking with Dr. Sara Bleich, the new Director of Nutrition Security and Health Equity at the Food and Nutrition Service at the US Department of Agriculture. Dr. Bleich is leading the department's overall effort to tackle food and nutrition insecurity in the United States.

Interview Summary

Sara, it's always wonderful to chat with you, and doing so in different roles that you've been in. So last time we spoke, you were doing full-time work as a professor at Harvard, and now you're in this vital position at USDA. I mean, personally, I can't think of anyone more capable and qualified for this kind of work. And so I'd like to begin by asking if you could explain the purview of your work at USDA.

I'd be happy to, and thank you. It's really kind of you to say that. And I do want to just underscore that for me, it really is an honor to have the opportunity to serve in this role and to help some of these populations that I care a lot about. And I do feel like so many folks in the public health community have been so generous with their time, their expertise, and have given really valuable feedback, so just really want to say thank you to those of you who are listening. You know who you are. You've really been a wonderful sounding board.

So in terms of my transition to federal government, at the start of the Biden administration, I took a leave. I was previously at the Harvard School of Public Health, this was in January of 2021, and I spent the first year as the Senior Advisor for COVID in the Office of the Secretary. And now, in the second year of the administration, I have this new hat, which you mentioned, which is serving as the Director of Nutrition Security and Health Equity, and this is within the Food Nutrition Service. So what's really interesting for me is that both of these jobs are brand new to USDA, so it's been really fun to sort of craft them and have the opportunity to sort of start fresh and take on these new responsibilities in very important areas. Now, one thing that they both have reminded me of is just how much I love federal service. This is my second tour of duty in government, and I honestly thought, the first time around, that I wouldn't like it so much, but I have fallen in love with federal service, I really love working at USDA, it's such a fun place to work, and I think that's largely because it has such a broad and diverse mission, so it touches the lives of 330 million Americans every day. I don't know of another job where you can have that sort of impact. So for me, it's great to be back. It's great to have an opportunity to serve, and it's especially nice to be able to do it in a topic area that I have worked on in my professional life, from the academic side, for so many years.

The enormous impact that this federal work has is clear, from what you just said, and everybody knows this, and in any administration, the country really relies on the service of people like you who are willing to take on these important tasks, so I'd like to say how much I appreciate you doing that. So it's heartening to know that the USDA is making nutrition security a key priority, and it's noteworthy that the term food security has become food and nutrition security. Can you explain why this transition has occurred in terminology and how is nutrition security being operationalized?

Great question. Really glad you asked it, because we are hearing a fair amount of confusion about the concept of nutrition security itself. And then how does it differ from the longstanding efforts at USDA to address food insecurity. So let's start with, first of all, what is nutrition security? So the concept is designed, or aims, to help us better recognize the coexistence of food insecurity and diet-related diseases and disparities. So specifically, what nutrition security means is consistent access, availability, and affordability of foods and beverages that promote wellbeing and prevent disease, and in some cases, treat disease. And this is particularly true among racial/ethnic minority populations, lower-income populations, and rural and remote populations, which includes tribal communities. Now, at USDA, nutrition security builds on and complements our efforts around food security, but it's different in two distinct ways. The first is that it, it being nutrition security, recognizes that we're not all maintaining an active healthy life that's consistent with federal recommendations, and the second is that it emphasizes taking an equity lens to our efforts. So put simply, you can think of nutrition security as having consistent and equitable access to healthy, safe, and affordable food. Now, many listeners may be aware of this definition, and may realize that it directly builds on the JAMA commentary by Dr. Dari Mozaffarian, my assistant, Dr. Sheila Fleischhacker, and Chef Jose R Andres, that came out a little over a year ago. So right now, what we're spending a whole lot of time doing, and that's why it's such a privilege to be on this podcast, is really trying to clearly articulate that definition of nutrition security to a broad range of audiences to really try to get everyone on the same page about what we're doing and how it is a complement to these long-standing efforts around food insecurity.

I'd like to explore this concept just a little bit more. So if you go back to when the country really started to take hunger seriously, in the 1960s, if the term security had been used back then, it probably would've been calorie insecurity, wouldn't it? There was an effort just to get food to people, irrespective of what it was, because they just needed to get more calories in them. But that's given way to a much more sophisticated concept that, if I'm hearing you right, not only do you want to get food to people, but the kind of food that specifically promotes health.

That's exactly right. So what we know right now about burden of disease in the US is that every year, about 600,000 people die because of diet-related conditions. Those are preventable deaths. So the burden of disease looks very different than it did 40 or 50 years ago. And so at USDA, now, what we're concerned about is not just giving people calories or food that fills up their fridge, but we want to give them calories or food that is also going to promote their health and their wellbeing, and that is the critical pivot, and the point that we're at right now, with all the messaging that we're doing, with how we're positioning the programs, and how we're prioritizing action as we move forward.

Sara, when we began the podcast, we talked about the very high rates of obesity in the country, and now you're talking about food insecurity, which people used to refer to as hunger, and a lot of people would see these as the opposite ends of the same spectrum, that they're somehow different and disconnected from one another, but they're not. Would you care to comment on that?

Food insecurity and obesity are definitely related. They often coexist. So we know, for example, that both food insecurity and excess body weight, which you can think of as obesity, they tend to be aggregated among historically disadvantaged populations. So communities of color, low-income populations. And because these two conditions coexist, it's really important to think about how do we use the power of the federal nutrition assistance programs to help move people out of food insecurity and toward nutrition security. And the power of the federal nutrition safety net is that it has a number of programs which are designed to do both. So, for example, if we look at SNAP, the Supplemental Nutrition Assistance Program formally known as food stamps, it helps about 41 million Americans - in fact, more than 41 million Americans, afford food each month. There's strong evidence which suggests that it pulls people away from food insecurity, so it lifts families out of hunger. But what we also know is that with the historic reevaluation of the Thrifty Food Plan, which is the calculation that underlies the size of the SNAP benefit that increased the benefit amount by 21%. This happened back in the fall of '21. What that does is, it puts healthy food within reach for so many participants who are on SNAP. So we view this change to SNAP, this reevaluation, which is the first permanent increase in over 45 years, we view this as core to our nutrition security efforts because it allows families to actually purchase food and put those foods within reach that are going to promote their health and their wellbeing.

Thanks for that explanation. So it sounds like some of your work lies at a very interesting intersection of two important priorities of the current administration. So on one hand, you have USDA Secretary Vilsack's goal of promoting and elevating nutrition security, which you've discussed, but also the President's goal of advancing racial equity. So what things are happening at this particular intersection of USDA?

Well, first I'll say this is an exciting time to be in government because there is so much focus on core issues that matter a lot. And so a key reason why the Secretary of Agriculture, which is Secretary Vilsack, the key reason why he is so passionately focused on nutrition security is really due to the pandemic, and the President's goal of advancing racial equity. So what we all know is that COVID-19 brought health disparities and the vital need for access to healthy food right up to the forefront. There's a study, which many listeners may be familiar with, which estimated that nearly two thirds of COVID-19 hospitalizations in the United States were due to four diet-related conditions: obesity, diabetes, hypertension, and heart failure. And so for this reason, given the disproportionate impact of COVID, its impact on diet-related conditions, and we know that it really disproportionately impacted communities of color, equity is central to our work to promote and elevate nutrition security. And so just to keep us all on the same page, let me just quickly say what we mean by equity: everyone having an equal opportunity to live the healthiest life possible, no matter who they are, where they live, or how much money they make. But when we talk about equity that also dovetails with considerations around the context in which we live. This means we also have to consider structural racism, and this is how we bring in the racial equity lens. So structural racism is not just individuals having prejudices, but it's also when racism gets produced and reproduced by laws and by rules. It becomes embedded in the economy, and so therefore, confronting racism requires that we don't just change how individuals think, but we also start to transform policies. In our efforts to build awareness around nutrition security, we are also making very concerted efforts to explain how structural racism is real, it reaches back to the beginnings of US history, and it stretches across our institutions and economy. So we emphasize that structural racism harms health in ways that can be described, measured, and dismantled. And this is a really important needle to thread as we think about nutrition security, because social disadvantage is not random. It has real roots that we need to acknowledge, and then address wherever possible. So for example, we know that there are disparities in diet-related conditions that have existed for decades, and those are associated with structural limitations to retail food outlets that sell healthier foods, among a whole host of other longstanding historical inequities. And this is where the work of nutrition security comes in, where we at USDA, and hopefully, all the listeners of this podcast, can really make a difference.

So I would challenge you all to lean in and ask yourself how can you be part of the solution. And maybe that's asking a critical research question, maybe it's trying to help connect eligible individuals with the federal nutrition assistance programs, but there are so many opportunities to promote and elevate nutrition security. And the key, going back to your question, is that the President cares about this, the Secretary of Agriculture cares about this. This is a window of opportunity to really make a difference in people's lives. And so I think that we really want to lean in as much as possible and take advantage of it.

This work is really important, so following up on something you just said about ways that people can engage with this process, so what kind of things are you seeing on the horizon, and what are the best ways for people who might be listening, to engage?

So I think it's going to depend on the lane that you sit in. If you're listening to this podcast and you're a researcher, I would ask yourself, "Given the data that I've collected, given the data that I plan to collect, could I do a secondary analysis that might help me understand some of the impacts of the COVID flexibilities that have happened during the pandemic?" For example, there was a temporary increase to the SNAP benefit, and then that became a permanent increase. There have been hundreds of waivers that have been issued which have made the programs more easily accessible. So for example, with WIC, you don't have to go in in person, you can do meetings over the phone. There are all sorts of things, all sorts of program modifications that have happened, and USDA doesn't have the bandwidth to do all that evaluation. So I'd say if you're a researcher, look at how your existing data, your existing portfolio, may be able to answer other important questions.

Second, if you are industry, or if you're somehow in the private sector, ask yourself, "What could I do to lean in on this?" For example, there is a waiver that's allowed, it's called the SNAP Incentive Waiver. Retailers can apply for this and it allows them to incentivize SNAP participants to purchase things like fresh fruits and vegetables, and whole grains that are in alignment with the dietary guidelines for Americans. This has been around for a few years, and it's a really nice way that retailers could take advantage of an existing waiver to try to help promote healthy eating purchases among SNAP participants. Which, again, covers about 41 million Americans each month. There are so many different ways to think about leaning in on this particular issue. And I would say that one of the things that we have really tried hard to do over the past several months is that we at USDA are trying to really clearly define our role. How we are trying to make a difference - with the hope that it makes it obvious how others can do complementary activities, because yes - we are investing tens of billions of dollars towards this portfolio. We are very serious about it. This is a top priority. But USDA alone cannot solve the problem of diet-related diseases and disparities. It is going to take a whole-government, if not whole-country approach. And so this is where creative ideas about how to make a difference, leveraging existing resources, is where many of you who are listening can make a difference.

Thanks for that. By the way, this focus on equity and this idea that the whole country can engage to help address these issues feels very optimistic, and just like there's hope for the future of really addressing these problems in a fundamentally different way. So back to your career: you've been in both academics and in federal service, as you mentioned earlier. So what makes you passionate about nutrition security as an issue, and do you have advice for people that might be interested in federal service?

I love questions like this, largely because when I was starting off my career, it would've been so helpful to hear what motivates people. So for me, my north star is that I've always wanted to help historically underserved populations, communities of color. How do I help them achieve a better quality of life? I'm from inner-city Baltimore. I have a twin sister and an older brother. My parents still live in the same house that I was raised in, and they were public school teachers, they're now retired, and when we were young, our family received food stamps, now SNAP, we received WIC, we received school meals. So I've always been very motivated to give back to the communities that have given me so much. And I think that our current reality is that every child and every person in this country doesn't have an equal opportunity to live a healthy life. And that's not the way that it should be. So every day, I am very, very motivated to ask myself what can I do to help push us in that direction, and push us in a meaningful way. I think the challenge is always, you can push hard but you want to push hard on things that are moveable, where you can actually make a difference. Because everything is all about timing and you want to just be very strategic about where you’re going to make investments or put your energy in an area. Because this is where there's an opportunity. And I would say that if we can achieve nutrition security, it is going to change people's lives. Diet-related diseases are preventable. Hundreds of thousands of people a year don't have to die from them. And that's particularly true among communities of color. I think that many of you listening probably feel the same, but these are things that need to change. As I mentioned earlier, I do think we are at a moment where there's a window of opportunity to make a difference. And I would say, more practically, if you're interested in federal service, I would strongly encourage you to just throw your hat in the ring and apply. So you can either go through the career staff route, you could go through the political route. If you go through the career staff route, the Food Nutrition Service at USDA is going to be hiring about 450 people in the not-too-distant future, and that process has started, so I would look at usajobs.gov and see what looks interesting. And I would also consider some of the political jobs, thinking about different fellowships that would allow you to insert yourself. I never expected to love government so much. I never expected to come back again, this is my second tour of duty, but I have just absolutely loved it. And then personally, it's such a pleasure to be able to work on the programs that I was able to benefit from as a child. So for me, it motivates me. I find it very exciting. And I think that for those who are in research and that choose to spend some time in government, I truly think it will make you a better researcher, because what it will teach you is that not every important question is urgent, and what are the urgent questions on which you should really focus your energy.

Speaker Bio

Sara Bleich, PhD was named Director of Nutrition Security and Health Equity for the Food and Nutrition Service in January 2022. Since joining the Biden-Harris Administration in January 2021, Bleich has served as Senior Advisor for COVID-19 in the Office of the Secretary. Previously, she served as a Professor of Public Health Policy at the Harvard T.H. Chan School of Public Health. Her research centers on food insecurity, as well as racial injustice within the social safety net. She is the author of more than 150 peer-reviewed publications. From 2015-2016, she served as a White House Fellow in the Obama Administration, where she worked in USDA as a Senior Policy Advisor for Food, Nutrition and Consumer Services. Bleich holds a PhD in Health Policy from Harvard University and a bachelor’s degree in psychology from Columbia University.

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Today's podcast is part of our Regenerative Agriculture series. I'm speaking with Mark Muller, Executive Director of the Regenerative Agriculture Foundation (RAF). The RAF seeks to foster the economic policy and knowledge conditions that support land stewardship, climate solutions, racial equity, adjust economy, and thriving rural communities.

Interview Summary

So Mark, your paths and mine have intersected over the years in very pleasant ways, and I've admired the work you do. And when you went to work with the Regenerative Agriculture Foundation, I thought, "Boy, this is a perfect match." And I'm so happy that you and the Foundation are part of the same picture now. So I'd like to ask, first if you could tell our listeners about the Foundation, and what does the organization hope to accomplish? Because the Foundation itself says that regenerative Ag is not a new idea, that it's difficult to define, it's grounded in community, and it's a journey. So I'd love to hear you explain how all this comes together into a coherent idea.

So the Regenerative Agriculture Foundation, we are an intermediary funder, which means that we received grants from RV Family Foundations. Our founding entity was the 11th Hour Project of the Schmidt Family Foundation. And the idea is that we can utilize those funds more efficiently by having a solid knowledge-base of what's going on - on the ground in regenerative Agriculture. And so that we can re-grant those dollars to be more effectively used around the country. I was brought on about 18 months ago with the intention of trying to diversify our funding, to continue our great relationship with 11th Hour Project, and then to find other funders to step up in a bigger way. And I'm thrilled to have several that have joined. And what I really like for us to do is be the bridge between the nonprofit community, and the funder community. And trying to find different ways that we can all work together more effectively, to move advanced regenerative Agriculture.

Is the concept of regenerative agriculture nebulous and difficult to define? Does the field kind of agree now on what it is?

I noticed a couple of podcasts ago you had a great conversation with Samantha Mosier around this topic. In my mind, and the reason why on our website we talk about it being a journey, is because it is such a difficult to define concept. And there is a lot of pressure, from an industry and a marketing perspective. You really want to have a clear definition, like what we have for organic. In my mind, I am comfortable in the discomfort of not really having a clear definition. And what I feel like is it is a little presumptuous of us to think that we can define what a truly regenerative Agriculture is. It is a journey that we're going to continue learning about, and there are steps that we can take. And it appears that there are practices that we can document saying, "Yes, these appear to be pretty strong regenerative practices, but we have an awful lot to learn in terms of what a truly regenerative landscape is, and how agriculture fits into that. So I prefer to talk about it as a journey, and not like a specific destination that we know that we're going to.

We've recorded a number of podcasts thus far with some farmers and ranchers who are living this day-to-day, with some scientists who have been looking at it, some people who pay attention to the policy part of it. And I know your Foundation will incorporate people who do all those sort of things. So let me ask kind of a big picture question then. So how do you think the regenerative agriculture can become part of the solution for addressing the climate crisis?

Yes, great question. One of my motivations is to try to figure out how regenerative Agriculture can be recognized as a key part of the solutions that we need to have to address this climate crisis. And agriculture has come up quite a bit right now, the Glasgow COP meetings are going on. And one of the issues that I'm really trying to highlight is that regenerative Agriculture can do a very good job of sequestering carbon, and providing those benefits, in terms of reducing the amount of carbon dioxide that we have in our atmosphere. That is one of the many benefits that we can receive from a truly regenerative Agriculture. And what I feel is undercounted is the benefit that can be provided through providing a more resilient landscape. We know, regardless of how well we do over the next decade on mitigating greenhouse gas emissions, we are dealing with a climate crisis that will continue to get worse. We need to have a landscape that could be resilient to the flooding, and the droughts, and the other impacts that will be happening. A truly regenerative Agriculture can provide that. And so part of the reason I'm trying to look at regenerative Agriculture as, yes, incorporating practices on our existing crops, such as corn and soybeans here in the Midwest. And, however, to get to the truly resilient regenerative Agriculture, we need to have a far greater diversified landscape. We need to have more perennials on the landscape, there are many other things that need to happen. But by doing that, we can be part of the solution, both for the mitigation of greenhouse gases, and then also for the resiliency that we need to have in our landscape.

So you mentioned the international climate meetings that have occurred recently in Scotland. I'm wondering if you happen to know how much agriculture was discussed in those meetings, and whether regenerative agriculture had much visibility?

Yeah, it is discussed. I have not attended that meeting, but I can't say that I'm paying as much attention as I probably should to it. But agriculture is obviously a key component, both for the economic reasons that it's such an important driver for so many economies. And then also for the landscape impacts of it, that agriculture is the primary way that we use much of our landscape. But I would say overall, the conversation has tended to be much more around power production, and then transportation and buildings. And down the line, we eventually get to conversations about agriculture specifically. And because of the reasons I mentioned about the landscape benefits from a truly regenerative Agriculture, I do believe and I do hope that it will become a much broader part of the conversation as we move forward.

So if you ask the public, what kind of things are contributing to the climate change, my guess is that not a lot of people will mention agriculture. It's a growing number, for sure, there's increasing awareness, but my guess is it's not a big percentage of people think about that. And they do think about transportation, and coal-burning power plants, and the generation of energy and things like that. Do you see any shift in public opinion, and what does that look like to you?

Yes, I believe that there is more recognition of perhaps the larger food system, and the impacts of the food system that it has on climate change. If we look at the entire food system, including the processing, the production, the transportation of the grains and the foods, we are a very large chunk, some estimates around 30%, of the entire greenhouse gas emissions output. I do believe that's getting more widely recognized as the concerns about climate change increase. And for those of us in the regenerative Agriculture sector I think there's a lot of excitement about how much can be reduced by having, not only regenerative Agriculture on the field, but also more regenerative economic systems that surround agriculture.

I agree, I'm optimistic as you are on that front. So let's get back to the Foundation. So I know the Foundation is focused extensively on racial equity over the past few years. So why is that what are you doing?

Yeah, that is a great point. And I have to say, when I started this job about 18 months ago, I came in thinking, "Oh, it'll be really nice if we could put in a stronger racial equity lens into regenerative Agriculture." I live in south Minneapolis, and so obviously the events surrounding the murder of George Floyd really kind of shook many of us up, in recognizing, for me, it felt like, "I'm not sure if it's just a nice thing to put racial equity into regenerative Agriculture." It has to be completely infused in it. And we cannot get to a truly regenerative system without not only providing the healthy soils and clean water, but I do believe that the farm worker justice, and racial equity lens, and the really hard conversations to have about land ownership, they have to be part of the component too. Part of the reason I say that is because when we looked at what happened here in Minneapolis, and we looked at what happened to our public safety systems, these systems break down if we ignore these racial equity issues for too long I can't help but look at our agricultural landscape, and see that we have somewhere around 96% of the land is operated and owned by white farmers and land owners. It's an untenable situation. And so I do really strongly feel that we need to provide a way of addressing this issue, just as much as we have to address these soil and water issues that we have.

So Mark, tell me about restoring regenerative agriculture?

Yeah, this is a program that I'm thrilled about. And I have to say I was so impressed by the REF Board, when we started having conversations about how we can infuse a greater racial equity lens. They set aside what would end up being $500,000 for grants to organizations that are led by Black, indigenous, and people of color. We started the process of looking how we would do that. And I have a lot of gratitude for a friend of mine, Brett Ramey, who's with the Iowa tribe of Kansas and Nebraska, and Brett agreed to help us with this process. And Brett really kind of hammered on the importance, of not only the distribution of funds to these BIPOC organizations, the importance of having a participatory grant-making process, and having the decisions made by a committee of Black, indigenous, and people of color. And so we went through this process, it was far longer than I had thought, I really wanted to get this done in a couple months. And it took, well, a good eight, nine months for it all to happen. And it was a far better process, because we did really infuse the decision-making process to be of all people of color. The process was called restoring regenerative Agriculture, and that was brought up by the selection committee. In part because there was some real tensions about the term "agriculture" in many indigenous communities. The restoring regenerative Agriculture, it really emphasizes that regenerative Agriculture is in part, the great stories that we've heard over the past 30 years, of largely white farmers that have been really innovative, and learned how to incorporate systems that reduce chemical use and increase yields. And there's a much longer story to be told about how traditional ecological knowledge was a key component of that work. And there's a much broader story to be told about how these efforts have taken place in so many communities; indigenous communities, African American communities, Latino communities. There is a lot of knowledge being built and utilized throughout, that is much broader than what we normally think of as regenerative Agriculture. And our hope is that this granting process continues this process of us thinking more broadly about what is truly regenerative Agriculture.

I'm not sure I'm using the right word here, but it almost sounds celebratory, that there's a celebration that the practices used in the past, going way back to the very beginning of our country, were important. They were ecologically sound, they were good for the environment, good for human health, and now they're getting rediscovered. And that that should be celebrated, rather than saying, "Oh, this regenerative Agriculture is a new thing."

Yes, I think you said that well, Kelly. It is, hopefully is, a celebration of the thousands of years of innovations and creativity that have taken place on the landscape, and a way of honoring and promoting a continued use of innovation by all sorts of different people. I always get frustrated when we talk about innovation as being inside of the seed companies, and the large corporations that are involved in agriculture. They do have a role in innovation. There is far more innovation opportunities in the small-scale farmers that are using innovative practices, that are really listening to the land, really listening to how the plants are growing. And I also have to say that there's a lot of opportunity in these farming communities that have traditionally been outside of the commodity system here in the United States. As we know from some of the historical racism that we've dealt with, many African American farmers have been excluded from the corn, soybeans, wheat, cotton, rice; the primary commodities that we have in the United States. And thereby have had to be incredibly innovative, in terms of how they grow, and make a living off the land. Honoring that innovation, and celebrating what has happened, and incorporating that into our broader perspectives, provides an awful lot of opportunity.

So Mark, you spent a good bit of your career dealing with policy-related issues, and have been a real leader in that arena. So let's talk about the Farm Bill. So organizing around the Farm Bill is beginning in earnest for the anticipated 2023 reauthorization. So what do you think are some of the key issues regarding regenerative Ag?

Yes, and I do remember, I believe I first met you, Kelly, when we were having some conversations about US farm policy in the Farm Bill, and the impact on public health, as we are learning more and more. So it is such a broad system, it has so many impacts on so many parts of our society. So for this forthcoming Farm Bill, one of the issues that I had been focused on is the conservation title of the Farm Bill is the second largest title. The largest program in the conservation title is something called the Conservation Reserve Program, sometimes called the Set Aside Program. And we have taken up to 40 million acres of land out of production to provide conservation benefits. I have always had very mixed feelings about this, and I have to say, in full disclosure, I am part owner of a family farm in Dubuque, Iowa, area. And we are in the CRP programs, so I benefit from this program. However, the challenge is it doesn't change how people farm, it doesn't create a pathway for farming more innovatively. What it really does is rewards farmers for putting in conservation practices, taking aside, putting in grasses, things like that, to provide wildlife benefits, water quality benefits. But often what happens after the 10-year program, the farmers put it right back into the same corn and soybeans that it has been in, without changing those practices at all. So I'm particularly interested in finding the programs in the Farm Bill that don't just provide some temporary environmental benefits, but actually provide long-term changes to how we farm. And thereby sequester far more carbon in the system long-term, provide much more water quality benefits and things like that.

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So there's much talk these days about weight stigma, in fact, we recorded a number of podcasts ourselves on the topic, and I believe it's very important, but this is our first podcast on another form of stigma. One that is powerful, often overlooked, and highly important to address. Our guests today are Matthew Garza and Nick Cuttriss. Matthew is Managing Editor at The diaTribe Foundation. And the dia in diaTribe derives from diabetes. The foundation's mission is to, and I'm quoting here, "to improve the lives of people with diabetes, prediabetes, "and obesity, and to advocate for action." I've served on an advisory board for diaTribe, and very much admire their work. Nicolas Cuttriss is a pediatric endocrinologist, and is founder of the ECHO Diabetes Action Network, and also has served on an advisory committee for the diaTribe Foundation. Matthew and Nick have been integral to a novel and welcome program on diabetes stigma that launched recently, that can be seen at the website, dstigmatize.org.

Interview Summary

So Matthew, let's start with you. So can you explain what is diabetes stigma, and how does it relate to stereotypes around food and obesity?

Mathew – Absolutely. So in general, we know that stigma refers to the experiences of exclusion, rejection, prejudice, that blame and shame that people unfairly experience based on some characteristic or perceived difference. And in this case, that's diabetes. And this might look like negative attitudes towards people with diabetes. It might be hurtful or insensitive jokes made at their expense. And in some cases, it can even be outright discrimination. While there are many forms that diabetes stigma can take, such as being singled out for wearing a visible diabetes device, like a continuous glucose monitor for example, or an insulin pump, it could also be the stigma that's associated with having a chronic condition that does require, in some cases, daily medication. What we're seeing is that most of the research actually shows that the bulk of the stigma associated with diabetes stems from the misunderstanding that poor choices and unhealthy behaviors are the sole cause of this condition. And that people who have been diagnosed with diabetes somehow brought it on themselves. And this is attributed to both people with type 1 and type 2. And the stigma comes from lots of different sources. So it can be external from the media in shows or on the news. It can come from your friends and your family, from coworkers, healthcare professionals in a clinical setting. And sometimes it can even happen within the diabetes community. We often see that in defending themselves from the harmful stereotypes associated with diabetes, that people with type 1 can sometimes unintentionally redirect that stigma back onto people with type 2. And in regards to how this form of stigma specifically relates to food and obesity, it really goes back to what I was saying that unless you have diabetes or unless you know someone close to you that has diabetes, a lot of time, your only real knowledge of the condition is that it's connected to eating too much sugar, right? Or eating too much junk food, and that that somehow caused this. And a lot of times, it's associated with obesity or having excess weight. And then, on top of that, especially in America, we have this culture that there's this really problematic assumption that health is primarily a matter of individual responsibility. And this creates this stigmatizing narrative that blames people with diabetes for bad choices, and it sets up this us versus them. And it makes us treat people with diabetes differently because somehow they did this to themselves. But all of these beliefs oversimplify this really complex biological condition. And it overlooks all of those other, the systemic factors, such as environmental and socioeconomic context that people live in. Their access to healthy food options, to healthy grocery stores, for places to exercise. And so the more that we can kind of separate out diabetes from these misconceptions about food or sugar being its only cause, I think it's the better that we can support people and make sure that everyone is getting the care that they deserve.

Boy, have you painted a detailed picture of that and I appreciate it, and I can imagine that navigating this world of stigmatizing events must be especially difficult for children. But let me ask you, overall, what are the negative impacts of diabetes stigma?

Mathew - Absolutely, so there's so much research that I think still needs to be done to get a picture of the prevalence, the impacts, and the interventions that can address diabetes stigma. And thankfully, we've had some really great leaders in the field who have started to lay the groundwork to show all of this. And we see that diabetes stigma, and especially the language that we use to talk about diabetes has extremely negative effects. People with diabetes report feelings of fear, embarrassment, blame, anxiety, low self-esteem as a result of experiencing stigma. And this can translate into really harmful mental health conditions such as depression or higher levels of stress that drive unhealthy behaviors and can increase a person's risk for developing even greater health complications. You know, I know that Rebecca Puhl has touched on this a lot in her research on weight bias that we have this idea that potentially having this stigmatizing attitude will somehow motivate people. And in this case, motivate people with obesity or excess weight to improve their current habits. But actually, it has the opposite effect, and it causes things like harmful disordered eating or leading people to avoid physical activity altogether. And in the same vein, we see it happening with diabetes as well, that the stigma associated with the condition actually leads to worse self-care and worse diabetes management. So for example, we've talked to people, and seen in the research that they report injecting insulin only in public restrooms or at home, that they might choose to make an unhealthy food choice to avoid declining what is being offered to them. And even manipulating their glucose logs or lying about the management that they're doing just to avoid criticism from significant others or from healthcare professionals. And specifically, when the stigma is from healthcare professionals, it can actually inhibit people from seeking the necessary care that they need. One of the really concerning things that we've seen recently is that the research shows that people with diabetes fear being exposed for having diabetes or being labeled as disabled. And it discourages them from being open about their diagnosis in a way that is also influencing those who might be at risk, because it's acting as a barrier overall to awareness about the condition and to prevention. And it's increasing those feelings of isolation right after a diagnosis. And so the sheer breadth of all of these negative effects is why we believe that addressing diabetes stigma is such an essential missing element of effective diabetes care.

Well, in a very short time, you've mentioned a number of very troubling consequences, and you can see how these things would feed on each other and you'd have this cascade of negative effects that could really impact just about every part of a person's life. So Nick, let's turn to you. So research on both diabetes and weight stigma has shown that people often report feeling stigmatized in healthcare settings. So what experiences are common in these settings, and how can healthcare professionals advise people on the relevant issues like lifestyle change without making stigma worse?

Nick - So Matthew touched on it earlier in terms of stigma around when people are diagnosed with diabetes, they are blamed and shamed “that it's your fault.” But then, it's also perpetuated after diagnosis, and healthcare professionals putting blame and shame on patients for, quote, "being uncontrolled." And there's a marker, the A1C, which many healthcare professionals use. And we report EDIS rates in terms of quality improvement. And A1C less than 9% is how the health system separates out between people who are, quote, "controlled or uncontrolled." And the majority of people living with type 1 diabetes and type 2 diabetes have A1Cs that are greater than 7%, and they're not able to meet the targets. And so we, as healthcare professionals, need to become more explicit in working to overcome these implicit biases we label our patients as uncontrolled and perpetuating this stigma. A couple examples of what we can do in the healthcare professional setting is focusing on our language. And diaTribe has a great resource on their website, or you can look at the dstigmatize.org website to watch a couple video clips and really understand how language matters. So not labeling someone as diabetic, but they're a person living with diabetes before diabetic. They don't have good or bad blood sugar control. Their numbers are high, their numbers are low. Using descriptives, not saying, "Let's test someone's blood sugar," but checking someone's blood sugar. They're not on trial for their diabetes. And I think us as healthcare professionals need to realize when the majority of people living with diabetes aren't able to meet targets, it's not their fault. It's our fault. It's the delivery of healthcare that's failing, and it's not the patients who are failing. And we need to be more empathetic to them. And then, when it relates to obesity, similarly, when almost 50% of adults in the US are obese, and more than half are obese and overweight, we need to stop labeling them as obese and their fault when it's the majority of people who have this. I just had a colleague in the healthcare professional arena come to me last week, he said, "Nick, you know what? They put obesity on my diagnosis, I'm so upset." And this is someone who is trying to address their weight and get newer medications that help address the weight. But the healthcare professionals said, "No, you need to try more." So I think we need to change our approach of how we label our patients, and how we approach them with this blame and shame.

Well, and it's easy to see how people who feel stigmatized and have difficulty in the medical settings with the healthcare professionals they're interacting with would be more likely to avoid care, and that could exacerbate their condition. So let me ask this, do you see any signs that this issue is being addressed in the medical profession? Does it come up in med school training? Is it part of continuing education? Is it on the radar anywhere?

Nick - I wish it was more systematically. I think maybe at some institutions where there are champions for people living with diabetes, where a student might get a lecture, but unfortunately, I don't see it there. And I think that's what's so exciting about diaTribe dStigmatize initiative is really to get more broader reach and get the basics. So in medical school, we get into all these details in terms of cause of diabetes and medications. But I think if we could just back up on the humanistic level and know how to talk to people with chronic conditions, we'll train the next generation of leaders much more humanistically and have better outcomes if we can focus on the basics of how to interact with people living with chronic conditions, and getting rid of this blame.

It sure would be nice to see some of those things happen. So I'd like to ask a question of both of you. So it's clear that addressing diabetes stigma is a complex challenge. So what does diaTribe think needs to happen to begin combating this problem? And, Matthew, let's start with you.

Mathew - Thank you both so much for mentioning dStigmatize; that's what we're really excited about. We just launched this online resource that we hope is going to be the first step, because when we started to look at what is the landscape of resources out there for someone who wants to make sure that they are able to understand what the problem is and how to address it, there really was no centralized location. So what we wanted to do is bring resources together to make it a one-stop shop that anyone who wanted to learn about how to identify this form of stigma, why it might be harmful, or hear the real life stories from people with diabetes, about their condition, and about how stigma has affected them, that they would be able to do that in this one place. And we launched this resource primarily because we think that there's two very essential first steps that we need to take. And the first is that in order to address this public issue, we have to shift away from that really pervasive blame and shame mindset, right? So we want to reframe the way that people are thinking about diabetes, so that it's viewed as this complex, but manageable condition that nobody asks for. And not that it's somehow a failure of personal responsibility. So part of that has been that we've been really grateful that so many members of the diabetes community have been so open to sharing their stories because it's really helping us paint a picture of what diabetes actually looks like, and the ways that stigma affects people on a day-to-day basis. And then, the second part that our website really addresses is that language. And so leaders like Jane Dickinson, Susan Guzman, and Jane Speight have all been really key in making sure that language is seen as one of those tenets when it comes to addressing diabetes stigma, that the words that we're using to talk about diabetes currently lack that kind of awareness, and consideration, and even empathy at times. But because language matters and it has real impacts on the way that people with diabetes view themselves, how healthcare providers view people with diabetes, and how the general public views them, we wanted to create very specific language guidance directed at people who might write, or talk, or communicate about diabetes in some way, that encourages them to use words and phrases that are neutral, that are nonjudgmental. And at its very core, that are based on the facts, and actions, and physiology or biology that can actually help people, right? We want to get away from using all those terms that Nick was talking about like bad glucose levels or controlling their diabetes, because those just aren't actually factual when it comes down to it. Looking forward, dStigmatize is just the first step. We think that there's so many other initiatives aimed at getting more research funding to really explore this issue and its impacts. We think that there's the potential for media advocacy campaigns, similar to what GLAD did at the beginning of the LGBTQ Civil Rights Movements in addressing the negative representation of people who are LGBTQ in the media that a similar thing could be done because there's so many negative portrayals of diabetes and inaccurate portrayals in the media. And then, finally, the campaigns that influence the general public's attitudes towards diabetes. One of the key next steps might be influencing healthcare providers' interactions because like both of you said, we know that the research shows that this is a key area where people are experiencing stigma. And this is also a group that I think truly wants to make sure that their patients are feeling empathy, and that they're able to help them in any way that we can. And so I know that this actually is a very specific intervention that Nick has been doing a lot of work around and can speak to the importance of.

It's a very comprehensive effort you're discussing. So Nick, what would you like to add to that?

Nick – Yes, so, I'm a hyperspecialist in pediatric endocrinology, and there's just not enough adult endocrinologists or pediatric endocrinologists to care for people living with diabetes. And we just need to recognize that frontline healthcare professionals have more of an opportunity, more touch points to make a difference than a specialist like me. And we really must do everything to support frontline healthcare professionals in overcoming diabetes stigma. So as founding director of the ECHO Diabetes Action Network formed to combat system failures in our society in how we educate clinician and approaches to medical management for people with diabetes. And we're seeking to democratize diabetes specialty knowledge, so they can reach frontline healthcare professionals and power underserved populations living with diabetes. So an example of the efforts to target frontline healthcare professionals and improve care, we've launched a monthly educational series focusing on diabetes and disparities in the primary care setting. And then, the initial focus was attention to CKD and diabetes, and we're going to be moving focus areas moving forward. And we'll do a block on cardiometabolic issues, and obesity-related diabetes disparities. And then, also, we'll collaborate with diaTribe on launching one for addressing diabetes stigma and behavioral health, just to name a few. So for more information, feel free to visit echodiabetes.org, and join us for being a champion for people living with diabetes in the primary care setting.

Bios

Matthew Garza is the Managing Editor of DiaTribe. Matthew Garza joined the diaTribe Foundation in 2020 after graduating with honors from Johns Hopkins University’s Whiting School of Engineering where he majored in Biomedical Engineering and minored in the Study of Women, Gender, and Sexuality. As an undergraduate Matthew was heavily involved in research, working in the Hopkins Translational Tissue Engineering Center. His research focused primarily on stem cells, three-dimensional matrix scaffolds, and surgical outcomes for transgender patients. He has a passion for understanding more about the socioeconomic determinants of health and how they affect health outcomes, primarily for the LGBTQ population. Matthew swam for the Hopkins varsity swim team and was the president of the Student Athlete Advisory Committee and Hopkins’s Athlete Ally chapter. He enjoys swimming, running, hiking, and backpacking in his free time and he will never turn down the opportunity to eat good food or listen to good music. Dr. Nicolas Cuttriss is a social entrepreneur and a practicing pediatric endocrinologist and public health professional with a unique dedication to health disparities and improving the quality of life of people living with diabetes. He currently serves as Founding Director and CEO of the ECHO Diabetes Action Network after serving as Director of Project ECHO Diabetes and Project ECHO Diabetes in the Time of COVID-19 at Stanford University. Prior to joining Stanford, Dr. Cuttriss served as the first pediatric endocrinologist for the University of New Mexico Project ECHO Institute ENDO teleECHO clinic to democratize diabetes specialty knowledge by empowering primary care providers to care for patients with complex diabetes who lack access to routine diabetes specialty care. Clinically, Dr. Cuttriss founded and serves as Medical Director for ENDO Diabetes & Wellness, a medical practice specializing in diabetes and telehealth where he also supports and consults with medical groups and hospital systems around the country to address barriers to routine diabetes specialty care. Dr. Cuttriss also serves as co-Founder & Chairman of the Board of AYUDA (American Youth Understanding Diabetes Abroad), a 501c3 global health volunteer organization that empowers youth to serve as agents of change in diabetes communities aboard.

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Today, we're going to explore one way that young people in North Carolina are working to improve their local food system. The Food Youth Initiative is a program based in the Center for Environmental Farming Systems, which is housed at North Carolina State University. Now we'll be talking with the Program Coordinator, Bevelyn Ukah, and the Program Partner, Ree Ree Wei, of Transplanting Traditions Community Farm.

Interview Summary

Great, well it's good to have you, and as I was explaining before we actually went live on this, we've done, I don't know, 150 podcasts or so, but this is the first one that specifically deals with youth in the food system and the role they can play, so I'm really happy to hear from you about what seems to me to be a very innovative program. So, Bevelyn, let's start with you. Can you tell us what the Food Youth Initiative is and talk about your work there?

Bevelyn - Yes, the Food Youth Initiative is a program of the Center for Environmental Farming Systems. It sometimes challenges me to call it a program, because it's more so a network of youth groups across the state that are doing food justice work in their areas. So as the Network Coordinator, my job is being in relationship with them, listening to the work that they're already doing in their own communities, and finding as many ways as possible to make sure that they're connected to each other's work. All the youth groups that are a part of the network, about eight now, are all doing various things that are connected to the food system. What makes it that much more powerful is when they come together because they're able to exemplify different entry points on what food, and food systems, and food justice looks like.

You know, community organizations are very often doing quite creative work, but work in isolation and don't get the chance to connect up with other community organizations to share ideas, and strategies, and things. I'm imagining this is a very powerful experience. Have you found that to be true?

Bevelyn - Yes, I have found that to be true. And I would love for Ree Ree to answer this question as well. It's always awkward when bringing people together. And youth tend to be super honest about how they're feeling in their bodies. So when bringing these youth groups together from these different walks of life, the first day or the first few experiences are a little bit awkward. And it's one of the most powerful witnessings that I see over and over again, how a bit of time and a bit of tools and resources can get people talking and moving. How it completely shifts the trajectory of how these youth can learn from one another. I think that the first step in bringing youth together is to make sure that there is a validation that the work that they're doing is innovative. And the work that they're doing is important. That it actually pushes against the grain of how the rest of food systems work looks. And once we start to name that and identify that, it's super powerful in terms of the transformation that takes place when youth come together.

Thanks for that explanation. Ree Ree, I'd love to hear your thoughts on that. It sounds like something pretty magical happens when the youth from different groups get to come together and share things. Has that been your experience, too?

Ree Ree - Yes, that has in my experience. Being part of FYI, and I started out as a youth with Transplant Traditions Community Farm back in 2013, it was very new. And very awkward, and very weird to be able to be in a space of I want to do something as a youth, but I feel very uncomfortable. But over time, having that physical connection, being able to see each other in person, and network, and share out changes perspectives, and youth confidence and youth visions for their future. I can say that I am a testimony to the work of FYI and TTCF Youth Program. I have learned skills that are beyond what I thought that I needed. Over time, I built a lot of skills and learned why my voice as a young person matters. Why collective working together matters, and that is unique about this. One youth group inspires another youth group, and different food systems and food justice work, it's very interconnected.

It's nice to hear from both of you on your perspectives on that. Ree Ree, let me ask you a follow-up question. I know there's a lot of interest in this concept of youth justice, and how does youth justice connect to food and environmental justice?

Ree Ree - Yes, there are these expectations and societal norms that youth are supposed to do this, and this, and this, and that. And sometimes adults and even society put youth in a box. But when we were talking about youth justice, we are able to create a space for them. And that's what FYI is really good at it, and being able to be say, "Okay, we are going to work on food justice or environmental justice," and, "Here, this is your space." And food work gets to be creative. They get to come up with things they want to do, and giving them the autonomy for them to be able to say, "I want this, because I see this, and this is what I can do," even though this youth might feel like they're unable to do it, but over time, that space, giving youth that autonomy, oftentimes there's not room for youth to be able to do that. And especially the work that FYI does and Transplant Tradition do is that we centers around where youth are able to have the decision making of how they want to strategize about this project. What goes on this picture, that type of thing. So when youth are given the space and the voice, they're able to see the connection between food and environmental justice and how work that they're doing is not just on a surface level; it goes deeper and they're connected. Youth are able to address these different generational issues that their ancestor experienced.

You’re giving voice to something really important, and I could see how this would be such a powerful experience for the youth that you work with. And let's talk a little bit more about the particulars of the program. So Bevelyn, I know that one part of the project overall, the initiative is the Mural Project. Would you describe what that's about?

Bevelyn - Bringing youth together is the important part, but the strategic planning that we put into the process of how we bring youth together is really important. And our theory of change acknowledges that for systems change to be possible, we need to work on multiple levels, including a policy level. We need to be able to educate ourselves and our communities through storytelling and other forms of expression. We need to be able to act and create models or create spaces that offer this reimagination of how our food system and our society should look like. And as we've been talking about, it's also important for us to build relationships and to be able to maintain those relationships, because ultimately what we're trying to create or continue is an ecosystem that brings a sense of belonging, for not only the youth participants, but also for the communities in which they live.

And so the Mural Project is heavily connected to the education part, the storytelling part of our theory of change. Every year, when we bring youth together, there are multiple skills that are being developed. We've focused on storytelling from different mediums and different forms. In the past, we've done photography and made sure that youth had access to really nice cameras, and that they could go around their communities and take photos. And they had a few exhibits. We also created a traveling exhibit for the youth to be able to own this exhibit and be able to use whenever they're doing presentations. We've worked on public speaking in the form of learning how to write monologues and sharing them. We did that at the Durham Art Council some years back. We've done a whole compilation of poetry and worked with a poet who worked with us for a whole week. And so right now we're creating a mural that is centered around community stories, around food and environmental justice. We have youth coming from Transplanting Traditions, and Chapel Hill, Pupusas for Education, which is based in Durham, and then A Better Chance/Better Community, youth and adult allies are coming together to form this experience.

It's an eight-month project where they have been learning about one another, relationship building, but also building their knowledge base on the root causes of food injustice and lack of accessibility to healthy, culturally relevant food, and also learning about root causes of climate change in ways that we can galvanize ourselves to shift this narrative, to be more connected to our natural environment and to be more ecologically conscious. That was a first phase. And the second phase we're in right now which is where youth are gathering together in Durham over the next three months to work on a storytelling project, get to know one another, but to work on a storytelling project where they will be going out into the community and creatively offering opportunities for people to talk about their experiences around climate, environmental justice, and food. They will bring those back to our hive, I guess I'll call it, in forming, designing a mural that expresses those stories and that mural will be on a food truck. Pupusas for Education has offered a food truck for us to paint on over the next few months, and it will be unveiled on June 11th at Transplant Traditions Community Farm. And I will say that that unveiling will be a party and everyone is invited.

That sounds so lovely. I can imagine how meaningful an experience this would be to the youth. The food truck idea is a really good one. Yeah, I can't wait to see this. It just sounds so neat.

Bevelyn - Yeah, we're really excited about being able to have a mobile mural that people can see all over the place. It's more accessible this way.

It represents a collective effort of a lot of different people, so it just sounds so nice. So I'd like to ask both of you kind of a follow-up question, and, Ree Ree, let's start with you. What kind of impact do you think the youth are having in their communities?

Ree Ree - Sometimes they feel like they don't, but it's a huge impact. They are the voices and they're the ones that are speaking up and publicly saying it out loud to the community that these issues are important, and they're being impacted at a very young age. And they're even impacting folks directly or indirectly one way or another. Like our youth group, they are doing tutoring, and they don't realize that is a huge impact to the direct causes of literacy issues. And the other bigger impact that they're having is they're addressing things that not many people are aware of, like food justice, environmental justice, climate just- Like why are we changing the narrative from seeing things as an issue to, "Okay, it's an environmental problem." Now let's flip the narrative to, "Okay, we're fighting for environmental justice or food justice." They are using their own voices and their bodies, and being able to say, "We are doing this work and we need you all to listen to us because these issues are going to continue."

You know what it reminds me of is the early days of seat belts, where there were a lot of adults that were reluctant to wear seat belts, but education programs started happening in schools. Youth then came home with the message, and adults were listening to the pleas of the youth to wear seat belts, and it really made a difference. And I could see that same thing kind of happening here. Bevelyn, does that make sense to you, and what kind of impact are you seeing youth having in their communities?

Bevelyn - I think that's a really great example, the marginalization of youth voices. It's very intentional. Historically, anytime there's been large-scale transformations, those societal transformations have been led by youth. For social transformation, younger generations have the juice. I think it's really, really important for youth to be able to share their own stories and talk about what they're doing. And at the same time, part of my job is to share as much as possible the actual activities, the actual things that youth are doing to shift our food system. So earlier, when I was talking about the theory of change, when I was talking about policy, education, replicable models and networks, I was more so speaking from the perspective of how we're building out our programs within the Food Youth Initiative, but ultimately, each of these youth groups are already working in their communities on all of those levels to make changes. And one example is Poder Juvenile Campesino. They've been doing a lot of work on farm labor rights, specifically building awareness around the challenges, not only that farm workers experience, but that farm worker youth experience, as our policy in the United States allows for children to be in our fields with very little protection. A lot of these youth are farm laborers themselves, and so they're not just advocates. These experiences directly impacts them and their families. And then Ree Ree's already talked about education and storytelling. Transplanting Traditions youth have been heavy advocates for the farm and for the farmers, as a lot of the farmers may have challenges around speaking English or even accessing certain systemic resources. And so, to be able to openly talk about the importance of recultivating home in the United States in Chapel Hill, that story has heavily been told by the youth of the farm. I can go on and on about the replicable models and networks, but I just wanted to be super clear that we're not just throwing these words around, climate justice, food justice, environmental justice, that the youth that are a part of this network are doing groundbreaking work in their communities. So I heavily encourage folks to continue to follow us so that you can continue to educate yourselves about the high impacts work that is being done.

It sounds like with the youth having voice and carrying messages forth is important to both the people who are speaking the message and the people who are hearing it, so you can see really important impact occurring with this, couldn't you?

Ree Ree - Yes, and I see in some ways, like something I have learned being part of the youth program that I have learned over time, is that the impact is both on a personal level and also at the big P, on a policy level, on a public level, so it impacts folks directly and indirectly in a way where it leads to cool things, like being able to address for policy changes. And they're able to learn how to advocate for themselves personally. So that's sometimes the impact that sometimes people don't often realize, youth also are learning how to advocate for themselves, which is like big things that, and especially a lot of youth that we have worked with and learning about you are able to advocate for yourself, you have that autonomy. Especially for BIPOC youth and being able to empower them, just tell them, "You can do both of these on a personal level and on a policy level."

So one final question for you both, what sort of support do you need to continue this kind of work? Bevelyn, how about you first?

Bevelyn - You mentioned earlier that there hasn't been a direct interview about youth in the food system. I believe that there's little awareness about the impacts that youth make on our food system. And therefore there are minimal resources for continued programming and continued network development around youth, and so I'm looking to do more intentional work around fundraising, as opposed to grant writing, because we're able to have a lot more freedom to support youth needs and to be able to identify blind spots that I think that grant makers are having in the process of creating financial opportunities for youth to be able to soar in this work.

And Ree Ree, what about you? What do you think? What kind of support is needed to continue this kind of work?

Ree Ree - Yeah, I think the type of support that's needed is from all kind of level, being able to, one, like listen to youth. Oftentimes adults have biases about youth. Listen to them, listen to their story, make time, being very intentional about learning about what youth are doing and giving time for that instead of making judgment. And the other thing is to follow the different youth groups of all of FYI network. It'll be really cool to be able to see what they're up to and why their work are, and it's very unique in a way that they're addressing these social issues on a local level. And the other thing is that all of our youth group, they're doing these intentional work that sometimes staffs are limited. We rely on volunteers and contractor peoples to be able to really do these meaningful work, to really continue to support and uplift youth, so on a fundraising level, to support that and reach out and donate.

Well, thank you both for being with us. This work is really exciting, innovative, and I'm glad that we can play a role in letting our listeners know about it. So, thanks so much for being with us.

Bevelyn - So, Ree Ree's really humble, but Ree Ree was 13 when she started with Transplanting Traditions, and about 14 or 15 when she was one of the co-founders with other youth groups of the Food Youth Initiative network, and essentially she hired me. I applied for the job and she hired me at maybe 15 years old. She went through the program, went to Guilford College, studied Human Relations, came out of college, and is now the ED at Transplanting Traditions. And so I just wanted to also name that career trajectory, that to me is so powerful of how when youth are supported and when they have intentional relationships, how many possibilities open up to young adult's leadership within these powerful food justice spaces.

For more information about the Food Youth Initiative: https://cefs.ncsu.edu/youth/food-youth-initiative/

Bios:

Bevelyn Afor Ukah works as a consultant to train youth and adults in building skills that encourage equity, organizational efficiency, cultural connection, and collaboration. She coordinates the Food Youth Initiative Program (FYI), a program of the Center for Environmental Farming Systems (CEFS), which engages youth that lead food justice work across North Carolina. She also co-coordinates the Racial Equity in Food Systems initiative at CEFS, which develops a shared understanding of language, history and race. She serves on the Transplanting Traditions Community Farm Board, the National Rooted in Community Board and the NC Climate Justice Collective.

Ree Ree Wei is the Executive Director of Transplanting Traditions Community Farm. She moved with her family from a refugee camp in Thailand to South Carolina in 2006 and later resettled in Chapel Hill. Ree Ree first joined the TTCF community in 2013 as a youth intern with the TTCF youth program. After graduating from Chapel Hill High School she became the Youth Program Coordinator, coordinating food justice activities for refugee youth participants. Ree Ree continued to work with TTCF while in college as a cultural consultant and interpreter, and she graduated from Guilford College in Greensboro, NC as Bonner Scholar with a degree in Community and Justice Studies and Forced Migration and Resettlement Studies. In the winter of 2021, Ree Ree joined the TTCF team as the Business Development Coordinator, supporting farmers to find innovative strategies to reach long term business and income goals.

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Much attention has been paid recently in both scientific circles and in the media to a drug for weight loss newly approved by the FDA. A flurry of articles in the media hailed this drug as a breakthrough. This was prompted by the publication of a landmark article in the New England Journal of Medicine addressing the impact of this medication in a large clinical trial. Today's guest is one of the authors of that paper. Another flurry of media attention occurred as the drug became available, with news that supply couldn't keep up with demand. Dr. Thomas Wadden is the Albert J. Stunkard Professor and former Director of the Center for Weight and Eating Disorders at the University of Pennsylvania School of Medicine. He is one of the most highly regarded experts on treatments for obesity, having done some of the most important research on very low-calorie diets, a variety of medications, bariatric surgery, intervention in primary care settings, and more.

Interview Summary

You and I grew up together in this profession, having spent some early years together working on treatments for obesity. You're one of the people in the field I admire most, both for the quality of your work and the breadth of your knowledge across various treatments for obesity. So let me begin by asking something regarding our former mentor, Albert Stunkard. So one of the most famous quotes of all time in our field came from Mickey Stunkard in 1959, no less, way before the field was really paying attention to obesity. He wrote that "most obese persons will not stay in treatment. Most will not lose weight. And of those who do lose weight most will regain it." There was a stark honesty to this, and it motivated Stunkard to help overweight people. So if we fast forward to today, do you think this is essentially still true?

Well, first, let me say that Dr. Stunkard's statement sounds somewhat critical. Today, we might say stigmatizing people with obesity. You know, they won't stay in treatment, they won't lose weight, they'll regain it. And Stunkard, as you know perhaps better than anybody, was an extremely compassionate, empathic person. To clarify that, he knew that the limitations to success were with the treatments available and not with the people who had obesity. So to answer your question, the first two parts of Stunkard's statement that people won't stay in treatment and people won't lose weight were probably no longer true by the early to mid-1980s. And pioneers like yourself showed that if you gave people a structured program of diet and physical activity, and most importantly, if you gave them behavioral strategies to improve their treatment adherence, then 80% of people would stay in treatment for 16 to 26 weeks. They'd lose an average of 6% to 10% of their weight. So what remained, however, and remains today, was that people have trouble maintaining the weight loss. And that's something that still challenges us.

Well, it's nice to start on that optimistic note with the hope that people will go into treatment. Let's talk about the drug. So what is the new drug, and how does it work?

Well, the new drug is called semaglutide. It comes in a dose of 2.4 milligrams and is injected subcutaneously once per week. The drug at the retail level is known as Wegovy. Some people will know about semaglutide for the management of type 2 diabetes. It is used at a dose of 1.0 milligrams and it's called Ozempic. So Ozempic was approved first many years ago. Now, semaglutide is a glucagon-like peptide 1 receptor agonist, and that's a mouthful. But glucagon-like peptide 1, GLP-1 for short, is a naturally occurring hormone that is released by the body when food, particularly carbohydrates, hits the stomach. GPL-1 is released by cells in the small intestine, and it does several important things. First, it signals the pancreas to release insulin to pick up the glucose that's coming in. And then it also slows gastric emptying, which as you know, leads to greater feelings of fullness. And then finally, these GLP-1 receptor agonists are hitting a part of the hypothalamus that stimulates fullness or what's known as satiation receptors, so people feel full earlier when they're eating and don't eat as much food. I think you may remember, Kelly, that naturally occurring GLP-1 has a very short life when it's released. It's active for about two to three minutes, so you have a temporary feeling of fullness. But these new drugs, semaglutide 2.4 milligrams, have a seven-day half-life. So people are feeling greater fullness and less hunger sort of around the clock, and as a result, they are just eating less. And to use your terms, they are less responsive to all the cues in the toxic food environment that are saying come on, it's time to eat more. It's time to have a large serving of ice cream or sugar-sweetened beverages, whatever it is. People don't seem to be as vulnerable to the toxic food environment.

I really appreciate that you've taken a pretty complex subject, namely the physiology of this drug, and made it come alive in terms that most of us can understand. So thanks for that. So before you talk about the weight losses that the drug produces, you mentioned that some treatments are producing weight loss of 5-6% of body weight. Can you place that in context for us? I mean, is that enough to produce medical benefits? Are the people losing weight happy with that degree of weight loss?

Sure, most individuals who go through a behavioral treatment program will lose about 7% to 8% of their weight on average. And those weight losses are associated with significant improvements in health. The landmark study in this area is the Diabetes Prevention Program published in 2002. People with pre-diabetes lost seven kilograms, about 7% of their weight, and they exercised 150 minutes per week. And those individuals with pre-diabetes reduced their risk of developing diabetes over 2.8 years by 58% compared to the control group. So that's a really important finding that modest weight loss, and modest physical activity prevents the development of type 2 diabetes. And weight loss is also going to improve blood pressure, and it can improve sleep apnea, so modest weight losses have benefits. But two things. First, larger weight losses have greater improvements in health. That's important to know. It's in a linear relationship there. The more you lose usually, the better the health improvements. And two, most people seeking to lose weight want to lose about 20% of their body weight. So if you're a 200-pound female, a 250-pound male, you want to lose 40 to 50 pounds, respectively. And so, larger weight losses are highly desired.

So how do you deal with that psychologically when somebody's goal is far beyond what treatment typically produces? Can people come around to the fact that the smaller weight losses are really good for me, and I've accomplished a lot even though I may not get to my goal?

Well, I always tell people, I know you want to lose 40 pounds. So let's start with the first 15 to 20. Let's focus on that because you have to go through 15 to 20 to get to 40, and let's see how you feel after you've lost the initial weight. And I can't promise you you're going to get to 40 pounds for potential genetic or biological reasons, but let's try to achieve what we can achieve and focus on larger weight loss. And many people are more satisfied than they'd imagined with a more modest or moderate weight loss, even though the dream is to lose more than that.

Okay, so back to the drug then. This big clinical trial you were involved with, published in the New England Journal of Medicine, can you quickly explain the trial and tell us what you found?

There were four big clinical trials of this medication that were presented to FDA for approval, but the seminal paper published in New England Journal treated about 1,961 participants. And everybody got lifestyle modification every month with a dietician for 15 to 20-minute visits. And then on top of that, half the participants got assigned semaglutide 2.4 milligrams, and the other half got a placebo. And they were followed for 16 months. And the reason it's a 16-month trial is that you have to introduce the drug slowly over four months to control gastrointestinal side effects. So as you start to take this drug, you're likely to experience a little bit of nausea. About 45% to 50% of people do so. So some patients, about 20%, will experience vomiting. Constipation and diarrhea also occur in response to the drug. So if you slowly introduce the drug, you can prevent some of those symptoms. And so it's not till four months that you're on the full dose of the drug, and that's why they run the trial for 16 months, so people have been on the drug for one year. And so what happens at the end of these 16 months is that the participants who get lifestyle light with placebo lose 2 1/2 percent of their weight. That's about what we'd expect. Those who get semaglutide, lose 15% of their body weight. So a remarkably robust weight loss. And when you break it down a little bit further, what happens is that 69% of the people on semaglutide are losing 10% or more of their weight. And then 50% are losing 15% or more of their weight. So that's a substantial loss. And this is something that I'd never seen in this kind of a trial. One-third have lost 20% of their body weight. And those weight losses are cumulative. So the 69% who lost 10% of their weight include the people who lost the 15% and 20% of their weight. But as you well know, those are substantial losses where the average loss is 15%, and that's achieved by 50% of the people. That is double what we get with our best behavioral treatment, and it's about double what you get with most weight loss drugs.

Yeah, that's pretty darn impressive to double the impact. I mean, most people will be excited with a a little bit of improvement. That's a lot of improvement. So certainly, we have to take note based on that. When you talked about the side effects, you were talking about the fairly immediate side effects of beginning to take the drug. And then it takes four months for people to get up to the full dose. Are there side effects that exist beyond those four months?

Well, most people will be through those gastrointestinal side effects within the four months. But, if you go out to 16 months, there will be a small percentage of people who have nausea, diarrhea, et cetera, throughout the trial. And you try to help those people with their side effects by doing things like chewing their food more thoroughly, eating smaller meals but more of them, and drinking more water. All of that can help them control their nausea if it's persistent. I think that the most serious side effect, Kelly, is that about 4% of people will develop gallstones or need to have a gallbladder removed. That is just a consequence of the large weight loss. Anytime you have large weight loss, whether it's from a very low calorie diet, from bariatric surgery, or these medications, you will find that a small percentage of people have gallstones and will need attention.

And what about the fact that people need to get this by injection? Are people able to do that okay, or is that a deterrent for people using it on a broad scale?

It's an excellent question. I can tell you that I have injected myself on several occasions just to see what it's like. You find a fat fold in the stomach and inject yourself. The needle is so small that you can't feel it. So once people try it, there's really very little hesitancy. I think certainly some people would think, "I don't want to be injecting myself with this thing," They may not even come in, but once you try it, there's no problem. And right now, there is an oral version of Ozempic. It's called Rybelsus. So it's the same medication for type 2 diabetes but in oral form rather than sub-q injection. And a trial is currently underway to see if we can make an oral version of semaglutide injectable drug, and I think that's going to prove acceptable. So that barrier should be eliminated over time.

So what happens if people stop taking the drug?

I think you know the answer. People who stop taking the medication are vulnerable to regaining their weight. And some people would say, well, that illustrates the drugs a failure because you take it and you lose weight, and you regain it, and you're no better off. But I am on a medication for high blood pressure and on a medication for high cholesterol. I can assure you that if I stop taking those medications, my cholesterol and blood pressure would go up. So this speaks to a very important issue which we have to look at obesity is probably a majority of persons as being a chronic health condition for which they're going to need long-term ongoing care and you would need to take these medications indefinitely just like I take my hypertensive or cholesterol medication indefinitely.

You know, the description of the cholesterol and blood pressure drugs is a great example. And I think this really speaks to the issue of obesity stigma, doesn't it? Because if you have these blood pressure, cholesterol drugs, and lots of others, if people are taking them and they're effective and then they stop taking them and then the medical condition comes back, it's even more evidence that a drug works. But in the case of some of these obesity drugs, people say, well, if you stop taking it and you regain the weight, it's proof the drug doesn't work. So how do you think that might be bound up with kind of general social attitudes about people with obesity?

It's such an important point. So persons with obesity are still stigmatized, as you, Rebecca Puhl, and many people have shown. And there's just so much unrelenting stigmatization of people saying, you know you should be able to control your weight by exercising more, cutting down on what you eat, push back from the table. You see, it's your problem, your shortcomings in self-control. So people with obesity are stigmatized. Similarly, obesity medications are stigmatized. Anytime I give a talk to physicians, I'll ask how many would consider prescribing an obesity medication? And only about 10% of hands go up at most. Then I'll ask, would you prescribe a drug for hypertension or cholesterol? Everybody's hand goes up, and I say, what's the difference here? And people invariably say, well, people should be able to control their eating and exercise with their willpower. And I say, well, it's an illness, it's a disease partly caused by this toxic food environment, so why are you treating that differently? You allow diabetes medications. That's caused by eating behavior to some extent. So I think you're correct. There's this profound stigmatization of people with obesity and of the medications. And I think that view is beginning to change. One of the most important things about this new medication semaglutide, and there'll be a new drug from Eli Lilly called tirzepatide, is that doctors, endocrinologists, and primary care physicians, are comfortable with these glucagon-like receptors because these are diabetes drugs that they prescribe. They're willing to prescribe that long-term. Now they may be willing to recognize obesity disease, which requires long-term treatment. They feel comfortable with the drug and that it's not going to have adverse side effects. So I hope this is a turning point in stigmatizing persons with obesity and obesity drugs.

Tom, how much does the drug cost, and is it covered by insurance? And what about people on Medicare and Medicaid?

This medication, if you go to your pharmacy and ask for it, I think is currently priced at about $1,300 per month. And so that is a very high barrier to the vast majority of people who would want to take this drug. It's possible, and I hope that the price will come down, but I haven't seen any indication of that. Some insurers and some employers cover the medication so that some people will benefit from it. But I think, as you know, Medicare and Medicaid do not cover any obesity medications at this time. There's a very important piece of legislation in the Senate and in the House called the Treat and Reduce Obesity Act, and part of that bill is to get Medicare to cover obesity medication. So even though they've got a terrific new medication, most people who would benefit from it, and particularly people of color who have higher rates of obesity, minority members, will have a very difficult time getting this drug to use it appropriately.

You mentioned that Eli Lilly may be coming out soon with a competitor drug. Do you think the competition will reduce the cost?

I would hope it would reduce the cost, but I can't say that I have any advanced knowledge of that or any assurance that that will happen. Eli Lilly has put a lot of money into producing their medication. Their medication tirzepatide looks like it will be as effective as semaglutide if not more effective by two or three percentage points. So I think probably the best bet for having a cost reduction is that another medication very similar in its mechanisms of action to semaglutide, it's called liraglutide 3.0 for obesity. It is a GLP-1 receptor agonist, it's just not as effective, it produces an 8% weight loss, it's going off patent, I believe in 2023 or '24 and when it goes off patent, I think that there will be generics to at least make that drug available at a very reasonable cost. I believe that that drug currently is at about $600 to $700 per month, but it should come down dramatically when it goes off-patent, and there are generics.

And for people who have health insurance, are insurers covering the drug?

A smattering of people are covering the drug. I don't think there's universal coverage. If you're under Blue Cross Blue Shield or whatever your company may be, remarkably, the University of Pennsylvania is covering some of these medications, which I'm delighted to see. But you would have to check your insurance plan carefully. For people who do have coverage, there are coupons to get your costs down to as little as $25 a week. So it's really worth looking into. And I know that Novo Nordisk, which manufactures semaglutide, is trying to work with insurers to get more to pick up the coverage of the drug. Let's hope that they reach some insight that'd be important to reduce the cost of this drug to make it more available to people who really need it.

Let me ask a big picture question to end our conversation. So where does this drug fit in the broad scheme of various options for treatments for obesity and how would someone or their physician know if this medication would be a good option to pursue?

Sure, if we follow just the FDA guidance and the guidance of expert panels, this drug is appropriate for people who have a body mass index of 30. So you can go, and your doctor will measure your weight, calculate your height, and tell you what your BMI is. So at a BMI of 30, you're eligible for this drug if you've tried diet and exercise, which just about everybody will have, and you haven't been successful with that alone. I think that the drug is most appropriate for people with a body mass index of 30 or greater who have significant health complications, meaning they have type 2 diabetes or hypertension, or sleep apnea. If the drug's going to be limited in availability because of it's cost, I would try to get it to the people who have the most benefit in terms of improving their health. That's the primary reason to seek weight reduction, I think. Technically, to address your question, the drug's available to people with a body mass index of 27 who have a comorbid condition such as hypertension or type 2 diabetes. And if you've got a BMI of 30, you would like to get this drug to people who have the highest BMIs and have the greatest benefit to health. Those individuals with higher BMIs at 35 who have a comorbid condition are eligible for bariatric surgery, which is the most effective obesity treatment. If you look at the most popular surgical treatment right now, it's called sleeve gastrectomy, where you remove 75% of the stomach so you can't eat as much food, and it does have improvements in appetite-related hormones such as ghrelin, the hunger hormone. That is dramatically suppressed by the operation so people are less hungry, have less desire to eat. And so that operation produces about a 25% reduction in body weight in one year. And at three to five years, people still have 20% off. So a person who's got a BMI of 35 or more with a comorbid condition such as type 2 diabetes wants to talk with his or her physician and see if they might benefit from bariatric surgery. If the doctor and patient don't think that's the option, you would like to consider an obesity medication to help you just control your feelings of appetite, hunger, and satiation, to make it easier to eat a lower calorie diet, to make it easier to want to get out there in physical activity. So that is the big picture of the options: Diet and physical activity for people who have overweight and obesity without health conditions. And then you add medications for people at a BMI of 27, 30, or greater who have health complications. And then you add bariatric surgery when medications don't work.

Bio

Thomas A. Wadden, Ph.D. is Professor of Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania. He served as director of the Center for Weight and Eating Disorders from 1993 to 2017 and was appointed in 2011 (through 2021) as the inaugural Albert J. Stunkard Professor in Psychiatry. He received his A.B. in 1975 from Brown University and his doctorate in clinical psychology in 1981 from the University of North Carolina at Chapel Hill. Wadden’s principal research is on the treatment of obesity by methods that have included lifestyle modification, very-low-calorie diets, physical activity, medication, and surgery. He has also investigated the metabolic and psychosocial consequences of obesity and of intentional weight loss, the latter as represented by findings from the 16-year long Look AHEAD study. He has published over 500 scientific papers and book chapters and has co-edited seven books, the most recent of which is the Handbook of Obesity Treatment (with George A. Bray). His research has been supported for more than 35 years by grants from the National Institutes of Health.

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Interview Summary

So I've been an admirer of your work for a number of years now and really perceive of you as a pioneer doing important community-rooted work. So let's start with grounding this conversation for our listeners. Would you share your thoughts on problems with the current food system?

Sure. I think there are multiple problems with the current food system. Beginning with that, we have great inequities within the food system because of the existing inequality in American society, based on economic standing and based on so-called race. And, to some extent, based on geographies - some people have great access to highly nutritious food. Others don't have so many opportunities. So, for example, in the city of Detroit, where I live, we have a few grocery stores; in fact, we actually have about 70 grocery stores. But most of those are independent smaller stores that don't offer the robust selection that we see from national stores. So the problem in Detroit is twofold: 1) that is the lack of stores, and 2) even if the store exists a few miles from you, if you don't have an automobile, you still don't have access. So these are just a couple of examples.

So we have great inequity in the food system that impacts the health of communities. The second major problem with the food system is that workers within the food system are really exploited and not paid fair wages. So we have food that is subsidized in a sense; subsidized by the exploitations of farmworkers and people working in meatpacking plants and what have you. And so, even though most people would, I suspect, think that they're paying a high price for food, the reality is we're not really paying the actual value of food. And we're externalizing some of those costs.

The third problem with the food system is the environmental degradation that it causes. The industrial food system that produces the majority of food in American society is heavily dependent upon pesticides and herbicides, dependent upon huge amounts of water, huge machinery, and the use of diesel fuels. Farms have to be huge farms for them to survive. And so there are all kinds of problems this causes for the environment, both the runoff of the pesticides and the herbicides into the water systems. And the creation of dead zones - problems created by herding cattle and pigs into small areas and trying to process the waste from that. And the system is not sustainable. We simply can't continue to feed the Earth’s population using the same kinds of methods that have been used for the last 60 years or so. So those are three of the major problems with the food system. There are many others as well.

When you think about a system so embedded in the American economy and so embedded in the way we've constructed racial barriers and inequities in our country, it's hard to think that you could produce big change in this. And people, when they think big changes might automatically think about big government top-down Washington or state-driven initiatives and things like that. I'm sure there's a role for those things, and I've worked on some things, but there's also tremendous room for local ingenuity. And very often, I know, at least in the public health arena, what starts locally becomes national before long. And that's really where the innovation begins. And that's exactly what you've done. So let's shift now and talk about some of the work that you're doing. I know that you've done crowdfunding campaigns to help black farmers buy land in Detroit and advocated for urban farming, local food, and local growers, particularly during the pandemic. So what are your current efforts?

First of all, I agree with your framing that as we think about how we change the food system - looking at a top-down approach becomes very difficult. There's been a number of efforts to make a Farm Bill that is more just than equitable. But I don't know that we've seen really significant systems-wide changes due to the Farm Bill. But we can do these things on the local level that create examples of the larger change that can come about. And it can help to shift people's consciousness about how they perceive and relate to the food system.

So we've been doing some of that work in the City of Detroit via the Detroit Black Community Food Security Network for the last 15 years or so. I'll start with the effort you just mentioned - the Detroit Black Farmer Land Fund. Urban agriculture will not place rural agriculture, but it certainly can supplement it. Urban agriculture grows food closer to where we have population density centers and thus requires less burning of carbon to transport food long distances. When people eat food in closer proximity time-wise to the time it was harvested, they're going to get food that is better for them and has more nutrients. So we don't think that urban farming will replace rural farming. We believe that urban farming is a good supplement, and there are some things that we can grow in urban areas, such as Brassicas, collard greens, kale, tomato, and all kinds of things. But we're not likely to see wheat fields, and we're not likely to see herds of cattle in the city of Detroit.

We've been working with the Detroit Black Farmers Land Fund, which is really an initiative coordinated by three organizations in Detroit: our organization, the Detroit Black Community Food Security Network, Oakland Avenue Urban Farm, and a group called Keep Growing Detroit. And so, we've come together to jointly administer this fund. So far, we've given away more than $70,000 to about 40 Detroit farmers who have been trying to buy land. Just as in rural areas, obtaining land can often be very difficult for farmers, particularly in a city like Detroit, where we see a tremendous amount of gentrification. Wealthy folks are coming in, buying huge tracts of land, and driving property values up. And so farmers in Detroit often have a hard time owning the land that they're farming on or finding land even that they can purchase to farm on. So the Detroit Black Farmers Land Fund is an effort to assist Detroit's black farmers in obtaining land. This year, it's altered slightly, and grants were also given to building infrastructure. So it's one thing to have an acre of land in a city or two acres or whatever the case may be. But, still, you also need infrastructure on that land, hoop houses, fencing, water, and all kinds of things that allow you to grow food robustly. So that's one of the things that we're very excited about. The second anniversary of the Detroit Black Farmer Land Fund is coming up in June of this year. So I'm looking for that continuing to expand. Also, that effort has inspired other folks in other parts of the country. Particularly in Michigan, where we see in the neighboring county, Washtenaw County Black Farmer Land Fund, which, of course, is influenced by the work they saw happening here in Detroit.

The second thing that we do and perhaps that our organization's best known for is that we operate D-Town Farm, a seven-acre farm in a city-owned park in the city of Detroit where we grow more than 40 different fruits, vegetables, and herbs. And probably more important than the amount of food that we produce, we're planting seeds in the consciousness of Detroiters about the role that urban agriculture can play as we rethink what the city of Detroit can be and as we rethink how we improve public health. So at D-Town Farm, we do lots of tours for school groups, university groups, Boy Scouts, Girl Scouts, who are being exposed to urban agriculture often for the first time. And they're able to see the techniques that we use and can hear the ideas that drive the work we do at the farm. We do large-scale composting. Soil health is the most important factor in making sure that we have nutrient-dense food. So we do large-scale composting to regenerate the nutrients in the soil at our farm. We also have three hoop houses that we use for season extensions. We also have public events at D-Town Farm, designed to get children and families to come to the farm who might not necessarily be ready to volunteer and put their hands in the soil, but who are interested in being outdoors and learning about the possibilities of urban agriculture. So we have a number of events throughout the year, such as something in April we call the Bio Blip, where students from the University of Michigan who are studying in the School of Natural Resources come out and bring magnifying glasses, microscopes, specimen bags. They lead a group of about 100 children. They identify all the fauna, flora, and fungi at the farm. And it's wonderful, by the way, to see children from the city out at the farm, reconnecting with nature. We have a harvest festival every fall where we have close to 1,000 people who visit the farm. We have workshops, speakers, food demonstrations, tours of the farms, live music, a farmer's market, and all kinds of things that can expose the public to the great potential of urban agriculture.

We also have a youth program called the Food Warriors Youth Development Program that functions at two sites in Detroit. One site is a church, and that site functions on Saturday mornings and is open to any children in the city of Detroit between the ages of seven and 12. The second site is the school site on the east side of Detroit, and that program is only open to students who are enrolled at the school and it functions as an afterschool program. So at both sites, we have raised beds. And we teach the children how to build those raised beds, how to cultivate the food, and how to harvest the food. Then they also learn about food justice concepts. Our organization thinks that our culture is very important. And that African American people have gone through a process caused by our enslavement that has intentionally disconnected us from our traditional culture. We think it's very important that we reconnect children of African descent with traditional African cultural concepts. As well as giving them an understanding of the role that African Americans have played in the development of agriculture.

And then the third major thing that we're doing is the Detroit Food Commons, a new 31,000-square-foot building that we're building on Woodward Avenue, the main street of Detroit. It's about a $20 million project. The Detroit Food Commons will house the Detroit People's Food Co-op, a cooperatively owned grocery store, which we also initiated. Although we initiated and continue to influence it, it's an independent body with its own board. And that board regulates what will happen inside that grocery store. The first floor will be the cooperative grocery store. Still, we'll have four shared youth kitchens on the second floor of the building, about a 3,000-square-foot community meeting space, and office space for the Detroit Black Community Food Security Network. So again, we're looking forward to the opening of this in June of 2023, and we think want to be a game-changer in Detroit on several levels. One, it is a cooperatively owned business that pushes back against the gentrification that we're seeing in Detroit, where generally, very wealthy white men lead all of the development that we see happening in Detroit. And then we're supposed to see that as progress because we can walk into these edifices that wealthy white men have created and spend our money there where the community has really no ownership. And there's very little circulation of wealth within our community. The cooperative ownership of the grocery store, on the other hand, does provide for ownership by community members. We currently have 1,437 member-owners of the Detroit People's Food Co-op. That's one reason it's important, the cooperative ownership structure and how that pushes back against the typical style of development that we see happening in Detroit. It will also be a game-changer, though, because of the neighborhood that we're building in, which is called the North End. It has a tremendous lack of access to high-quality food. And so it's going to provide high quality, often locally-grown food for residents of that community and Detroiters in general. There's a vast number of people who live in the suburbs north of Detroit who work in Detroit and leave the city each day, driving down Woodward Avenue. We're also hoping that an audience will shop at the Detroit People's Food Co-op before going back to their homes in the suburbs. The third way it will be a game-changer is to provide a consistent retail outlet on a scale that was previously unavailable for local growers. And so, we are very much conscious of our role in helping to catalyze the urban agriculture movement by providing this consistent retail outlet.

Malik, that's a jaw-dropping array of things you and others in Detroit are doing, and I can't tell you how inspirational it is. Let me bring up one in particular, and it has to do with your focus on youth. Given your background as an elementary school principal, I could see why that would be a focus for you. But you could see how involving youth in this would help address the issue of getting people interested in farming and interested in other parts of the supply chain. As I imagine as the Commons comes online, youth being involved in that might give them ideas for becoming food-related entrepreneurs. The space that you have upstairs could be used for youth to develop ideas and for new businesses and things like that. I could imagine inspiring a whole new generation of people to think about these food-related activities as a viable career path, and I'm just wondering, have you seen signs of that so far?

Since we started 15 years ago, we've seen a tremendous interest on the part of young people in being involved in the food system. We have something in Detroit, for example, called the Detroit Food Academy, which is a nonprofit that trains people for jobs within the food system. They learn a wide array of fields and areas within the food system where there are employment possibilities. We have a number of farms in Detroit that are encouraging children to anticipate those farms. We have some children, in fact, who have created value-added products that they're selling at various fairs and the farmers' markets throughout the city of Detroit. So yeah, we do see an increasing interest. Part of what we're setting out to do is first to help people think about the food system because the average person, people who aren't food activists, don't even use that term, the food system. That's not how they think about food. They're thinking about, "I'm going to the grocery store to buy what I want. I'm going to cook dinner, and I hope I like the way it tastes," and that's the kind of framing the average person has about food. So part of what we're trying to do with both children and adults is getting them to think about this broader system that provides food and all of the kind of steps in it from the seeds to the planting of those seeds, the cultivation of the crops, the processing of crops, the aggregation of crops, the distribution, the retail level, the post-consumer level. We want people to think about all of that and then think about how they begin to develop agency within it so that they don't just see themselves as subjects that this more powerful system is acting upon, but they see themselves as having the agency to actually shape that food system as it impacts their community. And so that's part of what we've been trying to do with the work of the Detroit Black Community Food Security Network, working in a number of areas both in policy and farming, in retail, trying to get people to really conceptualize what this food system is and that they have the right and the responsibility to help shape how that food system impacts them. So, yeah, we're seeing interest by youth, and we are hoping that the kitchens on the second floor will inspire not just youth entrepreneurs but also adult entrepreneurs. And there are a number of people in Detroit who participate in what we call the shadow economy, people who are making money in ways that are outside of the laws of the society. For example, you have a number of people who are preparing chicken dinners and fish dinners or perhaps soups and cakes and selling them. The kitchens on the second floor of the Detroit Food Commons allow those entrepreneurs to go from being underground shadow economy food entrepreneurs to actually coming into the legitimate legal economy by having a licensed kitchen where they can prepare their foods. So we are definitely looking to stimulate the local food economy both for children and adults.

Let's talk a bit more about that. So in some of your beginning comments, you mentioned low wages as one of the fundamental problems in the food system. Are you hopeful that this series of activities will provide better pay opportunities for people?

I'm hopeful, but I also want to acknowledge that it's a very difficult problem. And even as we look at the Detroit People Food Co-op and how to make that cash flow positively, as we look at the performance and all of the expenses, the wages that we're scheduling to pay employees are certainly not what we would like to pay. And so we're strategizing on how with very thin margins in the grocery industry, we can be fairer and just to the workers who will work in that store, but this is not a unique problem that we have. In fact, I would say that the major dilemma facing the food movement in American society is figuring out how we pay workers within the food system a fair and just wage while, at the same time, we make sure that we have food that is available and affordable to everyone in society, regardless of their race, income, or geography. It's a very difficult nut to crack, and I'm not absolutely positive that it can be done within the current economic system, but it's certainly something that we have to strive for and that we have to strategize on. I don't think there's an easy answer to that, but it's the question that we have to constantly put in front of us. For me, the obvious answer, though, is that we have to marry the struggle for food justice with the struggle to eliminate poverty. The answer to this problem is not cheap food per se. The answer to the problem is paying the true value of food but making sure that everyone has the income which is necessary to buy high-quality food.

Let me ask about the importance of community ownership of these things. So let's just say hypothetically that all the activities that you're talking out were being put in place from Washington or the state of Michigan, let's say, as opposed to a very community-involved effort. What's the symbolism of that, and what difference do you think it makes in the way people think about these things?

Well, I think it makes a huge difference, and again, part of what we're trying to instill in people is a sense of agency. I think it's true to say that in American society in general and in Detroit in particular, people have been locked into a lethargy where they think that people who are more powerful are in charge of structuring their lives, that the educational system is responsible for teaching our children, for example, and that doctors are responsible for maintaining our health. And in many ways, we've ceded responsibility for our own lives to these forces that we perceive as being more powerful and particularly in a place like Detroit, where, over the last 20 years or so, we've had the imposition of what the state of Michigan calls emergency managers. The largest or most well-known in the position of the emergency manager was in Detroit just before the city declared bankruptcy. The governor essentially suspended the powers of all of the elected officials and appointed one individual who was the emergency manager of Detroit. These powers superseded all the powers of the elected officials, so essentially, democracy was put into a coma in the city of Detroit. So I'm saying that in a situation that both intentionally disempowers people and also where people cede responsibility because they perceive these more powerful forces as being more qualified to run the systems that impact our lives, people have given up; in many cases, their agency over defining not just the food system that impacts their lives but defining all of the systems that impact their life. And so we're very concerned about developing a sense of community self-determination that every community first decides what their own goals and aspirations are and then decides how they reach that as opposed to external forces coming in and dictating to communities how they should move and develop, and so that's really at the core of what we're doing. So having these community-based projects that mobilize community members and ignite within them this sense of agency both within the food system, and then we're hoping that also as people see that we can exert control over the food system, they begin to look at other aspects of their lives as well and how we can, as a community, begin to exert control over those things. So having said all that, that's not to say that state and federal governments don't have the responsibility of behaving in a way that facilitates justice, equity, and access to high-quality food for all of their citizens. Still, I certainly don't think that we should put the majority of our efforts into that and that we shouldn't wait until those governmental entities act to make things better. We have the right and the responsibility to act on our own behalf while, at the same time, pressuring and urging the government to act in a responsible way.

That makes perfect sense. And I'd imagine another virtue of the community ownership part of this is that the initial innovation breeds more innovation because more and more people think that they can have the agency that you're talking about, come up with new and creative ideas. So I could imagine this building on itself over the years.

Yes, absolutely. I think that mobilizing people to solve their own problems certainly stems from innovation. The challenge is that often, very creative, innovative people in communities like the community I live in don't have the resources to implement those innovations. So we have to always look at that side of the equation also. How do we better resource communities so that the people who have the lived experience and who are most impacted, and who have this tremendous creativity, have the resources that are necessary to bring these ideas to scale, so they have a larger impact?

Bio:

Malik Yakini has been involved in the Black liberation movement throughout his adult life. His resume includes more than 20 years as principal of a K-8 African-centered school in Detroit along with founding the Detroit Black Community Food Security Network, which works to build self-reliance, food security, and justice in Detroit’s Black community. His connection to food work began about 20 years ago, when he began gardening on a small plot of land at his Detroit home to ensure he had access to fresh food. With few full-scale grocery stores in urban neighborhoods and just one national chain located in Detroit, Yakini saw the need to expand this work to community gardens and to teach young people to get their hands dirty. In 1999, he developed a food security curriculum as principal of Nsoroma Institute, an African-centered school that operated in Detroit from 1989 to 2014.

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Today, we're speaking with leaders of the San Diego Food System Alliance, about their far reaching 10 year vision for a healthier, more sustainable and more just food system in San Diego County. Our guests today are Elly Brown and Sona Desai, co-executive directors of the Alliance, who can speak about how this work is grounded in both community needs and evidence based research. It's an inspiring story of relationships, the transformational potential of food sovereignty and the belief that people can create a better food system when they work together. Welcome to the leading voices and food podcast.

So Elly let's begin with you. Could you describe to our listeners what the San Diego Food System Alliance is and how did this organization come to be?

Thanks for having us today Kelly. We're excited to talk about regional food systems work with you today and about San Diego's work. And as you know, Duke holds a really special place in my heart having attended graduate school there over 10 years ago. And it kind of feels like serendipity to talk about our work here in San Diego region around our food system. But on many levels the work has influenced my post MBA journey. Really the unlearning and the relearning, new ways of being, new ways of working together, and new economic systems that we can really nurture together in this region. And Sona, who's here with me - she's an incredible, humble thought leader and partner and has really inspired me in this work. So I'm glad that she can join us today together. And so to share a little bit about San Diego Food System Alliance. The Alliance was started a decade ago in 2012, and we are diverse and inclusive network guided by our newly-developed common agenda San Diego County Food Vision 2030. And really our mission is to cultivate a healthy, sustainable, just food system in our region of San Diego County. And we work to promote collaboration, influence policy and catalyze transformation in the food system here in our region of San Diego. And which really is the unseated land of the Kumeyaay, Luiseno, Cahuilla, and Cupeno people. And I think it's really important to recognize that as we're doing this work. Because we are all guests here and we need to recognize and honor the hosts or the original land stewards of this region. So that's who we are and what we're doing, and happy to share a little bit more as we go along.

Thanks very much. So Sona, let's turn to you now. The alliance has recently done some pretty extensive strategic planning that we discussed and I know you've had input from a large number of stakeholders in this process. Could you describe how this has all worked and how you gained input and what the plan consists of?

Yes, absolutely. Thanks again Kelly. And thank you Elly for your co-leadership in this work. So yes, we recently launched San Diego County Food Vision 2030, which we call a plan and a movement for transforming our region's food system over the next last 10 years. Developing food vision 2030 was a two year process. And we began this in the summer of 2019, and it culminated last summer in 2021. So the process itself included a pretty comprehensive literature review. We also did over a hundred interviews with key stakeholders within the community. We held several focus groups and then had, which you alluded to a sweeping community engagement process.

Our goal when we started food vision 2030 was to center the needs and aspirations of our community, especially those that are historically left out of these planning processes. So to meet this goal, we were very intentional about cultivating very deep and trusting relationships with community based organizations, and businesses across San Diego County, particularly those that were rooted in communities that had historically been disinvested in and those elevating the needs of essential food system workers. To guide the process of developing food vision 2030 and to ensure community participation, we first started with creating a steering committee that represented these voices and included leaders of these communities that could help us mobilize participation and engagement across the communities during the two year planning process. In collaboration with these partners, we designed the community engagement strategy. It included several forums, neighborhood convenings across the county, and of course unfortunately, the launch of this community engagement process was slated for March 2020, and it coincided directly with the statewide COVID 19 lockdown.

Despite those circumstances we remain committed to ensuring that community voices were centered in this process. We re-strategized with our community partners. We did a lot of research on the digital divide and collectively developed an accessible, interactive, customized digital experience that was tailored to 12 priority historically disinvested communities as well as farmers, fishermen, farm workers, food workers and independent restaurateurs and retailers. Through that process we engaged nearly 3000 San Diegons, and 60% of the voices came from those 12 priority communities and essential food system workers. It resulted in a common vision that includes three goals, 10 objectives, and several strategies for transforming our food system in San Diego County. The three goals are to cultivate justice, fight climate change, and build resilience. And the 10 objectives reflect priorities across the food system, including things like preserving agricultural lands, supporting the viability of local farms, fisheries and food businesses, strengthening food value chains, elevating wages and working conditions, expanding nutrition and food security, improving community food environments, scaling up food recovery efforts, and increasing BIPOC leadership throughout the food system.

San Diego County food vision 2030 is a shared vision. It's our community's vision. And really our intention moving forward is to help guide collective action and have the vision, mobilize and inform planning policy program and investment opportunities throughout our region.

Sona I'm really happy to hear about this because not only do you have a very ambitious set of goals, and the only way that one could possibly even imagine reaching those goals is to have a broad base of constituents who are working together on them, and you've managed to do that. But I also really appreciate you discussing the process of establishing these trusting relationships which isn't easy, it takes a long time but is critically important. Thank you for that. So Elly, I know from an earlier discussion that we had that your organization is working on five primary pillars.

I want to share that before we began the creation of this new common agenda food vision 2030, we conducted two internal strategic planning processes. First, we created the Justice Equity Diversity and Inclusion Roadmap, the JEDI roadmap. And second, we also created an operating strategy, and these two planning processes were really essential for us to hone in on who we are, what we do, and how we steward food vision 2030 forward as an alliance. And the JEDI roadmap really spells out our vision for racial equity and a lot around the how, but the operating strategy resulted in five pillars that helped to crystallize what we do to steward food vision 2030 forward. So these five pillars are: 1) build networks. Really our role in cultivating nurturing a diverse and inclusive network that's actively participating in the movement around this new vision, collaborating, learning, sharing together; 2) influence policy. Our primary focus is on the local level where we have the most influence. And we really are leaning towards moving towards community led organizing efforts around policy advocacy. And 3) is shift culture. So supporting our network and San Diegons in their education and awareness, to become better active participants towards cultivating a sustainable just food system. And 4) is increased capacity. So here we do a little bit more on the groundwork to actively support groups in their contribution towards a sustainable just food system. And one of the examples is the local food economy lab, which Sona I think will share a little bit more of. And lastly our 5) is operating strategy pillar is the nurture organizational health and viability.

So this is our work around culture, democratic governing management models, as well as viability matters for the organization. And lastly, I think one of the most important elements of our operating strategy also is our accountability and governance system. In addition to the board of directors for 501 we have a 21 member food vision 2030 stewardship committee consisting of majority organizers from communities that are most marginalized by our industrialized food system. These are what Sona has spelled out, the BIPOC neighborhoods across San Diego County, tribal communities, food farm workers, small farmers and fishermen, and BIPOC owned food businesses in our region.

What an accomplishment to bring together all those parties, and each of the pillars is really interesting. Sona I'd like to ask you about one of them in particular that has to do with the internal structure and environment of your own organization. Can you say more?

Yes, absolutely. Thank you for asking about that Kelly because it's the heartbeat of our organization and really what will allow us to have impact in the region. So as Elly mentioned, we see nurturing the health of our organization as absolutely foundational to our work and essential for transformational impact. While fundraising and resource development are clearly critical for sustaining the health of our organization, the structures of how we are organized, how we make decisions, and how we care for one another are equally essential. Over the past few years we have started allocating more time, capacity and intention toward creating internal policies that move us towards structures that reflect our core values of respect, inclusivity, health, collaboration and justice. This work has included working with a justice equity diversity inclusion consultancy organization, and developing an internal JEDI committee of staff board and alliance members. And together we developed a statement on justice as well as a detailed roadmap to ensure that we're actively working toward our vision of becoming an anti-racist organization and to help hold ourselves accountable.

We've also worked on our human resource HR handbook and policies. We have re-established our job descriptions and recruitment strategies, and also looking at our compensation structure. In addition to this, we also recognize that we need to be able to have a staff that is able to bring their whole selves to this work. And so we've really been working to cultivate a space for that and creating time and space for rest and reflection for our staff. And this is an ongoing work and we are beginning this and we have a lot that we can do as we move forward. But we have come to recognize that this is the work. This is the work. This is essential for our individual collective health and wellbeing. Another thing that we're starting to look at is outlining a vision toward moving toward becoming a less hierarchal and more democratic organization. So as part of this journey we transitioned to a co-executive directorship at the alliance late last year. We're also working now as a team to create a stronger culture of self-management. And as part of this effort, we're exploring various ways to create greater clarity and streamlined decision making across the organization. We're creating, experimenting and piloting with team structures to help hold one another accountable rather than a traditional supervisor employee type of relationship. And I think overall we believe that building equitable policies and procedures to govern our organization will ultimately foster an inclusive culture, and support our ability to retain greater diversity within our team and broader organizational network.

You're doing a lot of imaginative things and one of them that Elly mentioned earlier was the local food economy lab. Sona, could you say a little bit about what needs you identified that led to the development of this?

So we actually just had our kickoff call with about 50 partners yesterday for the local food economy lab. And this emerged through the food vision 2030 process. We heard consistent themes from small and mid-size farmers, fishermen and food business owners around limited technical assistant and business support services, to ensure their success in an increasingly competitive and consolidated marketplace, and this need that we heard was amplified across communities of color. So in particular, we heard the need for more equitable, customized and wraparound one-on-one and peer to peer services, especially lack indigenous and leaders of color. By wraparound services what we heard was that there's more than just a business plan that's required for a food business to be viable. Sometimes they also need to be able to combine that with bookkeeping support or marketing support or access to capital or infrastructure. And so by wraparound, we're really seeing that the lab could be a place where we could provide some of these needs. And of course, another theme that we saw a lot of last year was fractures across the food supply chain. And there was a huge need to try to meet demand locally from local producers and local food business owners. And so that's another area where San Diego County has a lot of opportunity to build infrastructure for the local movement and distribution and marketing of food. And then I guess one other theme that has really shaped the idea of the local food economy lab, is we've been hearing a lot more interest in community wealth building models and the idea of inclusive economic development. So we actually researched economic models like cooperatives and community land trust, employee ownership, and did develop a report building community wealth in San Diego County's food system. So this idea of the lab was really to create a space that merged all of these needs and opportunities and to provide, you know, one-on-one technical assistance, business support to farmers, fishermen, food businesses, primarily people of color, and to increase connections between local producers and local markets in the region. And then finally to elevate community wealth building models.

Bios

Elly Brown, Co-Executive Director - As the Co-Executive Director of the San Diego Food System Alliance, Elly Brown oversees the nonprofit administration and resource development domains, ensuring that the Alliance is achieving impact towards its mission. Elly began her journey at the Alliance as a part-time consultant in 2015. Since then, the Alliance has blossomed into an expansive network of over 150 multi-sector organizations and advocates with a $1m in operating budget. Elly is a first generation American, having spent the majority of her life in San Diego and Japan. Elly enjoys the ability to contribute her business and consulting skill set to a cause she loves—food and community. Elly’s fondest memories of her childhood involve visiting the countryside of Japan, eating cucumbers and momotaro tomatoes off the vines from her grandfather’s farm.

Sona Desai, Co-Executive Director - Sona Desai has been working to advance sustainable and equitable food systems for more than 20 years. She has a background in organic farming, food marketing & distribution, farm business development, and is recognized nationally as a leader in food hub and community food systems development. Before joining the San Diego Food System Alliance, Sona was the Director of Food Systems Development at the Leichtag Foundation where she provided thought leadership, research, and food and farm based consulting services to advance the Foundation’s food system strategy. She also served as the Associate Director of Coastal Roots Farm in Encinitas. As the Co-Executive Director of the San Diego Food System Alliance, Sona provides strategic and management support for the organization, strengthens support services for small-scale sustainable food producers and fishermen in the region, provides consulting services to advance economic development in the food system and leads diversity, equity and inclusion efforts.

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Much has been written and said about ultra-processed foods, first in scientific circles and now more broadly in the media. This concept is relatively new, but what is even newer in this discussion is how such foods figure into the issue of food and addiction. Our guest, Dr. Ashley Gearhardt is doing pioneering work on this. So, we eat a lot of these foods. A paper published several months ago, found that as much as 80% of all calories consumed in the US and in Canada come from such foods. Such diets are high in added sugar, in fat and saturated fat and low in fiber and key vitamins and minerals. We've recorded earlier podcasts on ultra-processed foods, most notably with Dr. Carlos Monteiro, who created the term. But now let's talk addiction. Ashley Gearhardt is Associate Professor in the department of psychology at the University of Michigan and as a leading expert on the issue of food and addiction.

Interview Summary

So, let's start by you telling us what is ultra-processed food?

Well, I'll start with the scientific definition which is foods composed of mostly cheap industrial sources of dietary energy and nutrients plus additives. But in layman's term, I think the easiest way to have a feel for what ultra-processed foods are, they're the sorts of baked goods and sugary treats and salty snacks that are on our shelves. That when you look at the ingredient list, you kind of can't pronounce or understand many of the ingredients in that food substance. That's a big way for me that I tell that something's ultra-processed.

You've made very interesting parallels between these ultra-processed foods and cigarettes. Can you explain that?

Yes, absolutely. So, with cigarettes, one of the things that's really surprised me is that we know nicotine is the addictive agent in cigarettes. But I think something that surprised me recently is we're all probably consuming nicotine every single week. Nicotine is in things like tomatoes and eggplants. But of course, we're not getting hooked on eggplants and tomatoes and consuming them to excess. It was really when Big Tobacco got involved and they were able to take the tobacco leaf which has high levels of nicotine and process and optimize it so that it gave us naturally extreme levels of nicotine that were absorbed really rapidly into the system. And they did that through manipulating the nicotine leaf, but also putting additives in there. Things like bronchodilators that let the smoke to get into the lung more rapidly and to hit the brain. And they added all these different flavors and tastes with sugar and cocoa being the most popular. So, really industry got in and ultra-processed the tobacco leaf that led it to be the perfect delivery device for nicotine in a way that made it addictive.

And I think about the same thing with our foods. When I think of naturally occurring foods that have sugars and fats that we enjoy, we find reinforcing, like berries and nuts, people just don't seem to develop a compulsive relationship with those foods. It's really when industrial processes get involved and it amps up the level of that reinforcing ingredients of the sugar sugars and the fats, but then it also ultra-processes it into these packages that just delivers it so rapidly into our body and into our brain, and adds all these unique flavorants and additives that further amplify the rewarding nature of things like sugar and fat. So, the way the companies are manufacturing the foods then makes them maximally palatable, but then they interact with the brain in interesting ways too.

So, how would you know if these ultra-processed foods are addictive?

I think one of the things that's a misunderstanding at times about addiction is that there's some sort of magical brain signature that if the brain just does this, we know something's addictive. And that is not the case. Scientifically, we haven't figured out what that would be. What we've done to figure out whether something's addictive or not is really to look mostly at the behaviors of the people who are consuming it. And so again, going back to cigarettes. What really led people to consider these substances as not just a bad habit, but truly addictive, was how compulsively people were consuming them. You know, that people wanted to quit desperately and they couldn't, even in the face of some really stark negative consequences like a lung cancer or emphysema. People come out of the hospital wanting to stop smoking and then start smoking right away. And we know as well that these substances impact our mood and our pleasure experiences. They'll often help us feel a little less stressed, help us feel more pleasure. And we'll work hard to get them and we enjoy them. If we know that doing a certain behavior will get us something like an addictive drug, we're willing to do it over and over again.

And that was really, when we looked at cigarettes, the three core criteria that we used to decide that cigarettes were addictive in the Surgeon General's report. They trigger compulsive behavior, they were really pleasurable and reduced negative feelings and they were reinforcing. Meaning they left us coming back for more.

And when I look at these ultra-processed foods, it's clear to me that they meet all of those behavioral signatures. That people want to cut down and they can't. Even in the face of something like having bariatric surgery and having your stomach fully rewired, about 30% of people are regaining the weight within a couple years. And they report that the cravings for these sorts of foods is one of the biggest obstacles. It's these ultra-processed foods. They are impactful in giving us a hit of pleasure and helping us feel a little less bored and a little less stressed. Those are some of our major motivations for using them. And they're very reinforcing. When we look at animal models, ultra-processed foods and the ingredients in those foods are arguably as reinforcing - meaning animals will work for them as much as they would for something like cocaine and definitely more than nicotine.

So, all of those factors together really strike me as fitting the bill for something that is addictive. And then when we bring the brain into it, we're starting to understand from looking at the dopamine system which is kind of the core system that gets activated by addictive drugs, the degree to which fats and sugars - which are elevated in these ultra-processed foods - can cause the dopamine system to release. It's actually a pretty similar magnitude to what alcohol and nicotine can do. So, all of these factors combined really lead us to see some really strong parallels, which to me, makes the case that these unique, novel, highly-processed substances should be considered addictive.

What you're saying is very persuasive and another issue that's come up in the context of drug addiction is tolerance. That people might need more of the drug over time in order to get the same reward. Is there any evidence of that in the context of food?

You know, it's been really hard to study in humans, because unlike other drugs of abuse, we're getting exposed to these sorts of foods from the time we're one or two years old. So, if I try and look at even a teenager, I don't have like that baseline to say, oh, this is how they used to respond to it and now they respond to it differently 18 years later. So, we've really kind of had to look at our animal models to help us get some information about tolerance. And in the animal models, we do see that exposure to the ultra-processed foods and the ingredients that are so heightened in these foods like sugar and fats cause changes in the reward system of the brain that is consistent with tolerance. I mean, look at those animals, they start binging on more and more and more of those foods over time, which also suggests they're becoming tolerant to the effects. To me, I see some parallels in what we see in our society. Just looking at the fact that our portion sizes are getting bigger and bigger and bigger, and the amount of sugar is going up and up and up and salt is going up and up and up, suggests that the same amount of food or the same amount of sugar, just isn't quite doing it for us. So, then we're amping it up and taking something a little sweeter or eating more of it to get the fix that we would've had previously.

Well, it would be interesting, wouldn't it, to take those animal intake curves that show increasing consumption of the rewarding foods and project from that what human weight trends would look like over time and then see how closely those lines parallel each other. I bet they'd be pretty close.

I bet they would as well.

And you know industry says, in defense of things like large portion sizes, that 'we're just giving consumers what they want.' And other critics say, ‘heck no, you're driving that consumers are eating so much by increasing portion sizes.’ It's quite possible both are true and both could be being driven by this common effect on the brain of these highly reinforcing foods.

Absolutely. You know, we have a sense that the ultra-processed foods, in addition to being really tempting and rewarding and really activating your drive for wanting more and the industry will say that, they're trying to create foods that have maximum craveability that inspire more-ishness, that you want more and more and more. I mean, these are all code words for addiction without saying it, but then they also seem to not be as effective at triggering our satiety signals. So, the food itself and the way that they're engineered, leads us to want more and more and more and to not have those signals that it's time to stop because we're feeling full.

So, how do these foods make trusting our intuitions about what we're eating more challenging?

The intuitive eating movement, I think has a lot of really wonderful things about it, of kind of connecting with yourself more. However, my one concern about it is that if you're trying to intuitively eat ultra-processed foods, it's not an even playing field. They trick your brain into wanting more. They're not signaling hunger and satiety signals in the way that normal, minimally processed foods do. And we see in my lab that it's really, really hard to distinguish when you're hungry, because you need calories, and when you're hungry, because you're tempted by reward. I have this simulated fast food restaurant lab and we'll bring people in, we'll kind of randomize people. And say, half of them will go into this kind of normal blank lab space and we'll ask them how hungry are you and ‘meh, not that hungry.’ And we'll randomize these other group of people to come into our fast food restaurant lab where it smells like French fries and there's all the cues of the restaurant and everything is kind of setting you up. And they'll say, ‘oh, I'm really, really hungry.’ And the only thing that changed is that that one group is in that acute environment. So, their reward systems are kind of perked up and it's hard to distinguish that fact that you're now desiring food from I'm actually calorically deprived and I need calories. So, I think we have a hard time as humans, knowing when we're truly hungry and when we're being tempted by ultra-processed foods.

Over the course of human evolution, body weights have been pretty healthy for populations, for the most part. And that's been true for century after century. Then all of a sudden in a very short period of time, body weight in basically all other countries has really skyrocketed. And it's pretty hard to argue that people have changed in some fundamental way or that biology has changed in fundamental ways. What really seems to have changed are the food and physical activity environment, and you're narrowing down exactly how those changes have been made and how ordinary biology that works well under normal circumstances, fails under abnormal circumstances and that's how we're living today.

Absolutely correct. And I think one thing that people sometimes don't understand is that drugs of abuse, addictive drugs, they are hijacking the system that was designed so we would be seeking out food and calories and making sure we were eating enough. And those drugs of abuse are so novel and potent that they can get in and take that system and start to shift the drive towards those drugs rather than things like food and sustenance and things we need for survival. Now, these ultra-processed foods that are novel, chemical substances that really just popped up since the 70s and 80s, really, they are working on that same reward sustenance system and they're on overdrive. So, they don't even have to hijack this system. They just have to amp it up higher than it typically is by normal foods to start to trigger this loss of control, this compulsive seeking, this hard time stopping yourself even when you know it's not good for you.

And what's really interesting to me about the timeline, if we kind of say, it's 70s, 80s, 90s, this is this time where we really feel like the food environment changed so drastically, that's also when big tobacco really got into food. Philip Morris and R.J Reynolds were the biggest producers of the sort of processed foods that we're talking about today, in the 80s. And they really used the same playbook, the same scientific strategies. Their know about how to develop and market and create these addictive substances like cigarettes to make them so optimized and apply that to the development of their food portfolios.

So, when we talk about ultra-processed foods, I think of them in my mind, much more as a similar substance to something like a cigarette, than an apple, or a salmon filet, because the process that creates them and the consequences for our brain and our psyche and our biology is much more similar to that cigarette than it is for those other sorts of foods, even though they all give us calories.

So, what do we know about how these ultra-processed foods affect children and adolescents?

To me, that's one of the most concerning spots about this. And I would say that research is really just beginning. We know that that is the dominant source of calories for adolescents and children, when we are looking at the United States, that ultra-processed foods is where they're getting most of their caloric intake. And our lab, we assess this addictive profile, the like classic signs of addiction with eating and we do that with these ultra-processed foods, and we do that in adults. And the current estimates is that about, anywhere between 15% to 20% of adults in the United States would meet this kind of diagnostic level of addiction to these ultra-processed foods.

What's concerning is that we see about 15% of children and adolescents are showing that same addictive profile. Our research finds that this is a profile that's associated with a harder time maintaining a healthy body weight, failure to respond to typical treatments, to help reduce obesity that it's associated with mental health concerns like depression and difficulties with inhibitory control. Seeing this in kids and teens, in many ways is not surprising, because you're not exposed to things like alcohol and cigarettes from the time you're one to two years old. Whereas in contrast with children, by the time a kid is two years old, a major part of their diet are ultra-processed foods. And we really don't know. We're in the middle of the experiment to understand how does that impact a developing brain that would be more vulnerable to addictive substances and how does that set them up for a lifetime of struggling to maintain a healthy relationship with food?

Again, the animal models are very concerning. The animal models suggest that young, early exposure to those sorts of ingredients in ultra-processed foods and ultra-processed foods is particularly likely to change the brain and adolescent and young rats in a way that makes them vulnerable, not only to show an addictive profile with a those foods, but also to be more sensitized to the addictive properties of things like stimulants and alcohol. So, it is not an issue that might just be in the realm of food, but might also be setting people up to be vulnerable for other addictive substances as they get more exposure to them in adolescence and early adulthood.

Now, what you're talking about is really concerning, especially in light of how much marketing of these ultra-processed foods goes on that's directed at children and adolescents, and almost all of it is for the least healthy foods in the company's portfolios. So, you think about kids getting bombarded by these inducements to eat these things, they're engineered to taste really good and their biology starts getting hijacked at an earlier age such that tolerance may develop and they need more of the foods over time, it's really pretty bad.

Yes. And you know, we've even done some work around withdrawal where I think people often think of withdrawal as really physical, with people like shaking or vomiting or sweating. That actually isn't often how withdrawal from addictive drugs presents. It's often, if you think of cigarettes more psychological. It is irritability and depression and kind of agitation. So, we've been looking at that in adults, what happens when people are trying to get off these foods and eat a healthier diet and people are reporting those same clusters of symptoms that we see with withdrawal from other addictive substances and it follows kind of the same time course, that it often starts in about 24 hours, it peaks in that first week where it's really severe and hard and then slowly starts to taper off. And the more withdrawal people are experiencing, the more likely they are to fail at their weight loss attempt.

Now, when we started to do this work, we thought, well, wait, this wouldn't just be happening with adults, we would expect this with children too if this is playing a role. So, we asked parents who had tried to cut their kids junk food down in the past year and asked them about the signs of withdrawal and they reported that, yes, their children had that experience, it followed the same time course as typical withdrawal syndromes and that children whose parents had addictive eating themselves were more likely to experience withdrawal. So, I just think for parents how challenging that is if you're trying to help your child and maybe help yourself simultaneously move away from these ultra-processed foods, that if it's triggering this aversive withdrawal syndrome that makes your child far harder to parent and while you're also feeling that way, it really sets people up to fail.

So, let me ask you one final question. How do we reduce the harm that's associated with these ultra-processed foods?

You know, I think if there's one lesson we've learned from addiction over and over again, is that while we need to have good treatments and we need to provide people with psychoeducation, if we don't address the environment, our treatments aren't powerful enough to overcome that. So, again, cigarettes is our best example. We knew so much and we were developing nicotine gum and we had treatments out there that were available, but what really helped us turn back the tide was by addressing the environment around cigarettes through policy, by things like restricting marketing and taxation and restricting vending machines that children could so easily access. So, I fundamentally believe that for this same change to take place in the context of the harms of these foods, it's going to have to take policy initiatives that focus on giving us an environment that allows us to have a fighting chance. And it's even more relevant in the context of food because you don't get to opt out of eating. So, you have to go into the grocery store that's dominated by ultra-processed foods. My students here in college, they have to go into the dining hall that's dominated by ultra-processed foods and that environment that's so dominated by that, I think really works with our biology in ways that really mimics what we see with addictive substances that makes it hard for us to eat in a healthy, nourishing way.

Bio

Ashley Gearhardt, Ph.D., is an Associate Professor of Psychology in the Clinical Science area at the University of Michigan. She also earned her B.A. in psychology from The University of Michigan as an undergraduate. While working on her doctorate in clinical psychology at Yale University, Dr. Gearhardt became interested in the possibility that certain foods may be capable of triggering an addictive process. To explore this further, she developed the Yale Food Addiction Scale (YFAS) to operationalize addictive eating behaviors, which has been linked with more frequent binge eating episodes, an increased prevalence of obesity and patterns of neural activation implicated in other addictive behaviors. It has been cited over 800 times and translated into over ten foreign languages. Her areas of research also include investigating how food advertising activates reward systems to drive eating behavior and the development of food preferences and eating patterns in infants. She has published over 100 academic publications and her research has been featured on media outlets, such as ABC News, Good Morning America, the Today Show, the Wall Street Journal, and NPR.

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In today's podcast, we're talking about ultra-processed foods. Our guest today is Trish Cotter from the global public health organization Vital Strategies. She's the author of a new commentary published in the BMJ Global Health calling for warning labels on ultra-processed foods.

Interview Summary

First I'd like you to tell us, what our ultra-processed foods? And how do you think they're affecting health?

So as you mentioned in the introduction, I lead the food policy work for Vital Strategies. Our team supports partners and governments to introduce high-impact policies aimed at creating a healthier food environment. Now, these policies that we focus on are taxes on sugary drinks and junk food, restrictions on marketing of unhealthy food, especially to kids, and front of package labels on foods that are high in fat, salt, and sugar. The common denominator amongst all these policies is ultra-processed foods. So your question, what are ultra-processed foods? They're foods that you can't make at home in your home kitchen. In fact, as you said, this debate about whether they're even foods at all, and you'll find them on the supermarket shelf, packed full of them, soft drinks, breakfast cereals, ice creams, frozen prepared dishes. They're products that go through many manufacturing steps which alter the food from its natural state, and they're quite literally torn apart and put back together again with the addition of a cocktail of preservatives and flavors and colors. And what we get at the end of it are products that are packaged, ready to eat, hyper palatable. Some research is indicating that they're addictive and ultimately leading to long-lasting consequences on a person's health.

So you're completely in agreement there with some of our other guests who have spoken about ultra-processed foods and noting the dangers of them. Why do you think the public has remained unaware of the risk of these foods?

One of the reasons is that the term itself is relatively new. It's coined by Brazilian professor Carlos Monteiro in about 2009, and while the research community's quite familiar with it and have been researching it over this period of time and increasingly so, there's been limited data about the public's understanding of ultra-processed products. So part of the Bloomberg Philanthropies Food Policy Program, Vital Strategies supported some studies in Brazil and Colombia in 2017 and '18, which included several questions on public perceptions of ultra-processed foods or products. And what we found was clear evidence of the food and beverage industry's success, really, at marketing these products where we saw a significant number of people associate them with satisfying cravings, being tasty, bringing happiness and joy, and you can all understand what those products are. Also, they associate them with family, social gatherings, children, ease, and even breakfast and physical activity. So the evidence also was really enlightening in that we found was that, while people aren't really familiar with the term, they recognize the group of products as harmful. So it makes sense to them that this scary sounding word, ultra-processed products, could be harmful.

What are your thoughts on the food industry involvement in food environments and food policies?

So look - unhealthy products, unhealthy diets are responsible for an estimated 11 million preventable deaths each year, and with this at the forefront of our minds, we cannot forget that food and beverage companies' first responsibility is to their shareholders, not our health. So let's have no illusions about why they may seek to be involved in food policy. The industry also has a vested interest in maintaining the status quo of continuing to freely promote thousands of individual products that they have us believe are tasty and convenient, but in fact, as we've described, they're full of nasties and harmful to our health. So while there are thousands of individual harmful products, they cannot be really targeted by public health policy. But the minute they become known as one, for example, ultra-processed foods or a collection of foods that are high in fat, salt, and sugar, governments will find ways to regulate them, and that's when we'll see large corporations flex their muscles. Letting the industry engage in policy solutions usually leads to ineffective or weakened policy at best. They're part of the problem, and while they need to be part of implementing the solutions, they cannot be part of the policy making. Health policy is for health experts. That process can't be muddied by commercial interests.

You've just answered this question, but it's an interesting one to talk a little further about. When an industry feels under threat from litigation or regulation, legislation, one thing they typically do is say, "You don't need the police us. We'll police ourselves, and we'll come up with these self-regulatory efforts, and we'll abide by this, or we'll create that standard." They do a lot of that kind of thing. It doesn't sound like you're optimistic.

Absolutely, and in fact, I'm less than optimistic. I'm convinced, and we've seen lots of examples worldwide, that voluntary agreements don't work. And of course that's what the industry will propose because that's what they can live with, and that's how they will continue to go on the path of least resistance. But it's incumbent on governments and public health practitioners to respond decisively and to implement strong mandatory policies so that we can advance the public's right to healthy and nutritious food because the fact that over 50% of the calories that they're consumed in US, for instance, ultra-processed means that these companies have just gone ahead and managed to take over our food environment without any opposition, and it's time they were held to account.

I agree with you entirely. All you have to do is read about how other industries have responded under these circumstances to know what the food industry was likely to do. And yet we still let them do it. For example, marketing foods to children - they created a self-regulatory effort that then the field has to spend a lot of time proving doesn't work. But now those things have been proven, and so the time to expect industry to change on its own seems to have long passed. So I agree with you that coming up with better regulations makes perfect sense. Let me ask you about obesity rates during COVID. Then I'd like to come back and ask about ultra-processed foods in particular. So the rates have risen in some parts of the world during COVID, obesity rates, that is, including the United States. What's your take on this?

I think that COVID-19 really exposed the vulnerabilities in our food system. And what it did was accelerate an already alarming trend in our global weight status, I guess, is the way to describe it. But also what happened is that, throughout the pandemic, many people were faced with food insecurity for the first time in their lives, and almost all of us have seen shifts in availability and supply. So when there's no food available, hardly any food available, any food is better than no food, and one of the things that the industry did so well during the pandemic is capitalize on it. They used that opportunity to really lift their corporate social responsibility profile. One of the things we must do is not blame the individual who often have very little control over their food environment. We think we're making our own decisions when we are purchasing food, but really, someone else is pulling the strings. Many times, a large food or beverage company has made that decision for us before we even get to the supermarket by setting prices, designing products that are easy and convenient and that look good, look tasty and nutritious, but in reality, they're something quite different. And even before the pandemic, worldwide palates and brains have been trained to crave these unhealthy foods, and we know that the industry has invested millions upon millions in formulating and marketing them to be highly desirable. So the person who's the consumer is very much like a puppet.

It's an interesting way of thinking about it and deadly combination of vulnerable biology, industry exploiting that biology, and the heavy marketing of foods makes for a pretty powerful picture. So what are some of the possible solutions? What do you think that public health community and policy makers and advocates and others can do to raise awareness?

Well, I think we really have a responsibility to warn consumers about the harms of ultra-processed foods. At the moment, they're in the dark. So what could we do really is the question. What could we do to warn them? The first thing in our favor is that the term ultra-processed food, as I said earlier, is really unfriendly, and people can conceive that these products as being unhealthy, and most recognize them in our research as being harmful. So we can use this to our advantage to fight against industry marketing efforts. Just like the marketing industry builds a brand around a product, the public health community needs to build meaning around this term ultra-processed to alert consumers about its harms. We can also look at past movements like tobacco control and see where the public health community has achieved huge policy wins in strong public understanding of the consequences of consuming a dangerous product. Raising awareness is incredibly important. We've spent over 50 years educating the public on the harms of tobacco. We're going to need to do that for this category of products. We can also add information about the level of processing to food packages and warn about the products that are ultra-processed. Evidence shown that and our own consumers to make healthy decisions through clear front of package labeling really has a positive effect. We know that most shoppers spend 10 seconds or less selecting each food and beverage item. They need quick and easy ways to select the healthiest foods to avoid unhealthy foods. A number of countries, particularly Chile, Mexico, have introduced front of package warning labels in an effort to address poor diets. If in these examples we could further strengthen the warning labels by adding the descriptor, "This food is ultra-processed," we would be further educating the community about which foods are safe to consume and which aren't.

That raises a very interesting point that I know these warning label systems that you're talking about tend to score foods according to being high or low in particular nutrients. So foods high in sugar, for example, would get a poor score. And I think the point that you're making, that's very well taken and others have made as well, is that there's something about these ultra-processed foods that is damaging beyond the fact that they carry lots of bad nutrients with them. It's the processing itself that is part of the reason our human biology is being thrown off. So if that's the case, then labeling these would be very interesting. It might be pretty simple to take these existing labeling systems and just add an additional criteria for giving a food a poor score. It sounds like you're optimistic that this could occur given that it's occurring in some countries already.

Yes, I do agree with that. The opportunity here is that when industry reformulate their product as they do in some countries if they're able to reduce the levels of fat, salt, and sugar in their products to avoid with the label, it doesn't stop the product from being ultra-processed. So what we are trying to avoid is the situation where we see no labels on ultra-processed products, so no warning labels for fat, salt, and sugar, but the product remains ultra-processed and, therefore, it's still harmful. So this is one proposal that might help mitigate that. It might help the public continue to understand that it's not just the fact of these single nutrients that are harmful, but it's the whole product that can be dangerous to people's health.

Bio:

Trish Cotter is the global lead for the Food Policy Program at Vital Strategies. She has extensive experience aligning strategic communications to achieve policy and behavior change outcomes across several areas of public health including food policy, tobacco control and cancer prevention and screening. Trish is the lead author of a new commentary published in BMJ Global Health: ‘Warning: ultra-processed’ — A call for warnings on foods that aren’t really foods. She holds a master’s degree in public health from Monash University in Melbourne, Australia

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Are there models for livestock production that support both farmers and communities? Today, we're going to explore the complex nature of relationships between farmers and nearby communities and the impact of industrial agricultural practices, such as CAFOs, stands for concentrated animal feeding operations, on those relationships. Our guests today are policy advocate Sarah Carden with Farm Action and community organizer Monica Brooks from the Maryland State Commission for Environmental Justice and Sustainable Communities.

Interview Summary

Sarah, let's begin with you. Can you tell us what is a CAFO?

Sarah: Sure. Let's begin with the USDA definition. The USDA defines a CAFO as an intensive animal feeding operation in which over 1,000 animal units are confined for over 45 days a year. When we say animal unit, we mean the equivalent of 1,000 pounds of live animal weight. So a CAFO can house anywhere from hundreds to millions of animals. CAFOs are a part of the industrial agriculture system, which is controlled largely by multinational corporations. These corporations have been able to externalize their true costs - meaning they pass their production and distribution costs onto other entities. For example, farmers raise animals for corporate integrators according to a very strict contract in which the integrator has all the power and can set the terms of the agreement to maximize their own profits. In this relationship, the farmer is responsible for financing everything that depreciates in value, buildings, manure from animals, farm equipment. Meanwhile, the integrator owns the only thing that actually appreciates in value: the animals. CAFOs include both open feed lots for cattle, as well as huge buildings with no windows where livestock and poultry are confined, often in boxes or stalls. They produce huge amounts of animal sewage. Even the smallest CAFO produces an equivalent amount of waste as 16,000 humans. CAFO waste is usually not treated to remove pathogens and emits hazardous chemicals, such as ammonia, hydrogen sulfide, and methane. CAFOs destroy the air quality around them with particulate that carries disease-causing bacteria, fungus, or other pathogens. Animals frequently die in CAFOs, and their carcasses often, in large numbers, must be dealt with. Infestations of flies, rats, and other vermin are commonplace around CAFOs and, therefore, around CAFO neighbors.

So Sarah, thanks very much for that description, and I'm really happy that you address that issue of the integrators, the big agribusiness companies that control so much of the food supply chain, and so many people think the farmers are at fault for what goes on in these operations, and it's discouraging how little control they have over it in many ways and, in fact, over their own livelihoods. So it was helpful to have your description. So Monica, can you describe what it's like to live near CAFOs?

Sarah: Sure. Unfortunately, residents who have to live near CAFOs experience everything from an enormous amount of flies to ammonia in the air that can cause burning in the throat, burning in the skin, coughing, asthmatic conditions, not to mention all night and all day, you're surrounded by large tractor trailers that are going up and down your highway at all hours of the night, lights flashing through your windows. You have feathers and all kinds of things on your property, and lastly, the main thing that happens is many of these people are on well water. Their wells lose water every time a CAFO moves in next door. So I'm talking about people who have actually had to, at their own expense, redig their own wells repeatedly just to have water for their families.

So it sounds like there are a number of things that range from being, I guess what you might call a nuisance to major things that could have big influences on health. And I know there's an epidemiologist at Duke who's done some very interesting work on the health consequences of living near CAFOs, and they're really pretty significant, significant an understatement, actually. So let's talk about activity on the ground and what happens in communities. So can you talk about what happened in your community when you found out that a number of CAFOs were approved to be built and what happened?

Monica: What of the things we've discovered in these rural communities, when you have a large industry, an agricultural industry as what we have here, is the agricultural industry seems to be able to get licensed to do things that the community may not approve of but the community is not informed. We found out that 13 football-size field CAFOs were coming to a small plot of land near our home, which was actually slotted to be placed on top of what's called the Paleo Channel, which is our source of water. We're on well water. And so our county thought, "This is a good idea for us to put 13 large CAFOs with manure that's going to be coming out particulate matter, ammonia, nitrates on top of the source of water for residents." There was this very tiny blurb in the paper about it. That was it. There were no hearings. There was no information disseminated to the community at all. When we got wind of it, we came together as a community, people who never knew each other before, all different walks of life, and we had to fight this on our own. We didn't receive local support. We attended every council meeting. We spoke, we testified, we had town halls. You name it, we had it, until we received some support from some outside coalitions, Socially Responsible Agriculture Project, Food and Water Watch, and some attorneys for Earth Justice who were able to come alongside of us to give us that emphasis that we needed, and yet it took us three years in order to prevent this project from coming. We were successful and basically literally wearing down the prospective CAFO owner. However, it would've been really nice for us to have support from our legislators and our representatives, but you know what? This was a great opportunity for the citizens to show that there is power when we come together. There's power, and we can bring about change and to go for what we want and in spite of us possibly being underdogs.

So Monica, do you have any advice or guidance for other communities who might be facing this kind of pressure from the big corporate agriculture interests?

Monica: Yes, I want to encourage you to know that, first, you're not alone. Don't be afraid to speak out. Mobilize your community. Connect with your neighbors. First go to your elected officials, and do whatever you can to ensure that these CAFOs don't come to a neighborhood near you. You can do town halls. You can do protests. You can write letters. You can make all the noise in the media that you want. These kinds of things are what helped our community to become successful in fighting, but you can do it. Don't be afraid to ask for outside help. There are several organizations all across the country that help in matters just like this, and you can be victorious. You can help get laws changed. You can help to bring better air and water and quality to your neighborhood.

Monica, thanks for that, and it's really nice to know that community voices can be heard and that there are specific ways of making sure that takes place. So Sarah, back to you. Are there my models for livestock production that you believe support both farmers and communities, and would any alternative to CAFOs be able to feed enough people?

Sarah: Yes, and I'd like to echo what my colleague Dee Laninga said in a previous interview, and this is very important: "Industrial agriculture is not currently feeding the world. Smaller farms are doing that. The industrial Ag model is focused on producing feed for livestock, not food for people. It exports its meat products to wealthier countries, not to the world's hungriest."

So to answer your question about alternatives, they do exist. They have just never been given the same legislative, regulatory, and financial opportunities as big agribusiness. We need to prioritize policies and lending practices that will. So we need to deepen our local food economies, expand regional meat processing capabilities, give independent producers more pathways to the consumer. Robust local and regional food infrastructure includes things like convenient food hubs that distribute the wares of local producers, independent processing plants that serve local farmers and provide region with local sustainable healthy meat, community supported agriculture networks that provide the freshest produce from farm to nearby table, farmers who sell directly to consumers at markets, co-ops, and roadside stands, and grocery stores that recognize the fact that customers want to see the names of nearby farms in the produce, meat, and dairy sections. If industrial agriculture interests were required to internalize their costs and mitigate these risks, they would not be economically competitive with these alternatives. So if alternatives instead were prioritized in our policies, we could have a food system that not only stimulates the economy and operates within fair markets but also positively impacts health outcomes, the environment, and our social fabric.

Bios:

Sarah Carden (she/her) joined Farm Action in December 2021. As Policy Advocate, she focuses her efforts on raising awareness and advocating for policies that meaningfully reform the nation’s food and agriculture system. Sarah holds a B.A. in Evolutionary Biology from Harvard University. She has been working on food system reforms for over a decade and brings expertise in local food systems and distribution networks, agriculture, non-profit development, and food entrepreneurship. Sarah has also worked as an organizer on two presidential campaigns and one congressional campaign. Sarah lives with her husband and their two young children on their organic vegetable farm.

Monica Brooks is a private citizen who serves on the Maryland State Commission for Environmental Justice and Sustainable Communities.

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Today, we're going to explore industrial agriculture and what that means to farmers and ranchers, to farm workers, to corporations, and consumers. Our guest today, Adam Zipkin, serves as council to New Jersey Senator, Cory Booker. He advises Senator Booker on issues related to food policy, agriculture, and animal welfare. Booker has been deeply engaged in legislation such as the Farm System Reform Act, Black Farmers Act, and the Climate Stewardship Act.

Interview Summary

Now, the work that you and your colleagues are doing, and of course, Senator Booker, is really important, groundbreaking work. So I'd like to dive in and talk about that. So first, could you tell us about the work that you and Senator Booker are doing - focused around the area of agriculture?

I was with Senator Booker when he was Mayor Booker in Newark, New Jersey. And when he was mayor, we saw up close how a lot of communities in Newark were food deserts. We did a lot at the city level to try to address that where we had communities where people just didn't have access to healthy foods and to fresh fruits and vegetables. So we would try to attract new supermarkets and started growing a lot more produce in the city. But ultimately, we realized that the scale of the problem was just bigger than any one city could solve on its own.

Then, when we came to the Senate, Senator Booker and I traveled and met with farmers, and went to rural communities, not just in New Jersey, but around the country. We went to Duplin County, North Carolina. And there, the Senator saw just how these massive factory farms, large CAFOs, were really hurting the local communities - primarily low-income communities, communities of color - with air pollution, water pollution, and health impacts. As we started working on the 2018 Farm Bill, we traveled to Missouri, Kansas, Illinois, and met with farmers and ranchers there. What the Senator learned was that the same broken food system that was really hurting people in Newark was really a broken system nationally for all of us.

So Senator Booker started working on legislation to try to change the system. And he introduced the Climate Stewardship Act, which is focused on investing in farmers and ranchers as part of the solution to climate change; and using existing voluntary USDA conservation programs and targeting dollars to regenerative Ag and soil health practices where we can reduce emissions and increase carbon sequestration. He introduced the Justice for Black Farmers Act, which is a bill to comprehensively address the terrible history of discrimination by USDA against black farmers over the past century. Another really important bill that Senator Booker introduced was the Farm System Reform Act, which is a bill that would put a moratorium on new large factory farms and phase out large factory farms. It really comes up with sort of a blueprint to transition us from this current industrial model that is failing us on so many levels to a more regenerative system.

That work is impressive and ambitious in scope. I wish you the best of luck with it. It's interesting to me that you happened to mention Duplin County, NC. So my colleagues and I at the World Food Policy Center did a tour of farms in eastern North Carolina several years back, and Duplin County was one of the places we went. And I just so happened to look up numbers for Duplin County. Now, this goes back several years, so I'm not sure how current they are. But if I remember, the annual production in that county - the counties in North Carolina aren't all that big, by the way, we have 100 of them - but Duplin County's annual production of hogs is 2 million hogs. And in addition to that, 5 million turkeys and 69 million chickens. And this is a single county. So the scope of the industrial agriculture, and of course, the consequences of it are really pretty impressive. So it's interesting you happen to go to that county as well. Let me ask about a report that was published by a group called Farm Action. They published this in 2020. It was entitled "The Truth about Industrial Agriculture." What was it that interested you about this report and how has it influenced your thinking and your work?

So Farm Action is one of the stakeholders that our office has worked with a lot, and we consider them to be a really important voice on these issues. The report that you mentioned, "The Truth about Industrial Agriculture," is a report that really does a great job of going through all of the ways in which our industrial meat production system is harming all of us. It shows how it's a system that is really hurting independent family farmers who are forced to try to compete with a system that externalizes all of its costs. We're seeing independent family farmers driven into bankruptcy and forced to sell or be foreclosed on. We're seeing how this current factory farm system hurts the environment through the air pollution, and water pollution. And how it's really dangerous for public health, both in the impacts locally on neighbors with respiratory diseases like asthma, but also, the pandemic risks that we face from large factory farms and the way that the system is so harmful to workers. These were things that Senator Booker and I had learned about and were motivating us in bills like the Farm System Reform Act. But this report just does a great job of consolidating all that information and laying it out and also goes through and dispels a whole bunch of myths about the current system.

Can I ask you a question about your perception of public opinion? So Americans, for decades, have spoken, in a way. They wanted food available all the time in their supermarkets in an abundant amount at the lowest possible cost. And the way to deliver on that, the hope that Americans had, was to have industrial agriculture. So do you think Americans are thinking differently about it now? Are you sensing a shift in public opinion or awareness that might be leading the general public along the lines of what you're talking?

I do think there's starting to be a shift. I think there's been some polling in the last few years that show that the public does want these factory farms to be better regulated. And, there is growing support for putting a moratorium on new, large factory farms. I think that part of what's really important about reports like this and about bills like the Farm System Reform Act, and having advocates and Senator Booker and others out there talking about these issues and raising awareness about these issues, is I think that, the more that the public learns, the more public opinion will be supportive of bills like the Farm System Reform Act. Because I think that, currently, the industry tries to keep the system as opaque as possible, right? They try to pass these Ag gag laws at a state level that will punish people if they just try to take pictures or show the public what the conditions are like for animals and workers inside of these factory farms. So I think that public opinion is, I think, shifting and I think that, collectively, we're working to try to accelerate that.

I'm a bit curious about your impression to see if it was consistent with mine. When we were doing the tours of farms that I mentioned, we visited some industrial-sized agriculture operations and the CAFO units and things. And it was our impression in speaking to the farmers that they weren't making a lot of money from this, that the big companies were, the big companies that are referred to as integrators, but the farmers weren't. And they looked like they were having tremendous risks because they bore most of the risks the companies didn't and their profit margins were very low and they had to work extremely hard under difficult circumstances. And so I think that, if there is any perception among the public, that it's the farmers themselves who work in these places that are making a lot of money. That didn't seem to be consistent with what we were doing. But I was wondering what your impressions were?

I think that's exactly right, Kelly. We've met with contract farmers out in the field. We've also had contract farmers come to meet with us in Washington. And the first thing that struck us was how scared they were to even be talking to us because they were telling us that if the big integrators, if these big companies that they were contracting with, if they even found out that they were talking to us, that they could get punished by them. Like you said, a lot of these contract growers, if they were just having to live on the farm income, they would be at or below the poverty line, right? So they're forced to have family income from off the farm just to keep their heads above water. And a lot of them, what we heard from them, wished they had never gone down this road, where they were forced to invest hundreds of thousands of dollars or millions of dollars to build these barns and these manure lagoons and these systems. And now, they've taken on all this debt and they feel like they're trapped and they just can't get out. So one of the things that we do in the Farm System Reform Act, in addition to putting the moratorium on new CAFOs, is to provide $10 billion a year for 10 years to give voluntary buyouts to farmers to contract growers that want to transition out of this industrial model to a more regenerative model. Whether it's using their barns to grow vegetables or mushrooms or to do pasture-based livestock or other types of regenerative agriculture to just help them get out.

Oh, that's impressive. It's really nice that you're sensitive to the needs of the people that are working so hard. So back to the report that we were referring to, how do you hope that government agencies and elected officials will use information?

I think it's a really important report for Senate offices and House offices to have at their fingertips and to be able to really learn about the system. Because other than the senators or the members of the House of Representatives who are actually on the agriculture committees and focus on these issues day to day, there are a lot of members of Congress, just like there's a lot of members of the public, that have no idea really, of what is going on in the current system. They've heard a lot of the industry talking points because there are well-funded campaigns to get their myths out there. There are also a lot of the dollars spent on lobbying by these big, consolidated, multinational companies. So I think that this report really can help raise awareness amongst members of Congress, both in D.C. and at the state level as well, where we've seen some bills similar to the Farm System Reform Act introduced in various states. And, I think that just having all this consolidated into one report and just laying out how, really, the current system benefits these big companies and their shareholders and really no one else. Sort of rural communities, the environment, animals, workers, independent farmers, all really are being hurt by this system, and having the report and having the sort of myths and the truths about some of the beliefs, I just think it could be really helpful. Because we need to add cosponsors to these bills and build momentum.

I think in addition to what you were saying, and those are all really important points, that the average consumer going to the store to buy chicken, let's say, may not be thinking about the welfare of people who live in rural areas or the environmental damage done by some of these operations. But in fact, everybody does get affected by this, by things like antibiotic resistance and overall damage to climate, and there are just so many things that ripple through our world that really nobody's unaffected by it, are they?

That's exactly right. I think that the report really, by focusing on all of the negative, externalities from these factory farms, that these big meat-packing companies, they don't absorb those costs, right? Instead those costs are being paid, whether it's by our healthcare system, or by the local communities, or the damage to the environment, through the water pollution where people's local streams and creeks are polluted and their Wells where their families have been drinking water from these wells for generations. And now, they've been poisoned. So all those are costs that don't appear when you're just paying the price at the supermarket, but that all of us are paying. I think the report does a great job of laying that out.

So if the kind of policies you're talking about, and let's say other related policies, actually get enacted, what does a transition look like as we change from industrial to other forms of agriculture?

Look, this system has been built over many decades and is massive in scale. And so it's not going to change overnight, which is part of why, in the Farm System Reform Act, we put in an immediate moratorium on new large factory farms but we phase them out between now and 2040, right. We recognize it's going to be a transition period that's going to take time. But I think the voluntary payments I mentioned, where we're helping to financially assist the farmers to transition to this new system, I think creating a system where we are paying for the types of practices that are beneficial from an environmental perspective and a climate change perspective, sort of transitioning to where the workplace is, right. Right now, these meat-packing workers are exposed to terrible working conditions. I mean, COVID-19 sort of tore the lid off of this system in terms of, what we don't usually get to see, the public got a view of these meat-packing plants and the conditions and how they became COVID-19 hotbeds and workers were getting sick and dying and creating COVID hotspots in their local communities. And so I think that the transition is where we start to create a system that, rather than benefiting just these big corporations, is benefiting rural communities, independent farmers, workers, and just getting started doing that.

So what is success?

I think success looks like starting to align our public subsidies with the type of food system that we want to create. Because one thing we haven't even talked about is the ultimate impact of our current system on the people that are eating the food, right. In our country, right now, we're seeing an explosion of diet-related diseases, type 2 diabetes, obesity, heart disease, certain types of cancer, all preventable diseases. That's sort of the end result from this system. And so I think that success will be where, right now, our dietary guidelines say we should be eating 50% or more of our diet should be fruits and vegetables, but less than 2% of our federal Ag subsidies go to fruits and vegetables. So I think aligning our public investments with the outcomes that we want to see. And then, ultimately, success is a system where rather than being part of the climate change problem, our food system is part of the solution by absorbing more carbon than it is generating. And a system that treats workers fairly and treats animals more humanely and has positive economic and environmental impacts on the rural communities. I think transitioning to that, ultimately, is success.

I just finished a book called "The Poison Squad," and it is a book about how really broken our food system was at the turn of the century, in the 1900s. And how there was just a decades-long fight by policy makers and the public and advocates to change the system. And they were successful over time. I think it gave me hope that collectively we can now fight that same fight and hopefully have a system that ultimately reflects our values.

Bio:

Adam Zipkin currently serves as Counsel to United States Senator Cory Booker. In this role, Adam advises Senator Booker on issues related to food policy, agriculture and animal welfare. Before his employment in the Senate, Adam was Deputy Mayor for Economic Development for the City of Newark, New Jersey. Prior to working in City Hall, Adam operated a law office primarily devoted to providing pro bono legal services to Newark residents in need, with a focus on providing representation to low income tenants. In 2006, Adam received the “Pro Bono Attorney of the Year” Award from Essex County Legal Services, Volunteer Lawyers for Justice Program in recognition of his service and dedication to meeting the legal needs of indigent persons.

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So there's a big question out there that's being asked over and again: do massive multinational corporations have an outsized control of our food system, and what does this mean for all of us? Disruptions in food supply chains recently have highlighted the vulnerabilities of an industrialized agriculture system that according to some does not benefit farmers, farm workers or even consumers. Today, we're going to explore a new report from the organization Farm Action entitled "The Truth About Industrial Agriculture: A Fragile System Propped Up By Myths and Hidden Costs." Our guest today is Dee Laninga, senior communications manager for Farm Action.

Interview Summary

So first, can you tell our listeners about Farm Action and what it does?

Absolutely. We are a small but I think pretty mighty nonprofit working to transform the food and farm system into something that works for everyday people rather than a handful of powerful corporations. And to do that, we do our own independent research, we do policy development, advocacy campaigns, we leverage political expertise on the Hill and that's all to educate people and advance policies that will democratize our food system. The thing about working on food system reform is that what we eat and how it's grown or raised intersects with just about every aspect of human life, health and nutrition, racial and social equity, indigenous rights, workers' rights, environmental justice, even economic competition. So by pushing Ag policies that create a more fair and inclusive food system, we're really able to move the needle on a lot of today's urgent issues. And that mission seems to be resonating with people a lot right now. Earlier this month we were reached out to by "The Hill," the top us political newspaper, they wanted to run a profile on the organization tracing our origins and showing how we've been able to influence the Biden administration. So what we're finding is that the way that new stories are spreading and catching on about the effects of corporate consolidation and industrialized practices that proves to us that people are really ready for change, they're ready to see a breakdown of corporate control.

I Agree with you by the way and it seems to me that more people, not just the advocacy groups who've cared about this issue for quite a while, but general public thinks about these issues a lot more than it used to and more and more people care about where their food comes from, the story of their food if you will. Would you agree that?

I would 100% agree. And what's so striking is that it seems like one of the last areas where you can reach people from across the political spectrum. Everybody cares about their food, everybody cares about the health of their families, even everybody cares about farmers and wants to see them succeed and do well. So it feels like one the places in our somewhat deeply divided society that we can still come together and talk about solutions.

So let's dive into the report entitled "Truth About Industrial Agriculture."

So I should probably first define industrial agriculture. So Farm Action defines it as a corporate controlled system, one that relies on extractive mechanized food production practices that prioritize excessive profit over people, animals, and the environment. For decades, the corporations that benefit from these practices who really put them in place have been controlling the public conversation and the policy debate by using their economic and political power to spread myths that defend the system. So after defeat after defeat to reform the system we felt like it was past time to change the narrative, tell the truth and raise awareness of the harms that industrial Ag does to the farmer, rural communities and eaters everywhere. So defining the problem we felt would be the first step towards the solution and people need to know about the widespread impacts of our brittle, vulnerable, consolidated, industrialized system. Following major breakdowns and the ones you alluded to earlier Kelly in our food supply system in the early months of the COVID pandemic, we produced this report to show how industrial agriculture causes problems for everyone. It's not just an issue for farmers or even for people who live near factory farms. Our industrialized food system is negatively affecting anyone who eats food and we really need to do something about it quickly. So the report was meant to address that.

Let's talk about one word in particular that you mentioned and it's extractive. Tell me what you mean by that?

Absolutely. So extraction - that is a process by which corporations have been able to externalize their costs. They are passing the burden of their production and distribution on to other entities who have less power. So that would include farmers, rural communities and taxpayers. They've had wealth extracted from them through this process.

And would also applied to extraction from the land like over use of land by monoculture in ways that aren't restoring the land and regenerating it?

Yes, absolutely. The soil health has been vastly depleted in Iowa and other states. Phil Potts' excellent book, "Perilous Bounty" documents this process of how the wealth of the soil, the health of the soil has been extracted by corporations for maximum profit.

What are some of the key findings of your report?

So the big ticket item that I hope listeners would take away from this conversation is that far from being the sort of inevitable savior of all of us, industrial Agriculture is just an economically flawed system that only survives due to two factors. The first would be the wildly successful marketing campaigns that are based in myth that convince decision makers and the general public that these big corporate, industrialized food production practices are our only option. And then the second fact keeping the system afloat is that these corporations have been able to externalize their true costs, meaning they pass their production and distribution costs on to other entities who have to then shoulder that burden. So the farmers that grow or raise animals for them and have to foot the bill for equipment and farm infrastructure, so that would include the people who work for their companies in dangerous conditions with low pay and few to no benefits, consumers who have to pay higher retail prices at the grocery store, taxpayers for infrastructure repair and environmental cleanup. And then of course, rural residents who live near industrialized operations and have to pay vastly higher healthcare costs as a result of the air and waterborne pollutants put out by factory farms. A recent report found that while US consumers spend 1.1 trillion on food each year, the true cost, which takes into account the impact industrialized food production has on the environment, on human health, on workers and more it's actually three times that amount. So it actually costs us more than $3 trillion annually to produce and distribute food in an industrialized way.

Okay, so what are some of the myths that you're hoping to counter?

I think the myths are a really accessible and memorable entry point into this research because they're going to feel really familiar to a lot of people. So for instance, the myth that rural economies would collapse without the presence of industrial Agriculture. Or that the chemicals associated with its methods are totally safe or that the so-called efficiency of these huge vertically integrated operations, that that's the only thing standing between American families and sky high food prices. These corporate talking points about the benefits of their own system, they've been around for so long and are so pervasive that they've really entered the public discourse as fact or like common sense that you don't even question. But when you look really hard at the facts, the myths just fall apart and that process is really eye-opening for a lot of readers. We have a blog series on our farmaction.us website that unpacks each of these myths in detail with real life examples and links to sources that just makes it super accessible for just the everyday reader. And then we've also posted these blogs in a weekly #MythBusterMonday series on our Facebook and Twitter and that's been able to help us get sort of bite sized pieces of the research and really break down the myths and get them into the hands of the public.

So let me ask the final question, which maybe is the most important of all. So is it really possible to feed the world without industrial Ag?

That is such a powerful myth and that has had just incredible staying power, but there's a couple of things here to address that myth. One, industrial agriculture is not in fact what's feeding the world. Our research shows that smaller farms are currently meeting 70 to 80% of the world's food needs and these farms could double or triple their production without adopting industrial farming methods. And then the second thing I want to mention is that the output of industrial Ag in the US doesn't even go to the world's hungry. Farm output around the world is rising so other countries don't necessarily need our goods. And then US meat exports are not going to those nations with the highest level of hunger or food insecurity and those countries are predominantly in Africa, South America, and the Middle East. And instead we see that US meat exports go primarily to developed and rapidly developing nations that have growing economic middle classes that can afford to pay global market prices for meat.

And I would just say that to anyone who's curious about what goes into the food you find on any given grocery shelf, I really encourage you to check this report out and share it with people you know. There's just so much at stake if we keep going down this industrialized consolidated road for our food system and so much to be gained from change. So we really appreciate this chance to talk with you about it and thank you so much.

Bio:

Dee Laninga joined the Farm Action team in April of 2021 to raise awareness about the organization’s core issues and drive engagement toward equitable, sustainable, and family farm-centered solutions. Dee draws from her background in strategic communications, creative writing, and design to craft resonant narratives and compelling graphics to advance an array of advocacy initiatives. Her past work in such diverse sectors as clean energy, antihunger, and agriculture inform her broad perspective. A full-time digital nomad since 2019, Dee spends her spare time hiking in the phenomenal state and national parks this country has to offer. She holds a BA from Grand Valley State University and an MFA from Washington University in St Louis.

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Antibiotic resistance has long been considered one of the greatest threats to global health. More recently, we're seeing growing public awareness around the overuse of antibiotics used in the US livestock system - a system that produces much of our meat supply. Widespread antibiotic use on US farms has evolved from something that only a small group of advocates and scientists worried about to something many more people are talking about now. The term antibiotic free is showing up on products and supermarkets and the way fast food chains are advertising their products. With drug resistant pathogens or superbugs, as some people know them, now being called the slower moving pandemic, it's time to check in on both how the science and the policy are evolving in this important part of our food system. And there's no one better than our guest to help deal with this. Dr. David Wallinga is senior health officer for the Food, Agriculture and Health, Healthy People & Thriving Communities Program at NRDC, the Natural Resources Defense Council, a leading environmental organization. David is a physician, and has led the way on connecting science with policy in the area of food and environment. He is highly regarded for his work on antibiotics and the food supply.

Interview Summary

So David, I recorded a podcast with you many years ago when I was at Yale University. We were discussing this important topic, and boy, a lot's been discovered since then. So it'll be nice to dig in and get updated. So again, thanks for being with us. I've really long admired your work and your passion and your ability to communicate what is pretty complex science in this area. So, David, how did the use of antibiotics in the food supply begin? What are the origins of the story?

Well, a book that came out in 2014 told a really compelling story that I'd never heard before (The Chain: Farm, Factory, and the Fate of our Food). And it seems to suggest that it started with the Hormel Company, the makers of SPAM, who were trying to keep up with demand for the SPAM product after world war II, and was having trouble. And one of the things they did was to reach out to researchers from the University of Minnesota to see if feeding antibiotics, these new miracle drugs, through animal feed to chickens and pigs could have an effect of them putting on weight faster, which they thought might be the case. And at least initially that did turn out to be true. So at Hormel Institute, this is what they called it, the collaboration between the researchers and the company continues today and is very involved with the University of Minnesota, as well as the Mayo clinic.

That's so interesting that the story began with not only using antibiotics to prevent or help cure disease, but just to make the animals grow faster and produce more meat.

Well, they didn't actually start off to prevent disease, that wasn't mentioned anywhere, at least in Genoway’s account. The thought was not to use them to treat disease, but rather they reasoned that if they could use the antibiotics to kill off some of the gut bacteria, then the animals would be able to divert more energy into growing. So really, it was always designed from the get go to put on weight in animals that were otherwise healthy.

Oh, that's so interesting. So, how widely used are antibiotics in the food supply?

Well, flash forward many decades, they're extremely widely used globally and in the US. Globally researchers estimated 70% of all the medically important antibiotics - and by that, I mean, ones that are used in livestock as well as in people - so about 70% or more are used on farms, especially in livestock production. In the US it's about the same amount, roughly two-thirds.

Oh, those are staggering numbers. So what are the up and downsides of this big use?

I see few upsides actually. People for time immemorial have been raising animals without antibiotics quite successfully. And there are still ways to raise them even at large scale, without antibiotics as we can get into later.

What about that assumption that the antibiotics produce more efficient meat production and make the animals grow faster, etc.?

I don't really see much evidence for that. When you actually look at the efficiency, there have been some studies of what's happened in Europe. They've really been very deliberate about reducing and eliminating antibiotic use that's not needed. And what they found is you can do it for the most part, without affecting productivity. And you can do it without any impact on cost either or very little impact on cost, including to the consumer. And when you factor in the public health benefit of just avoiding antibiotic use in the first place, it really comes out as a win-win.

Well, that's very important information. So what are the downsides?

Well, the downsides come from a couple of things. One is the vast majority of the antibiotics that are being used in livestock are put into their feed or in their drinking water. So that means you're feeding them on a pretty regular basis to entire herds. And the equivalent would be, I suppose, mass dosing human beings, whether or not they needed antibiotics, because you thought that some of those people might need them. Like putting it in a drinking supply for a city. You're just creating many more little breeding grounds for resistant bacteria. And that's exactly what we're doing on US livestock farms. We're creating perfect storm conditions for breeding superbugs, and then spreading them throughout the farm environment. And ultimately in the worst case, to the human population as well.

And how dangerous are these?

Well, they're really dangerous. We can't separate the superbugs and farms easily from the superbugs and hospitals. And in many cases, they're the same species of bacteria. We're talking about salmonella and staphylococcus and E. coli and drug resistant strains of these are killing large numbers of people in hospitals and outside of hospitals. So the CDC periodically updates these numbers, but the last numbers we have are that every year there's about 2.8 million or more drug resistant infections in the US and they contribute to at least 35,000 deaths a year, and maybe as many as 162,000 deaths a year in the US. Now, globally, if we don't do a better job about using antibiotics smarter, there's estimates that globally by the year 2050 there might be 10 million deaths a year. Ten million deaths, and trillions of dollars in costs.

Let me ask you this question. How do these bugs spread from the farms out there into the broader world? Is it through the food itself?

Well, for one thing, bugs, whether they're viruses or bacteria, don't really respect the same kind of boundaries between farms and hospitals and communities that we believe exist. The bugs travel pretty freely between them all. And so they get from animals to people in a variety of ways. First of all, as I said, the antibiotics are put into feed and the feed gets pooped out by the animal and ends up in the manure. So anywhere the manure goes, whether it's manure dust blowing in the wind, manure runoff into streams, or people just handling the animals and then taking the traces of that manure home with them, all of those can spread drug residues, but also a resistant bacteria. The genes in the bacteria are what make them resistant. Those can travel in all those environments as well. Maybe the thing people worry most about is on food. And in fact, in the US and in other places too, we have programs that test raw meat and poultry looking for signs of resistance. And the bad news is that it's fairly ubiquitous. Virtually anywhere we look, with a fair amount of frequency, we see evidence for resistance and resistant bacteria on those raw meats. Now, ideally, people would be using really good hygiene when they're in the kitchen, handling those meats. They would be cooking the meat really well, but that's not a failsafe. If it were, we wouldn't be having millions of cases of food poisoning every year, but we do.

Pertinent to that, I just saw a news report today - and you may not have seen it yourself - and I'm just quoting from it. It said that a gene that causes bacteria to be resistant to the one of the world's most important antibiotics, Colistin, has been detected in sewer water in Georgia. What do you make of that?

I say it's not at all surprising. Colistin is what we call a drug of last resort. We've been using up a limited supply of these miracle antibiotics for decades. It's very hard to come up with new ones. We're not investing in making new ones, and I'm not even sure we can make new ones. So we have to keep the old ones safe for as long as possible. But more and more, the bacteria are resistant to a lot of the older antibiotics like penicillins and tetracyclines. So we've got a few of the newer ones, namely Colistin, and some what are called next generation cephalosporins and fluoroquinolones. But those two are spurring resistant. And now we have examples of superbugs that are basically resistant to everything, they're untreatable. Now, thankfully, those are pretty far and few between for now. But we can see the writing on the wall. And when those start to break out and multiply, we're going to have a lot bigger increases in deaths and cases.

Well, it's a pretty scary picture. So let's talk about how things are changing. Is my perception that consumers are growing more aware of this issue accurate, and is this affecting corporate practices?

Yeah, it's accurate. I've been working on this exact issue for over 20 years. When we started public awareness, we did polling, public awareness was very low. For one thing, science literacy is not what it should be in general. People just have a lot of misconceptions about what drug resistance is. There's a common misconception that people are resistant to the drugs, and that's not the case. So what we're talking about is not eating foods contaminated with the drugs themselves, we're talking about using these drugs too much, whether in human medicine or on farms, and creating the conditions that make drug resistant bacteria multiply. And they multiply very, very quickly and then spread. And as a result, our farm environments, our streams, our sewage, as you said, and our meat and food supply are all contaminated now with drug resistant bacteria. And they're spreading, and that's the problem. And people are getting aware of it because like COVID, eventually more and more people have loved ones who are getting sick with hard to treat infections or even dying.

So, tell me how corporations are responding to this public awareness. It is changing things in the food supply chain by let's say fast food restaurants or big food sellers?

Well, groups like NRDC and our partner groups, we've been advocating for quite a while now to some of the countries and the world's biggest fast food chains, restaurant chains, and the like, to do a couple of things. One, make commitments to use fewer antibiotics in their supply chains. We know it's possible. We can get into how we know that later, but we know it's possible. And those are the biggest purchasers of those meat and poultry suppliers. So presumably if they ask their vendors to sell them product that's produced with fewer antibiotics, some of the vendors will find a way to do it. That whole strategies worked pretty well for chicken production, for example. In part companies like Tyson and Purdue got out early and discovered that in fact, they could raise broiler chickens almost without any antibiotics at all, it turns out. And so now, well above 90% of the chicken produced today in the US is produced with no antibiotics at all, or very few antibiotics. And you had mentioned at the top of the podcast, seeing labels like antibiotic free at the supermarket, that's mainly on chicken. It turns out it's been really much, much harder to see any kind of leadership by companies in pork or beef production. And the fast food chains too, have been really slow by and large too. And with just a few exceptions to commit to buying and serving pork or beef raised without routine antibiotics. Now, the exceptions are places like Chipotle, for example, or some of the smaller chains. But if you're talking about big places like Wendy's, McDonald's, Burger King, they really have been slow to make any forward progress at finding ways to reduce antibiotic use in their supply chains.

So such significant changes occurred in the chicken sector, why not in beef and pork?

Well, there's practical reasons with a big caveat. The practical reason is that a modern chicken only lives for six weeks. So all you've got to do is create conditions where you can get those fast-growing birds from the egg to the chicken, then from the chick to the slaughterhouse in just six weeks. So that makes it a little bit easier to control conditions for that long. Pigs and cows live a lot longer. The time to slaughter for a mature hog is about six months. The time to slaughter for a cow that goes from a calf stage then goes to a feed lot and gets fattened up, about a year and a half, maybe longer, maybe shorter, but it's a lot longer than a chicken. Now, with that said, have other countries found ways to produce chickens and cows with no or very few antibiotics? Well, yes, they have. Even pretty industrial producers of pork like Denmark and the Netherlands are using these medically important drugs at a rate that's one fifth, one sixth, one seventh, as much as what the US uses. So let me just repeat that. The US pig and pork industry has seemed to be using four or five, six or more times as many antibiotics on a milligram per kilogram basis as do their counterpart industries in other countries.

So this is a good segue to ask about the role of government in that picture in your mind.

Yeah, good question. The role of government is one, to protect the public. And here it's good to go back to basics. When it comes to superbugs and the spread of resistance, we know what the biggest problem is. The biggest problem is using antibiotics, and especially overusing antibiotics. And that doesn't matter if we're talking about the clinic or the hospital or the farm. Wherever you're overusing drugs when you don't need to, you're helping create the spread of resistance. And so that job number one for government should be to track the problem, to find ways to reduce antibiotics, to avoid using antibiotics, and also we argue, to set targets. And then if you've got a program in place to track the use of antibiotics, you'll be able to tell whether you're meeting your target or not. Now, sadly, the US doesn't do any of those things. Much of Europe is doing all of those things, and quite successfully. And so one of the things we're doing at NRDC with partners is we're jumping into the failure of the US agencies to protect the public. And we're doing their work for them. We're tracking antibiotic use on farms and the way that Europe does. And then we're comparing the overuse in US farms to much, much lower levels of use across much, if not all of Europe.

Bio:

Dr. David Wallinga is a physician with more than 20 years of experience in writing, policy, and advocacy at the intersection of food, communities, and health. His work on food and farming as an ecologically-based system has laid the groundwork for understanding them as important social and environmental determinants of health. He has worked to address the impact of federal pesticide policies and practices on child brain health; to change Farm Bill policies that promote overproduction and overconsumption of junk food calories and have helped fuel a rise in obesity; and to reverse the enormous overuse of antibiotics in industrial-style U.S. livestock production, its contribution to a “slow-moving” pandemic of superbug bacteria, and the federal policies that incentivize these practices. Dr. Wallinga advocates for policies that promote production of good food for communities that is more accessible, safe, and nutritious; more resilient, climate-friendly livestock production that is also safer for downstream communities; and investments in food systems and rural communities based on equity and fairness. He completed his medical school education at the University of Minnesota. He also holds a bachelor’s degree in political science from Dartmouth College and a master’s degree in public affairs from Princeton University. He lives in St. Paul, Minnesota, but is descended from Iowans.

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Today, we're going to speak about micropantries as a form of community resilience in the face of the food insecurity exacerbated by the COVID-19 pandemic. Our guests today are Reverend Wendy Miller Olapade of the United Church of Christ in Medford, Massachusetts, professor Norbert Wilson, who's Professor of Food Economics and Community at Duke University, and lead author of a recent paper on micropantries in the Journal of Nutrition Education and Behavior, Sara Folta, with the Tufts Friedman School of Nutrition, Science, and Policy.

Interview Summary

Sara, let's start with you. Can you describe what a micropantry is? I know a lot of people won't be familiar with that term, and explain why you decided to study these as a community coping strategy during the pandemic.

Sara - Sure, so the best way to describe them, I think, is if people are familiar with little free libraries, they're very similar to that. So the usual structure is a box on a pole, and the box you would fill with food. Sometimes they have other configurations and people have done things like convert old newspaper boxes and so forth, but the general idea is that it's a small box in a neighborhood where people can put food and take food. They're also sometimes called blessing boxes or little free pantries.

The way they work is there's often a volunteer or an organization that takes oversight of them and has primary upkeep, but they're anonymous and open to all to contribute or take from them. And the way I got interested is because there's actually one in my neighborhood. And honestly, I became pretty obsessed with it. Early in the pandemic, I started taking walks around the neighborhood as I was working at home. I'd go by this one and just became very fascinated with what's in there, what's going in, what's coming out, and started putting stuff in myself. And as I learned more, I realized there were these little free pantries or micropantries all across the city. And then I realized they were across the country, too.

So, as a nutrition professor, I've studied food choice among very low income folks, and I was also very much aware of how the pandemic had disrupted the food supply. And realized that micropantries were a part of the solution and had many advantages, in fact, in a pandemic situation. So I became very curious about their role. You know, I thought it was an interesting phenomenon to learn more about, and what I put in, I saw it go out, and I wanted to know the stories behind what was coming out.

It’s a fascinating concept. And so, nobody from outside the community is stocking this, a bank or a food pantry or anything? It's all done by people who are residing in the community, it sounds like. We'll talk about the study that you did and published, but before we do that, before you started officially studying, what kind of things did you observe about the kinds of foods going in? Was there a lot of in and out? Was it heavily used?

Sara - You're right in saying that it's not stocked by a food bank or a pantry. It's entirely neighbors helping neighbors, so it's people in the neighborhood putting things in for their neighbors. And there's obviously a lot of nonperishable canned goods and such, and certainly saw a lot of that in the micropantries. And I saw very high turnover. I think that was one of the things that really caught my eye at first and fascinated me, you know, was just seeing even stuff I would put in, I'd go a couple hours later and it was already out. Going on my morning walk, and then the next morning, everything had completely turned over and there were new things in there. So realizing what a need it was filling. You name it, it was in there. A lot of it was very healthy food, I saw a lot of canned beans, like legumes, some canned fruits and vegetables, relatively healthy for a non-perishable. I also saw, every so often someone will put in sweets, which drives me crazy. Not that people don't want sweets every now and then, but that it would cause an ant problem in the micropantry. So, you know, everything in moderation, but not when it comes to the feast for ants, I guess.

So, Reverend Wendy, let's shift over to you now. So I understand that you organized a citywide micropantry system in your town, Medford, Massachusetts. Can you talk about what this is and who it reaches?

Wendy - Well, thank you so much for including me in this conversation. And I just need to say to Sara and Norbert and you, Kelly, what an honor it is that somebody took the time to pay attention to this. I'm sitting here in my office, a little choked up by the story of Sara's interests and her work. And when I got the chance to see the paper, you know, it was very powerful to see the outcome of what, from my perspective, as a pastor who is not a nutritionist, although my mother's a nutritionist, ironically, but, you know, a pastor whose purpose was to just spread love and care, who feels, and forgive the reference, Jesus told me to do this. You know, out of our faith, a colleague of mine, Tom Hathaway, who serves the other UCC church here in Medford, actually installed the first micropantry by his church in the Hillside neighborhood next to Tufts. I got jealous and said, "I want one of those at my church." And so, this all happened before the pandemic. We installed the micropantry that Sara was obsessed with was the third one that we installed, that we helped another church install.

So it started out as having nothing to do with the pandemic and everything to do with our sense of loving our neighbor. Jesus calls us to do that, and so we should find ways to do that. The intention to give people who are not a part of the church meaning and purpose in their life. And so, you know, one of the things that is so meaningful about doing this is that everybody can spread love, even if they're not a believer, if even if they're not involved in our church. They can, as somebody said to me once really early on, I can't do much, but I can put a 50 cent can of beans in that micropantry and show my kids that we have the responsibility to love our neighbor. So that was really the starting point.

When the pandemic happened, when other people started to see the opportunity to give, to serve, to care for their neighbor, our motto is take what you need, leave what you can, and this system allowed for a really just way of doing that. So, you know, a lot of the other systems require that you show up with your ID and you sign up with your address and so on and so forth, and there are many members of our community who don't feel a sense of safety in doing that, whether it has to do with their immigration status or just their lives are such that they can't show up, they don't have the car to go to the pantry or whatever, right? They don't have the time away from work to show up when the pantry is open. So this 24/7, 365, no questions asked, nobody's measuring how much you take, it's just available, created access in a way that other parts of the system don't have. And don't get me wrong, this is not a solution to the food security, but it is one little way for neighbors to help neighbors.

So once we started to put a few of them out there and really use social media to publicize the availability of it, people started to say, I want one in my neighborhood. I want to do that. And so, it began to build, and then the pandemic just exploded the need and people's commitment to serve. We had help from the department of public works in our community. The mayor got involved and started to ask them to build the boxes. We worked to find these sponsors, so each micropantry - we have 17 of them now in the community, this is a city of about 60,000 residents - we have 17 of these micropantries, and each one is “owned” by a different community group. Some of them are owned by faith communities. Some of them are sponsored by Boy Scout troops and Girl Scout troops, and a community service group at the high school. So there's a wide range of people who, quote, own making sure that things stay safe and filled and clean, and, you know, it's a pretty amazing thing. Like we don't do a lot of management, but my church maintains a website and maintains the social media system that keeps them visible and keeps people engaged.

This is really inspiring to me, and I'm going to ask a question that you partially answered already, and here's the question. So there are very tangible benefits, obviously, to something like this, because people who are without enough food are able to get at least some of it through these micropantries, so that's terrific, but there are also a symbolic benefits to this that you pointed out, that the people in the community can get directly involved in addressing food insecurity by giving what they can. Is there symbolism that's important, too, for the recipients of the food? Do you think it matters to the people who are taking the food, who it came from, the way the community is involved, what do you think about all that?

Wendy - What a beautiful question, Kelly. Yes, I absolutely do. I've heard anecdotally, and I know Sara has, you know, sort of referenced this in her work, the recognition that my neighbor cares enough to help me. I've heard from many, many people who have reached out in gratitude to say thank you, thank you for giving me a place to show up. Thank you for helping my neighbors to support me at a time when things are really, really difficult. Thank you for normalizing love of neighbor. So that's a beautiful question, and, absolutely, yes.

It's so nice to hear that. Well, and then the community ownership of it extends also beyond the two individuals, let's say, who are dropping the food off and then receiving the food. There's also the community organization, so it's nice that there's so much community involvement and ownership in this.

Wendy -When I talk about how many people this touches, I'm talking in the thousands and thousands and thousands of people. There are hundreds of people who drop cans off in each of those micropantries, and you multiply that times 17 micropantries, times 365 days a year. That's a lot of people being served and a lot of people who are able to serve, and that feels pretty good.

Norbert, let's turn to you, and I'd like to ask you a question. So I know that one theme of your own research focuses on the economics of food insecurity. And so, from that perspective, what did you learn or what surprised you during the research for this paper that we're talking about?

I wanted to start by saying thanks to Sara for bringing this topic to me, and it was good to reconnect with you, Reverend Wendy, to learn about this project. And I'm so appreciative of the work that you and others in the communities are out there doing. As a researcher who's tended to work on quantitative studies, so grateful for the opportunity to work with Sara on this qualitative study, to understand the stories behind the numbers, to understand how people are really living with the challenges of food security. And I think there's something really important about what our study did in reference to what happened nationally. So this is in the middle of the pandemic, lots of people were greatly concerned about food insecurity, we saw the lines up and down food pantries or food banks reported in the news, and we sort of anticipated that food insecurity rates would go through the roof, at least the official numbers. And I think many of us were surprised when the national numbers came back, that they were no different in 2020 as they were in 2019, which was surprising for some people. And one of the things that a lot of people have argued is that there were a number of support programs, unemployment insurance, the child tax credits. There were a number of policies that the federal government implemented, and Feeding America and the Food Banking Network really did increase their service to provide help for folks.

But when we were doing these interviews, especially at the beginning of the pandemic, one of the things that we learned is that folks are really struggling. I was amazed to hear how some families had sent, if you will, their child to their parents, to go live with the grandparents, because the kids weren't in school, and the family, the parents, couldn't afford to provide the meals through the day, but they knew that their grandparents could, that the grandparents could do it. And seeing how families made these major shifts in their lives just to meet these needs. Now, these are individuals who were participating in the food pantry, in the micropantries, so I am not questioning the numbers at the federal level.

Now, I will say there was an increase in disparity where black and Hispanic households were more food insecure in a greater rate than white households, and so there's something important that did happen during the pandemic, and I think that there's going to be a lot of research that's going to actually understand that better. But the fact that families were really trying to make ends meet in really innovative and complex ways, some early work that Sara and I had done really reflected on the complex ways that families were helping their families eat using food pantries and using complex systems with the grocery store in terms of benefits and coupons. And we worried that, during the pandemic, all of those complex systems fell apart, because you couldn't go to the store like you once could. The challenges of supplies were in question, and so, I was so grateful to see communities find innovative ways of helping people meet their food needs through these micropantries. And as Reverend Wendy made it very clear, it wasn't going to solve the problem, but we did hear from patrons who used the micropantries that it did meet some of their food needs and it helped stretch the meals that they were able to get. And so, that was really important to hear, that even that small bit of help was important.

I was really struck by listening to not only the people who were able to get food, but those people were also people who were able to give food, and I think that's a very different model than what we normally think of when we think about food pantries. There was a sense of pride and community fellowship and the notion of mutual aid was something that came through in some of the interviews with the patrons of these micropantries. They realized that some things they didn't want, and so they were able to leave food that someone else would want, and not in the sense of didn't want because it was something wrong with the food, but rather they knew that that wasn't a preference of their family, and knew that other families could benefit from this. This idea of security and dignity of being able to give and not just receive was an important thing that I've heard, but it was also striking to listen to the people who were setting up these micropantries - this sense of community and wanting to support folks, regardless of background, and having a real interest to give people the freedom to take food as they need it, not to monitor, not to surveil, but just put it out there. Hopefully, someone's going to take it, and then, when there is a need for more, giving more. It totally changed the way I understood how we can do the work that we're doing.

Lastly, I'll say I really do hope that there is further work in this space to understand how these systems work. It really challenged the way I thought about what communities can do and maybe even what they should do, and I'm grateful for the opportunity to get to learn from both folks like Reverend Wendy, and then, also, with Sara Folta, who brings an important lens in terms of understanding how people are making good choices when it comes to food.

Thank you, Norbert. There's something that you all have reminded me of, which is that, so often, the solutions to problems, including food insecurity, are very top-down oriented, where governments of one sort or another, or foundations or universities, or somebody, declares what a solution to a community problem might be without the community getting an opportunity to exercise its own ingenuity and determine what its own solutions might be. And this is a very community-driven solution that sounds creative, effective, inspired, involved. There's so many wonderful things about it. I really appreciate hearing about this. So, Sara, we began with you, let me end by asking you this question. In addition to the things that Norbert said came about as a result of this study, what do you think some of the takeaway messages might be?

Sara - I guess the other takeaway is not only people needing the food, but neighbors needing to give the food, you know? In this sense, in the pandemic and all of our lives disrupted, another thing we heard was I want to do something, I want to give back to my community, I want to help my community, I want to care for my neighbor. And so few ways to do that in the pandemic, especially in the early days, and so, during the isolation of those early days, it gave a concrete way to connect neighbor directly with neighbor. So, I think, on both sides, it really so much achieved that sense of community that got so disrupted.

Access the paper here: https://doi.org/10.1016/j.jneb.2021.11.002

Bios:

Sara Folta

Sara Folta is an associate professor in the Tufts Friedman School of Nutrition Science and Policy, and associate dean for diversity and inclusion. Her research focuses on public health nutrition, or the utilization of community-based strategies for improving dietary intake, physical activity, and body composition. She has particular expertise in behavioral psychology, communications, and qualitative methods. A major line of Folta's research involves community-based interventions to improve heart health among women. A second area of research includes behavioral strategies to improve health and well-being among older adults, particularly through the development of physical activity interventions. Folta's third line of research involves community-based interventions for obesity prevention among children. These studies, in which theory-based communications strategies were a major component, are notable for the use of the eco-social model in which multiple levels (individual-organization-community-policy) are targeted.

Norbert Wilson Norbert Wilson is a Professor of Food, Economics, and Community at Duke University, with joint appointments in the Duke Divinity School and the Sanford School of Public Policy. His research touches on several food issues, such as access, choice, and food waste, food safety and quality issues in international trade and domestic food systems. Wilson is an ordained vocational deacon in the Episcopal Church USA. Additionally, his work is moving to explore equity in food access. He has published in AEA Papers and Proceedings, World Development, American Journal of Agricultural Economics, Journal of Public Health, Food Policy, Agricultural Economics, and other publications. Before joining Duke Divinity School, Wilson was a professor of food policy at the Friedman School of Nutrition Science and Policy (2017-2020). He was also a professor of agricultural economics at Auburn University (1999-2016). While at Auburn, Wilson served as a deacon at St. Dunstan’s, the Episcopal Student Center of Auburn University (2011-2016). He was an economist/policy analyst in the Trade Directorate (2004-2006) and the Agriculture Directorate (2001-2002) of the Organization of Economic Development and Cooperation (OECD) in Paris, France. In 2014-2015, Wilson was on sabbatical leave at the Dyson School of Applied Economics and Management at Cornell University. Pastor Wendy Miller Olapade Since 2013, Rev. Wendy has led Sanctuary United Church of Christ in Medford to become an emergent, post-modern faith community whose purpose is affecting deep spiritual transformation and spreading love and care. As Lead Pastor, Rev. Wendy has envisioned numerous new ways of ‘being the church’ such as ArtChurch, Faith and Film and a “Medford Cares” program. As Community-Connector-in-Chief, Rev. Wendy has inspired and led grassroots action such as SafeMedford; Medford’s Big Table, Big Ideas; and a city-wide micro-food pantry mission – taking Sanctuary-To-Go every chance she gets.

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In this podcast, we’re talking with ecologist, Steven Apfelbaum, author of "Nature's Second Chance," a book that was named a top 10 environmental book in 2009, and was one of the top 10 books for understanding what you can do about climate change. So Steve is going to talk about his work to improve soil health, a really amazingly interesting and important topic, but also how grazing and how farming can be improved, and how to restore land using nature's own processes. He'll also speak about how such work minimizes climate impact, while also reducing flooding, increasing food quality and nutrition, and improving land health.

Steven Apfelbaum is a senior ecologist and science advisor at RES, Resource Environmental Solutions, and Founder and Chairman of Applied Ecological Services. This podcast is part of our Regenerative Agriculture series.

Interview Summary

So there's lots of talk these days about food and environment. Perhaps not enough still, but certainly more than what used to be the case, and it would help to have some context. So, do you think food systems changes can really help reduce climate risks, and if so, kind of how much? Give us some context for this.

Great question, Kelly, and a very interesting question, because it's not really clear to most people how significant the land base is that we alter currently and what we've managed over time. There's about 5.5 billion hectares of land, 3.5 billion in grazed landscapes, and about 2-2.5 billion hectares on the planet that we manage in row crops, in rough numbers. And that is out of about 14 billion hectares of terrestrial land on the planet. It turns out that approximately 43% of the excessive atmospheric greenhouse gases now in the atmosphere are derived from the collapse of soil systems. They're emissions released as organic matter in soil that's deteriorated by tillage and caustic fertilizer use, and through the erosion and decomposition of soils. The greenhouse gases that have come out of the disruption of soil systems include carbon dioxide, methane, nitrous oxide, and others. Currently around 14% of the greenhouse gas emissions result from these same causes. When you factor in externalities like the mining and manufacturing of fertilizers, the emissions are actually higher than 14% currently. So, historically and currently, Ag plays a very, very huge role in greenhouse gas emissions. And therefore, as we'll talk about in a minute here, a very big role in solving the excessive greenhouse gas emissions that are currently in the atmosphere, and those that will be.

So, improved grazing and improved cropping are two strategies. You know grazing can be implemented on some or all of the 3.5 billion hectares of range land, and the improved cropping on the 2-2.5 billion hectares of farmland on the planet. And what we've learned through research on improved grazing, especially adaptive multi-paddock grazing, which is very high density, long recovery grazing, is consistently in the range of three to five tons of CO2 per hectare per year improvements over and across the fence where conventional grazing may be occurring. So if you multiply 3.5 billion hectares of grazed land on earth, by just one ton of CO2 per hectare per year, that's around 3.5 gigatons, or 3.5 billion tons of CO2 that we should be able to pull down from the atmosphere and put back into the soil. And when you add improved cropping - such as low disturbance cropping, one pass no-till, and a range of other practices, you know, cover cropping, crop perennialization, eliminate a range of fertilizers served besides irrigation, significantly reduce or eliminate soil tillage - what we've measured where those changes have occurred is upward of two tons of CO2 equivalent per hectare per year being achievable. And when you add that together with the improved grazing potential, the answer is a very loud yes, that agriculture can be, should be, and is probably the only scalable, rapidly economically-viable solution to some of the climate change issues that we're facing.

Those are impressive numbers. So you're really talking about addressing climate through agriculture in two ways. One is you can stop some of the destructive things that are going on now, but you can actually help reverse the destructive nature of climate change by changing practices and drawing down carbon from the atmosphere, and using the soil as a way to reverse damage that's already done. Is that correct?

Exactly. If you view the soil as a large storage battery, where what it stores, among other things, is soil carbon and soil carbon is most readily stored below ground, out of harms’ way from wildfires that trees and above-ground biomass are subjected to or vulnerable to, it's surprising even with poor farming management practices, how soil organic matter, soil carbon, continues replenishing. It replenishes at a slower rate, and therefore less of it becomes produced annually, but soil microbes and bacteria, fungi, and plant root dieback on an annual basis draws soil carbon from the bottom-up. And it is an important way that the earth has stored carbon since the earth began getting in the carbon business.

Well, let me ask a question about farmers, and how in general, farmers, and I know you can't generalize across all of them, but how much attention are farmers paying to this issue? And the one the reason I ask that is I was actually at a breakfast meeting this morning with Duke colleagues. One of them said that the term climate change is radioactive to many farmers, and they turn off to it and don't want to engage in the conversation. But if you mentioned weather changes, then they'll be very responsive because they kind of witness the impact of this in their day-to-day lives. So, certainly there are a group of regenerative Ag farmers who were very keen on this, and of course speak the same language that you're using, but what about farmers in general? Is this something that's of concern to them, what do they think about the future, and climate, and what do you think the picture is with that?

Well, I think the picture is coming into crystal view at different rates in different parts of the country, different parts of the world. And it largely depends on the availability of moisture to grow crops. Where farmers are experiencing a reduced availability or reliability of moisture and growing conditions for their crops, they're listening attentively to what's happening. Our language matters. One of the things that we've learned consistently is that every farmer believes that soil health and good rolling conditions are critical to their farming operations. And every farmer also realizes the importance of the appropriate meteorological conditions, weather conditions, such as you brought up, Kelly, to support the farming production that their life and livelihood depends on. So the language that is most easily understood, most easily communicated, and it's what's communicated within the farming circles rather than external language that's brought to that circle, is the language of weather, is the language of how are my crops doing, how are your crops doing? It happens at every coffee house, every coffee shop, every restaurant diner in rural America, probably every single day during the growing season. And then they talk about it the rest of the year during the winter about what it did or didn't do during the year. So, farmers are very focused on the economics of their operation, and any effect on the economics, whether it be policy or regulatory, or most usually weather, meteorological conditions, get their attention. The changes in the weather and the availability of moisture is a easy conversation to have with farmers. And as soon as you bring up, in some parts of the country, climate change or global warming, a switch oftentimes goes off depending upon who's in attendance, and you're so right, eyes glaze over. But as soon as you get back to talking about rainfall and what they've experienced, they're full on and fully engaged. So, the economic side of the story is farmers are being hit hard where there's excessive rainfall, flooding, and in the opposite, you know, severe drought. So they're paying attention to this and they're beginning to realize around the world that they can control their destiny to some extent, that once a region dries out, it's very difficult for that region to generate moisture, to help generate moisture that feeds the clouds that comes back down in the form of rain. And it turns out that the soils that are the droughtiest are those that typically have the least amount of soil organic carbon. Also sandier soils, textural differences of the soil itself can lead to droughtiness. But the areas of the world where the farming stress is being felt right now is where soil organic carbon has been lost or depleted, and in the coarser-textured soil areas. And there, remedies and solutions are sorely needed, and there's grassroots movements to redo, rethink the agricultural practices and to basically honor water as a precious resource.

Thanks for that explanation about the way the issue was framed and the language that gets used. And of course, it makes sense to meet people where they are and to use language that brings people into the conversation rather than turns them away from it. So I appreciate you addressing that. Let me ask you another question. So in your earlier comments, when you were talking about the vast expanses of land that are used for grazing or for growing crops, people's minds were probably thinking about the rural landscape. But you've also thought about the use of urban land, I know, and you've spoken about something fascinating in the urban toolkit. Can you explain a little bit about this?

Yes, it turns out that most of the eating of the food that occurs on the planet occurs in urban areas on the planet. And the production occurs in the ex-urban, the urban perimeters or the rural areas. New strategies for bringing food production into the cities, into the urban areas, really are vital to deliver fresh and wholesome food in many locations. It may be one of the primary methods being deployed now, there's a lot of resources in addition to a lot of mouths to feed in these urban areas. Yeah, there's compostable bio-waste that come out of every urban household kitchen, every restaurant, every food store. There's recycled water, there's labor, and there's small acreages to moderate size acreages that can really handle highly-concentrated investments in labor, in production of large quantities of food, right where people live.

So some really interesting technologies and behaviors and business models in the past several decades. You know community-supported agriculture, everybody's probably heard of that where you can subscribe to food production that are locally produced by farmers. There are reuse of buildings for aquaponics and hydroponics, that's a water-based soil-less system for growing fish and vegetables. Some of that is being done in urban buildings in downtown high rises and old warehousing buildings. There's containerized food systems where you basically can move these hydroponic, aquaponic systems right into your neighborhood, and participate in the production of the green vegetable material you might consume in your community. We've worked on a number of projects that are in cold regions where there's greenhouses that are retractable so you can roll the greenhouse off the area during the winter, that would be fully contained and winterized, and during the summer, during the growing season in that colder climate area, you can grow open air grow vegetables and so forth.

One of the other things that's happening in this urban vegetable production, and the next topic, native landscaping and ecosystem restoration projects, which are becoming very common in urban areas, all benefit pollinators, flood damage reduction, rebuild soils, rebuild organic matter, draw down atmospheric carbon dioxide. What we've seen where native landscaping has been used, it can replace lawns, high-maintenance lawns and formal landscapes, and that can reduce greenhouse gas emissions associated with lawnmowing, and simply the opportunity cost of growing a lawn, where in fact, most Kentucky bluegrass lawns in the Midwest, about 90% of their root mass of the grass plants is in the upper inch or two, and native plants will distribute their root systems down, perhaps a meter, two meters, three meters into the soil, so you can really draw organic carbon that depth with the native landscaping plant materials, and that doesn't typically happen with the lawn and the mowed lawn systems that people usually produce in urban yards.

So, big opportunities with native landscaping, urban food production. And then green infrastructure, where instead of undergrounding the storm sewers, bring the water management, storm water management in our cities to the surface and create native landscapes that manage that water's volume, rate, and quality. And right now all the storm sewers do is deliver the volume at a very, very high rate of speed from the concrete landscapes or impervious landscapes to downstream receiving water bodies, and it contributes to downstream erosion and flooding. By using green infrastructure, we basically manage each raindrop as close to where it hits the ground, and reduce the runoff, in rebuild soil organic carbon, and you know, myriad other benefits. So it's a great way to view an urban area as a potential sink for carbon dioxide and other greenhouse gases rather than only a source.

Those are really fascinating developments that you're talking about, and can you know, really transform the way we think about where food gets produced, and whether more of it can get produced close to home and urban areas can become even healthier ecosystems than what they are now. So I think you've kind of answered this already, but let me see if you could expand on a little bit further. So, are there some soil areas on farms currently, or even in urban areas, where you think it would be better to restore the ecosystem, rather than trying to farm or develop the land?

Absolutely. Not all acres of land are created equally. Some were created historically under grassland ecosystems, and those are typically upland settings, upland soils. Others were created in the lower drainage ways and depressional areas, and the soils that developed are wetland soils. In many places those are peat and muck soils. North Carolina, where you're at has the coast and wetlands, which is 5 or 600,000 acres of deep peat derived over probably 12,000 years of accumulation of plant material. So the farms that have de-watered these peat and muck areas are trying to farm these areas, and they're very challenging to farm when the muck soils or peat soils, these historic wetland soils become overly dry during a drought, it's really challenging to grow anything. They overshoot what drought effects are on a normal soil, they become non-wettable. They're very difficult even to wet up with irrigation and use for crop production. And when they become a little bit overwet with rainfall, the crops die. So there are marginal areas with these wetlands soils that are becoming a real challenge with the predictably unpredictable weather intensification that we're seeing around the country and the world. And those marginal soils are becoming, have been on many farms, a liability for the overall revenue generation, primarily because they cost more to manage and the yield is unpredictable.

So, places like that really represent an opportunity for restoration. And we're not talking about just a few acres here and there, this is literally tens of millions of acres that could be restored without negatively affecting the economics of the farm. In fact, impacting in a positive way the economics of the farm. And then there are all sorts of landscapes at the urban, suburban, rural interface where some of these same historic wetland soils occur, where these are becoming wetter, water inundation is becoming more frequent, and the farming of these areas really is a tough choice for the farmers because of the pumping and/or additional water drainage infrastructure needed to able to continue using them. And these are also locations with disproportionally high greenhouse gas emissions. Methane and nitrous oxide in particular from these wetted-up soil areas.

So, there's wonderful areas available, and the economics appears to be favorable, more favorable and increasingly so for farmers to make the tough choice to not invest in a new tile or a new pumping system to de-water these landscapes, and instead to restore these landscapes. And there's alternative economic resources that can be generated. There's wetland mitigation, banking opportunities, there's flood damage reduction where a farmer can hold water back on their land and get paid by a downstream municipality that's experiencing flooding for managing the stormwater on their land. So, a range of new and valuable economic opportunities that farmers could tap into. If this was organized and facilitated, it would be a real benefit to agricultural futures in the country and the world.

Steve, let me ask a bit of a related question. So you made a very strong case for the importance of addressing soil health. And so, consumers who are purchasing the food, and they're becoming more and more interested in the environmental impact of their food choices, and certainly the environmental community is paying a lot of attention to this, another reason that people make food choices as they do is how food tastes, and also how nutritious it is. So, is there a link between the quality of the soil, the health of the soil, and how nutritious the food is, and how it tastes? So let's say you have two farmers who have farms right next to one another, and one has been using traditional agricultural techniques, and the other has invested in the soil health and is using regenerative agriculture techniques. And they're both growing carrots or lettuce. Will the carrots or lettuce from those two farms taste different, will they have a different nutrition profile?

That's a great question, Kelly, and I've been profoundly impressed with the acuity of chefs to be able to taste the differences that were either beyond my perception or my ability to even understand the language they were using to describe some of the flavor tones. I'm told that tastes are different, and, you know, look no further than the wine industry where they talk at great length about soil management and the mineral content of the soil affecting the quality and flavor of the wine, and certainly the price of the wine as I understand it. But when it comes to vegetables and fruit, and grain, I've been remarkably impressed with the documentation about nutritional density, and know how much protein, for example, is found in an ancient variety of wheat growing right across the fence from a conventional variety of wheat on the exact same soil, farmed by the exact same farmer.

So part of what I've learned is that selection of genetics is really, really important to flavor, and quality, and chemistry. For example, with the wheat reference, we've been working with an ancient native relative of wheat, and it's higher protein, more balanced nutritionally than all of the conventional varieties of wheat, but it also doesn't elicit Celiac's disease and some of the gluten protein-related diseases that are now associated with conventional wheat. So the chemistry really does change. The taste and flavor tones, although I'm not an expert in that, I'm told they are real and they are different. I think what's intriguing me most is that if you grow crops in healthier soil, even the same genetics, the same crop, the same production methods, if the soil is healthier, it's not unusual to get a significant bump in the protein content. So for example, if wheat is 9 to 14% digestible protein, some of these wild varieties are 23 to 28% digestible protein. The yields of the wild varieties are lower than the industrially-produced wheat, but because the protein content and the nutrition is so much higher, at 30, 40% higher by weight, we can produce more food value for people, for livestock, for wildlife, on less land. And that's becoming really clearly of intrigue to me because we just talked about wetland soils. If those wetlands soils were restorable, and generated another revenue stream for farmers, and they focus their attention on creating healthier soil on a smaller acreage or a reduced acreage, reduced by the wetland acreage equivalent, the economics and the value proposition that the farm offered to the world might be significantly different from what they're currently experiencing in a commoditized world where, you know, everything is a race to the bottom in terms of pricing.

I wonder if this might not start showing up at some point in the marketplace, where consumers may realize that there are foods with different flavor profiles or nutrition profiles, depending on how they're grown. And would it ever be the case that Walmart, for example, which is the nation's largest supermarket chain, would start making purchasing decisions in its supply chain to get those carrots, or those heads of lettuce that have the maximum amount of nutrition, because consumers are going to want that. I mean, it could be sort of a push/pull thing ultimately, and the marketplace might really speak as people become more familiar with this issue and more knowledgeable about what the importance of soil health really is. It'd be interesting to see if that happens.

I think that's probably the primary pathway for change. It's not going to happen easily with a new regenerative Ag standard, that won't drive change as fast as something that tastes good and is better for people. Especially buying habits of mothers buying for children, there's a lot of attention to detail, a lot of attention where they can afford the time and the cost to making sure kids are nutritionally fed well. So I think that's the pathway, and I think the Walmarts, and the Costcos, and the companies all over the world, I think this is exactly the sort of market change that is now underway in many places for many product lines or sectors of the food marketplace, and I think those companies are realizing it, and I think there's a lot of corporate movement to align with those sort of consumer-driven behavioral changes. So, great idea, Kelly.

Bio:

Steven I. Apfelbaum is Chair of Applied Ecological Services, Inc., one of the larger ecological-sciences and restoration firms in the United States. He is also a Senior Ecologist and Science Advisor at RES. He is co-author of Restoring Ecological Health to Your Land (Island Press), written to help landowners and land stewards—including agency staff managing state, federal, and other public lands—successfully develop and implement land-restoration programs. Apfelbaum’s book Nature’s Second Chance (Beacon Press) won awards as one of the “top ten environmental books of 2009” and one of the “top 10 books for understanding what you can do about climate change.” Steven Apfelbaum has conducted ecological research, designed award winning projects, successfully navigated regulatory programs, and contributed his unique creative scientific expertise and enthusiasm to over 7,000 projects throughout North America and beyond. He is one of the leading ecological consultants in the U.S., providing technical restoration advice and win-win solutions where ecological and land-development conflicts arise. He has authored hundreds of technical studies, peer reviewed technical papers, books, reports, ecological restoration plans, and regulatory monitoring and compliance reports. Steve’s book, Nature’s Second Chance (Beacon Press), won accolades from the New York Times, and was listed as one of the “Top 10 Environmental Books of 2009.” Restoring Ecological Health to Your Land (Island Press), his most recent book (coauthored with Alan Haney and part of a three-volume series), has won praise as the first comprehensive ‘how-to’ restoration books for landowners. He promotes using ecological and conservation design principles in developments, industrial projects and parks that help clients save money while increasing ecological functionality, improving public perception and generating award-winning outcomes.

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Our guest today is Dr. Gary Foster, Chief Scientific Officer of WW, the company that many of us remember as Weight Watchers. Gary is one of the most respected scientists in the obesity field and is the author of a book released recently called "The Shift: 7 Powerful Mindset Changes for Lasting Weight Loss."

Interview Summary

So Gary, you and I have known each other now for about 40 years, having worked together at the University of Pennsylvania at the early stage of careers for both of us and I've always admired your work and was eager to read your new book and I expected that it would break new ground, and in fact it did. And it's not a topic that hasn't been written about a lot, so it was interesting to see how you would handle these issues. So, I'm so glad you can join us. We look forward to digging into the book. Thanks so much for being with us.

My pleasure, Kelly, great to be with you. I was just thinking in preparation for this conversation that you were the person responsible for starting my career. You actually gave me my first job at Penn. So, for that I'll always be grateful.

Well, I mean, that can't feel anything but good because your career has been amazing and you've accomplished and contributed so much. And it's been really fun to be friends and colleagues over all these years so I guess it's been a real source of pride for me. So, let me ask a career question of you. So, you spent many years as a highly regarded figure in academics, first at the University of Pennsylvania and then running a well-known obesity center at Temple University that you created but then you moved to the corporate world. Why make such a big career change?

Yeah, it was an interesting process. I loved everything about what I was doing as a researcher and a clinician, and administrator, and academia both at Penn and at Temple and the opportunity at WW came up and I was actually approached and someone asked that I know somebody who would be suitable. And the more I heard about the position, the more it excited me. And the main reason is the ability to scale science and to have impact. One of the nice things about being a scientist and write papers and give talks is that you're actually creating science, and that has its own impact. And again, I'm not knocking it. That was one of the most gratifying things I ever did in my professional life. But the ability to take that science that I had done and broadly the whole field had done, and to scale that to impact the lives of literally millions was really compelling for me and it was just an offer I just couldn't pass up.

Well, it's so interesting that you made that change and you're right boy, it's an opportunity to affect an awful lot of people and now you are expanding the opportunity even more with your new book. So, usually, in the world of advice written by professionals, and sometimes non-professionals, for people wanting to lose weight, it's filled with basically information on what the diet should be. Is it low carb or high carb or low fat or whatever. And there're just versions and versions and versions of these things over the years but you focus on mindset. So, what goes into the way a person's thinking is a really important determinant of weight loss according to you. So, tell me why you believe that and why is mindset so important?

Yeah, I think first is the world doesn't need another diet book. To your point, most people, when they think of improving their weight or health or their overall wellness are told things like high this, low that as you just referenced. Then, what's been clear to me and this wasn't clear early in my career, but probably 10 or 15 years in patient after patient, study after study, what became clear is the people who were most successful in a weight and wellness journey are necessarily those who track their food intake every day or every week, or lost weight in some linear fashion, who worked out just as they had prescribed. Well, eating and activity were important. The thing that most distinguished people who were successful versus those were less successful are the people who had changed the way they thought and importantly, the way they thought about themselves and the way they thought about the journey. And that's really what the book's about, it's trying to help people think differently about themselves especially among people who are heavily stigmatized based on their weight and shape, but also to think about the journey because one of the most common off-ramps is when people had setbacks then they think in some erroneous ways that aren't helpful for overall health and wellness.

So, we'll get back at setbacks in just a minute. But first I'd like to ask you the following question. It sounds like you have abundant personal and clinical experience working with individuals suggesting that the way people think is an important determinant of whether they can lose weight and keep it off. Is there a research that supports that as well?

Yeah, but there's no long-term clinical trials on that. We're now just starting to measure things like self-compassion and our own clinical trials. What we find is a lot of experimental research. Kristin Neff has probably done the best work at this at the University of Texas where she can experiment totally manipulate self-compassion in the context of eating. So, there's a famous experiment that she talks about where people come in and they're given a classic preload where they're given some cookies under the guise of the taste test and then one group gets a self-compassion intervention and the other group gets a more general intervention having nothing to do with self-compassion. And when they look at the subsequent intake of things like M&M'S or various candies, people who get the self-compassion intervention actually less, and the hypothesized mechanism there is that if you violate some rule that you have or some guideline that I shouldn't eat this or I shouldn't eat that or I have to have a certain number of calories or a certain number of points, once you violate that, what you say to yourself really does matter. It goes back to the original premise and 60 years of research that what you think determines how you feel and how you feel determines what you do. So in short, how you think about yourself in the journey is going to affect your behavior.

That leads us to maybe a little bit more thorough discussion of setbacks. You mentioned that dealing with setbacks, which really are inevitable for sort of anybody doing anything but especially when they're on a weight loss journey that how people are responding to these in their mind becomes really important.

The first is to expect setbacks. They happen to 100% of the people, 100% of the time and this isn't just a weight and wellness play. This is in relationship and our role as parents and our role as workers in a workforce. It never goes perfectly. So, first thing is to expect them and then the second thing is to learn from them. Use it as Carol Dweck would say, use it from a growth mindset perspective. Instead of saying, "This is just the way it is, I'm in this rut and here I go again." Just say, "Okay, things didn't go as exactly as I planned, I wanted to eat this and I ate that. I wanted to move my body in a certain way and it didn't happen." Okay, can you view that? Be aware of it but in a nonjudgmental way in which you can learn. I think the other thing about setbacks that's important is to just increase your awareness of what you say to yourself. Sometimes we say the most nasty things to ourselves. Some are neutral like I've blown it. It's exaggerated, it's not true but others are like, "Can't believe you did this. You're such an idiot. Here you go again, you have no willpower." We wouldn't utter those things to any other human being, but somehow we feel justified to say very nasty things to ourselves. If it helped it be one thing, it would still be in my mind unconscionable to talk to yourself that way. But the data are very clear, it doesn't help. It actually depletes motivation. And it goes against this commonly held myth that the harder I am on myself, the more nasty things to myself, the better I'll do when in fact the data are pretty clear that self-compassion beats self-criticism every single time.

It's interesting because this sounds like a very modern and updated version of what the well-known psychologist talked about many years ago where he talked about people having the inevitable lapses but then it really was the way they were processing them psychologically that turned them into a full-blown relapse. And so, you've kind of taken that basic premise but enriched it a lot, given people more concrete ways of addressing and then also layering in this whole emotional part of it about compassion. It's very impressive how that's transformed over the years.

Thanks you, I agree. I mean, probably from my exposure to you and training by you was very aware of my lapse model and the abstinence violation effect. And really it's trying to get at the crux of when people have setbacks, how do they view them? And one is how you view the setback itself. Is it a bump in the journey? Does it really say something about how you're doing on the journey overall? I would say, no, it's a bump that tells you nothing about the overall journey. It's a momentary snapshot but also importantly, I think this is where a slightly different angle than previous theories perhaps is how you think about yourself. The more you engage in self-criticism, the worst is going to be.

So, this issue of compassion has come up a number of times in our discussion already. Let's talk about it a little bit more because I think it's really one of the most important and unique parts of your book. You talk a lot about compassion and kindness toward yourself, these are central themes. And you also want readers to feel this more often when they're addressing the inevitable setbacks. So, explain a little more concrete detail how they can go about doing that.

Yes. One of the things that I'm really proud about the book is that we don't just talk about self-compassion is important and here's some science on it and here's a reason to believe and good luck to you. As a behavioral psychologist, it's really important to me to not just lay out the what, but the how. So at the back of each chapter, whether it's a self-compassion chapter, leaning into your strengths or experiencing happiness and gratitude, all of those things have science proven techniques at the back of each chapter to help you do that. So, the basic premise around self-compassion is you need to start the journey from a fundamental sense of worth as people are right now. So, no qualifications. If I was a little bit lighter, if I was a little bit fitter, if I was a better parent, if I... Not, just as you are right now, you have fundamental worth and that's why you're worth taking care of. And that's to me the cornerstone of any self-improvement project whether it's weight-based, wellness-based, relationship-based or anything else. And what that does is it turns the journey upside down. Instead of seeing yourself as deficient from the start and needing some remediation of all these deficiencies, you're really saying, "I'm worth taking care of." And because I am, that's why I'm going to engage in this. And what that does is this now makes something, feels like something you're doing for yourself, not against yourself. It's almost the analogy I say in the book it's like giving a gift to yourself. If this starts to feel like making up for past transgressions, it starts to feel moralistic. It starts to feel onerous. That's not a gift to yourself. And it probably is started with the premise that the harder I'm on myself, the better I'll do. And again, the science is just the opposite.

Well, it's almost like going from swimming against the tide than going with the tide, isn't it? Because you're trying to take advantage of people's inherent strengths and have them feel that they deserve these sort of things. And then, the actions that they're taking are trying to fight off some evil force that makes people want to eat more but to do things that are nurturing and informing.

Exactly, exactly. One of the techniques we talk about in the book is how you would talk to a friend given the same situation and think about your body postures, think about the words you would use, how you would talk to your child who is having a setback and contrast that against the ways you talk to yourself. And there's a pretty big fundamental difference for most people on a weight and wellness journey. And you're so right in terms of leaning into your strengths and otherwise it becomes a game of whack-a-mole where here's the deficiency, here's the weakness. It's exhausting and it doesn't feel like it's a gift you're giving to yourself. It feels like you're in never ending search of fixing one weakness after another.

So, what role does a person's social network play in losing weight and maintaining it?

It's critically important and your work many years ago sort of highlighted this in an empirical way where people had so-called at the time cooperative spouses and uncooperative spouses. And I think the field has evolved over time but there's certainly a few tenants that I think are important to consider when it comes to getting help. One is to believe that you deserve help. A lot of people say again, given the pervasive weight and shape based stigma that you know well about, been a pioneer in talking out against and studying its causes and consequences. A lot of people feel like, "I got myself into this situation, so I shouldn't ask for help." So again, that's the antithesis of self-compassion. So, start at a place that you're worthy of taking care of and you're worthy of asking help for it. The next step is really, and this is where most people I think get off track a little bit, is to ask for what you need in very specific terms. So, it's up to you to decide what's supportive and what's not, one of the landmines that can happen in relationships sometimes as people say, "Honey, please be supportive." And then honey gets to decide what's supportive or not, which may not be supportive to you. So, it may be things like, "When I order a dessert out of the restaurant, it's really not helpful for me when you roll your eyes or you make a comment, that's not helpful. So, I'd appreciate it in the future but if I order anything whether you think I should have it or not then you just don't make any comments about it." So, the first is that specific request and then of course the next step would be a specific follow-up. Not, "Honey, thanks for being supportive." Or, "You're a terrible partner because you're not supportive. But anyway thanks so much, I noticed when I ordered something the other night, you didn't make a comment." Or "Truly helpful for me, if you're going to have ice cream at night to have it in the other room and not to have it close to me while we're watching TV." So, first thing is you deserve it and the second thing is specificity both on the request and then on the follow up.

It's really nice that you begin with a principle and describe why the principle is so important and justify it scientifically but then you give some very concrete examples, like you just have. So, that makes a book way more accessible than it might otherwise be. And I could see how we're be very helpful for people. Let me ask about another issue that you alluded to. And so, the subtitle of your books last chapter is "Experiencing Happiness and Gratitude." Again, this is something that makes your book unique. Tell us more about what you mean by that.

A common myth and practice is that people often put their own lives on hold or put their happiness on hold as if their happiness is determined by some number on the scale or some size of their clothing. So, what the book really attempts to do is to say the more the journey can be, and this goes again for any self-improvement journey, can be a happy one and one filled with gratitude. A, you're just happier when you're more grateful, that's a good thing to be in and out of self. But B, it gives fuel to the journey. So, if I have this preset notion that I can only be happy once I've lost 50 pounds, boy, it's a long time between now and 50 pounds. And really, is that what determines your happiness? So, one of the things we talk a lot about in the book again are these techniques at the end of each chapter and there's a really great technique called three good things. It takes no more than five minutes a day and it doesn't have to be done every day. But if on most days at the end of the day, it could be at the beginning of the day, it could be at meal time, whatever it can be a ritualized routine for folks, it's truly important just to think about big, small, medium, don't worry about it. What brought you some pleasure today? It could be the smell of a great cup of coffee. It could be hearing from an old friend and just to wallow in those feelings and just think about what you'd liked about it. It could be some moment of pride around a young child having an accomplishment, just that process of remembering them and wallowing in it for a very short period of time has been empirically shown to improve people's happiness. So, the idea is to do those things now. The things that we've both heard from patients over the years like, "I'll wear nice bright colors when I lose weight, I'll get out of a bad marriage when I lose weight, I'll ask for a promotion when I lose weight." No. Live life now. Lean into your own happiness. You deserve to be happy and don't make a contingent on your weight or shape or any other thing.

Bio:

Gary Foster, Ph.D., is the Chief Scientific Officer at WW International, Inc. Foster, a psychologist, obesity researcher and behavior change expert, was previously the Founder and Director of the Center of Obesity Research and Education and Laura Carnell Professor of Medicine, Public Health and Psychology at Temple University in Philadelphia. Prior to Temple, he served as the Clinical Director of the Weight and Eating Disorders Program at the University of Pennsylvania School of Medicine. He has authored more than 225 scientific publications and three books on the causes, prevention and treatment of obesity. Foster has received numerous honors including President of The Obesity Society, Honorary Member of the Academy of Nutrition and Dietetics, Outstanding Contributions to Health Psychology from the American Psychological Association, and the Atkinson-Stern Award for Distinguished Public Service from The Obesity Society. Dr. Foster's current focus is on scalable, evidence-based approaches to wellness for adults and children in community settings. Foster earned his Bachelor of Arts degree in Psychology from Duquesne University, an M.S. in Psychology from University of Pennsylvania, and a Ph.D. in Clinical Psychology from Temple University.

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We’re speaking today with Mia Hubbard, vice president of programs at MAZON, a Jewish response to hunger, which is a national advocacy organization working to end hunger among people of all phase and backgrounds in the United States and in Israel. This is the fifth and final episode in our series partnership with MAZON. This time we will focus on the organization's work to increase access to nutritious foods in the charitable food network.

Interview Summary

Now let me start off with this question so I understand that MAZON has for quite a long time provided partnership grants to state and local organizations fighting hunger in their communities, but in 2018 MAZON refocused this grant making in states specifically with the highest rates of food insecurity. Can you please speak about this pivot that the organization made? How was it decided? And what's been the impact of this decision?

So our grant making for the first 25 years or so really focused on advocacy and on the need for strong government response to hunger with this understanding that charity has an important role to play, but it is not set up to address this issue. And it's really government food programs that have the capacity and the reach and the ability to address this issue at the scale that's needed. So in our early years, we focused on prompting the anti-hunger field to understand the need for advocacy and policy change directed at improving government programs. And we did that through our early years of grant making. So we're known for funding anti-hunger advocacy organizations, helping them to seed and grow and supporting their work. And helping to establish this country's network of state level anti-hunger organizations that were doing advocacy at both the state and national level.

And then in 2018, we really decided we wanted to take a step back and re-examine our grant making and see if there were some new opportunities for MAZON to uniquely contribute to the field. And by that time the nation had a very strong anti-hunger advocacy infrastructure in place. And a really solid group of organizations working at the national level on developing drawn government food policies and programs. And a broad network of state-based organizations doing the same at the state level. So one of the things that became clear is that there still were some states that had relatively weak advocacy capacity. There wasn't as much advocacy engagement taking place in those states and not surprisingly, these were also some of the most food insecure states. We decided at the time we would target our grant making to just a handful of the top food insecure states where advocacy capacity could be grown and created what we the Emerging Advocacy Fund, which is providing three-year funding to organizations in these food insecure states to create the capacity. And really what it means is to hire staff, to be able to do the advocacy work that needs to be done in those states. And we call it the EAF program. So our EAF partnerships are largely concentrated in the Southeast, and we have some partners in the Midwest and some other parts of the country. But primarily in the Southeast and you know it turns out that these are states that tend to be deeply conservative. They tend to be states that are politically and socially hostile, in some instances, to public benefit programs like SNAP, formerly known as the food stamp program. So unfortunately these are also the same states that are likely to benefit the most from these programs. Participation among those who are SNAP eligible in these states tend to lag behind the national average. So folks aren't getting the resources they need to be able to feed themselves, and the state is leaving precious hunger fighting resources in DC, rather than having that money being circulated in their local economy, as people are using their SNAP dollars to buy food. The goal of the EAF program is really to help close that capacity gap and to enable organizations to hire staff who can do the advocacy to really make the case for these programs and supports.

I think we saw in the last 18 months, the economic fallout from COVID generated a really large surge in hunger. These organizations and these advocates, were in a great position to be able to educate their congressional representatives about how COVID was impacting food insecurity in their state. They were able to contribute to national advocacy that helped generate all of the support and funding that came out of federal relief packages, and then to work with their governors and state officials to encourage them to take advantage of all the federal waivers and flexibilities, and options that states had available to them during those early months of COVID to get resources quickly into the hands of food insecure people. And so we didn't predict that COVID was going to happen, but these grants turned out to be timely investments and enabled advocates in states that were already struggling with high levels of food insecurity be able to better respond to the needs during COVID.

Mia can we talk about one of MAZON’s priority areas in particular - your concentration on strengthening food security and also food sovereignty in Indian country. So why have you chosen to invest so much in this issue and where and how do you think your organization can have the greatest impact?

You know MAZON is known for our focus on advocating for equal access to food for populations that have been historically ignored in policy arena. So we advocate on a lot of different populations including active duty military, single mothers, Americans in Puerto Rico, and also in indigenous communities. Our work in Indian country is focused on food sovereignty in recognition of the fact that tribes are sovereign nations and our work should be contributing to the ability of those nations to regain autonomy over their food systems and for tribes to be able to feed their own citizens. So we have learned very quickly in our work in Indian country that US food programs, government food programs are an important part of the food safety net. But we also know that the US has a long and troubled history in Indian country and that government food programs have been used as a tool of colonization. So we are working to advocate for improvements in these programs, but we're also working for a day when they are less needed. And where tribes can have greater control over these programs and how they operate, that's why MAZON joined the native farm bill coalition back in 2017 to be able to advocate and join over 170 tribes, to be able to advocate on behalf of tribal nations that were interested in being able to administer these programs on their own. We were the first actually non-native organization to be a part of the coalition. We're very excited about our role is as a non-native ally in this field, we weren't able to get that provision in the farm bill, but there were some other successes and in fact, there were 63 tribal specific provisions in the bill, which is the largest number in the history of the farm bill.

So we're very excited about the work that we're doing alongside our partners in Indian country. If you'll indulge me I just want to mention their names. It's the indigenous food and agriculture initiative, Intertribal Agriculture Council and the Native Food and Nutrition Resource Alliance. We are doing advocacy alongside these partners and we're also funding them, really in recognition of the fact that government and foundation funding really isn't going to native communities and causes. Less than half of 1% of foundation dollars go to Indian country. So we're really excited to be able to support their ongoing advocacy and policy work.

That’s really is important work. So let's talk about other important work that you're doing. And I know that MAZON recently announced new partnership grants in Puerto Rico signaling that the organization is interested in addressing equity for those facing hunger in the territories. So why was this an important decision, particularly at this time? And what do you hope to achieve through this?

So Puerto Rico is a very exciting addition to our emerging advocacy fund. And we're currently supporting three partners there on the island. These grants are part of MAZON larger advocacy effort around food security in Puerto Rico. It's one of our top public policy areas and priorities where we're really trying to advocate for equal access to federal food programs for Puerto Rico. So as you may know Puerto Ricans are US citizens, but they don't have the same kind of access to federal programs that are intended to help vulnerable Americans and in the case of Puerto Rico, they are specifically barred from the SNAP program. I mean in the 1980s, the Reagan administration removed Puerto Rico from the SNAP program and created a separate program called the Nutrition Assistance Program (NAP), which is a block granted limited funded program, which provides food assistance to the island in lieu of SNAP. But because it is block granted and has limited funding, most SNAP participants receive much lower benefits than they would if they were participating in SNAP. And so this is an area where we are particularly concerned about the inequity that's built right into the structure of the program. And even before COVID over half of Puerto Rican children lived in poverty about one third of adults were food insecure.

We know the island has been struck with multiple natural disasters, hurricanes earthquakes. It has a very fragile economic situation. And so there's a lot of work to be done in Puerto Rico on a number of issues. We're very excited to be working with our three partners on the ground to support advocacy for and by Puerto Rican people. Think it's very important for mainland advocates like MAZON to be allies, but we really want to make sure that federal food programs and policies are shaped by the needs and experiences of Puerto Rican's. Similar to the work in Indian country. There's this colonial kind of relationship that we have with Puerto Rico. And I think it's created a false narrative that Puerto Rican people are passive beneficiaries of aid right that they are reliant on US federal support. And I guess the reality that we're seeing in the work that we're doing with our partners is that Puerto Rican advocates and leaders have their own vision for how they want to achieve food security for their island. And so we're just really proud to be able to invest in their capacity and their ability to determine their own future around food security.

The investment in these populations in need is very impressive. And you find an area where you could really make a difference. Let me ask you one final question about one time quick reaction fund grants that MAZON and gives for rapid response initiatives, things that might just come up on the spur of the moment. So why is this an important tactic in addressing hunger in the way the world now addresses hunger and why is being nimble so important? Can you give us an example or two of this?

Our quick reaction fund, we call it our QRF fund, is something that's really, I think new for the anti-hunger advocacy field. You know, you see these kinds of rapid response funds exist in other areas whether it's you know racial justice or immigrant rights, we were excited to bring this expedited access to financial resources, to the fight against hunger. And I think it's an important tool in the toolbox for MAZON and for the field because even though government food programs have historically had bi-partisan support, we've seen in the last 10, 15, 20 years that they have come under increasing attack and being able to respond strategically to that requires the ability of advocates to be able to move quickly and nimbly, particularly in their state capitals. So whether it's doing an ad buy in a key media market to influence the vote of a lawmaker in a given state or organizing a campaign quickly to get a group of folks with lived experience up to the Capitol for a hearing or for a day of action, those are the kinds of things that the quick reaction fund is intended to be able to enable our partners in the field to do. Last March right before COVID hit the Kentucky state legislature for example, was quickly moving on a bill that would have put lifetime bans on some public assistance programs in the state including SNAP. And we were approached by our partners in the Kentucky equal justice center to do a quick response to this piece of legislation that was moving pretty rapidly through their legislature. And they mounted a digital campaign aimed at the lawmakers who were sponsoring this bill. They raised a lot of visibility about the bill and about the harm that it would cause for folks who were struggling with hunger and poverty, and they were successful in being able to strike down this law. And it was a very timely victory of course, because a month later COVID hit and a lot of Kentuckyians turned to these very programs to get through those early months of COVID and the surge in hunger that we saw.

Bio

Mia Hubbard is the vice president of programs at MAZON. She provides leadership and direction for MAZON’s advocacy, grantmaking, and strategic program efforts to reduce and eliminate hunger and expand low-income communities’ access to healthy food in the United States and Israel. Since Mia joined the organization in 1993, MAZON has established itself as a leading advocate, funder, and capacity builder in the field of hunger as well as a critical source of expertise, leadership, and inspiration for advocacy and public policy solutions to hunger. Mia has served on several boards of directors, including most recently as the international program committee chair for an international association of food and nutrition programs serving people living with HIV/AIDS. Mia holds an M.A. in International Relations and Public Policy from the Graduate School of International Relations and Pacific Studies at UC San Diego and a B.A. in International Relations from Stanford University.

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This is "The Leading Voices in Food" podcast but today we're speaking with a leading voice in tobacco control. "How come," you might ask, "why?" So I believe for many years that the parallels between the tobacco industry and food industry practices are nothing short of stunning, and that our field would do very well to learn lessons learned from the pioneers in the tobacco wars. Our guest today is Dr. Kenneth Warner, Distinguished Emeritus Professor and former Dean of the School of Public Health at the University of Michigan. Ken's research focuses on the economic and policy aspects of tobacco and health.

Interview Summary

So Ken, you and I have a long history, and I thought it might be instructive to mention just a little bit of it because you really helped shape some of the ways I think about addressing food policy. So I first became familiar with your work long before I met you in person, when I was teaching classes at Yale. I was assigning papers you wrote on tobacco control and I was especially interested in work that you'd done on tobacco taxes. It really gave me the idea of pushing ahead with food-related taxes. Then finally I got a chance to meet you in person at a meeting that was hosted by the first President George Bush in Kennebunkport, Maine, on cancer control. You and I got to talking about similarities between the tobacco industry behavior and the way the food industry was behaving. We were both struck by the similarities. That led us to write a paper together that was published in 2009 in "The Milbank Quarterly." And I have to say, of all the papers I've published over my career, this was one of my favorites because I really enjoyed working with you. I learned a ton from it, and it really, I thought, made some very important points. And I'd just like to mention the title of that paper because it pretty much summarizes what it found. So the title was, "The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food?" In my mind, the playbooks are still very similar, and that's why it's really interesting to talk to you today, get a little sense of what's happening more recently, and importantly, think about what lessons are learned from tobacco control. I wanted to bring up one thing from that paper that I always found fascinating, which was the discussion about something called "The Frank Statement to Cigarette Smokers." Could you describe what that was and what role you think it played in history?

Sure. Just to give you some context for it, the first two major papers that implicated smoking in lung cancer were published in major medical journals in 1950. In December of 1952 there was an article in the "Reader's Digest," which incidentally was the only major magazine that did not accept cigarette advertising, that was entitled, "Cancer by the Carton." And this was the American public's first real exposure to the risks associated with smoking, and it led to a two-year decline in cigarette smoking, a very sharp decline, something that was unprecedented in the history of the cigarette. Following that there was some research published on mice and cancer. And needless to say, the tobacco industry was getting pretty nervous about this. So the executives of all the major tobacco firms met in New York City in December of 1953, and they collaborated on what became a public relations strategy, which drove their behavior for many years thereafter. The first thing they did was to publish "A Frank Statement to Cigarette Smokers" in January of 1954. This "Frank Statement" was published in over 400 magazines and newspapers, and it reached an estimated audience of some 80 million Americans, which would be a very good percentage of all Americans in those years. And they talked about the fact that there was this evidence out there, but they said, "We feel it is in the public interest," this is a quote, "to call attention to the fact that eminent doctors and research scientists have publicly questioned the claimed significance of this research." Then they went on to say, and I quote again, "We accept an interest in people's health as a basic responsibility, paramount to every other consideration in our business. We believe the products we make are not injurious to health and," and this is the kicker, "we always have and always will cooperate closely with those whose task it is to safeguard the public health," end quote. They went on to say that they would support research on smoking and health, and, of course, that they would always be the good guys in this story. This was designed as part of a strategy to obfuscate, to deceive the public, basically, to lie about what they already knew about the health hazards associated with smoking. And it was essentially a first very public step in a campaign that, one could argue, in many ways has persisted ever since, although, obviously, now the tobacco companies admit that they're killing their customers and they admit that smoking causes cancer and heart disease and lung disease and so on. But that was kind of the beginning of the strategy that drove their behavior for decades.

You know, that was one of the issues we raised in our paper. How similar were the big food companies in talking about concern for the health of their customers, planting doubt with the science, pledging to make changes that were in the interest of public health, agreeing to collaborate with public health officials? All those things played out in the food arena as well. And that's just one of many places where the food industry behave very, very similar to what the tobacco industry has done. But boy, is it interesting to hear that particular anecdote and to learn of the cynical behavior of the industry. So fast forward from there, and you think about the tobacco industry executives testifying before Congress that nicotine wasn't addictive, and you have that same process playing out many years later. These similarities are really remarkable.

So let's talk about your work and some of the issues that I think apply to the food area, and let's talk about taxes at the beginning. So I worked for years on the issue of soda taxes, and these taxes now exist in more than 50 countries around the world and in a number of major cities in the US, including San Francisco, Philadelphia, Seattle, and Oakland. And these taxes have been shown to have really positive effects, and they seem to be growing around the world. And I'd like to understand what you see as the overall findings from the work on tobacco taxes. But before we do that, you have a very interesting story to tell about how the tobacco control community responded when you first began speaking about taxes. It turns out to be taxes on tobacco have had whopping effects. But what was the initial reaction to people in that field?

Yeah, it is kind of an interesting story. So around 1980, when I first started writing and talking about tobacco taxation as a method of reducing smoking, I used to have public health audiences booing me. If they had rotten tomatoes with them, they would have been throwing them.

You know, Ken, it's hard to imagine because now these taxes are completely routine and accepted.

Yes, they're not only routine and accepted, they are a first principle of tobacco control. They are enshrined in the World Health Organization's Framework Convention on Tobacco Control. So they really are kind of the first thing we turn to because we know that they work. We know that they reduce smoking.

But let me give you a story about how I learned that this is not only a phenomenon with people smoking. It's a phenomenon with people using all other drugs, and it turns out it's a trans-species law, the Law of Demand. And that law says, basically, that if you increase price, the demand for the commodity will decrease. Well, in the beginning, the public health audiences believed two things. They believed that smokers were so addicted that they would not be affected by price, so it was ridiculous to even think about it. And they said, you have to have intrinsic motivators to get people to quit smoking. They have to care about their kids. They want to see their kids grow up, their spouses, and so on, and not extrinsic forces like a tax. So those were their two objections. So the story that I think is really kind of fun. I was on a plane flying to a small conference in Kansas City. This is sometime in the early '80s. And I happened to be seated next to Jack Henningfield, who is probably the preeminent psychopharmacologist dealing with nicotine, maybe in the world. And we were talking about price response, the fact that cigarette taxes work. And he said, "You know, I've got something I want to show you here." And he pulled out some what are called response cost curves from the psychology literature. And this is where you take a laboratory animal, in this instance addicted to narcotics or other addictive substances, and you give them a challenge to get their drugs. So first, I should note that these animals are so addicted that if they're given the choice between food and their drug, they will choose their drug, and they will in fact end up dying because they place a preference for the drug over food. But it turns out that when you increase the price of the drug to them, they decrease the amount that they consume. So what do I mean by that? If they have to push a lever, a bar, a certain number of times to get a dose of their drug, and you raise the number of bar pushes per dose, they will dose themselves with fewer doses. I took a look at these curves, and basically, a response cost curve for these lab animals is essentially a demand curve as we economists see it. And I calculated the price elasticity of demand, which is our standard measure of the responsiveness to price. And it turns out that addicted laboratory rats have essentially the same price elasticity of demand, the same price responsiveness that human beings do to cigarettes.

That's an absolutely fascinating story. And, you know, I know Jack, and have admired his work, as you have, and it's amazing to think about that conversation on a plane, and what sort of scientific work it led to, and how that, in turn, found its way into policies that exist around the world. So tell us then about tobacco taxes, and how high do they have to be in order to affect consumption in an appreciable way, and have they worked in reducing tobacco use, and what's your overall take on that?

So we have, quite literally, hundreds of studies in countries around the world, and we know a lot but we don't know everything. So we don't know, for example, if there's a particular price above which, you know, nobody will use the product. We don't have even really good data suggesting of, you know, what's the minimum increase in price that you have to have to have a noticeable impact. Overall, the literature suggests that if you increase the price of cigarettes by 10%, you will decrease the quantity demanded by 3 to 4%. Now, what this means is that roughly half of that decreased demand reflects decreases in the number of cigarettes that continuing smokers use, while the other half represents decreases in smoking, people quitting or kids not starting. So the demand is what we call price inelastic. The price change itself is larger, proportionately, than the decrease in consumption. But that decrease in consumption is still substantial and it's enough to have a large impact.

Now, cigarette prices vary all over the world, and cigarette prices vary primarily because of taxation differences. So if you go to the Scandinavian countries, you'll find that a pack of cigarettes will run $15 or more. If you go to Australia, you're looking at $30 or more a pack. In the US, currently, we're looking at an average price in the range of about 7 to $8. In some jurisdictions, like New York City, it's $10 or more. But the prices in the US are actually relatively low among the more developed nations in the world. Any tax increase will have an impact but obviously the larger tax increases will have larger impacts. And there's some good and bad news in tobacco taxation, particularly in a country like ours, and this is, again, true for most of the developed world. Smoking is now concentrated in marginalized populations. I'm talking about low socioeconomic groups, the LGBTQ community, and racial minorities, in particular. If you think of this as an economic phenomenon, when you raise the price on cigarettes, you're going to hit the worst-off economically segments of the population hard. That's the bad news. The good news is that those people, precisely because they are poor, tend to be much more price responsive than high-income smokers, and more of them will quit. So we have this problem that the tax is regressive, it imposes a larger burden on the poor, but the health effect is progressive. It will reduce the gap between the rich and poor in terms of smoking rates. And of great importance, there's an enormous gap between the rich and poor in this country in life expectancy, and as much as half of that may be differences in smoking rates.

Ken, there’s a hundred follow-up questions I could ask, and I find this discussion absolutely fascinating. One thing that came into my mind was that some years ago I looked at the relationship of taxes, state by state in the US, and rates of disease like lung cancer and heart disease. And there was plenty of data because there was a huge range in tobacco taxes. Places like New York and Rhode Island had very high taxes, and the tobacco Southern states, like North Carolina, had very low taxes. But what's the sort of recent take on that, and the relationship between taxes and actual disease?

Well, it's still true. And there are, in fact, what you suggest, the southeastern block of tobacco states have unusually low rates of taxation. And I haven't seen any recent data but one presumes that they are suffering more from smoking-related diseases because their smoking rates are higher. I mean, that has to be true. So I don't know that we have any particularly good data recently, but there have been studies that clearly relate tobacco or cigarette prices to health outcomes associated with smoking.

I'm assuming US scientists have played a prominent role in producing the literature showing the negative health consequences of using cigarettes, and yet you said the United States has relatively low taxes compared to other developed countries. Why, do you think?

I think we're going to get into a very philosophical discussion about the US right here. It has to do with individual responsibility. We know for sure that the initial reason the taxes were so low was that the tobacco block was so influential in the Senate, particularly in the days when Jesse Helms, the senator from North Carolina, was in the Senate. He was the most feared senator by the other senators, and if you wanted to get anything done for your cause, you had to go along with his cause, which was keeping cigarette prices low and doing everything they could to support smoking. So there's clearly been a built-in bias in the Senate, and basically in the Congress as a whole, against tobacco policy. You see a huge variation from state to state in tobacco policies, and it's reflective of basically their political leanings in general.

You brought up this issue of personal responsibility, and boy, does that apply in the food area. You know, the food companies are saying: if you have one sugar beverage every once in a while, it's not going to be harmful. And it's not use of the products but it is overuse of the products. Thereby saying, it's not corporate responsibility we're talking about here, it's personal responsibility. That same argument was made by the tobacco industry, wasn't it?

It was. They would be less inclined to do that today, for a couple of reasons. One is that we know that even low levels of smoking are harmful and indeed cause many of the diseases that we were referring to earlier. And I think all the companies have now admitted publicly that smoking does cause all of these diseases that we've long known it causes. And all of them are claiming that they would like to move away from a society with smoking to one that has alternative products that would give people choices and ways to get their nicotine without exposing themselves to so much risk. I mean, we have to remember, the fact that cigarettes kill their consumers is a real drawback as far as the industry is concerned because they're losing a lot of their consumers, you know, 10, 20 years before they normally would, and they have to deal with all these lawsuits. So it's unfortunate for them. Having said that, cigarettes are the goose that lays the golden egg. They cost very little to manufacture. The industry is sufficiently oligopolistic that the profits are enormous, and their profitability has continued even while smoking has dropped rather precipitously ever since the mid-1960s.

Is that because the markets outside the US have been growing?

They certainly have helped. Although now, and this is only true within the last few years, the aggregate cigarette sales in the world are declining. They've actually started dropping. So we were seeing a relatively stable situation as smoking decreased in the developed world and was rising in the developing world. The only place now where we're seeing increases in smoking are areas in Africa, which, by the way, is the one place in the world where we might be able to forego the tobacco epidemic because smoking rates are still quite low in most of the countries, not all of them, and also parts of the Middle East. But elsewhere we've been seeing smoking declining all over the world. That doesn't mean the profits have to drop because one thing that the companies can do, is, they can raise their prices. Now, if prices go up because of taxes that hurts the companies. But if they raise their own prices because demand is inelastic, what that means is that the percentage increase in the price is larger than the percentage decline in the demand for cigarettes. So they're actually adding to their profitability by doing that. They've always played this very interesting game for years of keeping price below what we would think to be the profit-maximizing price. And I think the reason for that has to do with addiction because they know that they have to have what are called replacement smokers, kids coming in to take the place of the smokers who are dying or quitting. And for years, I think, they kept their prices down because they didn't want to discourage young people from smoking. Now, I think they see the writing on the wall. Smoking is declining very rapidly. Smoking prevalence, which was 45% in the mid, early-1960s, is now a little over 12% in the US, and I think they're raising their prices with the understanding that they want to take as much advantage of the opportunity with the addicted smokers, the adults, as they possibly can, even though smoking among kids is becoming vanishingly small.

I think of so many parallels with the soda taxes that now exists in a number of places, and the companies have responded somewhat differently. And perhaps it's the level of addiction issue that kicks in here, and the need to have replacement customers. Maybe that's another key difference. But with the soda taxes, the companies have not increased prices beyond the level of the tax. You know, to delight of public health experts, the companies have tended to pass along the entire tax so the companies are not eating that difference in order to keep prices the same. Higher tax gets reflected in the ultimate price that they charge, but they're not increasing prices beyond that. Do you think it might be the addiction issue that's different here?

I don't know. I mean, that certainly could be an element of it. The other thing is that they're manufacturing other drinks that are being used in place of some of the sodas. So they've got waters, they've got juices. I mean, obviously these sugary juices are no better, but they do make other products. They make the diet drinks. And to the extent that they can find substitutes for those products within their own companies, it may be that they're content to allow people to make those substitutions.

Interesting comment. The results so far on the soda tax suggest that the most common substitution as people drink less soda, is water, which is of course better than a lot of the alternatives that people might be consuming, so that's a bit of really good news. Even though the companies do sell water, Coke and Pepsi have Aquafina and Dasani, for example, they face a basic problem. Number one is that these companies are the biggest sellers of sugary beverages but not bottled water. That happens to be Nestle. So if people migrate to bottled water, they're likely to migrate from the big companies, like Coke and Pepsi, to Nestle. Also, people tend not to be very brand-loyal to water. They tend to buy whatever is on sale or whatever they find available to them, and that creates a problem for these companies like Coke and Pepsi that do rely on brand loyalty for their marketing. So it's very interesting. And also, I wonder, based on the research on food and addiction, if the companies don't take a hit if people switch from full sugar beverages even to diet beverages that they might sell because there wouldn't be as much addictive potential, and therefore the customers wouldn't have to have as much just to keep the habit going. So it's really interesting to think this through.

That's certainly very plausible. The whole thing would also depend on the price elasticity of demand for sodas, and specifically for the brands that they're concerned about. If there is greater elasticity there than what we observe for cigarettes, then raising those prices aren't necessarily going to help them all that much.

You mentioned that the elasticity estimates for tobacco suggested that a 10% increase in price led to a 3 to 4% reduction in consumption, and the numbers are even more positive in the case of the sugar beverages, where if you get a 10%, 15% increase in price, you end up with 10, 15% reduction in consumption. So that's good news in the food arena.

That's good news but it also means that they can't do as easily what the tobacco industry can do, which is to raise their prices and expect to see profits rise. Because if they're losing as much in sales as they're gaining in price, it's no win.

So Ken, let's talk about product formulation because you mentioned that earlier, and this is a really interesting issue that, again, connects tobacco and food products. So you think about the tobacco companies mainly selling cigarettes, but now there's vaping, there's cigarettes with things like menthol and other flavors, or low-fat foods, or artificial sweeteners. The list of product reformulations in order to attract customers goes on and on and on. So I know a controversial topic in your field has been e-cigarettes. Can you explain what these are?

E-cigarettes have been around now for about a decade, let's say. Basically, they're devices that allow people to inhale nicotine and other substances, but the purpose is to give them their nicotine without combustion. And we know that the major problem associated with smoking is the products of combustion. There's 7,000 chemical compounds in cigarette smoke. 70 of them are known human carcinogens, causes of cancer in humans. Many of them are cardiotoxic. They cause lung disease and so on. The e-cigarettes have about two orders of magnitude fewer toxins in their emissions than do cigarettes. And it turns out that the amount of the comparable toxins, when they are in fact comparable, that you find in the e-cigarette emissions is much lower, usually a 10th to a 400th, of what you find in cigarette smoke.

So logically, and based on a fair body of evidence at this point, vaping, use of e-cigarettes to get nicotine, is substantially less dangerous than is cigarette smoking. However, the controversy here is incredible. This is the most divisive issue that I have witnessed in my 45 years of working in the tobacco control field. It has torn the field asunder. The mainstream of public health, and by that I'm including governmental agencies, the Campaign for Tobacco-Free Kids, the Truth Initiative, the American Cancer Society, heart and lung associations, all of mainstream public health is strongly opposed to e-cigarettes, and for one reason. They're concerned about kids' uptake of e-cigarettes, which has been substantial. It's been decreasing the last couple of years, but it has been substantial. And there are a number of things they're concerned about in that regard, and they're completely ignoring the fact that there's pretty good evidence that e-cigarettes are increasing smoking cessation for a subset of smokers. And a number of us on the science side of this, believe that the net effect of e-cigarettes is beneficial, that it's actually, possibly, a tool to add to the armamentarium of things like cigarette taxation, like smoke-free workplaces, like restrictions on advertising, and that it will help a group of inveterate smokers, those who either can't quit nicotine or don't want to, to move to a less dangerous alternative to smoking. I am not saying that e-cigarettes have no risk associated with them. They almost certainly do. But it is substantially lower.

Now, historically, this is divisive within the field in part because all of the earlier attempts at, quote-unquote, tobacco harm reduction have been produced by the major cigarette companies, and they've been fraudulent. So cigarette filters were manufactured and sold, starting in the 1950s, in response to the scare that I referred to earlier about cancer. And they were sold with a message that the filters block the dangerous stuff but let the flavor through. And people bought this. That decrease in smoking in the early 1950s reversed, smoking went up sharply, as sales of filtered cigarettes went up. By the way, the first successful filtered cigarette was Kent, and it used what it referred to as the miracle Micronite filter. Well, that miracle Micronite filter turns out to have been made of asbestos. And there are lawsuits continuing to the present day by workers in the factories that made the filter tips for Kent cigarettes, who themselves ended up with lung cancer or other diseases due to the asbestos. Then came low-tar and nicotine cigarettes, and we actually have ample evidence from the documents that had been revealed by lawsuits, that the industry knew that this was a public relations device. It was not a harm reduction device. And in fact, because people believed that low-tar and nicotine cigarettes were less dangerous, it's likely that it actually increased the toll of smoking because people who would have quit, switched to low-tar and nicotine cigarettes instead. So there's some pretty awful history here that makes people legitimately concerned about alternative products. A critical element of this story is that the alternative products, in this case, the e-cigarettes were introduced by non-cigarette, non-tobacco companies, and their goal was to replace smoking. Now the major companies are all making their own e-cigarettes as well because they have to do it from a defensive point of view, but basically they don't have any great interest in slowing up the sale of cigarettes. They want to benefit from that as long as they can.

So I should know the answer to this but I don't, but are e-cigarettes taxed? And wouldn't it be optimal to tax e-cigarettes but less than regular cigarettes so you discourage use of both but discourage the use of regular cigarettes more?

That is very insightful. Two colleagues and I actually published a paper saying that in 2015 in "The New England Journal of Medicine," that we should be taxing e-cigarettes modestly, the reason being that we want to discourage kids from using them, and kids are far more price-sensitive than our adults. Kids have a very elastic response to cigarette prices. Adults do not, and in particular, older adults have even lower price responsiveness. So yes, there should be some taxation of e-cigarettes to discourage youth use of it but that taxation should be dramatically lower than the taxation of cigarettes. Some states are now taxing e-cigarettes. Not all of them. The federal government is actually looking into a proposal to double the tax, the federal tax, on cigarettes, which would take it up to $2.01 a pack, and at the same time, to establish an equivalent tax, similar to the $2 tax, on all vaping products. This would be a disaster because it would definitely discourage kids from vaping, but it would also discourage adults from using e-cigarettes as an alternative to smoking, and the most addicted, the inveterate smokers, those are the ones that need these alternatives. So that's a bad policy proposal. A much better one would be to increase the cigarette tax by more than a dollar, raise it to 3 or $4 or something, and impose a modest tax on e-cigarettes. This would discourage people from smoking, both adults and kids, but especially kids. It would discourage kids from using e-cigarettes but it would create a price differential that would encourage the inveterate smokers to switch to e-cigarettes. Now, part of the problem, and this has gotten worse over time, is that the American public believes that e-cigarettes, that vaping, is as dangerous and even maybe more dangerous than cigarette smoking. Nothing could be further from the truth but so far the mainstream of public health has sold that message to the public, and the public, including smokers, believe it.

That's a fascinating story about how the public health field might be getting in its own way with this.

And maybe doing damage to public health.

So let's loop back a little bit to the behavior of the tobacco industry. So in 2017, the Phillip Morris Company funded and launched an organization called Foundation for a Smoke-Free World. So I think, hmm, a tobacco company saying they want less smoking, and one could view this with pretty high cynicism but what do you think about it?

I've always shared your sense of cynicism about it. There's an interesting anecdote related to this. The individual who negotiated the deal by which Phillip Morris offered $1 billion over a 12-year period to establish this foundation, that individual was the main actor in the World Health Organization during the development of the global treaty on tobacco control, the Framework Convention on Tobacco Control. He also became director of the organization and served in that capacity until just the other day. He has stepped down from being director. But let me give you a little context for it. Philip Morris International that needs to be distinguished from Altria and Philip Morris Domestic, but Philip Morris International sells the leading brand of what is known as heated tobacco products, HTPs. These are products that actually have tobacco in them. E-cigarettes have no tobacco in them but these products actually have tobacco in them. But instead of burning the tobacco, they heat it. They volatilize it, and the nicotine is inhaled. Like e-cigarettes, they appear to be substantially less dangerous than smoking, although it's not clear that they're as less dangerous as, than, e-cigarettes. But they're produced only by the major cigarette companies. Philip Morris is now selling these products successfully in many countries, many cities around the world. While they actually have the authorization to sell an older version of the product in the US, it's not very popular at this point. But in Japan, over the last four years there's been a drop in cigarettes sold of about a third at the same time that there's been this great increase in the use of these heated tobacco products manufactured by Philip Morris International and by Japan Tobacco. They have a product called Ploom. Philip Morris' product is called IQOS, I-Q-O-S, which, I was told, originally stood for I Quit Ordinary Smoking. So they are the leader of the theme song that the industry is singing these days about how they want a smoke-free world and they want to move toward one. But the only way they're ever going to do that, willingly, is if they can sell other products like these heated tobacco products and make large sums of money on them. Philip Morris has a good start at that. They claim that about a third of their revenue now is coming from IQOS, this heated tobacco product.

So whether that foundation ultimately has beneficial effects or not, forget corporate beneficial effects but on the public good, would pretty much depend on who's choosing to use these e-cigarettes, I'm imagining. That if it's people switching from normal cigarettes to them, or using them instead of normal cigarettes, it's one thing. But if they're recruiting new people who otherwise wouldn't smoke, then it would be a bad thing. So how do you think that'll all play out?

That's actually a critically important question, Kelly. And one of the great concerns that the opposition to e-cigarettes has, is that they're addicting lots of kids to nicotine, and that many of them will go on to smoke, and that that will reverse the progress that we made on smoking. Now, it turns out that there is no evidence to support the latter contention. And in fact, there's evidence to the contrary. I think it's entirely possible that some kids who would not have touched a cigarette otherwise are vaping and then trying cigarettes in the future. Whether they become regular smokers, remains to be seen. But I think there certainly are some kids like that. But what we do know is that the rate of smoking among kids, what we call current smoking, and smoking among kids means that they've had at least one puff on a cigarette in the last 30 days, that number has plummeted over the last quarter century, and, and this is the interesting thing, it has gone down at its fastest rate precisely during the period in which vaping has been popular among kids.

So one theory is that vaping is displacing smoking to some extent. That kids who would've smoked are vaping instead. It's a very complicated area and we don't know the answer. Among adults who vape, and they are relatively few in number except for very young adults, we observe mostly dual use, but the question is how much of this is a transition to vaping only, and then, maybe, a transition to nothing after that. In the UK, where vaping has been advertised by the health organizations as a way to quit smoking, and they have encouraged its use, and they use it in their smoking cessation clinics, and you'll even find it in hospitals, in the UK we have seen that more than half of the people who have quit smoking by using e-cigarettes have also quit vaping. So it is no longer the case in the UK that a majority of the people who vape are also currently smoking.

In the US, the data have been moving in that direction but it's still a majority who are dual users rather than vaping only. But we have evidence of four or five completely different kinds of studies, commercial data, other products in other countries, that all lead to the conclusion that vaping is already increasing the rate of smoking cessation in the US and in the UK by probably 10 to 15%. That's a hard thing to see in the data but it is something that, if you dig into the data, you will see it, and as I say, we see it all over the place. Let me give you one example of the tobacco harm reduction story that's fabulous. 40 to 50 years ago, large numbers of Swedish males started using a smokeless tobacco product called snus, S-N-U-S. It's a relatively low nitrosamine product, nitrosamine being a carcinogenic element, and they substituted it for cigarettes largely because cigarette taxes were going way up and there weren't any significant taxes on snus. So what you observe today, some three, four decades or more later, is that Swedish males have the lowest male smoking rate of any country in Europe, and maybe in the world. They do not have a low tobacco use rate. Their tobacco use rate is pretty typical but it consists mostly of snus. And they also have by far the lowest rate of tobacco-related diseases, like lung cancer, of men in all of the European Union countries, and the second lowest is typically a rate twice or more that of what you see in the Swedish males. Swedish females, who did not quit smoking in large numbers and did not take up snus until fairly recently, have rates of lung cancer and other diseases that are average or above-average for the European Union. So that's a great example of tobacco harm reduction in action, and it's one that's been around now, as I say, for decades.

Ken, this is a remarkable history and you're just bringing it alive beautifully. But let me ask you one final question. So given that you've been working in this field for more than four decades now, and have really been a pioneer, a leader, a warrior, and a hero, all those things could be applied to you and your work, if I asked you to sum up what's been learned from all these decades of work on tobacco, what would you say?

There are a lot of lesson. Certainly, we have learned specific kinds of interventions that really matter. You and I spoke about tax at some length. That's the preeminent one. Smoke-free workplaces, including smoke-free restaurants and bars, have not only themselves had a direct impact on health but have also set the tone for a more smoke-free society. So we have seen quite dramatic changes. I mentioned we're going from a 45% rate of smoking for the nation as a whole down to a little over 12%. That, however, has taken us six to seven decades. So it's kind of a good news, bad news story. It's a very complicated area. Tobacco control was ranked by CDC as one of the 10 most important public health measures of the 20th century, and also the first decade of the 21st century. And I think that's completely legitimate, and it is something about which all of us who care about public health can feel very proud about. The problem still remains. It is an enormous problem, as you alluded earlier, in many parts of the developing world, the low- and middle-income countries, and it's a growing problem in some of those countries, and it's just not going to disappear real fast. The lesson that I've taken most recently has been a discouraging one, and that's how divisive our field has become. We really have a chasm between the people who are opposed to tobacco harm reduction and those who are supportive of it. They're good people on both sides, they believe what they're saying, but they can't talk to each other civilly at this point. I hope that that will not become the case for those of you who are fighting the good fight in dealing with unhealthy foods.

Bio

Kenneth E. Warner is the Avedis Donabedian Distinguished University Professor Emeritus of Public Health and Dean Emeritus at the University of Michigan School of Public Health. A member of the faculty from 1972-2017, he served as Dean from 2005-2010. Presented in over 275 professional publications, Dr. Warner’s research has focused on economic and policy aspects of tobacco and health. Dr. Warner served as the World Bank’s representative to negotiations on the Framework Convention on Tobacco Control, WHO’s first global health treaty. He also served as the Senior Scientific Editor of the 25th anniversary Surgeon General’s report on smoking and health. From 2004-2005 he was President of the Society for Research on Nicotine and Tobacco (SRNT). He currently serves on the FDA’s Tobacco Products Scientific Advisory Committee. In 1996 Dr. Warner was elected to the National Academy of Medicine. He is a recipient of the Surgeon General’s Medallion, the Luther Terry Award for Exemplary Achievement in Tobacco Control, and the Doll-Wynder Award from SRNT. Dr. Warner earned his AB from Dartmouth College and MPhil and PhD in economics from Yale University.

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For nearly 70 years now, Americans have been bombarded with advice on how to lose weight. Countless diet books have become bestsellers. Some diets like Atkins keep coming back in sort of a recycled way. And there really hasn't been agreement, even among nutrition scientists, about which approach is best. Lots of attention has focused in recent years on carbohydrates, but over the years, protein and fat have had plenty of attention. In this podcast, our guest, Dr. David Ludwig of Harvard University, discusses this history and the reason for re-envisioning how best to lose weight – and for people to maintain the weight loss, perhaps the most important issue of all. Ludwig recently published a landmark, exquisitely designed and controlled study that tests whether limiting carbohydrates actually makes sense. This study, published in the "American Journal "of Clinical Nutrition 2021," has been generating lots of attention.

Interview Summary

Access the study: https://doi.org/10.1093/ajcn/nqab287

I'll begin by asking a question fundamental to this work. Why care so much about carbohydrates?

Great question, Kelly. Carbohydrates amount to at least half the calories in a typical diet today, which is interesting from a historical and evolutionary perspective. Because of the three major nutrients we eat, protein, fat, and carbohydrate, carbohydrate is the only one for which humans have virtually no requirement. Think of Northern populations, especially in the Ice Ages but also up to recently, such as the Inuit, that had access to only animal products and could eat plant products like berries maybe one or two or three months a year at most. So for nine months a year, they were eating only fat and protein. And yet, those populations were healthy. The women were fertile; they could breastfeed. And children grew normally. So recognizing that there's no absolute requirement for carbohydrates, the question then becomes: How much carbohydrate and what kind would be optimal for health and allow for the greatest flexibility, diversity and enjoyment in our diets?

So David, if the body doesn't have an innate need for these, presumably there's no biological driver to go out and seek these, why in the heck are people eating so much of this?

Well, carbohydrates are delicious. And the food industry certainly knows that and has taken advantage of that. In fact, when you step back and ask: What are the foods that we tend to binge on? They may have a combination of key flavors and nutrients. Oftentimes, we hear sugar, salt and fat. But I'll argue that there are virtually no binge foods that are just fat. Do people actually binge on butter? I mean, butter is very tasty. You might enjoy an initial bite. But very few people, perhaps with the exception of a major eating disorder, would sit down and eat a quarter pound, a stick of butter. But there are all sorts of high-carbohydrate binge foods. Sugary beverages are 100% sugar. Bread, baked potato chips, popcorn, especially the low-fat versions, these are easy to binge. And from one perspective, the key difference is the hormone insulin. Fat does not raise insulin. And so fat is digested slowly, and doesn't get directly stored in large amounts into body tissue. It has to be metabolized more slowly. Whereas carbohydrates, especially the processed ones, when eaten in large amounts, raise insulin to high levels. That insulin directs those incoming calories into storage. And a few hours later, blood sugar crashes and we get hungry again and are ready to have another blood sugar surge by indulging the next time in those foods.

So what question specifically was your study designed to address?

We conducted a large feeding study that had two parts. The parent study had 164 young and middle-aged adults, who were at least a little bit overweight, ranging from overweight to having obesity. And the first thing we did was bring their weight down by providing them all of their foods, delivered foods to their home, in a calorie-restricted way. You know, you cut back calories, and of course you're going to lose weight for a while. It doesn't address why people get hungry, and why they regain weight. But in the short term, we cut their calories, and they lost 10% to 12% of their weight. Then we stabilized them at their new, lower body weight, and then randomly assigned them to one of three groups: low, moderate or high-carbohydrate diets. And we kept them on these three different diets for another five months. And during this time, we were again delivering all of the meals to the participants. This was over 100,000 prepared meals throughout this time, so it was a really major effort. And during this low, moderate, and high-carbohydrate diet period, we adjusted calories to keep their weight the same. We wanted to keep them at that weight-loss anchor, 10% to 12% below where they started. The first study looked at what happened to their metabolism and their energy expenditure. And we found that when people were on the low-carb diet at the same weight as the other groups, they were burning about 200 calories a day more. So the study raised an interesting possibility, that the kind of calories you eat can affect the number of calories you burn. That from a biological perspective, all calories are not alike to the body.

David, this is fascinating work. I'd like to ask a strategy question. So this was an extremely intensive study of 164 people. And you mentioned the people were provided all their meals, very careful measurement and things like that. So the same amount of money, you could have studied many more people but just done a less intensive study with less supervision and fewer measurements of outcome. So why do the study in such an intensive way?

Right, there's always going to be a trade-off in design considerations. And you've identified a classic trade-off. You can study fewer people more intensively, or more people less intensively. Most weight loss trials have chosen the second route. They take a lot of people, and they try to study them for a long period of time, or at least some of them do: a year or ideally two years or longer. The problem is that without an intensive intervention, so what are we talking about? These studies would oftentimes have participants meet with a nutritionist once a month. They would get written educational materials, and maybe other kinds of behavioral support. But that's about it. And without greater levels of support and intervention, people characteristically can't stick to these diets over the long term. Maybe they make changes for two, three or four months. But by six months or a year, they're largely back to eating what they were originally. And the different diet groups don't look much different. So if the groups didn't eat in much of a different way throughout most of the study, why would we expect to see any differences in outcomes, such as weight or energy expenditure, or cardiovascular disease risk factors? So these studies don't test a dietary hypothesis very well. It leads to the mistaken conclusion that all diets are alike. Really, what the conclusion of these studies has to mean is that we need more intensive intervention in our modern toxic environment, if you will, to promote long-term change. And it's only when we get that long-term change can we actually figure out which diet is better and for whom.

So you've explained how the study was done and why you did it. What did you find?

So the first leg of the study, which was published in "BMJ" late in 2018, so just before the pandemic, showed that the kinds of calories you're eating can affect the number of calories you burn. And, that by cutting back on the total and processed carbohydrates, you can increase your metabolic rate. And that could be a big help in the long-term management of a weight problem. You know, you want your body on your side rather than fighting you when you're trying to maintain weight loss. And a faster metabolism would be a tremendous help if this is a reproducible finding and applies to the general population. We recently published in the September "American Journal of Clinical Nutrition," a second part of the study. And that asks: How do these different diets, low, moderate and high carbohydrate, affect cardiovascular disease risk factors? It's one thing to lose weight. Maybe a low carbohydrate diet helps you lose weight. But if your cardiovascular disease risk factors go up, that might not be such a good trade-off. So that's the aim of the second study. Because low-carbohydrate diets are often very high in saturated fat. So we wanted to find out what were the effects of this low-carbohydrate, high-saturated-fat on a range of risk factors.

So tell us specifically some of the cardiovascular risk factors that changed. And if you would, place the changes that you found in your participants in a context. Like are these big-deal changes? Are they small changes? Or put it in context, if you would?

The big problem with saturated fat is that it clearly raises LDL cholesterol, low-density lipoprotein cholesterol, which is a classic cardiovascular disease risk factor. It's the main one that's targeted by many of the drugs, such as statins. Yeah, I think there's no question that on a conventional high-carbohydrate diet, a lot of saturated fat is harmful. So the combination of bread and butter is not a good one. But the question we wanted to ask was: What happens when you get rid of a lot of that bread? Does the saturated fat still comprise a major risk factor? And so our low-carbohydrate diet was exceptionally high in saturated fat, as is characteristic of how these low-carb diets are usually consumed. It had 21% saturated fat, which compares to the 7% saturated fat on the high-carb, low-fat diet that's oftentimes recommended to people at risk for heart disease.

So what did we find? Well, the first thing we found was that LDL cholesterol was not adversely affected at all. There was no difference in LDL cholesterol between those getting 21% versus 7% saturated fat. Suggesting that when you substitute saturated fat for processed carbohydrates, from the standpoint of this key risk factor, it's pretty much a wash. However, the low-carbohydrate, high-saturated-fat diet benefited a range of other risk factors that go along with what we call the metabolic syndrome, the insulin resistance syndrome. Specifically, we saw strongly significant, from a statistical perspective, improvements in triglycerides, that's the total amount of fat in the bloodstream; HDL cholesterol, that's the good cholesterol that you want to be higher; and other lipids that indicate overall levels of insulin resistance. Suggesting that insulin resistance was improving. And we know that low-carbohydrate diets show promise for diabetes in other studies, in part because they do tend to improve insulin resistance and lower blood sugar. And so our study suggests that if you are pursuing a low-carbohydrate diet, and we can talk about the different degrees of restriction of carbohydrate, and at the same time you're reducing the processed carbohydrates, then the saturated fat might not really be such a problem.

So then if you take all this information in this, as I said, exquisitely designed intensive study and distill it into what dietary recommendations would be, what do you think is a reasonable proportion of fat, carbohydrate and protein in the diet? And what sort of things should people think about as they want to lose weight and keep the weight off?

One key qualification I need to mention is even though this was an intensive study with a relatively large number of people for a feeding study of this magnitude, we still don't know how generalizable these findings are to people at different ages, different body weights, different levels of susceptibility. So no one study can inform a change of clinical practice like this, especially in the world of nutrition where there's so many complicated and interacting factors. I will also venture to say that there's no one diet that's going to be right for everybody. We know that some people can do perfectly well on a high-carbohydrate, low-fat diet. I mean, think of the classic Asian agrarian societies where rates of obesity and diabetes are very low. But those societies tend to be highly physically active and the people insulin-sensitive. America is characterized by high levels of overweight and obesity, sedentary lifestyle. And these create insulin resistance as a highly prevalent problem. For societies such as ours, we think that high-carbohydrate diets that are raising insulin levels on the background of insulin resistance is a recipe for metabolic problems. And so for Americans, especially those struggling with weight, pre-diabetes, and even more so diabetes, a reasonable first step is to cut back on the processed carbohydrates. And I think that's an intervention that increasingly few experts would argue with. We're talking about concentrated sugars and refined grains. Where we start to get into the controversy is whether carbohydrates should be further reduced down to say 20% as in our study, which still leaves room for some unprocessed grains, beans, and a couple of servings of whole fruit a day, or even lower to what's called the ketogenic diet that's less than 10%. And that's where you really have to give up most carbohydrates and focus just on the proteins and fats. I think for people with diabetes, such a strict approach looks appealing in preliminary research studies. But again, this is going to need more research. And I would caution anybody with diabetes or anybody who's thinking about a ketogenic diet to discuss these kinds of dietary changes with their healthcare provider.

I realize your study wasn't meant to address this issue that I'm about to raise, but I'd appreciate hearing your instincts. One key, of course, to any recommended nutrition plan or diet, if you'd like to call it that, is whether people will stick to it. What do your instincts tell you, or data if you have it, on how readily people can adhere to this sort of an approach over the long term compared to other kinds of approaches?

Great question. And I'll approach that by saying: We all understand that if diet is a problem that's contributing to obesity, diabetes, heart disease, other chronic health problems, then we have to change our diet in one way or another regardless of what the mechanisms are. So I'll return the question to you by saying: Which do you think is going to be easier for most people over the long term: cutting back calories, getting hungry and trying to ignore that very intense drive to eat, or getting rid of certain kinds of foods that may be triggering hunger and making it so much harder to stick to a lower calorie intake?

As a doctor, as a pediatrician, and as a researcher, and also myself, I try to do N of 1 experiments on myself with any kind of a nutrition approach I might use with patients or with research participants. I've found that it's so much easier to just give up the processed carbohydrates and enjoy a range of other very satisfying, delicious, higher fat foods. And oftentimes, in my experience personally and I hear as reported by patients that the cravings for these highly processed carbohydrates go down. And lastly, I'll just say, it's not that these processed carbohydrates are inherently so irresistibly delicious. I mean, white bread, these common binge foods, white bread, unbuttered popcorn, baked potato chips, even though these are almost 100% carbohydrate yet they're commonly binged on not because they're so incredibly tasty. But I would argue because they're producing changes in our body that are driving overeating. So it's not that they're so tasty and we're getting so much enjoyment. We're eating these foods because we're driven to metabolically. And once you come off that blood sugar rollercoaster, it becomes much easier to say no.

When you mentioned before that with one approach, you're kind of fighting your body; and another approach, your body is becoming your ally in this process, I thought of going to the beach and, you know, you can go out and try to swim against the waves coming in, or you can ride the waves toward the beach. And one, of course, is a lot easier than the other. And it sounds that's kind of what you're talking about, isn't it?

When you line up biology and behavior, and clearly behavior, psychology, and our food environment are all factors that are going to have to be addressed. We don't want to make it much harder for people. So we do need to think in systems dynamics: the food supply, the environment. But on a strictly individual level, when you line up biology with your behavior, the effort required to accomplish your goals becomes less. You know, this is characteristic of so many areas of medicine and research. This is why we aim to identify the cause of a problem when you treat a cause. So let's use the example of fever. Fever you could say is a problem of heat balance: too much heat in the body, not enough heat out. And so from that perspective, you could treat any fever by getting into an ice bath. Couldn't you, right? The ice would pull the excess heat out of your body. But is that an effective treatment for fever? No, of course not. Because your body's going to fight back violently with severe shivering, blood vessel constriction. And you're going to feel miserable and you're going to get out of that ice bath quickly. In the case of obesity, the timeframe is much longer, but similar kinds of responses occur. The body fights back against calorie restriction because calorie restriction, according to this way of thinking, is an effect. It's not the cause. If the cause is the body's been triggered to store too much fat, then we have to address that problem by lowering insulin levels and producing a more stable blood sugar pattern after eating. If that happens, then the effort that you put into cutting back calories goes a lot further.

Bio:

David S. Ludwig, MD, PhD is an endocrinologist and researcher at Boston Children’s Hospital. He holds the rank of Professor of Pediatrics at Harvard Medical School and Professor of Nutrition at Harvard School of Public Health. Dr. Ludwig is the founding director of the Optimal Wellness for Life (OWL) program, one of the country’s oldest and largest clinics for the care of overweight children. For 25 years, Dr. Ludwig has studied the effects of diet on metabolism, body weight and risk for chronic disease – with a special focus on low glycemic index, low carbohydrate and ketogenic diets. He has made major contributions to development of the Carbohydrate-Insulin Model, a physiological perspective on the obesity pandemic. Described as an “obesity warrior” by Time Magazine, Dr. Ludwig has fought for fundamental policy changes to improve the food environment. He has been Principal Investigator on numerous grants from the National Institutes of Health and philanthropic organizations totaling over $50 million and has published over 200 scientific articles. Dr. Ludwig was a Contributing Writer at JAMA for 10 years and presently serves as an editor for American Journal of Clinical Nutrition. He appears frequently in national media, including New York Times, NPR, ABC, NBC, CBS and CNN. Dr. Ludwig has written 3 books for the public, including the #1 New York Times bestseller Always, Hungry? Conquer Cravings, Retrain your Fat Cells, and Lose Weight Permanently.

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A paper just released in the American Journal of Clinical Nutrition challenges, and I mean really challenges conventional thinking about nutrition, weight gain, and what has caused the very rapid and profound increase in obesity rates over the last 50 years. This is a landmark paper by any standard, and saying that it will raise eyebrows is an understatement. The paper is authored by a number of distinguished nutrition scientists. The lead author is Dr. David Ludwig from Harvard University.

Interview

David Ludwig MD, PhD is Professor of Nutrition at the Harvard School of Public Health, and Professor of Pediatrics in the Harvard Medical School. He has published innumerable books and papers on nutrition, contributors to obesity and diabetes, and what might be done with both practice and policy to improve things. He has a real remarkable breadth and scope of his work. David, Time Magazine once named you a warrior in work on obesity. This is exactly how I see you as well. You're really challenging the traditional ways of thinking, and as I said, you've broken new ground. So I'm proud to say that you and I have been friends for a number of years, and I'm also proud to say that we've written a number of things together. So thanks so much for being with us today. It's a real honor to have you.

Thanks, Kelly. Great to be with you. And I'm sitting here in my office looking at a plaque I have on the wall of an op-ed we wrote for the Washington Post almost two decades ago, so it's been a real honor and productive pleasure to know you.

The pleasure has been mine. So let's talk about the paper. So in this paper, you and your co-authors challenged the widely-embraced energy balance model. So can you say what the energy balance model is?

Well, the notion of energy balance is really just a restatement of physics, the first law of physics that says, that speaks to energy conservation, and it's commonly interpreted that in order to gain weight, you have to have a positive energy balance, that is you have to consume more calories than you burn off, and that to lose weight, you have to reverse that. You have to have a negative energy balance. You have to consume fewer calories than you burn off. But we argue first off that this doesn't tell us anything about causality, cause and effect, what's actually driving obesity. We use the example of a fever. Of course, a fever can only happen if the body generates more heat than it dissipates, more heat into the body than heat out of the body. But that's obvious that's, it's, you know, we don't need to be emphasizing that in textbooks. We don't need to be teaching patients that notion. The question is what's cause and what's effect? And the conventional way of thinking is that the positive energy balance is driving weight gain, is causing obesity. So we're surrounded by all these convenient, inexpensive, energy-dense, hyper-palatable, highly tasty foods. We lose control. We overeat them. We don't burn off those excess calories with our modern lifestyle, and so those excess calories get forced into fat cells, and we gain weight. So ultimately this view considers all calories are alike to the body, and that we have to eat fewer calories, and ideally burn more of them off by exercise to address the problem. So that's the conventional way of thinking.

So you have a different, and very science-based explanation for all of this that I'll get to in a minute, but before we do that, why did the field come to adopt this energy balance model?

Well, it does seem to make sense, and certainly over the short term, we know that this way of viewing things applies. If you force feed an animal, or if we just intentionally overeat ourselves, we can gain weight, and conversely, if we put ourselves on a low calorie diet, we can lose weight for a while, but characteristically, we know the body isn't a, you know, an inert energy storage depot. The body fights back in a dynamic way against changes in body weight and in energy balance, and this is something that almost every dieter has experienced, right? If it were just a matter of eating less and moving more, 150 calories less a day, that's a serving of juice, 150 calories out more a day, that's walking moderately for half hour, then virtually every weight problem should be solved within, you know, months to at most, a few years, but that's not the case. Very few people can adhere to, can stay with low calorie diets for very clear reasons. The first thing that happens is we get hungry, and hunger isn't a fleeting feeling. It's a primary biological signal that the body wants more calories. And even if we could, those few of us who are highly-disciplined, and can resist hunger, the body fights back in other ways, most notably by slowing down metabolism, which means that to keep the weight coming off, even as we're getting hungrier. We have to keep eating less and less, because the body's getting more efficient. So the conventional way of thinking about things, all calories are alike, calorie in calorie out, just eat less and move more. Doesn't seem to address the difficulty that people are facing, and recognize that despite a lot of attention to calorie balance, the obesity epidemic is getting worse and worse every year. I mean, the data just from the last year suggests that the weight gain during the pandemic was even faster than it was just prior.

Well, let's talk for a minute about what's at stake here. So vast numbers of people in the United States, both adults and children are overweight. This is increasingly becoming true of essentially every country in the world. The amount of weight that people have been gaining seems to be going up over time, and people find it very difficult, perhaps for the reasons you mentioned, to lose weight and keep it off, so it's a pretty dire situation then, and given the health consequences of excess weight, and the psychosocial implications of things, there's really a lot at stake here, isn't there?

Certainly so. We know that in childhood, obesity can affect virtually every organ system in the body, and set the stage for a lifetime increased risk of diabetes, heart disease, even many cancers. Among adults, the majority, and in fact 70% of adults in the United States have at least overweight, if not obesity, and this is becoming a huge driver of the chronic health burden on the healthcare system, and which so many patients themselves experience, in terms of diabetes, risk for heart disease, fatty liver, orthopedic problems, sleep apnea. So we have a problem that has gotten so much attention, and yet keeps getting worse with every effort that we can bring to bear. My coauthors and I have this new paper in American Journal of Clinical Nutrition, arguing it's time for new thinking. And the carbohydrate insulin model that we are proposing is perfectly consistent with the laws of physics around energy balance, but it suggests that we've been coming at the problem in exactly the opposite way than would be most effective.

So let's talk about that. So if you have a different explanation than the traditional energy balance model, what is it exactly?

So the usual way of thinking, as we considered earlier is that overeating causes weight gain, and that certainly happens in the short term, but that model has a hard time explaining why people are gaining weight year after year, and their bodies are wanting to hold onto those calories. So we argue that a metabolic perspective would better explain this continuing creep upward in the so-called body weight set point. So the carbohydrate insulin model suggests that we've had it backwards, that overeating is not the primary cause of weight gain, that the body's process of gaining weight, and storing too much fat is driving overeating. So overeating and a positive calorie balance certainly has to exist. That's a law of physics, but it's a downstream effect. It's not at the source of the problem. And so this may sound a little surprising. How could the body gaining weight cause us to overeat? Well, let's take the example of an adolescent during the growth spurt. We know a teenager might consume hundreds, or a thousand calories more than he or she might have a few years earlier, and that adolescent is growing really quickly, but which comes first? Is the overeating that that child is doing causing the growth, or is the rapid growth and the deposition of many calories into new body tissue causing that adolescent to get hungry and to eat more? Neither explanation violates any law of physics, but they have radically different implications to how we understand growth, and what we might do about growth disorders. In the case of the adolescent, it's clearly the other way. It's the growth that's driving the overeating, and how do we know that? Well, Kelly, neither you or I, no matter how much we're going to eat or overeat are going to grow any taller. So something in the body is regulating hunger, based on the needs of growth, and we argue that the same thing is happening in the case of obesity, that the aspects of our diet, importantly, including the processed carbohydrates that flooded our diet during the low fat years, that these are triggering fat cells in the body to hoard too many calories, to hold onto too many calories, so there are fewer calories available for the muscle, the liver, and the brain, and our body recognizes that. We get hungry, and we eat more as a consequence.

You mentioned the highly processed foods, especially carbohydrates that bombarded the American scene during the low fat craze. Explain more about that.

These processed carbohydrates, that at one point, just 20 to 30 years ago, people thought, and you can find many examples of this written in the literature. In fact, the first food guide pyramid is a clear illustration of the fact that all fats were considered unhealthy, because they have so many calories per bite, more than twice the calories per gram than carbohydrates. Whereas the bottom of the food guide pyramid, you know, we were supposed to eat six to 11 servings of grains, many of which were highly processed. Sugar was considered benign, and a good way to, and this is what they said, dilute out fat calories. The problem is that these processed carbohydrates, white bread, white rice, potato products, virtually all of the prepared breakfast cereals, and of course, concentrated sugars, and sugary beverages. So when you eat these foods in substantial amount, and it's worse if the meal is also low in fat and protein, because they tend to slow down digestion. So if you just eat a lot of these processed carbohydrates, the body digests it into glucose literally in minutes. So blood sugar shoots upwards 10, 20, 30 minutes later, and that causes a lot of the hormone insulin to be produced. I sometimes refer to insulin as the Miracle-Gro for your fat cells, just not the sort of miracle you want happening in your body. We know that when a person with diabetes gets started on insulin, they'll typically gain weight, and if insulin is given in excess dose, they'll gain a lot of weight. So insulin is the hormone that promotes fat storage, and we argue that basically just endocrinology 101, all these processed carbohydrates, by stimulating more insulin than we would normally make on a less processed, lower carbohydrate diet, are driving too many of the incoming calories from a meal into storage and fat cells, instead of into muscle where they can burn. And so when you store, all it takes us to store one gram of fat too much a day to explain basically the whole of obesity, if one looks from childhood to adulthood.

So David, provide some context for this, if you would. So what fraction of the American diet is comprised of these kinds of foods, and what would that number be if people followed the recommended dietary guidelines you suggested?

Well, back in the 1950s, it's not as if Americans were extremely healthy. We had much higher rates of heart disease, although much of that related to smoking, and we of course, had many fewer medications, and surgical procedures to help prevent or treat heart disease. But at that time, obesity rates were much, much lower, you know, about only one third of the rates they are today. And at that time in the 1950s, Americans ate about 40% of their calories as fat, and about 40% as carbohydrate, and maybe 15 to 20% as protein. Because of concerns around saturated fat and heart disease, which then got generalized to all fats being bad, well, we got the low fat diet of the 1980s, nineties, and the beginning of the century. Fat came down as a proportion of our diet. Carbs went up, but also the processing of those carbs. We got foods like the fat-free SnackWells cookies, a whole range of these fat-reduced products that simply took out fat, dumped in sugar and starch. These are after all processed foods, so they're not going to be putting in fruits and vegetables. And these products were considered healthy. We ate them as we were told to eat them, and at that time, obesity rates really exploded. And we're arguing that this is not just an association, that this change to our diet has played an important role in driving obesity, and that by bringing both the total amount of carbohydrates down, not necessarily a very low carb or ketogenic diet, but bringing them back down, maybe to what might oftentimes be characterized as a Mediterranean diet, focusing on getting rid of the processed carbs, eating more of the delicious and nutritious high fat foods, like nuts and nut butters, olive oil, avocado, even real dark chocolate. All of these high fat high, calorie foods look a whole lot healthier than the processed carbohydrates do in the best cohort studies.

You know, it's a somewhat hopeful message, isn't it? Because you're not just telling people you have to eat less of everything, but there are actually some things that are quite delicious where you can eat more, and maybe that hope will lead more people to try this sort of approach.

That is exactly the issue with the conventional approach. If all calories are alike, and overeating is the primary problem, then we really just have to control our appetites. We have to discipline ourselves. Yes, clearly the conventional thinking recognizes that environment has a lot to do with it, and psychology of behavior, but ultimately, one way or another, you have to cut back on calories, because overeating is driving the problem. But if the driver is at the fat cells, if the foods that we're eating are triggering our fat cells to store too many calories, and that's what's causing the hunger and the overeating, then just eating less doesn't solve the problem, and it actually could make it worse by slowing down your metabolism. So this model argues that a focus on what you eat, not how much is more effective. You focus on controlling the quality of the foods, importantly, the processed carbs, but there are other aspects that can help hormonal and metabolic response. That's what the person focuses on, and we let the body, based on our hunger levels, and satiety levels, determine how much we need to satisfy metabolic requirement.

So you've got what we call in the field a testable hypothesis, that people will do better if they follow the approach that you've mentioned, compared to the traditional approach. And you put that to a test in a study that we're going to be talking about in a second podcast. But before we get to that, what sort of pushback, if you had, as your paper has been published, are corporate interests involved in this picture at all?

Yeah, let me just say that we recognize that these ideas are not fully proven. There are animal studies, we've done one of them that provides what we could call a proof of concept, that when you give rodents, and this has been reproduced by many different groups. This is a very rigorous finding. When you give rodents high glycemic index, versus low-glycemic index starch, so that's fast-digesting, versus slow-digesting starch. You keep everything else the same, the ones that get the fast-digesting starch, that's like, all of those processed carbs we're eating that raise insulin a lot, well, they in fact show this whole sequence of events. Their insulin levels initially go up, they start getting fatter, and their energy expenditure goes down. They start moving less, and if you restrict their calories to that of the control animal, they're still fatter, because more calories wound up getting stored than burnt in muscle. So they wind up getting more fat tissue, and less lean tissue, even at the same total body weight when you prevent their weight from going up. So we argued that there's no way to explain that finding based on the conventional, calorie in, calorie out way of thinking. We need to examine whether this applies in humans, and to whom, you know? It may be that one model explains certain situations, or certain people better than the other, but it is a testable hypothesis. Unfortunately, this debate has become polarized, and we, in our article, specifically invite opponents to work with us on generating common ground. There's plenty of basis for common ground already, and in our article, which is freely available online at American Journal of Clinical Nutrition. We put out a diagrammatic model in which each step leads to another step, and each of these steps is testable. So we can figure out what we got right, what needs improvement, you know, and where common ground is. After all, this is what science is supposed to be about, to come up with new ways of thinking for intractable problems.

You know, you reminded me when you talked about the animal studies of work that occurred many decades ago on something that people in the field were referring to as the cafeteria diet. And I remember the slide that I used for years in my own talks that was given to me by Ted Van Itallie, one of the pioneers in the obesity field, that showed a rat sitting on top of basically a junk food diet, where they take animals, and in the cage, they would put Cheetos and Hershey bars, and marshmallows, and things like that. And the animals would eat a lot of those things, and gain an enormous amount of weight. But people were really attributing the weight gain to the fact that these were highly palatable foods. The animals would eat a lot of it just because it tasted really good, and that would bring a lot of calories, and that was the reason for the weight gain. And what you're saying is just, "Wait a minute, what happens to be that food that goes in there is a really important part of the picture," And that's been proven by controlling the calories in the experiment that you set.

Well, I think that's a really great point that you raised that it's easy to think in the cafeteria diet model, that the animals are getting fat because of the tastiness of the food, but these studies can't distinguish tastiness, and whatever that means, and we could come back to that point, because tastiness is elusive. It's a very squishy term to define, for reasons we can consider, but it's impossible in these studies to distinguish tastiness from the nutrient content of the foods, and they tend to be full of sugar and processed carbs. In fact, the few studies that have aimed to disentangle this provide clear support for the carbohydrate insulin model that tastiness by itself, when you control nutrients, does not result in obesity, but the nutrients, even in a bland or untasty diet does result in weight gain in animals.

Fascinating science. So, David, what do you think are some of the main policy implications of all this?

Well, there has been push back. Some of that relates to just the difficulty of paradigm change, amidst scientific uncertainty. You know, we need ultimately to be all working together on all sides of this. But in addition, there's resistance from the food industry that loves the notion that all calories are alike. All calories are alike, and there are no bad foods, and that you can drink a sugary beverage, have any kind of junk food, as long as you eat less of other things, or burn off those calories with physical activity. Whereas if this way of thinking, involving the carbohydrate insulin model, this opposite cause and effect conception is correct, then those foods have adverse effects on our metabolism above and beyond their calorie content. And that from that perspective, you really, can't just outrun a bad diet, that we really need to be thinking about how our food is influencing our hormones and metabolism, otherwise we're going to set ourselves up for failure, and that's not a message that many, although not all in the food industry like to hear, because it requires corporate responsibility for helping to create the nutritional nightmare that confronts so many of us, and especially children throughout so much of their days.

You reminded me about an interesting parallel with tobacco here, where the tobacco companies, you know, long after it was known that cigarettes were killing people, just said that it's not the tobacco that's killing the people, it's the fact that they're just consuming too much of it, and the food companies have made very much that same argument. And then the tobacco researchers said, "No, tobacco is bad in any amount, and even a little of it can be harmful." And that's not totally true of the processed foods you're talking about. I'm assuming people can have them in small amounts, but the parallel really kind of exists there, doesn't it? That these things are risky, and dangerous really, after you go beyond whatever that small amount is, and then you're going to have trouble, no matter what you're doing elsewhere in your diet?

The metaphor with tobacco is useful to a point, although it can also elicit some strong responses, because obviously, tobacco products aren't needed for survival, food clearly is. But I do think that there are some parallels that if these highly processed carbohydrates are undermining our metabolism, and also triggering, in part because of the metabolic changes. Fat cells communicate with the brain in many ways, including by releasing or withholding nutrients. If these foods are also triggering pathways in the brain that make managing calorie balance increasingly difficult, then we do really begin to need to think about food way beyond calorie issues, and that all calories aren't alike, and that the food industry may indeed have to manage the food supply in a way that makes weight control easier rather than harder.

The paper we were discussing today was published in September, 2021 in the American Journal of Clinical Nutrition and is publically available for free.

Bio:

David S. Ludwig, MD, PhD is an endocrinologist and researcher at Boston Children’s Hospital. He holds the rank of Professor of Pediatrics at Harvard Medical School and Professor of Nutrition at Harvard School of Public Health. Dr. Ludwig is the founding director of the Optimal Wellness for Life (OWL) program, one of the country’s oldest and largest clinics for the care of overweight children. For 25 years, Dr. Ludwig has studied the effects of diet on metabolism, body weight and risk for chronic disease – with a special focus on low glycemic index, low carbohydrate and ketogenic diets. He has made major contributions to development of the Carbohydrate-Insulin Model, a physiological perspective on the obesity pandemic. Described as an “obesity warrior” by Time Magazine, Dr. Ludwig has fought for fundamental policy changes to improve the food environment. He has been Principal Investigator on numerous grants from the National Institutes of Health and philanthropic organizations totaling over $50 million and has published over 200 scientific articles. Dr. Ludwig was a Contributing Writer at JAMA for 10 years and presently serves as an editor for American Journal of Clinical Nutrition. He appears frequently in national media, including New York Times, NPR, ABC, NBC, CBS and CNN. Dr. Ludwig has written 3 books for the public, including the #1 New York Times bestseller Always, Hungry? Conquer Cravings, Retrain your Fat Cells, and Lose Weight Permanently.

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Today's podcast is part of our Regenerative Agriculture series of podcasts. We're talking with agroecologist Dr. Jonathan Lundgren, CEO for Blue Dasher Farm in South Dakota, and also founder and director of the ECDYSIS Foundation. Dr. Lundgren connects the worlds of science and agriculture, and his working regenerative farm is also a scientific research hub. And he has a humble goal to foster a revolution in our food system, and demonstrate feasibility and sustainability of regenerative agriculture.

Interview Summary

So Blue Dasher Farm in South Dakota sounds like a fascinating place. Can you tell our listeners a little bit about it?

Blue Dasher Farm is an operating demonstration farm and regenerative ag, located here in the middle of kind of nowhere, South Dakota. We wanted to be on the front lines of where change needs to happen, and we're at this great interchange here between corn, soybean, row crop ground, as well as rangeland systems, but also this is where a lot of the nation's honeybees ended up being too. We've got this kind of trifecta of crop lands, orchards, rangelands and honeybees. What this is intended to do is not only be a regenerative farm and integrated into a farming community, but also be a training ground for the next generation of scientists in practicing hands-on, get your fingers dirty agriculture, and that's really important. That firsthand perspective really shapes the questions that we ask, and how we ask them in science.

Tell us about what's grown on the farm. Is it animal agriculture, plant-based agriculture, both?

It's an integrated system. You know, it's not a very large farm with 53 acres, and half of that is actually a native, unbroken prairie that's one of the finest that I've seen. We also have a lot of wetlands that are integrated into this matrix here too. We have sheep. Our biggest moneymaker is honey. We have 200 beehives this year. We have an orchard, chickens, an egg production, as well as a number of other poultry products. We raised a couple of pigs this last year. We have some annual and perennial crops that we harvest for seed, especially native grasses, and things like that, and it's all fused into one big farm that presents us with consistent, unpredicted hurdles and opportunities.

So the concept of integration here is really important. Sounds like each of these pieces you've mentioned, and there are a lot of them, work together, and that if anything were just taken out and done by itself, it wouldn't work as well as having all these things together, and that's the overall concept here, isn't it?

That is absolutely correct. The integrated system is intended to increase the resilience of the farm, but also provide stacking of enterprises that increases the likelihood of success.

Our listeners will vary, because people come from lots of different backgrounds, and some will know a lot about agriculture, but others less so. Can you give us an example or two of something on the farm where the integration really helps?

We have annual crop ground that we are working on right now. We don't spray. We're not certified organic, but we don't spray anything, and we also don't till, and those are two really important premises of regenerative Ag, if you ask me. And so we use our sheep as ways of managing vegetation out there, and then we work with the land, and so in the case that we don't end up getting, like this last year, the drought was horrible in South Dakota. We ended up not getting an annual crop to establish in there, but perennial plants, the prairie ended up coming in, and so off of that piece of ground, instead of an annual crop, we took meat from the sheep, and honey from our bees.

That's a fascinating example. So the no-till is an interesting concept, and I'd like you to describe a little bit more about that. I know that a goal of yours is develop and evaluate ecologically-based test and farm management solutions, and you do this in order to reduce disturbance. I'm assuming that has to do with a no-till, but I'm not entirely sure, and then that you want to increase biodiversity in crop and livestock production. Can you explain this concept of disturbance?

Pests are never the problem within a food system, right? Pests are always a symptom. The pests are trying to correct what we have monkeyed up from a natural system. They're trying to reset the balance in the biological community, and until you solve the underlying issues with that system, you're going to continue to battle pests, and you're going to have to spend more and more money on input costs like pesticides. So what we determined is what the underlying problem is, is a lack of diversity, lack of life on the farm, and too much disturbance, and disturbance comes in many ways. Tillage is a disturbance, agrochemical use is a disturbance, and so when you start to eliminate that disturbance, you find that life ends up doing a lot of the things that we've been trying to replace with technology. Regenerative farming is much more knowledge-intensive, and less technology-intensive.

So what's the problem with tilling?

Tillage is one of the worst things that you can do to your farm or garden. What happens when you do that is number one, you break down organic matter in the soil, which is the soil's fertility, and you disrupt the balance of nutrients within that soil. The only way that you can replace that organic matter is with life, right? Be it worms, or insects, or microbes, or fungi, that's where the soil's fertility ends up coming from. And the one-two punch with tillage is that not only does it disturb the nutrient balance of the soil, but it also kills most of the life from the soil, and so it removes your ability to recover. We end up seeing a lot of farmers, you know, they want to do the right thing, and they're faced with this conundrum, do I spray or do I till? And boy, I think I'd pick, and I don't like either of those options, and we don't use either of those options on our farm here at Blue Dasher, but I would pick spraying over tilling any day of the week.

Thanks for that description. So let's turn our attention for a moment to science, because you were trained as a scientist, and you've done lots of science yourself over the years, and you support science on your farm. So with your permission, I'd like to read a little quotation from your website, because I think it captures your approach to science, and then like to talk about a little bit. So here's the quote,

"Scientists have to become farmers to increase the relevance and credibility of their research. Scientists also have to become part of the farming community, and farmers need to be intimately involved in producing scientific research. The metrics that scientists assess their success by have to be reinvisioned to incorporate outcomes that farmers care about."

So explain a little bit about why science is so important, and maybe you could give us some examples of some science that's been done on the farm, or even some things that might be underway.

Regenerative agriculture science is essential. Stories are really important, right? Anecdotal examples of, "This farmer did this, and it worked super well, or didn't work at all." Those are really, really important foundations for science, but until we replicate it, and use consistent methods for measuring the outcomes of these different systems, those are anecdotes, right? And so science is going to be essential for us to take and increase the credibility of this regenerative movement to show that it always works, where it works, where it doesn't work, what aspects of it are driving the success of those farmers, and there really isn't a whole lot of primary data that's being generated on regenerative farming right now, and we saw that niche, and decided we needed to be a part of that.

Just to give our audience a sense of what kind of outcomes might be important here, let's just say somebody is doing a study where they're randomizing a hundred acres here, a hundred acres there, using a regenerative versus traditional ag. What sort of outcomes would one be looking for? What are the most important things that people doing research on regenerative agriculture need to show?

Regenerative food systems increase soil health, and improve biodiversity, while producing nutritious food profitably, and so outcomes that need to be measured in these systems fall within those general four categories, soil health, being carbon sequestration, water balance in the soil, micronutrient availability, biodiversity being life, be it microbial life, or insects, or worms, or plants, birds, all would fall into that category, nutrient density, nutritious food yields. We actually have to feed the planet. We've lost 40% of the nutrient value of our food over the last several decades through our farming practices and destruction of our natural resource base. We need to restore that. Food isn't as nutritious as it used to be, and then finally profit. All of this as well and good, but if the farm goes out of business in the interim, then it didn't work. We're showing these on actual farming operations all over North America right now. We have boots on the ground science that is generating the data that shows that this does work in all of the systems that we've examined so far.

You know, Jonathan, with these podcasts, I always have a series of questions that we prepare in advance, but you've stimulated so many interesting ideas, I'm going off-script like crazy. So there are a couple of things I really wanted to dive into here. When you were mentioning outcomes, I assume one outcome is how many external inputs are needed, like pesticides, and herbicides, and fertilizers, and things like that, and I'm assuming that that's important for a number of reasons. I'm imagining profitability as one, because if you can produce crops without having to buy those things, you're able to be more profitable. But I'm assuming these things are really important for the environment as well. Is that true?

So with regenerative farming, it ends up being a win-win for just about everybody in the situation. By improving the resilience of their operation, and the profitability of the operation, the farmer wins, right? By reducing the environmental exposure to agrochemicals, their families win, communities win, conservationists win. We find that increasing the nutrition of food, suddenly the medical field wins, society wins. We can use this to combat many planetary-scale problems. One estimate is that by changing to regenerative grazing lands across the U.S., we can largely offset, if not completely replace most of our carbon emissions, while producing healthier beef, and making healthier rural communities. That makes a heck of a lot of sense.

Do you think there would ever be a time when instead of measuring productivity as yield per acre, number of bushels, let's say, and people might change that to think about nutrition per acre?

We have found that corn farmers in our area get prizes if they are the top-yielding corn producer, right? And we found in one of our studies, the first one that was published that used regenerative Ag, and compared those two systems from a primary literature standpoint showed that yields were actually not correlated with profitability. You know what was correlated with the profitability of the farm was how much soil organic matter they had generated on their farm, yeah. So I think that that's going to be a really important metric, and, you know, as these soils start healing, the nutrition of food comes from the soil. It's not from a jug that the farmer is putting on the plants, right? It comes from the soil itself.

You know, I've often thought in this context about whether consumer pull for certain types of products might help drive this market. So for example, let's say you have two carrot farmers, and one is using conventional methods. The other uses a different set of methods along the lines of what you're talking about, and that farmer produces a more nutritious carrot. Could consumers be attracted to the carrots with the most nutrition? Might, is there any talk about this in the farming community?

Oh, absolutely, farm to table and farm to school programs are really important. I think we talk about labels. We talk about all kinds of ways of increasing the value of regenerative. Regenerative has to be cost-competitive with conventional if it's going to be successful, and it is. In every system that we've studied it is. It's cost-superior. These producers are more profitable, and that doesn't necessarily have to be associated with a premium. At the end of the day, what is incorruptible is consumers knowing their farmer, and that is the answer to so many of these issues within our food communities right now is people starting to learn who their farmers are, and that relationship-building, and that trust, and that's going to put a lot of value on a food item.

I can second that. As a person involved in this field, and a consumer, like everybody else, that does really make a difference. So my colleagues and I at the World Food Policy Center have spent a fair amount of time on farms and meeting farmers, and I really want their products, because I know who they are, and those personal connections mean everything. So I totally agree with what you said. It's interesting to hear that that's part of your perspective as well. Speaking of honey, let's go back to the bees for a minute. You mentioned this early on in the podcast. Why are honeybees so important?

Honeybees are a character, at the end of the day, and what we're trying to show is the massive extinction event that the planet is currently facing right now. We are undergoing a massive evolutionary experiment, and we're losing species at a rate that the planet has never experienced before. Honeybees are a character that people understand, and they see the benefits, and even if they've been stung a few times, they still love these little insects, right? The honeybees are dying at a really rapid clip, and the reason that they are is because they're such a good bellwether for what's going on in the environment. I mean, they forage for up to five miles from their nest, or their colony, their hive. They sample multiple plant species, numerous, if not hundreds of species of plants, and they pull all of the chemistries that are out there in the environment, and bring it back to the nest, and most of agrochemicals are actually lipophilic in that they like fat. Guess what their hive is made out of? Wax. And so they end up aggregating a lot of agrochemicals. Those agrochemicals make them sick, and stressed, and diseases come in, and pests come in, and wipe them out. But on the flip side of that, regenerative systems provide a tremendous opportunity for conserving life, and we've been working on trying to demonstrate that with the honeybees and tell that story.

Do I recall right, you said you have 200 hives? Wow, so how much honey can you produce from that number of hives?

Well, this year, not much at all, but last year, I think we got a thousand pounds, or something like that. You know, people that go to the grocery store, and buy honey at the grocery store, they don't know what honey tastes like. That's not real honey. A lot of that is actually adulterated rice sugar from Asia that they ended up circumventing U.S. trade restrictions on, and most people tell me, "I don't like honey, but I really like your honey, John." And I'm like, "Well, that's because it's made from prairie flowers, it's got no additives whatsoever, and it comes out with this breadth of flavor that most people have never experienced before."

It sounds so good. I want some right now. So let me ask you one final question. This often comes up in the context of discussions of regenerative agriculture, and has to do with how scalable it is. People might say that, okay, the results from regenerative agriculture are impressive, but you still need the feed the world, and can that model be used on a big enough scale to accomplish feeding the world? So how do you respond to that?

If you want to feed the world, grow food is the first step in the process, and right now we have about what is it, 176 million acres in the continental U.S. that's devoted to corn and soybeans that we really don't eat? And so if you want to feed the world, let's start there. Can regenerative farming feed the world? We have shown that yields are equivalent in regenerative systems, if not superior, and the caloric content of products that are generated off of a regenerative farm versus a monocrop of a conventional farm are pretty superior, actually. So we really need to be measuring actual food production, things that humans are eating directly, and the efficiency of that system, as well as how stacking enterprises increases the resilience and efficiency of a farm.

You mentioned just now that there are vast amounts of acreage that are devoted to corn and soybeans that we don't eat. What do you mean we don't eat them?

Well, when's the last time you went down and grabbed a handful of corn, yellow number five, and took a bite? We end up burning it in our cars. 40% goes into ethanol production. We end up putting another 40, 50% of that into cattle that would rather be eating grass, and so when we hear arguments against beef production because of the methane production that's ended up being produced there, that's not an artifact of the cows. That's an artifact of poor management of the cows, and if you put them on grass, and manage them correctly, cattle production is a carbon sink. It's not a source.

Bio

Dr. Lundgren is an agroecologist, Director ECDYSIS Foundation, and CEO for Blue Dasher Farm. Lundgren’s research and education programs are helping applied science evolve in ways that foster the movement in regenerative agriculture. He received his PhD in Entomology from the University of Illinois in 2004, and was a top scientist with USDA-ARS for 11 years. Lundgren received the Presidential Early Career Award for Science and Engineering by the White House. Lundgren has served as an advisor for national grant panels and regulatory agencies on pesticide and GM crop risk assessments. Lundgren has written 129 peer-reviewed journal articles, several book chapters, authored the book “Relationships of Natural Enemies and Non-prey Foods”, and has received more than $6 million in grants. He has trained 5 post-docs and 15 graduate students from around the world. One of his priorities is to re-envision how science is conducted to help fuel a revolution in regenerative agriculture. He regularly interacts with the public and farmers around the world regarding ecologically intensive farming and how diversity fuels the resilience and productivity of an agroecosystem and rural communities.

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So what does it mean for something to be considered organic, or to be considered regenerative or sustainably produced? Defining these concepts in agriculture production and in food labeling is complicated, but very important. So government defines and oversees certain terms, while other terms are generally overseen by producers, by industry experts, or even by non-governmental organizations. The politics and governance structures of labeling can be very important in how sustainably produced goods are made and marketed. In today's podcast, we'll speak with Dr. Samantha Mosier, political scientist on the faculty of East Carolina University, as part of our Regenerative Agriculture podcast series.

Interview Summary

So let's begin with this question. Why do you believe there's so much interest in alternative agriculture production?

So agriculture has been changing. We only have the concept of alternative agriculture because we went through a really rapid industrialization and mechanization of agricultural practices in the past 100 years or so. So this idea of alternative agriculture sprung out of a critique of agricultural production norms that were industrialized, that were causing environmental harm, like declining soil quality, which led to such events as the Dust Bowl. Today, the shift and interest into alternative agriculture stems from some pretty hard lessons learned about modern production, where we are seeing soil quality continuing to decline. Yields are also declining, and we want to be able to feed the world and our population. And so these practices that were once advocated are not necessarily working as they should. For producers, there's also some profit to be made in a number of markets if you're able to shift your production and get that certification in that sustainable market, or at least adhere to the norms of a particular production concept enough to make that claim.

You know, in some ways, what I hear you saying is that from a consumer point of view, many more people are becoming interested in the story of their food, where it came from, how it was produced, how animals were treated, what the labor situation was like, etc. And my perspective on this, and tell me if I'm right, is that this trend seems to be growing exponentially. There was a time not too long ago when people didn't think about this or they didn't know much about it, and now, boy, there's whole generations of people care about this an awful lot. And it shows up in the way they make purchasing decisions and where they do their shopping and things. But is that right? Do you think that this trend is really increasing?

Yes, rapidly increasing. So from a consumer perspective, you can look across a range of these alternative food markets, anything from organic, non-GMO, fair trade, and you'll see that sales across the board have exponentially increased in the past 10 to 20 years. So where there wasn't so much of an interest or spending habit in these categories, all of a sudden it just went through the roof. And so a lot of this does come from deferring or changing consumer behavior and expectations. We know that younger consumers in particular are concerned about climate change and the environment. So they're more likely to be environmental consumers to the degree that they can afford to do so because it is more costly often to buy these products. But there's also this whole component that these types of foods have also become more mainstream and readily available. And so organic foods 30, 40 years ago, were really difficult to find if you were to go into a typical grocery store. Today, you can find organic, fair trade, non-GMO products in Walmart, and Target, and Kroger. Even the Dollar Tree or Dollar General stores, you can find products that are labeled as sustainable in some capacity. So they're more readily as well.

Thanks for those comments. And I think in addition to those things, there are other signs like number of people shopping at farmer's markets, farm-to-school programs, farm-to-childcare programs, and you can go on and on, the list is pretty long. And I think it's pretty exciting. You know, I was thinking about this myself the other day. Not too far from where I live in Durham, North Carolina, there's a state farmer's market in Raleigh, which is just an absolutely wonderful, massive farmer's market. And when I was walking through the other day, I saw a farmer selling honey. And I thought, you know, this farmer appealed to me. I hadn't met him, I hadn't spoken to him, but I thought, he probably works really hard and he probably cares about what he does. And that really appealed to me. And I have plenty of honey at home, so I didn't need to buy any, but I wanted to buy it anyway. There's just something wonderful about that kind of connection that exists. It seems to me more people are caring about the farmers in this picture too. Do you think that's correct?

It depends on the consumer. I think in some cases, the ones that may be more informed and maybe go to farmer's markets, they're going to be more interested in where the food comes from. But there is a segment of consumers out there that they'll go off of the certification label because it's a little bit easier. Maybe they're crunched for time, they have kids, their job's demanding. But overall, we still like the idea that our food comes from a wholesome place.

Two terms that we've discussed, organic and regenerative, let's talk about how these two things are different from one another. Most people are familiar with the term organic, if not knowing how it's defined, but regenerative is newer on the scene.

Organic is specifically defined by government regulations and what a certification program dictates as organic. It's a concept that is really grounded in a consumer perspective because the label creates a singular four-based minimum standard for what it means to be organic. Not all producers actually agree with the current standards for what it means to be organic and organic production. There are a number of them that are interested in going above and beyond organic standards that are currently set. And this includes concerns about animal welfare. So how we're treating cattle and chickens in our production systems that are organic.

There are also a lot of concerns centered around hydroponic production systems being considered organic. Hydroponic is a type of production system that can't improve soil quality because there is no soil. And this is where regenerative discussions come from. The modern regenerative movement is based out of a movement from organic production and their critiques of our current system. The Rodale Institute about 30 or 40 years ago, specifically talked about regenerative organic production. The more modern concept of regenerative is a critique about the broader concept of a sustainable food system, and the need to do more than just be sustainable. And it really engages quite a bit of concessions about soil health. The problem with, I guess, modern regenerative agriculture is that it's not neatly defined. There's a heavy emphasis again on that soil quality and regeneration concerns, but there's no universal definition. It's not universally regulated, government's not involved with it. And so the most you can really hope for when you're seeing this term currently is producers acting in good faith when they're advertising their goods as being regenerative, and they can go get certified for it now. But again, you'd have to look into the details as to what that certification actually entails.

Let's talk about the role of government in this process a little bit more. So how do you think the government has impacted the way agriculture production is occurring and market activity? And do you think there's a benefit to having these claims certified or regulated?

So government does play a role. It legitimizes the market to some extent. It protects the term that's being used. It provides, you know, a standard, a reference point to where we can all say this is organic, but there's some challenges with that of course. So anytime you involve government that means you're going to take away certain freedoms to interpret the concept the way you may want to as a producer. And so when we start getting into certification programs, we know for example, that third-party certification systems for labels and production systems are a Gold Standard. We know this, but the challenge becomes is that when you start certifying and you start regulating these markets, is that, well, the cons are consumers could still misinterpret the term because what the USDA, for example, defines as organic may not be what I, as a consumer, believe organic to be. And so kind of this image of a small happy farm with a dog doesn't necessarily exist. Organic production, some have claimed, is really highly mechanized and it's became large scale. And this is part of that challenge with the one-size-fits-all standard. And the baseline standard is, all of the sudden there's a market being developed, and producers are going to adapt to that and enter it. And so a lot of people, at least with organic certification, have claimed that it became corporatized. It's industrialized production, just in a slightly different form. But the pros are, if you're looking for a guarantee, say you're one of those consumers that's really short on time and can't go to the farmer's market, well, it helps minimize false claims. You have a general idea of what you're actually buying. So it's a unified messaging signal. And you know, the semantics of course, is debatable about what it means. And for producers, this means they can receive a premium for the products they're producing.

Has the fact that organic production in some cases is highly industrialized, has that led to greater yields? Has that brought down price?

I think it depends on who you ask. I know the pandemic has thrown some concerns in terms of sourcing and other certain certification systems that are dealing with the reckoning of ending their contracts with small scale farmers in favor of larger scale farmers. But overall, organic has perhaps gotten maybe a bit cheaper because it's more readily accessible, but there are challenges with some companies with being able to source enough organic material to meet the demand. And so typically, you do still pay a little bit more for organic or sustainably produced, however defined, goods, but the price will always be a little bit higher than conventionally produced materials and products.

For consumers who are interested in purchasing these alternatively produced foods, what kind of challenges do they face out there in the market?

Well, they probably need to figure out what matters to them the most, and they need to do their homework about what a label means. So certified claims do come with some particular benefits. You can research very easily what that may mean, and you might not understand all the technical and scientific information, but kind of understanding the basis of what you're looking for in an item. So, as an example, you mentioned looking for honey. I was shopping for toddler food, and I was looking on the toddler can of food, and it had USDA Organic Certification Seal. And then, right next to it, it was also advertised with a label saying it was non-GMO. The thing is, is if you know anything about USDA Organic, it doesn't contain genetically modified ingredients to begin with. But as a consumer, which we have more or less-informed consumers, they may not know that USDA Organic means it's non-genetically modified. So these producers, the seller of goods, also have to advertise other benefits of the product because that consumer is not aware. So it's educating yourself and understanding what you're buying and not getting duped by just marketing claims.

Bio:

Samantha Mosier is an associate professor of political science and part of the Master of Public Administration program faculty at East Carolina University. Her research focuses on sustainable agriculture, food labeling, and local sustainability and resilience initiatives. Mosier is author of Creating Organic Standards in U.S. States: The Diffusion of State Organic Food and Agriculture Legislation and co-author of Performance Measurement in Sustainability Programs: Lessons from American Cities. Her work has also appeared in Environment and Planning C, Environmental Management, Food Policy, and Review of Policy Research. Prior to joining the faculty at ECU, Mosier was an assistant professor at Missouri State University and served on the University of Missouri Extension Council in Greene County, MO.

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As many as 13 million children in the United States live in food insecure homes, meaning that these households don't have enough food for every family member to lead a healthy life. Hunger is a problem that most often affects children from low-income families. And today we're going to discuss the Child Tax Credit aimed at helping low-income families and the historic increases in the credit made through the American Rescue Plan in 2021. Our guest today is Billy Shore, the founder and executive chair of Share Our Strength, a nonprofit working to solve problems of hunger and poverty, both in the United States and around the world. Share Our Strength is also the parent organization for the well-known No Kid Hungry campaign, the national policy, advocacy, outreach, and research effort to improve childhood nutrition, support school meals, and provide resources to schools, food banks, and community groups working to end hunger.

Interview Summary

So the child tax credit has been around for years, but this year there was some significant, albeit temporary, changes that made it a powerful tool in fighting poverty. Could you quickly walk our listeners through what these changes have been?

The most important change for The Child Tax Credit is that Congress and the Biden administration made it fully refundable - which is a way of saying that even if you don't earn enough money to pay taxes, you still get a check from the government somewhere between $3000.00 and $3360.00 per child. And one of the ironies of the Child Tax Credit in the past has been that many of the families who need it the most might be the least likely to get it if they weren't earning enough to pay taxes or file taxes. Now there's a portal that's been developed with the Internal Revenue Service and a nonprofit called Code for America that we worked very closely with, where even if you haven't earned any money, you can file for the Child Tax Credit. And you can use those funds for food, for education supplies, for healthcare, for really whatever you need it for, for your kids. It's estimated that it can bring 5 million children above the poverty line, which would really be absolutely transformational.

That's a remarkable impact this could have. So just out of curiosity, are there programs or means for letting people who might be eligible for this benefit know that it exists providing help in using the portal and doing things like that?

That's a great question because there's an all out effort beginning right now, not just to raise awareness of the Child Tax Credit, because a lot of families are not aware of this new benefit, but to also make it more accessible. Many families are going to need technical assistance as to how to access the portal called Get Child Tax Credit, getctc.org. And then when they're on the site, they might need assistance then as well. So there's a major effort. Think of this almost as like a political campaign. One of the things that Share Our Strength is doing right now as a pilot is building out a field operation in two states to see how this would go in Mississippi and in Maine. And we've got regional directors and field staff. And just as you would have a staff on the ground to register people to vote and to make sure they get to the polls, we've got a staff on the ground that is going to make sure people are aware of the tax credit. They get to their Community Centers or the sites or the volunteer tax assistance sites that they need to get to so that they could actually file. And then as we learn from those two pilots, we'll spread that into all 50 states.

Given that you and your organization are working to address food insecurity, why put efforts behind legislation that would address poverty rather than just food insecurity itself, providing more food for people or more benefits that provide food? Why work on poverty overall?

You know, one of the things that we've learned over the last 35 years of doing this work, and I would say, honestly, it took us too long to learn it, but we've really come to the conclusion that it takes more than food to fight hunger. And so, you know, we all have a reflex when we think about people being hungry, how do we get them food? And we think in terms of emergency food assistance and food banks and soup kitchens and programs like the school meals programs or the SNAP food stamp program, but to really end hunger in a sustainable way, it does take more than food to fight hunger.

Families have to have the financial stability. You know, when you think about hunger as a symptom of a set of deeper problems, in some ways it's a problem in and of itself, but in many ways it's a symptom of deeper problems of poverty and inequity, racism. When you think about all the reasons that families are struggling today, you realize that we've got to do more than just provide food. And so the Child Tax Credit is the first and the largest opportunity that's come along, probably in a generation or more, to really give families the unrestricted resources they need. And one of the things that we've learned just from the July tax credit payments, so just as recently as a few months ago, we found out that 47% of the families who received the tax credit used it to buy food for their families. So we know that the impact is direct. Other families, of course, used it for some of the other things I mentioned, educational supplies, healthcare, that type of thing. But food is going to be one of the biggest allocations that the child tax credit receives.

That makes perfect sense. You mentioned just how many families could be affected by this. Families now living in poverty who would have some benefit from this program. And you've also talked about the issue of how the child tax credit could be important in building equity. Could you speak to that?

As you know, disproportionate numbers of black and Hispanic and Asian American Pacific Islander, indigenous children, experience hunger and the Child Tax Credit has a direct impact. It also has a disproportionate impact, in a positive way, on them. So it would cut poverty by 52% for black children, by 45% for Hispanic children, by 62% for indigenous children. There are of course, a lot of white families, the majority of families who received the Child Tax Credit are likely to be white and many will receive it automatically if they've been filing taxes. But again, often the families that need it the most are going to be the hardest to reach. So we think it'll have a powerful impact in establishing some equity in a sustainable basis, particularly for black and brown kids.

So you mentioned that many families will receive the Child Tax Credit automatically, but there will be several million families who qualify for the tax credit, but may not be signed up. What can they do?

There's a new portal that's been created. It's in English and Spanish. As I mentioned, it's been created by a terrific nonprofit called Code For America. And if you go to http://www.getctc.org or we have a direct portal, http://nokidhungry.org/getctc. CTC stands for Child Tax Credit. You immediately get to a portal where you could follow the information and get a check sent to you or deposited. So it's really going to take a massive effort to make this happen.

The current law has this Child Tax Credit in place until the end of this year, until December of 2021. Congress is now debating whether to extend it or to make it permanent. I think most practically, politically, it's probably not going to be made permanent as much as we'd like to see that. It'll probably get extended for three to five years. And it will take that amount of time to make sure that all the families that need it become aware of it and get the assistance they need. So we've got to have a long-term view of this, but you know, you and I are having this conversation in mid-September, and there was a headline today in The New York Times. Just to give you a sense of how important something like this can be, front page of The New York Times and many other papers was that as a result of the assistance programs of the last nine months, including the stimulus payments and so forth, 8.5 million Americans were lifted out of poverty. And that's just remarkable. The poverty rate went from 11.8% to 9.1%. The lowest it's been since they've been measuring poverty in this country. So it's just a great proof point that these programs work. That the social safety net, when it's resourced, when it's applied the way it's supposed to be and maintained the way it's supposed to be, the social safety net really has the intended impact. It lifts people out of poverty and that's good for the economy and it's good for all of us.

Thank goodness the program is working like it is and thank goodness people are paying attention. And the article you mentioned is one way to make that more visible. So let's follow up on this last issue you raised, that this is put in place temporarily, and it's only in effect through December. Obviously, it would be great if this were to continue, what do you think needs to happen to make sure that it continues? And what sort of political actions might take place or data could be collected or other things that could be influential in seeing that this continues?

I think the most important thing is going to be for Congress to hear from Americans, that they want this Child Tax Credit to continue. That they're seeing the impact of it in their own families, in their own communities that they want to live in a country that lifts kids out of poverty. We tend not to be as good at that as other industrialized nations. And, you know, Congress of course, is so evenly divided right now. The Senate completely evenly divided. The House, I think speaker Pelosi, can only afford to lose three democratic votes to get this passed. So this is one of those cases where literally every voice counts and letting your member of Congress know that this Child Tax Credit is going to be important in your community is absolutely vital. You know, when people hear about tax credits, sometimes your eyes kind of glaze over. People don't really know a lot about the tax system or necessarily want to be involved with the Internal Revenue Service, with the IRS, and I get that. But this is one of the big positives to come out of it. And if it does become extended, I think it puts it on a path to permanence and imagine being the first generation of Americans to live in a country where we don't have child poverty at record levels. That would be just an incredible legacy for our entire generation.

Bio

Billy Shore is the founder and executive chair of Share Our Strength, the parent organization for the No Kid Hungry campaign. Since founding Share Our Strength in 1984 with his sister Debbie, Billy has led the organization in raising more than $700 million to fight hunger and poverty and has won the support of national leaders in business, government, health, and education, sports and entertainment. Billy is also the chair of Community Wealth Partners, Share Our Strength’s for-profit consulting firm which provides strategic consulting to help leaders and communities solve social problems. Before founding Share Our Strength, Billy served on the senatorial and presidential campaign staffs for former U.S. Senator Gary Hart and as chief of staff to former U.S. Senator Robert Kerrey. In 2014, congressional leaders appointed him to the National Commission on Hunger, tasked with finding innovative ways to end hunger in America. He is the author of four books focused on social change, including “Revolution of the Heart” (Riverhead Press, 1995), “The Cathedral Within” (Random House, 1999), “The Light of Conscience” (Random House, 2004) and most recently, “The Imaginations of Unreasonable Men” (Public Affairs, 2010). He also hosts Add Passion and Stir, a weekly podcast that brings together high-profile chefs and change-makers to talk about the central role food plays in social justice.

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Think for a moment about how much influence the food and agriculture industries have over food policy. Too much influence, too little influence, maybe? People look at this in very different ways. One thoughtful voice in this discussion is today's guest, Gary Sacks, a person who has written extensively on corporate influence on food policy. He has considered corporate control of the food system, running the gamut from global brand consolidation to lobbying and direct involvement in policymaking to actual litigation against country governments, seeking to curb corporate influence. He asks a very key question, is it pastime to question the outsize role of food corporations in our lives?

Dr. Gary Sacks is associate professor at the Global Obesity Center at Deakin University in Australia. His research focuses on policies for improving population diets and preventing obesity and he has coauthored international food policy reports, such as the Lancet Commission on Obesity and several reports for the world health organization on obesity prevention.

Interview Summary

Let's start with this question then: what are some of the ways that food companies do influence public health policy in their favor?

We can group those into five strategies. So, the first one is company lobbying of politicians. That's when they meet directly with politicians or they get involved directly in the policy process, like being on government committees that develop policy. The second one is what we call coalition building. That's when companies fund charities, build relationships with professional associations and that's about winning public support and building relationships that makes it hard for governments to regulate. The third category is their influence on research. They might fund research particular topics and they might host scientific conferences and fun prizes and fellowships in the research area. A fourth strategy we've seen is legal strategies. That's when companies might litigate against governments or have influence over trade agreements, which sets the regulatory framework for how markets operate. And the final way is what we call framing the debate. That's through the way industry talks about things in the media and through their communications. It changes the focus to things that favor the industry. They might shift the blame away from their products and promote individual responsibility for health. So, that's how we've grouped the categories and the ways that food industry influence policy.

So interesting to hear you lay this out and it's an issue near and dear to my heart and I'm thinking back to a paper that I wrote with a colleague, Ken Warner, an economist at the University of Michigan in 2009, comparing the behavior of the food companies with the tobacco companies. And it was just as said, if you look at the tobacco industry playbook and then put next to it, a list of the strategies of food companies used back in 2009, it was check, check, check, everything was quite similar. It's interesting to hear an update on that issue. And what appears to have occurred in those years is that some of the same strategies are still being used, but there are even newer ones and that the companies are becoming increasingly sophisticated at doing these things. So, I guess the big question is, what impact do these strategies have and do they actually work?

Well, they do work. Globally, there's really a lack of action to address unhealthy diets. And yes, there are some success stories, some countries have taken some good actions. But on the whole, across the globe, there's not enough happening to address the nutrition issues we face and it's industry's preferred solutions that have the run. Industry likes self-regulation of things like marketing to kids and product reformulation and they prefer the predominant focus to be on education. So, trying to educate people into what's healthy. But the public health evidence shows that those strategies alone aren't enough. We need much stronger government action. And unfortunately, that's severely lacking.

That is very consistent with the way I've seen things too because there are case after case of industry fighting off, needed government actions, stalling thing, planting doubt with respect to the science and taking all these actions that you mentioned that really are having a big impact. And it's not surprising, government generally doesn't invest money in an unwise way. And they're spending, as you said, billions of dollars doing this kind of thing and obviously it's having an impact and I'm glad that you could point out how. So, what can be done about this?

There are a range of strategies that governments and researchers and health organizations can use to limit the influence of industry. A clear one is to limit industry involvement in policy making. And so, when governments are developing policy, they need to keep industry off the table. While there could be a role to consult with industry about how to implement a policy, they need to get out the policy table, leave that to the public health experts and the policymakers. A second way is much clearer disclosure of lobbying activities and things like political donations. Ideally, with some limits on corporate political donations. Some countries have actually really good disclosure laws, but many countries lobbying is not transparent at all. The third way would be independent funding of research, so that researchers don't need to take money from food industries and universities and research institutions to have better conflict of interest policies. And that's just some of the ways, but really, the conflict of interest needs to be front and center of both policymakers, researchers and even media organizations.

Thanks, those are really innovative ideas. And let me talk about one of them in just a little bit more detail. You mentioned that the food industry shouldn't be at the table when these policy decisions are being made. Now, I know the food industry says, well, wait, we're that stakeholder here. And you'd like to have stakeholder involvement when you're making decisions. And also, we happen to know a lot about issues, but they also very often will claim that disclosure is the solution here. As long as we're transparent about who's on these committees and who might have industry ties and things like that, we're okay. Do you think that disclosure is anywhere near a meaningful solution?

No, I don't. I think disclosure is a start, but actual management of conflict of interest and the risks associated with that needs much more than disclosure. So, as I said, if there's a policy getting developed that is really about regulating harmful products, it's a clear conflict of interest to have the makers of those products at the table. And so, stronger steps need to be taken to manage those risks.

That makes sense. So let's talk about the food industry itself. And I know you've thought about the market power that a surprisingly small number of multinational companies can have. Can you tell us a little bit more about that?

The factor that enables companies to have an influence is that they have a huge amount of power. Globally, it's just a handful of multinational food companies that have enormous market power. And that's grown over the last 30 years through things like mergers and acquisitions and marketing and whole range of strategies companies use to ensure they have this tremendous market power. And so, really, if we're thinking about limiting corporate influence, we need ways to reduce the power of these corporations. We may need to consider stronger policies around merger control and trading practices that enable these companies to have the sort of power that means they have influence.

It's interesting to hear that so many companies have become so much bigger over the years and you're right, that those concentrate power in a small number of hands. So, I know you've also thought about the role that investors play in this picture.

Yeah, we've seen recently that large institutional investors, so your big hedge funds and big asset managers, are starting to play an increasing role in shaping corporate behavior. We've seen examples where these large investors push the companies that they invest in to adopt more responsible practices. And so again, I think if you're looking at leavers for change, if more of these investors push companies to adopt globally recommended public health measures and I guess, refrain from lobbying against them in the first instance that could be an important lever for change.

That's a good way to draw this to a close because you're ending on an optimistic note that if the industries aren't showing much willingness to do this kind of thing on their own and it looks like, in fact, they're doing the opposite, investors can have an important role in industry behavior. And it looks like there are more signs of that happening.

We are seeing investors focus on things like the sustainable development goals and really taking a long-term view to what kind of behavior we want companies to have. And I think if those investors take up the challenge of trying to address nutrition issues and engage with companies to push them to take recommended global actions, then we may see some improvements.

Bio

Gary Sacks is an Associate Professor based at the Global Obesity Centre at Deakin University, Australia. Gary’s research focuses on policies for improving population diets and preventing obesity. Gary has co-authored several international reports on food policy, including the Lancet Commission on Obesity and several reports for the World Health Organization on obesity prevention. Gary co-founded INFORMAS (International Network for Food and Obesity / non-communicable diseases Research, Monitoring and Action Support) – a global network for monitoring and benchmarking food environments. Gary leads the component of INFORMAS dedicated to monitoring the actions of food companies in relation to obesity prevention and population nutrition. Gary led the first-ever studies to benchmark progress on obesity prevention by Australian governments and food companies.

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A paper published recently by the journal Obesity Reviews brings attention to the role of EDCs - endocrine disrupting chemicals - in weight gain, and in the very high rates of obesity around the world. The results of this review are enlightening and alarming, I must say, even to the two of us who wrote the paper. Our guest today is the lead author of the paper, Dr. Timothy Lobstein. Tim recently retired as director of policy at the World Obesity Federation in London, UK, and is currently visiting professor at Sydney University in Australia. He is an advocate scholar and policy expert, and one of the world's most effective and impactful voices in addressing obesity. He has several decades experience on obesity efforts around the world, working with groups, such as the World Health Organization and the United Nations Children's Agency UNICEF. And in 2020, he was the inaugural winner of the Philip James award.

Interview Summary

So let's dive into the details of the paper because it produced some pretty remarkable things. So first tell us if you would, what are endocrine disrupting chemicals?

These are chemicals in the environment that affects our hormones and they can mimic our hormones and they can block our hormones and they can alter their function. So as you know, hormones are finely tuned balance of chemicals that regulate reproduction and cell development and appetite, and many other functions, and they make up, what's called the endocrine system and that controls how we grow and our moods and our health. Now in the last few decades, we've become aware that there are chemicals we absorb from the environment that can disrupt the normal function of our endocrine system, hence the name endocrine disrupts.

So how present are these in our lives and what are some of the key sources of exposure?

Well, the more we look, the more we find them. The last few years have shown a wide array of chemicals that can have disrupting effects, especially the manmade chemicals that are used in modern life, including for example, plasticizers that are used in the production of plastics to keep plastic from hardening and becoming brittle. So in the food industry that would include plastic bottles and film wrap, and also the inside lining of canned food, for example, where these plasticizers are used, but it's not just the food supply. There's similar chemicals are used in cosmetics and sunscreen and in household furnishings and automobile tires. So these chemicals have become increasingly present in the air and on our skin and in our food and water supplies and concern over these chemicals has led some countries to ban their use in baby bottles and baby teats. But even there, there are worries that the replacement chemicals are also a source of endocrine disruption.

It seems like from the things you've described - plastic wrapping for food and plastic bottles - that they're all over the place. So can you give us some context for biological evidence that this exposure is actually getting internalized and that people have these things in their bodies?

There is because we have a variety of ways of approaching this. We can look at how they affect animals, and then we can look at human surveys and test for blood content and urine content to see how these chemicals are getting into humans. And the surveys, particularly in Europe and North America are showing widespread consumption of these chemicals. Inadvertent consumption, as I say, through air, through skin, through water and food. So yes, they are widely prevalent in the human population now.

People wouldn't intuitively think that such chemicals might be related to risk of obesity, because your mind automatically goes to calorie overload in the population and too little physical activity. So as interest in the EDCs related to obesity, new and what got you thinking about writing this page?

We have seen studies 20, 30 years ago, showing that there are concerns around these chemicals causing problems for reproduction and also triggering cancer growth because they trigger cell growth, but their effects on appetite and on the formation of fatty cells suggest that there are links to weight gain. And there's now increasing evidence that populations with high levels of these chemicals in their blood have a higher prevalence of overweight and obesity. So these are not just animal laboratory studies. These are now being shown in surveys of human populations, as I say, in Europe and North America. So we are definitely concerned that there is a, a trigger here that may be happening in humans.

So I knew that there had been papers here and there showing up in the literature, suggesting that such a relationship might occur. But when you stepped in and wrote this paper recently, you felt that I know, and as we wrote this paper together, there was sufficient evidence now to really say that there might be a pretty strong link. Would you say that's true?

Yes, I would say that the bottom line is that the endocrine disrupting chemicals in our environment are a potentially important cause of weight gain. I mean, the science, as you say, has developed very rapidly, mostly in the last 10 or 15 years, but there are now approaching a thousand odd scientific papers on the issue. And in our paper, we looked at 60 old systematic reviews and meta-analysis of the science and virtually every one of these reviews agreed that there was a potential problem here.

So let's put this in the context then how strong is the relationship between exposure to EDCs and risk for obesity compared to other known risks factors?

Yes, that was one of the questions we wanted to answer. I don't know if we've fully explored it yet. And I think there's plenty of scope to have more work done on this, but we did want to ask what are the potential effects, these chemicals compared to food patterns or the amount of exercise people take, because the usual argument says that to lose weight, you need to eat a healthy diet and exercise more. But when we looked at the potential effect sizes of endocrine disruptors, we found that they were up there with diet and exercise that surveys of the most common endocrine disruptors show that people with high levels in their bodies can have twice or three times the prevalence of obesity compared with people with lower levels. And that sort of effect is at least as serious as drinking two or three sugar sweetened beverages every day, for example, or two or three hours extra sitting, watching TV.

Well, you know, this is big news. So I just wanted to underscore this particular conclusion from the paper that everybody would agree that dietary contributors and lack of physical activity are our major drivers of obesity. And then here you come saying that it looks like this is on a par with them. So this is really very important news in both understanding rates of obesity and also understanding what might be done about it. Has anybody ever looked at historical trends about rates of obesity and exposure to EDCs in the population?

I don't believe they have. I mean, our evidence about EDC is linked to obesity. As I say is only in the last 10 or 15 years, the rates of increase in plastic productions, which might be probably the major cause of EDCs in our diets. At least if not in the atmosphere have only really escalated in the last 30 or 40 years. And it's quite hard, I think to control if you like the rate of increase for one against the other and ask, you know, is that the cause or are other factors that cause it it's a difficult epidemiological question. And what we cannot do of course are experiments that deliberately increased consumption of an EDC and then ask how much a person gaining weight, because that would be unethical. So we have to rely on these sort of external surveys. And if you can't tell cause and effect from a survey, you can show the trends are in parallel. It's hard to show cause and effect. So I think we need to do a little bit more work on this to see if we can tease out the various issues. I say that because exercise trends have not really changed very much in the last 30 years and even food consumption that calorie levels are not that much different over the last 30 or 40 years, particularly in Europe or in North America, it's been fairly flat, but obesity levels, particularly in children have been increasing. And at the same time, the levels of endocrine disruption in the environment have been increasing. So I think there's a serious question doesn't need to be answered.

So Tim, you mentioned children and one would imagine they're a special concern given the development that's occurring, is anybody looked at EDCs and children?

Oh yes. Well they haven't in a population survey sense and there's a good paper that was done looking at body weight and EDC in urine of children and showing that the quarter of the children with the lowest levels of EDC in the urine were at half the prevalence of obesity compared to the three quarters of children that had high levels of UVC is in their system. So there's a clear relationship epidemiologically in the survey material, but cause, and effect is still another question.

The numbers that you just pointed out given the cause and effect caution there show not only the relationship, but potential powerful nature of that's coming through time and time again in these studies that you're discussing. So let me ask about one particular part of the diet sugary beverages. And so there are some fascinating issues in this context. Can you explain?

Well, yes, they've been surveys of people's consumption of beverages associated with weight status showing of course, as usual that sugary beverages are associated with higher body weight in a sort of cause and effect where you would expect, but there's also evidence that diet beverages with no sugar are also linked to a higher body weight. So that's a bit of a puzzle because you could argue that it's because some people who are already living with a high body weight or perhaps cutting back on their sugary beverages and consuming more diets. So that would sort of skew the pattern a bit, but it could equally be argued that both bottles and cans rather than the sugar is what's causing the problem that the endocrine disrupting plasticizing chemicals that line the inside of soda cans and that are used in making the bottles that you serve up sugary beverages and diet beverages in, that they are the cause but we don't know what the answer is here. It's a, it's a speculation here, but we do know that there's evidence that people who have more processed foods in their diet are more likely to have a higher level of endocrine disrupting chemicals circulating in their body.

I found this to be a particularly interesting part of working with you on this paper, that if you think about doses of things that are contributing to obesity, somebody who's drinking sugary beverages are basically getting doses of calories from the sugar. And then of course getting a dose of the endocrine disrupting chemicals. And so you'd expect especially high rates of obesity, which is exactly what the literature shows, but this finding about diet beverages is fascinating. And so you'd expect people to have higher rates of obesity who are drinking diet beverages. And you mentioned the difficulty of understanding that relationship. But given that they're getting a dose of the endocrine disrupting chemicals, that this could help explain that relationship. And I don't think the field has thought about this very much. Would you agree with that?

I would. And I don't think people realize that endocrine disrupting chemicals have at least three ways in which they're contributing to weight gain, they can stimulate appetite. So even if you're trying to lose weight, you may feel hungry because of the EDCs that you're still consuming or that you have already circulating, but they also contribute to storing more fat in fat containing cells in your body. And they contribute to creating new fat containing cells. So they act quite powerfully and there are several different chemicals that are at work here. So it's a complex system, but it's a pretty convincing one to me.

So I'd like to ask you in a moment about the policy implications of this, but before I do that, do you see evidence that the major experts around the world and the organizations that deal with obesity, like the world health organization or the obesity society and America or the world obesity Federation that you've been so involved with for so many years, is there a lot of people paying attention to this and starting to think about this as a potential major driver will be sitting in something that needs more policy attention?

I think there were a little chinks of light occurring here and there, but on the whole, no, there are some policy papers that talk about potential environmental causes of obesity might include toxins, but they don't talk about the strategies that are needed to deal with it. So you have to go elsewhere to look for policy proposals. And that's usually in a sort of reproductive system or cancer determining systems where EDCs are now more completely recognized as being a problem in the obesity policy area. It's still really new. And I think that's where I'm hoping that our people will have a bit of an impact because it did look at 50 of the sort of leading governmental and inter-governmental policy statements on obesity strategists and only four or five of them, actually even referenced possible chemical influences. And none of them really had a strategy for dealing with them.

You know what this reminds me of, and this may not seem like a reasonable parallel to you, but I'm thinking back on the early days of interest in food and addiction, and now there is a robust literature on this and people, in the food and nutrition and obesity fields are thinking about it much more than they did before. But in those early days, it wasn't the BCT or nutrition field that started an interest in this. It was the addiction field. And then finally the nutrition related field started to catch up. I wonder if that might be true here to some extent that it may not be the obesity field that drives this interest, but it could be the people who were working on the EDCs and environment or health or things like that outside of our field who really do the majority of the work and ended up pushing us forward. And then finally our field might catch up. What do you think?

Well, I agree with you and of course you and I likely to be cited as the pioneer, as I hope, and I'm trying to bridge these gaps, but it also speaks about if you like the sort of wider interconnectivity of different aspects of commercial and policy issues that affect health and how they interact with each other. So I'm fascinated by the way, in which, for example, policies and strategies to try and deal with global warming or to deal with environmental pollution will also have an impact on human health and even on obesity prevalence. So I think all these things do interconnect, but it's a matter of drawing those connections and trying to get them included in policy decisions, which I think we need to talk about.

You and I go back many, many years and have been the countless meetings together, have written things together and have done a lot of thinking together about the field. And it's been a real honor for me to be involved in this and in this particular project, but also things we've done in the past, but this strikes me as something of particular importance and something where I really believe you've done a major job of helping move the field forward. So let's hope people pay attention like they should. So let's get to the policy things now. So what do you think are some of the main policy implicate?

I'm going to raise two particular points. I think first, when you ask people to lose weight by dieting and exercising, what are you doing? Because if it's not actually dietary intake or even exercise, that's causing their weight gain, then they're going to fail. It would be a useless thing to ask them. So if people are still being exposed to endocrine, it's going to make them hungry, and there's going to add to their stored fatty cells. So blaming people for their weight gain or failure to lose weight when it's actually being caused by invisible chemicals in the environment or in food wraps in packages or furnishings or roadside air pollutants. I mean, you can't avoid these chemicals. So it is not your fault. If you gain weight or find it hard to lose weight. And I think that is a hugely important step forward in this whole issue about stigma and obesity, weight bias and so on. And the blame game that's played by politicians. So that's the first policy point that I want to bring out from here that it's not the individual's fault. Particularly if endocrine disrupting chemicals are contributing to their weight gain. Secondly, the policymakers who designed government interventions to improve population health, they need to look at these manmade chemicals. If you think about it, it's a government regulation to take the lead out of automobile fuel or the asbestos out of houses when it was showing how poisonous these chemicals are. So I think now we've got to get governments to act and act fast to reverse the flood of these endocrine disruptors. That means tackling the commercial interests that use these chemicals so that they change their products. Now I know that getting commercial producers of harmful chemicals to change their practices is a huge political issue. And I guess you might want to discuss what has to be done in another of these excellent podcasts.

So Tim, might there also be some interesting advocacy coalitions to be built in this field with the people who are working on the environmental part of this and the health part of it, coming together with the people that are working on the diet, nutrition and obesity part of it.

Oh, definitely. In fact, it spreads even wider. I think that the coalitions that need to be built have to tackle this issue in at least three dimensions, because firstly you have to weaken commercial influence on government strategies and government thinking. And that means weakening their lobbying, weakening their political donations. So we need to join with others who are trying to expose and reduce the lobbying that gets done by industry. But you also need to strengthen popular demand, getting the media and popular messaging on side, you need to make politicians feel the heat, making it easier for them to intervene and to regulate against commercial interests. And you need to show that failure to act costs more than acting now. Now we know this is the case with global warming and with environmental pollution, not doing anything is not an option. So I think there are plenty of parallels and links between these issues.

There might be some interesting litigation opportunities here too, because you can imagine the people who are working on the environmental parts of this are thinking about the damage to the environment and the need to recover those damages from the companies that are creating the problems. But they're probably not thinking about obesity as one of the potential outcomes of this, which of course carries enormous cost to society. So that might be part of an interesting picture going forward to at least in some countries.

I see another paper coming on, Kelly.

Bio:

Dr. Timothy Lobstein retired as Director of Policy at the World Obesity Federation in London, UK, and is currently visiting professor at Sydney University in Australia. He is an advocate, scholar, and policy expert and has, in my opinion, one of the world’s most effective and impactful voices in addressing obesity. He has world on obesity efforts around the world, and with groups such as the World Health Organization, and was the inaugural winner of the Philip James Award.

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This podcast focuses on why now is the right time to fix the US food system. I'm talking today with Marla Feldman, Senior Program Director at MAZON: A Jewish Response to Hunger, which is a national advocacy organization working to end hunger among people of all faiths and backgrounds, in both the United States and Israel. As our regular listeners will know from previous podcasts, for 36 years, MAZON has worked towards systemic change to address hunger and its root causes. This is done through a combination of initiatives, including programs with low-income populations or problems that have previously been overlooked or ignored, including food insecurity among currently serving military families, among veterans, single mothers, Native Americans, LGBTQ seniors, and the people of Puerto Rico and the territories. This is the fourth in our series of episodes in partnership with MAZON. And this time, we'll focus on the organization's work to increase access to nutritious foods in the charitable food network.

Interview Summary

So Marla, I know there's been a significant shift in thinking about nutrition in the context of food banks, and that this topic was addressed in an influential report that MAZON put out in 2018 titled, "A Tipping Point." Can you explain what things were like prior to that, and what prompted you to write the report?

"A Tipping Point" did have a significant impact on the field. Prior to the report, MAZON worked for years to improve nutritious food options offered in food banks. It was probably 2005 or 2006 when we began a conversation on the links between obesity, hunger, and health, when not many people in our field were discussing this yet. We then launched our first formal initiative around nutrition and healthy eating in 2007. So "A Tipping Point" was really the culmination of a decade of work for MAZON. After many years of working with food banks around the country, helping them to implement strategies that facilitate the acquisition and distribution of healthier foods, we wanted to collect data to take a closer look at how successfully this work was going, to improve the nutritious offerings through food banks and the charitable food system.

Prior to "A Tipping Point," there was momentum building in the field for sure, as food banks across the country began to prioritize the health and wellness of those they serve. And they were trying various strategies, including to increase the distribution of fresh produce and other nutritious offerings. But the kind of data gathered in our report did not exist, and has since been instrumental in helping to assist the field to gain even further momentum around nutrition and as a benchmark to gauge progress, especially when it comes to the less-helpful foods in food bank inventory.

So what were the main recommendations in that report and what have been the most significant developments in your mind since then?

Well, "A Tipping Point" was impactful for many reasons, and I'll talk about in a moment, the recommendations, but I'd say one of the biggest impacts it had was providing data that jolted the field and really served as a lever of change. The data we reported was and still is used to support and fund several important national projects, including Robert Wood Johnson Foundation's Healthy Eating Research, which since developed HER nutrition guidelines that Feeding America has adopted for food banks to use as a strategy for distributing more nutritious foods. But one of the most impactful findings that we reported, which has been and continues to be cited throughout the field, showed that 1/4 of the inventory distributed from food banks at that time was empty calories, or as some refer to as junk food, meaning that it was not nutritious food. These included sugar-sweetened beverages, candy, and sweet and savory snacks. And that data point was eye-opening for so many. And in contrast, about 1/3 of the food they were distributing was fresh produce. So the recommendations we provided, which included the development and implementation of formal nutrition policies, the development of national nutrition standards, and to update the metric system with one that measures the nutritional value of foods distributed, these recommendations helped many national organizations obtain funding so that food banks across the country who wanted to implement similar nutrition standards had the data, the support, and the strategies to do that.

Now, if I can just editorialize for a moment, this is a big deal because just Feeding America alone is an enormous organization that has purview over food banks all around the country. And if the nutrition standards can change in an organization that big, and others, then vast numbers of people who rely on food banks could be affected in a positive way through their nutrition. So congratulations to you and your colleagues for helping accomplish this, and others who've worked in the field as well. And I'd also like to bring attention to the Healthy Eating Research guidelines that you mentioned, which I think are outstanding, and really have been helpful. So let's change the topic a bit and discuss COVID-19. So during the pandemic, how has the increased demand on emergency food assistance services created even new challenges?

The need for emergency assistance services like food pantries skyrocketed in the pandemic. Nearly 80 million people faced food insecurity at the height of COVID-19. Many people facing hunger also struggle with diet-related health conditions like diabetes, heart disease, and obesity. So it became even more important that food pantries helped promote healthy eating and provided more nutritious foods. COVID-19 also exacerbated the racial disparities that already existed with food insecurity. Black and Hispanic families have always been disproportionately impacted by hunger. And COVID-19 had an out-sized impact on these same communities. One positive outcome has been that food pantries have expanded their community services and support. So they always offered certain services like SNAP enrollment, but the pandemic required them to expand these offerings and reevaluate how they'll serve the community moving forward, which has the potential to create a positive impact even after the pandemic ends. So the pandemic has also made clear, if not obvious, that charity alone cannot end hunger in this country, it was never designed to do so. That's why MAZON has doubled down on our advocacy to protect and boost programs like SNAP, which is designed to enable people to get the food they need with dignity. And we were very pleased and excited to see the recent USDA decision to update and increase SNAP benefits so families can reliably access an adequate healthy diet.

So lots of progress has been made, but I'm assuming there's still a lot that can be done. So why is it important to continue discussing this issue of healthy food options in the charitable food sector, and what do you think should be done?

Well, it's so important to talk about healthy food options in the charitable food sector, because until the safety net is strong enough, we are going to continue to need the charitable food system to bridge the gap where SNAP falls short. We also know that, unfortunately, some people face obstacles to accessing SNAP, and they still rely on food pantries and other direct service providers. And these obstacles range from policy barriers, to misinformation, to stigma and shame. So a stronger, more robust safety net has already proven to lift families out of poverty until they have more resources and no longer need to supplement their SNAP dollars with a food pantry visit. But right now, some families cannot get by on SNAP dollars alone, and as a result, those families cannot access enough nutritious food to adequately feed themselves and their families. There's more we can do as well. There are many stakeholders that play a key role in the charitable food system. And one of the most important are the large corporate and retail food donors. As our report revealed, food donations make up approximately 60% of the inventory at food banks. So the food donation stream has a very important role to play in making sure that the food in the charitable food system is more nutritious. "A Tipping Point" aimed to influence food donors and offer solutions, whether through education and engagement, policy, tax credits, or otherwise that would incentivize healthier food donations. So again, all stakeholders, including food donors and the corporate community, play a key role in the food provided at our food banks and food pantries, and all stakeholders can improve efforts to make the charitable food system healthier so that we're nourishing the people who need this vital support.

Bio

Marla Feldman is the Senior Program Director for MAZON: A Jewish Response to Hunger. Since joining the organization in 2002, Marla has led efforts to promote positive health outcomes and improve access to nutritious food for low-income communities. Marla has spearheaded national initiatives, including Healthy Options, Healthy Meals™, which encouraged food banks to prioritize nutrition and implement strategies to procure and distribute healthier food through the charitable food system. Most recently, Marla conducted a national food bank study and published the findings in the research report A Tipping Point: Leveraging Opportunities to Improve the Nutritional Quality of Food Bank Inventory. Prior to joining MAZON, Marla spent nearly a decade managing small business development programs with the African Development Foundation and the Peace Corps. She holds a Bachelor of Arts in Communications from the University of Maryland.

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Researchers and policy makers in agriculture, food security and nutrition share a common need for accurate and timely information on the what, when, where, and why people eat and what they eat, of course, this is particularly true in low and middle income countries where the data infrastructure is less well developed to put this challenge in perspective in 2015, the Global Panel on Agriculture and Food Systems for Nutrition reported that, and I quote "more than half of the countries in the world do not collect the statistics, which are needed to assess whether or not they are making progress toward their nutrition goals." So today we're talking with two researchers who are working to solve this very data challenge.

Our guests are food policy and applied nutrition researcher, Jennifer Coates, Associate Professor at the Tufts Friedman School of Nutrition, Science, and Policy and senior researcher Winnie Bell. Jennifer and Winnie are leading development of the International Dietary Data Expansion Project

Interview Summary

Jennifer, let's start with you. Your research focus at Tufts is on the development of methods for improving the design implementation and evaluation of international nutrition and food security programs. And I know in particular, in the context of development in humanitarian emergencies. Could you help our listeners understand the issue of this INDDEX Project that you're working on?

Jennifer - Just to give a little bit of history. The international community has probably over the past five or so years really begun to embrace the need to think about nutrition's role at the nexus of agriculture and the environment and health. So not just a standalone sector, but rather a culmination of whole bunch of different forces within the broader food system that in combination have this remarkable impact on people's food choices and ultimately their diets. So we also know that in turn, the food choices really drive health outcomes and in a very systemic fashion affect agriculture, the environment, food security, poverty, and so on. So the problem though, for those who are interested in the interplay of these forces in much of the world, is that we know shockingly little about what people eat and we're not able to easily distinguish the dietary patterns of adult men, for instance, from school age girls or from those living in one region of the country to another. And this information gap has really hindered policies in all of the different sectors that I mentioned and others, because policy makers are often driving blind without having more frequent and more granular dietary information. This data gap is particularly a challenge across low and middle income countries.

So let me follow up on this. It seems like this information is pretty darn important because it could drive nutrition guidelines for countries that could drive bio-fortification programs. They could certainly have an impact on agriculture policies.

Jennifer - There are a number of different reasons, in fact, for one thing, we're globally really lacking a kind of cohesive dietary data infrastructure, I will say, and this is made up of several different missing pieces of information. So we lack the kind of information that can help us actually carry out dietary surveys. So information on what are the most commonly consumed foods across many of the countries where people live and also what are the nutrient composition of that food in the US for instance, we have a very rich repository of data on the foods consumed by people all over this country, including many, many different kinds of processed foods. And we also have information on the nutrient content of those foods. And so it makes it very easy to take that information and go out and conduct a survey on what people are consuming, but we don't have that kind of information for most low and middle income countries. And another reason is that partly because we lack this dietary infrastructure, people have over time, come to view dietary data as being very challenging to collect and have shied away from it because of that. So now we're reaching a point, I would say, where we're seeing a groundswell of recognition for the need for dietary data and then that is driving a lot of efforts, not just our project, but other related projects that are really trying to begin to close this gap.

I appreciate that hopeful note. So Winnie, you're leading key aspects of the second phase of this project, which is the rollout of the INDDEX24 dietary assessment platform. Could you describe the platform in more detail and why you believe it is needed.

Winnie - The INDDEX project, the International Dietary Data Expansion Project has been around for about six years. We started in 2015 with funding from the Bill and Melinda Gates Foundation, and our main objective has been to increase the availability access and use of dietary data in low and middle income countries. The platform is designed to address some of these underlying challenges that Jenny just spoke about.

INDDEX was conceived to begin to address the lack of dietary infrastructure for collecting individual level quantitative dietary data. One part is the Global Food Matters Database where we house and fold all of the dietary reference data that are required for individual level food consumption surveys. So that includes food composition information, standard recipes, necessary conversion factors, and the probes that are used during the interview process. So that's the first kind of big component of the INDDEX24 platform.

The next piece is the INDDEX24 mobile app, which is actually what's used in the field to collect the dietary data during the survey, both of these pieces are connected through a survey management hub where the data can be monitored in real time during data collection, as well as used for easing the processing and analysis of the 24-hour recall data on the backend. So the 24-hour dietary recall method is commonly used to collect detailed quantitative information on what individuals consume. Individuals are asked to recall everything that they consumed in the past 24 hours followed by a more detailed information on each of the food items, getting into that type of food consumed and the brand, for example, the third step is to then collect the quantity of each food consumed and then finally reviewing that information with the respondent.

All this might sound a bit abstract, so I would encourage listeners to check out our website for a full visual and a demo of the different aspects of the platform and in terms of why it's needed. And this, as Jenny highlighted, we have this critical gap in information and this platform has been designed to increase a collection of 24 hour dietary recall data in low and middle-income countries.

This could be enormously powerful to have this tool available and it's really nice that you're doing it around the world with a special emphasis on countries where the data are most lacking. So Jennifer, let me go back to you in your opinion, how has the international nutrition and dietary assessment landscape changed over the, say the past decade and looking into your crystal ball, how do you think it will change?

Jennifer - I mentioned earlier, one of the reasons there has traditionally been so little dietary data available is that it was often written off as being too expensive, too time consuming and too difficult to collect. So traditional dietary assessment methods, such as those that rely on respondent recall can also produce inaccurate results, which people recognize and were discouraged by this narrative. This ridiculous challenge of dietary data assessment really became a mantra, it became almost paralyzing I'd say, one of the biggest changes that I've noticed over the past five to seven years is an acceleration on so many fronts. There's been an acceleration in terms of the demand for dietary data, absolutely. And then in response, but also out there leading, I'd say those involved in generating dietary data have developed a new can-do attitude, a real rolling up the sleeves and just getting it done.

Partly this has been catalyzed by very generous funding by the Bill and Melinda Gates Foundation, not just of our project, but of other similar projects with INDDEX24 we're trying to make dietary data, I guess, increasingly available. We're hoping that it will be collected more frequently and therefore be used by policy makers more often, but there are also other aspects of the dietary data value chain that other projects are addressing. For instance, the WHO/FAO GIFT Project has been working to make dietary data more readily accessible in a centralized repository and much more usable by policymakers, through simple visualizations that communicate very readily to those who aren't up to their eyeballs and dietary data, and might not know otherwise how to interpret it. So this kind of information has improved on the way that people both access and use dietary data.

And then looking forward, one of the things that we're seeing are a huge number of efforts going on to develop innovative technology. Much of it is still nascent, not quite ready for prime time, but to improve the possibility of capturing information on diets in real time, like while people are eating, researchers are using imaging approaches coupled with artificial intelligence in order to upend the traditional field of dietary assessment. So, no, we're not there yet, we've already made leaps and bounds on this front, over the last, over the past 10 years and I think that 10 years from now this whole challenge will look completely different, in fact, I think we will probably have done away with many of the things that we now find to be very difficult about dietary assessment.

What you just mentioned about technology being used to more accurately assess what people are consuming sound very promising. And I remember back when I was first paying attention to work in this area, and there were a lot of concerns about the accuracy of things. Researchers were reporting that people may not be able to accurately judge portion sizes. They may intentionally under or over report consuming such things. And there was talk in those early years about having other information available where you could correct for things to actually establish a more realistic number. So say people underestimate by an average of X %, then you could correct for that, are people doing that at all? Or will this technology help with that issue?

Jennifer - There's work going on for both of those fronts, so you're absolutely right, that those types of corrections are possible and are actually very useful. One of the things that is very challenging right now in our efforts in low and middle income countries is that we don't actually have enough information yet to really be able to establish appropriate correction factors. One of the reasons for that is that, for instance, in the US people most commonly under report, what they've consumed the previous day and that's partly because they forget, and it might also be because they think it might be more socially acceptable to under-report. But we really don't know all that much about how people from various cultures report their diets, when they're trying to recall, there is documented under-reporting.

There's also documented over-reporting and there's a lot of variability establishing the correction factor is a whole other level of work that would be very helpful and remains to be done. One of the benefits of the imaging technology is that you're not relying on people's memories. And in fact, the camera is present, even though that sounds a little creepy, big brother watching everything that you're eating, but the camera is present and often in an unobtrusive way, as people are eating their meals. And so of course you might be concerned about people modifying their behavior, if they're aware of a camera recording, what it is that they're eating, but at the same time, some of this research has suggested that having the camera be situated in a very, very small way on, the special glasses that people be asked to wear or as a button that they wear on their shirt, for instance, has really helped reduce some of that kind of potential bias too. So there's a lot of promise from the imaging and there are still challenges to be worked out for instance, how to take the images that the camera's capturing and in a very automated way, convert that into something that can be recognized as food, especially in complex dishes, like stew with lots of different kinds of ingredients. So that's kind of the excitement, but also the challenge of this new frontier.

That's really interesting. So let me close by asking you both this question moving forward, what do you see as the biggest challenges as well as the opportunities for increasing collection and use of dietary data in low and middle income countries? And Winnie let's begin with you.

Winnie - So, as we've both mentioned, the dietary data infrastructure has been historically one of the largest barriers to successful completion of dietary surveys in low middle-income countries. The INDDEX Project has been focused on trying to build up this research infrastructure over the last six years of our project. But the challenge remains is it an enormous undertaking that really will require political will from a variety of key players and champions from both governments as well as on the donor and investment side, as well as on the research end of things. We're absolutely moving in the right direction, but I think the challenge remains, how do we develop this robust and necessary dietary data infrastructure to ensure that we can collect more easily and use more frequently the dietary data from low middle-income countries.

We have successful examples of this being developed where political will has converged. So in the health sector, for example, we've seen huge movement over the last several decades to creating health systems in low middle-income countries. So we're hoping that the momentum continues to grow, to overcome this challenge in relation to nutrition. And as far as opportunities, I think there are several, but a very concrete one is on the technology side of things as Jenny mentioned with artificial intelligence and other efforts. And I think the other overall opportunity is general growing awareness of the importance of dietary data. Everybody is interested, everybody wants to see the results, and historically people are happy to have the data available, but few people have been willing to put in the effort to invest and collect those data.

Thank you, Winnie. So Jennifer, what are your thoughts on this issue?

Jennifer - I'd say that with dietary assessment in low and middle income countries, having historically been such a neglected area relative to say the many advances that we've seen in terms of information systems in the health sector, there has also been a lack of opportunity for very vibrant knowledge exchange. There are countries that have developed a lot of expertise and a lot of capacity in the area of dietary assessment and yet the kind of infrastructure that would enable country to country learning as well as training and mentoring between those who have already amassed a deal of experience in dietary data assessment, and those who are trying to improve their skills in this area has really been lacking. I'd say that the flip side opportunity to that challenge would be to scale up a global community of practice that can serve as a platform for exchange, for training, for learning and for maintaining this positive momentum that we've seen over the last five years. So we need to be thinking about the next generation and equipping them with the tools and the skills and the capacity to be able to carry this forward.

Bios:

Dr. Jennifer Coates is the Principal Investigator of the INDDEX Project and is an Associate Professor at the Friedman School of Nutrition Science and Policy and a Senior Researcher at the Tufts Feinstein International Center. Dr. Coates’ research focuses on the development of methods and metrics for improving the design, implementation, and evaluation of international nutrition and food security programs in both development and humanitarian emergency contexts. In addition to her research and policy engagement, Dr. Coates teaches a range of graduate courses at the Friedman School.

Winnie Bellis a Senior Researcher with the INDDEX Project. Winnie was responsible for leading the INDDEX24 research activities in Viet Nam, including conducting the feasibility and validation studies. In addition, she is providing technical expertise and managing the development of the INDDEX Project’s Data4Diets Platform. Prior to joining the INDDEX Project, Winnie had worked for over five years as food security analyst and researcher with the Food and Agriculture Organization, the Food Security Information Network (FAO/IFPRI/WFP), and Tufts University. Winnie is currently a PhD candidate at Tufts University, where she also earned an MS in Food Policy and Applied Nutrition and an MPH in Epidemiology and Biostatistics.

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Taxes fund many important services, such as education, transportation, parks, and healthcare that benefit us all and our society. But does it make sense to tax groceries? Today, we're exploring research on the impact of grocery taxes, particularly, on low income families. We have two guests today who have collaborated on a really interesting project. Agricultural economist, Yuqing Zheng, of the University of Kentucky, and Norbert Wilson of Duke University. They're co-authors on a research paper entitled Putting Grocery Taxes on the Table, Evidence for Food Security Policy Makers.

Interview Summary

Why do we need to care about grocery taxes?

Yuqing - For low income populations, it matters a lot. For example, if you're paying $8,000 a year on grocery bill and you are paying 10%, that's about $800. And especially for low income population, we are concerned that grocery taxes could be very regressive. That means low income populations are paying a higher share of the burden. That concerns us quite a bit, and we would like to see if the grocery tax is hurting the low income populations the most.

Let me ask a follow up question to that. So, it's been a while since I've seen these numbers, but I know at one point, people in the United States paid the lowest amount per capita of any country in the world for food. So how does that figure into your thinking about this?

Yuqing - For middle income population, they are paying very reasonable share of income, but for low income populations, the burden is much higher. So for some states, if taxes are high, then it can be quite big percentage of a total income.

So Norbert, let's turn to you. Could you explain why your research team wanted to study grocery taxes?

Norbert - I lived in Alabama for a number of years and there were grocery taxes in the state and they still exist. I had heard a number of community groups express concern about the grocery tax and argue that it was hurting people who were struggling to make ends meet. And so I wondered, were the grocery taxes really that important? Part of the motivation as Yuqing has already made very clear, the grocery tax is a regressive tax that may be a heavy burden on lower income consumers. And the question is, was this really a problem? Do we see a relationship between the grocery tax and one of the measures that we think is really important, food insecurity? And so that's what motivated this original project.

So where do grocery taxes exist and who gets to decide if groceries are taxed and how large are these taxes in general?

Yuqing - Grocery tax is a sales tax imposed on the grocery food you purchase. So it could be in the form of a county or a state tax. It also could be in the form of combined. Overall, 16 of the U.S. states have grocery taxes. And if you look at these 16 states, the average of grocery tax percentage is about at 4.2%. So I lived in four states before, North Carolina, Alabama, New York and Kentucky. In Alabama, we are paying about a 4% state level taxes and another 4% county level and up to 2% of city taxes. So that's easily 10% of grocery tax. In North Carolina, in the county where I used to live, it's about a 2.7, 5% of county grocery taxes. There's no state level grocery taxes at all. In New York and Kentucky, there are no grocery taxes at all. In Kentucky, I'm paying 6% sales taxes on general merchandise but not food.

That's very helpful to know, and that's pretty startling how wide the variability is. So Norbert, what are your main findings from this study?

Norbert - We see that there's a relationship between the grocery tax and food insecurity. For every 1% increase in the grocery tax, we see a 0.84% increase in the probability of a household being food insecure. So, given the average of a 4.2% grocery tax across the U.S., we would argue that it increases the probability of a household being food insecure a little more than 3%. And so this is a substantial result in that, we are seeing more households that are food insecure in communities where there are grocery taxes. And as you have had on previous podcasts, food insecurity is an important indicator of wellbeing. There are a number of studies that showed that food insecurity is linked to various negative health outcomes. And it's also associated with issues around behavior, especially among children. And so managing food insecurity can be an important way of helping reduce inequalities in a society. And we're finding evidence that this grocery tax, at least, is related to the probability of a household being food insecure.

Those are pretty startling numbers and highly impactful, I think. In places where these taxes are being considered, does the impact on food security come up in legislative discussions?

Norbert - It does show up, at least from the people who are advocating for the removal of these policies. But it's also interesting to note that these are controversial taxes and that many states that have considered or discussed removing the tax are concerned about the loss of revenue and rightly so, and are concerned about them raising new revenue or new taxes to recuperate the lost revenue. And that's where I think a lot of the challenge comes is it's difficult for states to make the decision of switching one tax for another.

So let's talk about the policy implications of this. And I'd love to hear thoughts from both of you.

Yuqing - First, I want to add is that grocery taxes tend to exist in Southern states, where higher food insecurity is more prevalent. So actually, there are some policy discussions recently in West Virginia and the New Mexico, they used to have grocery taxes and they were abolished. And then now they were thinking about bringing it back. So one aspect, I think, tend to be overlooked is, how does reinstating grocery tax impact food insecurity and other health conditions or other counts as well? So this is pretty complicated situation because as Norbert mentioned, if you want to have no grocery taxes, you might want additional revenue sources. For example, in Alabama, it's a very unique situation. Alabama income tax is very low. And alcohol taxes, tobacco taxes is very low. Property tax is very low, but in order to make up the revenue, that's why I think the grocery tax is pretty high. The main message right here is when policy makers are thinking about increasing or decreasing grocery taxes, they might want to take into consideration this potential impact. Persons with relatively low income or persons who are on the margin of being food insecure, that's the outcome we want to print to the policymakers.

Norbert - Just thinking about the well-being of the citizens of a particular community and the issue around food security, repealing the tax may have the potential of lowering some of these burdens. One of the things we should note is that people who are participants in the SNAP program, the Supplemental Nutrition Assistance Program, do not pay the grocery tax on foods that they purchase with SNAP. For those folks, this tax may not be that important except for the times when they are not buying food off of their SNAP benefits. As some of us have seen, SNAP benefits typically do not last a whole month. So while these individuals may avoid paying the tax for, say, three weeks of the month, the last week of the month, they're facing this. And that means individuals are facing an extra cost associated with purchasing food. And we know that there are a number of responses in order to meet those food needs using charitable food sector, and depending on other resources to help meet food needs. Therefore, if removing a tax could just lessen the burden for families that are already struggling, could just make it a little bit easier, I think that's a good outcome. I do believe we need to be thoughtful and there have been some states that have removed the tax and replaced it with taxes on other aspects of their economy. So there are some examples out there, and I just encourage policy makers that are considering this to look at other states that have done this successfully, and explore ways that they can remove that tax, if they have the political will to do so.

Let me ask a couple more follow-up questions. So one, how do taxes on specific categories of foods, like soda taxes, figure into your thinking given what you found in this study?

Norbert - Because these are general taxes, they're taxes on all products. It's not quite the same as thinking about the soda tax, which is targeted to a particular product, typically, the sugar sweetened beverages, and therefore we don't equate the two. It is the case, there has been concern about the role that sugar sweetened beverage taxes can impose on individuals who are lower income, that there is a regressivity to those kinds of policies, but those are policies where, if the revenue is then turned around and encouraging other health behaviors, they may not be as burdensome or the long run effects may be different. Grocery taxes, however, are on all foods regardless of the health consequences. And because we need food regardless, placing a tax on that is a burden and it's unavoidable except in the case of using federal benefits, like the SNAP program. So I'm careful not to equate those two types of policies. They have different purposes, they have different implications. And I think that while there may be levels of regressivity from both, I don't see them as equals.

Thanks. That's very helpful clarification. So let's get as concrete as possible. Let's say I'm a state legislator in a place that has these taxes and might want to get rid of them, or is thinking about having such taxes, and we want to keep the amount of tax revenue constant. So if I say to you, "Okay, we'll get rid of the grocery tax", but how would we get additional revenue coming in from some other form of tax to help correct this disproportionate impact on low income families? What would you recommend?

Norbert - One way of alleviating the burden of the grocery tax is to spread it out across the other taxes. So if we know that the tax rate at the state level is 4.2%, there are probably ways of spreading it across. If the state has an income tax or taxes on cars like tags and other aspects of life, the various syntaxes like cigarettes and alcohol, I can imagine those state legislator making a change where there's a small increase across multiple tax bases, so that it doesn't feel like it's an overly burdensome increase in the tax of one product or one sector of the economy. That way, folks who have higher incomes can carry a little more of that burden than people with lower incomes. So I would argue that there are ways of spreading that tax around, so that it takes that burden off of lower income households that have to buy food. And I think that's a potential way forward.

Bios:

Yuqing Zheng is an associate professor at the Department of Agricultural Economics of the University of Kentucky conducting research in food marketing and policies. His main research interests include consumers behaviors, health and food safety economics, and demand studies using big data. He has published papers in American Journal of Agricultural Economics, other field top journals such as Health Economics, Regional Science and Urban Economics, Nicotine & Tobacco Research, as well as Economic Inquiry, Southern Economic Journal, Food Policy, and Economics Letters, among others. He directed the development of the FDA Food Regulation and Enforcement Policy Trade Impact Model (for the Center for Food Safety and Applied Nutrition) and the FDA Tobacco Category Demand Model (for the Center for Tobacco Products) and was a consultant to the development of the recent USDA Trade Impact Model. His paper on sales tax received the 2013 Best Economics Paper Award from the food safety and nutrition section of the Agricultural and Applied Economics Association (AAEA) and he was a recipient of the 2019 AAEA Quality of Communication Award. Dr. Zheng is an associate editor of Tobacco Regulatory Science.

Norbert Wilson is the director of agricultural policy at Duke’s World Food Policy Center, and a professor of food, economics and community in the Divinity School at Duke University. His research touches on several food issues, such as access, choice, and food waste. He continues to work on food safety and quality issues in international trade and domestic food systems. Wilson is an ordained vocational deacon in the Episcopal Church USA. Additionally, his work is moving to explore equity in food access. He has published in AEA Papers and Proceedings, World Development, American Journal of Agricultural Economics, Journal of Public Health, Food Policy, Agricultural Economics, and other publications. Before joining Duke Divinity School, Wilson was a professor of food policy at the Friedman School of Nutrition Science and Policy (2017-2020). He was also a professor of agricultural economics at Auburn University (1999-2016). While at Auburn, Wilson served as a deacon at St. Dunstan’s, the Episcopal Student Center of Auburn University (2011-2016). He was an economist/policy analyst in the Trade Directorate (2004-2006) and the Agriculture Directorate (2001-2002) of the Organization of Economic Development and Cooperation (OECD) in Paris, France. In 2014-2015, Wilson was on sabbatical leave at the Dyson School of Applied Economics and Management at Cornell University.

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For youngsters in school, nutritional meals really do lead the higher grades and better performance across the board. Today we'll explore a policy called the Community Eligibility Provision or CEP that allows schools in low-income areas to offer free meals to all students. We have two guests today. Marianne Hedrick Weant, Programs Manager at the North Carolina Alliance for Health and Dr. Sarah Crittenden Fuller, Research Associate Professor at The University of North Carolina and a proud Duke alum from our own program. She's also the coauthor of a new policy brief on this topic, entitled Meals Matter, The Community Eligibility Provision and Students' Success in North Carolina.

Can you help our listeners understand why school meals are so important to students and how universal free meals are so different than the traditional way these programs are structured?

Sarah: There's a large body of research that shows how important proper nutrition is for children's cognitive development, as well as their health and development. Kids who aren't getting proper nutrition. They aren't able to concentrate in school and to perform the way that they would if they were receiving proper nutrition. School meals have historically provided nutrition and increased food security for low income students. As adults sometimes we tend to have the perception that school meals are low in nutritional quality, but that's not really true. Recent research suggests that school meals provide better nutrition for students than the alternatives that they might be bringing from home or eating otherwise.

The traditional structure of the National School Lunch Program and the School Breakfast Program requires many eligible families to apply to receive these free meals, even if they are eligible based on their income. And so that can create a barrier to participation either because families simply don't know that they need to apply, don't know how to do so or have some concerns about signing up for this benefit. In addition, because receiving free meals is tied to income, it can be stigmatizing for students. Kids can be pretty savvy, especially when you think about the middle and high school level. And they can recognize that receiving a free meal is a marker of family income, and that can result in students not really wanting to walk up there and get those meals.

So the Community Eligibility Provision allows high poverty schools to opt in to providing universal free meals for all students within their school, rather than collecting this individual eligibility. Instead school meals just become available for everybody, which is great in several ways. It reduces the administrative burden from schools who are having to still collect these applications, have a cash register in the cafeteria where they check off students and make sure that they're eligible for free meals or collect money if aren't eligible. In addition to removing that administrative burden, this has the potential to change the culture around school meals.

Thanks and Marianne I'd appreciate your thoughts.

Marianne: School meals ended up being such a weird part of the day as they are right now. And that's because there's really no other part of the school day where you expect some kids to not pay anything at all and you expect other kids to pay a certain amount. And then a third group of kids to pay a different amount. It's a really really strange point in the school day that can cause cultural issues at a school and create groups of kids that have and groups of kids that have not. But it doesn't have to be that way. And CEP is a real opportunity for a lot of schools to change that.

So what are the effects of universal free meals for students?

Sarah: First off, one of the questions I think a lot of people have as well, do more students actually eat meals when there are universal free meals? Because in theory, the students who would benefit most, the low-income students already had access to free meals. But what we do see is that when schools switched to universal free meals through the Community Eligibility Provision, there is a big increase in the number of meals served. In North Carolina in that first year that school started implementing the Community Eligibility Provision, the increase was equivalent to every student within the school eating 20 additional breakfast and 20 additional lunches, which is a pretty big impact. And now of course we know it's not evenly distributed across the school, but this means many students are either eating meals more days or students who weren't eating school meals at all are now eating school meals. And so that's a pretty notable change.

Research also shows that providing universal free meals through CEP can have impacts on educational outcomes. So some studies show improved attendance for students and schools that are offering free meals. This makes some sense if you think about the incentive students have to come to school so that they can pick up that free breakfast. In many studies and including some work I've done myself increases in academic performance on test scores related to school meals and reductions in suspensions, particularly among older students, a brand new study even shows that students at schools with Community Eligibility Provision report improves school culture, they report feeling safer at school and particularly feeling safer within the cafeteria.

So all of these things are really big benefits that extend beyond just making sure students have food security that also impacts everything about their school day. In the state of North Carolina, you see that the schools that are participating in the Community Eligibility Provision compared to schools with similar rates of low-income students have a higher report card grades. Broadly we're seeing, it looks like these schools are performing better academically and that's really great news.

I remember in the early days when people were considering universal free meals, there was a special concern around breakfast that some kids may be eating at home and then coming in and having another breakfast meal and that it might be contributing to the childhood obesity problem.

Sarah: So the evidence I've seen looking at obesity and the Community Eligibility Provision suggests that that's not what's happening. When you think about kids, particularly young kids, eating a second breakfast may be fairly normal for that age range. I think the assumption that if students are eating twice, that that is leading to obesity, isn't always a great assumption.

You've raised good points that it's overall nutrition that counts, not necessarily the number of meals. So I'd like to get both of you to weigh in. What do you think the future will look like for universal school meals?

Sarah: So the pandemic has created a big change here where nationwide schools have been able to offer universal free meals, whether they were in school or out of school for at least some portion of the time they've been providing school meals to students who aren't actually physically in the school building. For the moment, the US Department of Agriculture has extended some of those waivers to allow schools to continue offering universal free meals through the 2021-22 school year. So that's going to last this second pandemic school year, we're approaching here. After that, the future's uncertain. That's an important problem that we have now, a year to think about it is well what does the future look like?

The data that I'm talking about with regard to the Community Eligibility Provision is really only for those first three, four years of implementation. It's great that we're seeing positive results already, but we really don't know what it looks like once this has been in place for long enough to really create that culture shift that you would hope to see, particularly at the high school level. Even if you remove the cash register and you change the mechanisms for receiving school meals, particularly at the high school level, it's going to be a lag while students are still thinking about these meals in the same way. And so some of those reductions in stigma and increase in uptake of school meals may take a while. And so we don't really know yet the full potential of universal school meals. Hopefully, as we're moving forward here and coming out of this pandemic and thinking about, well, are we going back to a system that requires some students to pay for meals and others to not, this is something that states and the nation need to be thinking about.

And Marianne what are your thoughts on the future?

Marianne: I think it's interesting because we're in kind of a really critical moment for school meals, where we have another year of universal meals for our pandemic school year, but we're also right up on child nutrition reauthorization at the federal level. And so it's an opportunity to eliminate this weird point in the day and make universal meals available to all schools and all school systems this year. Will they do it? I don't know. I feel like we're seeing more energy around this than we have in the past. And I think it's hard to imagine going back to it and telling kids in a year, that they'll be paying for school meals when they didn't this past year. And if it's not that at the federal level, there's of course an opportunity for it to be done at the state level. We just saw California pass universal meals there, and then it always can be done just by making sure that every school system and every school that's eligible for CEP participate.

Bios:

Sarah Crittenden Fuller holds a Ph.D. in public policy from the Sanford School of Public Policy at Duke University. She currently serves as Principal Investigator for the multi-year evaluation of the Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) North Carolina intervention. Fuller is also leading projects examining the impacts of natural disasters on educational outcomes nationwide and the impacts of remote learning due to COVID-19 on schools in North Carolina. Other areas of ongoing research include high school reform models, the impacts of school nutrition on academic outcomes, and the influence of hurricanes in North Carolina on childhood outcomes. Fuller’s work leverages large administrative datasets and quasi-experimental designs to estimate the causal effects of particular policies or events on student outcomes. She uses primarily quantitative methods to address research questions surrounding schools and students focusing on questions that have the potential to inform policy decisions. Fuller has received grant funding from the Spencer Foundation, the National Science Foundation, the Robert Wood Johnson Foundation, the Russell Sage Foundation, and the W.T. Grant Foundation. She has recent publications in Economics of Education Review, AASA Journal of Scholarship and Practice, AERA Open, and Urban Education.

Marianne Hedrick Weant is the programs manager at the North Carolina Alliance for Health (NCAH). Prior to joining the staff of NCAH in 2018, Weant spent nine years with the North Carolina PTA. Weant completed a BA in anthropology and history at George Mason University and an MA in anthropology and development at the George Washington University before receiving an MSPH from the University of North Carolina at Charlotte. Weant lives in Cary with her husband, six kids, five chickens, and dog, and her children attend Wake County schools.

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The COVID-19 pandemic changed our lives and led to mandated business and school closures, families and communities all around the country experienced record levels of unemployment and record levels of food insecurity. This led to unprecedented policy innovation designed to increase access to nutritious food through the supplemental nutrition assistance program, known as SNAP. The program that was formerly known as Food Stamps. In today's podcast, we'll talk with the authors of a new report entitled, Supplemental Nutrition Assistance Program Waivers and Adaptations During the COVID-19 Pandemic, A Survey of State Agency Perspectives in 2020.

Interview Summary

Our guests today are two of the authors of the report, health policy expert, Alyssa Moran of the Johns Hopkins Bloomberg School of Public Health, and Matt Lyons, the Director of Policy and Research with the American Public Human Services Association.

So your report addressed how states responded to the increase in need for SNAP during the pandemic. Matt let's begin with you, can you tell us more about the report and why it was important to document the state experiences?

When the pandemic first hit last year, the sharpest spike and need for basic help was in SNAP. And this isn't a typical and economic downturn SNAP has always been one of the most effective tools to help meet people's basic needs and to stimulate local economies. This time around though, we had to weather an economic crisis that was layered on top of a public health crisis, and that dynamic raised all kinds of new questions about how state agencies were going to get help to millions of families in a world that literally shifted to virtual overnight. In those first weeks of the pandemic, we as the membership association supporting those state agencies, we were literally convening state agency leaders on Zoom calls daily just to figure out basic questions of how are you going to keep the lights on so that staff could keep processing applications when they're working from home? Or how are you going to navigate through federal requirements that frankly were developed at a time when SNAP was assumed to be a program people applied for in person? And as difficult as that was for our agencies to make sense of, we could only imagine how infinitely harder that was for all of the people that were trying to apply for help. So as federal policies and guidance started to catch up in the coming weeks and months, and states really settled in for the long-term COVID response, states had to plan for how they're going to adapt their services so that people could keep accessing the benefits through the duration of the pandemic. And as we worked through all of these monumental changes to how the program is being administered, it really just became self evident that it was crucial. We had to take the time to rigorously document this experience and just draw on all the insights and lessons learned so that we can improve access to SNAP in the long-term and strengthen its impact on peoples and communities based off of this experience.

Well, some of the problems, the challenges you mentioned make perfect sense now that you've brought them up, but they're not the kind of thing most people would think about, and you could imagine how hard it must've been to keep things going that even a modest level, much less been ramped up. So Alyssa, I'd like to hear your thoughts on this.

I'll preface this by saying that I'm a public health researcher. So I think about SNAP through that lens, and from a public health perspective, SNAP is a tremendously important program. It reaches about one in eight Americans and nearly half of those participants are kids. And it's a critical program for reducing poverty and improving food security, which are really important social determinants of health affecting everything from dental caries to diabetes, to depression. But the design and the delivery of SNAP also really better for health. For example, there are obvious ways that design choices in SNAP affect health equity, things like eligibility criteria, which prevent certain people from accessing the program or decisions about the benefit amount, which affects the types of foods that are available to participants. But there are also more subtle ways that program delivery can impact health, something as simple as how the state communicates with you about your benefits. So did they send you a text message right to your phone, or do you have to call a call center and wait on the line for two hours for information? Can you submit all of your application information online or do you have to come into the office for an in-person interview? So all of these requirements to enroll and stay enrolled in SNAP can affect health by limiting or expanding access to benefits and can also cause significant stress, increased anxiety and cause people to worry about whether they're even going to actually receive their benefits each month. And as Matt described, the pandemic acutely changed how states deliver SNAP and how participants interact with the program. And I was really interested in learning what we can take away from this experience to strengthen the public health impact of SNAP moving forward, not just by breaking down barriers to access, but also by improving the client experience through these structural changes.

It's nice to hear of the interest among public health researchers in helping improve the delivery of these programs, because as you said, they reach so many people. Matt, you mentioned that there were program changes that needed to be made in SNAP during the pandemic, how successful do you think these changes really were in helping states serve their clients?

Well, in those first few months of the pandemic, you had more than 6 million people newly enrolled in SNAP and participation has remained well above pre pandemic levels as a nation have continued to grapple with all of the disparities in the COVID response and recovery. So I think from this perspective alone, it's important to consider the SNAP pandemic response a success. Fundamentally more people needed help affording food during the pandemic and the program was responsive. We've all heard the stories of it taking weeks, if not months for unemployment insurance systems to respond to the spike in demand and to be able to issue new benefits. And that just wasn't the case for SNAP. State and local agencies really did step up to the table to meet the challenge, but I will say SNAP's ultimate success, it certainly didn't come without its fair share of bumps in the road. And I think that probably starts with the fact that SNAP rules, they're just not well suited to work in a virtual world. When you think of things like interview requirements and procedures for recertifying for benefits and even things like a signature requirement, they all lean heavily on in-person interaction. And that's particularly true for underserved communities that already face access barriers.

For our clients, if you mess up and following those rules, you're back to square one, you got to start all over in the application process and even beyond just the benefit itself, there's other components of SNAP that are there to help people receiving a help learn more about healthy food or engage in employment and training services. And those services are similarly modeled towards in-person activities. So to say that the program had to make changes would be an understatement, I really think everything had to change about SNAP. And I will say to their credit, the federal government approved a broad range of temporary flexibilities to mitigate a lot of these issues.

But really, the devil is in the detail of whether these flexibilities can be successfully implemented. Early in the pandemic in particular, states would often not get approval for waivers that were really critical to help families keep their benefits until days before or even after an action was due in a client's case. The reality is that states needed to know weeks in advance. They could be updating their eligibility systems and sending out notifications to people receiving SNAP of what was expected of them. And these issues unquestionably led to unnecessary confusion and problems in the pandemic response. I will say fortunately, the federal government did learn from a lot of its early mistakes, in late September Congress passed new legislation that allowed for a lot more flexibility in states being able to select waivers, they could deploy over a longer time horizon and customized to their specific needs and implementation approaches. And that approach, it worked a lot better for states to be able to proactively plan how they could use these waivers and transition over time to a new normal. In the months after that even both Congress and the administration made a number of additional changes to help states provide more equitable benefits access. So I would say even in just the short period of this pandemic response, we've already come a long ways.

Alyssa, I'd appreciate your reflections on this issue as well.

The pandemic really forced states to think differently about how they interact with and provide services to clients. Some of those changes were successful and others existing deficits in technology, staffing models or community partnerships that were really difficult or sometimes even impossible to adapt during the national crisis. So one example of a change that worked well was the expansion of telephonic case processing. So this allows caseworkers to support client applications over the phone instead of in-person or online. And federal policy really facilitated that by allowing clients to give verbal signatures over the phone instead of a written signature. Before the pandemic, states had some options to do this, but they were required to collect and store an audio recording of the signature and purchasing that technology to be able to do that was a major barrier. So only some states were doing it and it wasn't always fully available statewide. So this flexibility that allowed for verbal signatures was seen as a really successful low-cost option facilitating remote services.

Another change I'd consider successful was the expansion of the online purchasing pilot. So before the pandemic, only two states allowed SNAP participants to use their benefits for online groceries, and now almost all 50 states offer that service. And we know that there are still a number of barriers to access, so things like few participating retailers, high delivery and service fees, lack of delivery particularly in rural areas, but it does represent a big shift towards modernizing SNAP, which was long overdue. On the flip side states also experienced some challenges moving SNAP online, particularly in communicating these frequent program changes to clients, shifting supportive services like nutrition, education, and workforce training to a virtual setting and engaging people who might lack reliable access to internet or digital devices. Very few states were able to provide mobile friendly services to clients, most relied on mass communication through their websites or social media or call centers. And even though most states were able to transition their supportive services online, somewhat, they tended to have difficulty engaging clients in this new setting.

So you both painted a picture of things that may be helpful to know in the future if there's some crisis like the COVID-19 pandemic, but also there's a lot to be learned about the way SNAP might be changed going forward overall no matter what's happening in the background. So Matt, let me ask, what are you taking away from this experience about making SNAP stronger and more resilient?

Well, I think that's the million dollar question. So the first thing I think that sticks out to me, we really desperately need a playbook ready to go should we ever face a crisis like this again. The time it took to get legislative authority from Congress so we could get SNAP rules adjusted and then the process of developing and refining USDA Guidance has a real insignificant cost on the people in the communities that need help. Being able to come into a crisis where we've codified automatic triggers that are most essential for SNAP to be responsive during a time of crisis that would really ensure that state and local agencies can hit the ground running with a plan and knowledge of what flexibilities they can use and how to best deploy them. This is needed around a lot of different issues.

I'd say most glaringly, we need to be talking about SNAP benefit increases and looking at suspending work requirements during a crisis, but we also need to look at those administrative rules that make a really big impact on how people access and participate in services. So things like interview requirements, the way that people can recertify for benefits, the use of telephonic signatures, quality control procedures, and then things for particular populations that have specific needs, looking at student eligibility rules, purchasing of hot and prepared foods. These all come to mind to me as things that we really need to come prepared day one of whatever that next crisis is to be ready to respond, to be nimble and adaptive.

The second thing that sticks out to me is we have learned a tremendous amount about what works and what doesn't work in SNAP this past year, and we should use it to strengthen the program. Many states have found that the amount of meetings and paperwork that we're required to put people through, it really does little to preserve program integrity. What it does do is it places a lot of significant administrative burden on families. So less rigid interviews and change reporting requirements can help us cater the program to better support people that are participating. And I think federal pilots demonstrations that could test alternative strategy that could help states build the evidence for what best practices work and what contexts, that's really needed right now and the time is critical that we be thinking about that as we transition out of the pandemic.

Thanks, Matt. And Alyssa, what are your thoughts on this?

Testing ways to minimize participant burden is really critical. And what we've learned during the pandemic is that a big part of that is investing in technology to expand the ways that people can interact with SNAP. So one example that I think is helpful is thinking about what it's like to do your taxes now versus what that looked like even 10 years ago. So if you recall, you used to have to go to your accountant to file your paperwork in person, if they needed more information they had to call you, or you had to come back into the office. If you got a refund, you'd have to wait for weeks for your check to arrive in the mail. And now I can easily submit everything online. I can chat with an accountant on demand. There's a streamlined process to file state and federal taxes all at once. And I can easily track my refund on my phone and even have it delivered to my virtual wallet. So if we can use this best available technology to do our taxes, why can't we expect the same services for SNAP? And I think these kinds of changes that make it easier to get and keep benefits, not only have potential to break down barriers to participation and reduce participants stress and anxiety, but will also make SNAP much more adaptable and responsive in future crises.

We found that states were largely constrained by the technology they had available before the pandemic. Very few were able add or expand modes of interacting with clients while they were in crisis mode. And understanding best practices and providing these virtual services is key. So there's a real need for investment in technical assistance and research to help states better understand how clients interact with these remote services. What are some of their strengths and limitations and what are some of the access barriers for certain groups?

And then one last point I wanted to lift up is the importance of making SNAP more client centered. One thing I personally learned through this work is that state performance is evaluated using metrics like payment errors and application processing time, and this can come at the expense of customer and staff satisfaction. So in thinking about modernizing SNAP, it's really important to center the client voice and to really value the lived experiences of participants to improve customer service and to ensure that we're prioritizing equitable program access. Something that one state said that really resonated with me is we need to put the human back in human services.

So the report is co-branded and coauthored by Johns Hopkins and the American Public Human Services Association. So Alyssa, how did your two organizations come together to do this work and why do you think this relationship between the organizations is so important?

Alyssa - Working with APHSA on this was like a dream partnership. They have such deep working knowledge of SNAP policy which we try to understand as best we can as researchers, but can't possibly keep up with all of the intricacies of implementing these program changes on the ground. And the team at APHSA provided that policy context and made sure we were asking really relevant and meaningful questions. And they also offered a direct line to the people we really wanted to get our findings in front of. So often when you submit a policy research grant application, they ask about your plans to disseminate findings to key stakeholders. And depending on the research, it can be really challenging to figure out who to contact and how to communicate your message in a meaningful way. But for APHSA that's their bread and butter. So they already have these great relationships with Congressional and USDA staff, and they know exactly how to communicate the research in a way that will resonate with them. So that made getting the word out to policymakers really easy.

Matt - Recently, we had a chance to preview the final report with our state SNAP directors. And one of the comments that just really stuck out to me was hearing how this report is just a gift to have this kind of information readily available at your fingertips to be able to drive and inform future changes that are needed to make SNAP programs more equitable and resilient.

Bios:

Alyssa Moran has more than a decade of experience working with individuals, community organizations, and government agencies on food and nutrition programs and policies. Currently, she is an Assistant Professor of Health Policy at the Johns Hopkins Bloomberg School of Public Health, where she is Core Faculty within the Institute for Health and Social Policy and Impact Specialist in Obesity and the Food System. Her research, teaching, and practice focus on the role of food and social policies in improving diet quality, reducing food insecurity, and eliminating health inequalities. She is a registered dietitian, earned her MPH in public health nutrition from NYU in 2011, and earned her ScD in nutrition from the Harvard Chan School of Public Health in 2018.

Matt Lyons is the Director of Policy and Research with the American Public Human Services Association (APHSA). In his role, Matt is responsible for developing and executing strategies for policy advocacy and influence in areas impacting health and human services programs. Prior to joining APHSA, Matt served in a variety of roles in state and local government, including administering economic support programs for Maryland's human services agency, managing disaster recovery programs for the State of New Jersey in response to Superstorm Sandy, and coordinating the delivery of housing and healthy homes programs for the Baltimore City Department of Housing & Community Development. Matt also has worked for a non-profit research institute where he provided technical assistance, data analysis, and information system design and implementation for low-income energy efficiency and community services programs across the country. Matt has an undergraduate degree in Government and Politics and a Master of Public Policy from the University of Maryland.

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America's children and teenagers spend tremendous amount of time on the internet and never more than during the Coronavirus pandemic, with families at home so much, people ordered food, got news and engaged with family and friends online. Youngsters whose schools closed, relied on YouTube for educational videos, attended virtual classes on Zoom and to Google Classroom and flocked to TikTok, Snapchat and Instagram for entertainment and social interaction. This cost of digital immersion has a serious health downside however, because the nation's youth have been exposed to a steady flow of marketing for fast foods, soft drinks, and other unhealthy products. Today we'll be discussing a new report from the Center For Digital Democracy entitled, "Big Food, Big Tech, and the Global Childhood Obesity Pandemic."

Interview Summary

Our guests today are Jeff Chester, Executive Director of the Center for Digital Democracy and Senior Strategist Kathryn Montgomery, both are dogged and their work on this topic and in my mind are true pioneers.

So Jeff let's begin with you, before we dig into the nuts and bolts of the report could you explain to our listeners the role that data play in online food and beverage marketing? What kinds of data are the companies collecting and how?

Well today you no longer can separate marketing and advertising from data, data collection, data analytics, and data use, whether you're online doing any of the activities you just mentioned that kids were doing during the pandemic, where you go to the grocery store and use your loyalty card, go to the gas station, even pass a billboard, data about you is increasingly being collected, everything you do, everywhere you go, and not only you, what your family does and what your friends do and what your community does. All that is now collected and harvested. So personalized advertising can be delivered to you regardless of where you are and what you're doing. And food and beverage companies have been in the forefront taking advantage of all this data to push very unhealthy food marketing to children and teens.

So Jeff you painted this picture of a lot of data being collected of a lot of people and so I'm assuming this applies to children as well as teenagers when they're visiting the internet - that their data are being harvested and that gets used to market things specifically to them. So is that correct?

It works in a number of ways, even though there is a children's privacy law that supposedly limits the amount of data that can be collected on children under 13. In fact, companies collect huge amounts of data, they violate the law on children, and certainly teens are easily accessible by the data companies, but it's not just personal data, it's data about their families. So for example, the companies now know what mom and dad buy at the grocery store or the commercials even that the kids watch at home for example, when they're viewing streaming video or just regular television, so all that data is compiled. Let's talk about family data in addition to personal children's data, that's used to target advertising to them. What's important in the report is that today the food and beverage companies have become kind of Google's and Facebook's, the food and beverage companies are now leading data companies as well, which illustrates how much they value and understand the role that data plays in targeting audiences today, not just the United States, but throughout the world.

It’s a very concerning picture, especially given that there is a law meant to protect this population that's being violated. So we'll come back a little bit later and talk about what might be done, but Kathy, how has the COVID-19 pandemic impacted the way children and teens are being exposed to this food and beverage advertised in the digital world?

First of all, we know that children are already online in huge numbers, and that they're living their lives in this digital environment, they're conducting their friendships, they're interacting with people all over the world, using their mobile phones constantly, they are already in this digital ecosystem, as the industry likes to call it, 24/7. With the pandemic that was intensified, these young people were in greater numbers for a multiplicity of purposes. So they were perfect targets. They were in the crosshairs of the food industry and the tech industry constantly. And particularly for black and brown kids, this raises a lot of serious issues. And we also see some important intersections between the COVID-19 pandemic and the obesity pandemic, which is really one reason why we wrote this report. We wanted to have people understand how these two global pandemics are connected and that many of the young people who have been most at risk for COVID-19 have been those who suffer from childhood obesity and the related illnesses to that condition like diabetes, etc. These young people suffered from COVID and were more inclined to be very sick and sometimes die from it in greater numbers than other young people. And then at the same time, we have this huge pandemic of obesity that unfortunately in the US has fallen off of the public radar. That's another reason why we wanted to raise this issue and let people know about it. But in terms of black and brown youth, they are really in the cross hairs of the food industry. They are more avid users of digital media, they're on the gaming platforms in greater numbers, they're fully immersed and they're trendsetters for other young people. And the food companies have enlisted some of the icons of pop culture from these communities to promote some of the unhealthiest food you can imagine from fast food to sugar sweetened beverages and to do it through games, mobile technologies, every possible digital venue.

Let's talk just a little bit more about that if you wouldn't mind Kathy. So one might think that on the internet kids are just gonna be seeing the ads that they would have seen if they were watching TV, it would be similar things, they'd be seeing the sugar beverage company advertising its products with some athlete or some music celebrity or something, but you're painting a picture that's a little more serious than that. There are clever things that are done, it comes in different forms on the internet that can be especially hard to note as advertising, tell us a little bit more about that.

Kathryn - For a lot of people who as you say might have an understanding of commercials on television which we all can see and we can all get outraged about, but it doesn't work that way on the internet. The brands are really woven intricately into the inner relationships that young people have with digital culture. In gaming for example, you see brands woven into the so-called game play. It's done in a way that is personalized to each game player. They can crop up in the middle of a particular part of the game, they can be offered as rewards or ways to enhance your character's ability to fight a battle for example, or in some cases like with one of the Wendy's campaigns, they've created entire games based on character, so that's one example. And the other thing is that there's a lot of influencer marketing in this environment where influencers on social media will promote our brand to all their followers. And it doesn't look like advertising. It looks like recommendations, and it may be even more subtle than that.

Jeff - And unlike the commercials that many of us have grown up with, digital advertising is different, first place it learns about you. It learns what you like, what you do, how you respond, and it's able to change increasingly in real time. So for example, an ad or marketing message that you might view on your mobile phone is going to look different. It's going to be enhanced, adapted in some way. When you see the same ad, when you're on a gaming platform or a streaming video platform, these ads are increasingly personalized. And the ability to constantly track you wherever you go and use that data to create very relevant, engaging real-time advertising, which of course has been tested, measuring whether or not it triggers your unconscious and emotional spheres is one of the reasons why this powerful medium needs to be regulated.

So Jeff, the issue of marketing targeted this specific groups came up earlier, does that happen in this context?

Digital advertising works on an individual basis, on a group basis, the ability to leverage all the data that's collected today, and the fact that we live our lives in the pandemic enhanced that, on these digital platforms, enables the advertisers and marketers to create vast numbers of targeting categories. And also to understand that even if you don't buy, let's say junk food product X, that because of the habits of others who may have the same interest as you, but who do buy a junk product X, you're a potential target. And then they can then focus on you, even if you've never shown any interest in this particular food product. So there's just a growing number of ways to leverage data, to push unhealthy products, to young people that we've ever witnessed.

So I'm imagining that both the sheer amount of such marketing is of great concern, but also the fact that it's so precisely targeted and data are being used so effectively in this context probably gives the company as much more punch for every dollar they spend or every minute they have of your attention. So this is especially concerning. So Kathryn, what can be done to limit children's exposure to this type of marketing in the online world. And does the report make any specific recommendations in this regard?

We made a number of recommendations and we were so disheartened when we started this research that so little had been done recently, this was an issue that was discussed much more publicly. And a lot of us were involved in these efforts, not that many years ago where the concern about childhood obesity was really on the public agenda and companies were under some pressure to report to the Federal Trade Commission, for example, on how they were spending money to advertise to young people, and that has not happened in recent years. Interestingly, a lot of that has happened overseas. So in the EU countries, in the EU, generally in the UK and Latin America, there are stronger rules. And this issue is very much on the agenda. These are also global companies. So one of the things we've done in this report is to inform people about what's going on globally and to see how we need to look at U.S. policy in the context of global trends and the rising concerns in other countries about this issue. We have a long list of things that we recommend to policymakers and to companies. We think that the tech companies, for example, have some responsibilities and they've not stepped up to the plate on these issues. They play a major role here in the way they set up systems to facilitate and enhance this kind of marketing in the same way they did with the election. And what we learned from controversies over the Cambridge Analytica scandal, for example, so companies can do things to restrict what marketers can do on their site. So for example, we're very concerned that we need to do more to protect adolescents. They're very vulnerable to this kind of marketing. They're very much influenced by their peers. They have other kinds of vulnerabilities that make them particularly susceptible to the techniques that are used by digital marketers. We also believe that we need to look very closely at setting some clear standardized guidelines for what unhealthy food and beverages are. And I'll tell you everything we found in our report was unhealthy, whether it's the soft drinks or the French fries or the candies or the energy drinks that are commonly promoted aggressively on gaming platforms for example, we need to have clear guidelines about what can and can't be promoted. And we also need to focus on brands because if you restrict a certain product, but you don't restrict the brand, research has shown this causes young people to increase their consumption of unhealthy food. We list a whole bunch of techniques that are unfair and manipulative that needs to be addressed, particularly targeting black and brown youth. There needs to be a really clear focus on ensuring that is stopped.

So I'd like to ask Jeff in just a moment about some more of the policy implications for this and what might be feasible and effective in the context of what government can do. But Kathy, let me ask you one additional question. I know the food industry has for a number of years said, government doesn't need to regulate us because we'll regulate ourselves and they set up the children's food and beverage advertising initiative, which was an industry sponsored organization that was supposed to protect children from the marketing of unhealthy food, what happened to that? And why isn't that enough?

Kathryn - First of all they made sure that they only set up self-regulatory guidelines that applied to children under 12, not even 12 and under. So they've done nothing about adolescents at all. And they've been adamant about not wanting to do anything in terms of protecting adolescents. Most of the provisions focus on television, a few deal with digital, but not in a really adequate way. And generally what we see is there's no enforcement, there's no oversight. So you look at the techniques, you'll see that really these marketers are getting away with murder.

Jeff - And that's why the public health community and people who are concerned about public health and especially obesity need to start focusing on the food and beverage companies, as well as the platforms like Google and Facebook and take that snapshot because they are responsible for unleashing all these techniques, which we catalog. And until the industry feels the pressure, hopefully from regulators, these self-regulatory regimes will not in fact respond. What we found is not a secret. This is all known. And yet the people who were supposed to protect our nation's youth from this unhealthy group marketing simply have their heads purposely stuck in the digital sand.

So Jeff, are you any more optimistic that the social media platforms will have more effective self-regulation than the food companies do?

We're moving to a period of regulation, I think that the days of self-regulation are over, we have an unprecedented opportunity with the Federal Trade Commission now. President Biden has appointed someone who might be the most progressive champion of consumers and children and public health that we've had in decades. Her name is Lina Khan from Columbia University. She just took over a few weeks ago and we're seeing really a major overhaul. Now the Federal Trade Commission, which has the power to examine the data practices and the marketing practices, especially when it comes to the children and young people. We have a real opportunity to have the FTC act In this regard, in Congress, there is bipartisan interest to strengthen the rules that protect both young people and teens from a number of these data collection practices, which would have a direct impact on the ability of the companies to advertise and market junk food to them. And we're very helpful, right now we're on a path to try to reign in the power of big food and big tech, but it's certainly going to be an uphill battle. Too few people understand that the battlefield to protect young people's health in terms of obesity is really online.

It's nice to hear your optimism, that the FTC is one possible avenue for change. Are there other policy routes that might be effective? For example, can the states do anything on this level?

You are absolutely correct Kelly that the state attorney generals are taking a leading position in trying to break up Facebook and Google and Amazon really can and should play a role. The state of Ohio attorney general, a Republican has proposed that Google in essence, be declared a public utility, which would allow all kinds of regulation in state to protect the consumers, to protect the public. So, yes, there's also opportunities at the state level and even perhaps at the municipal level, in terms of the regulation of broadband, for example, or wireless communications, question is, is there enough capacity and interest and frankly support within the public health advocacy and professional scholarly community to start doing some of these things, because there's really just only a tiny handful of organizations working on this. And it's still frankly, very under appreciated.

Bios:

Jeff Chester is Executive Director of the Center for Digital Democracy (CDD), a Washington, DC non-profit organization. CDD is one of the leading U.S. NGOs advocating for citizens, consumers and other stakeholders on digital privacy and consumer protections online. Founded in 1991, CDD (then known as the Center for Media Education) led the campaign for the enactment of the Children’s Online Privacy Protection Act (COPPA, 1998). During the 1990s it also played a prominent role in such issues as open access/network neutrality, diversity of media ownership, public interest policies for children and television, as well the development of the FCC’s “E-Rate” funding to ensure that schools and libraries had the resources to offer Internet services. A former investigative reporter, filmmaker and Jungian-oriented psychotherapist, Jeff Chester received his M.S.W. in Community Mental Health from U.C. Berkeley.

Kathryn Montgomery is Professor Emerita in the School of Communication at American University, where she founded and directed the 3-year interdisciplinary PhD program in Communication. She is also Senior Strategist for the Center for Digital Democracy (CDD). Montgomery's research, writing, and testimony have helped frame the national public policy debate on a range of critical media issues. In the 90s, she spearheaded the campaign that led to passage of the U.S. Children's Online Privacy Protection Act (COPPA). She is author of two books: Target: Prime Time – Advocacy Groups and the Struggle over Entertainment Television (Oxford University Press, 1989); and Generation Digital: Politics, Commerce, and Childhood in the Age of the Internet (MIT Press, 2007). Montgomery’s current research focuses on major technology, economic, and policy trends shaping the future of digital media in the Big Data era. Her recent work includes numerous reports and articles on digital food marketing, children’s privacy, health wearables, and political microtargeting. She earned a PhD in Film and Television Studies from the University of California, Los Angeles.

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Evidence-based Policy relies on strong data and measurements. So if you want to improve a development target like nutrition, you need to be able to measure that. But with fisheries and aquaculture, we often don't have the metrics we need to make sound policy decisions. This podcast is a part of a series on fisheries and nutrition and a movement to bring fisheries into international food policy and programming.

Interview Summary

Welcome to the Leading Voices in Food podcast. I'm Sarah Zoubek, associate director of the World Food Policy Center at Duke University. My co-host today is World Food Policy Center alum and Michigan State University, fisheries social scientist Abigail Bennett.

We've got another full house of guests today with Harvard T.H. Chan School of Public Health's ecologist and epidemiologist, Chris Golden and fisheries planning analyst, Nicole Franz at the United Nations Food and Agriculture Organization, FAO.

So I'll just jump right in, garbage in and garbage out, is what I often hear researchers say when referring to making decisions based on bad data or essentially no data. In your view, what are some of the most important data and information gaps for fisheries and aquaculture, and then subsequently for developing policy that promotes their contributions to food and nutrition security.

Chris - One of the most interesting things is that as a society, we still don't know who is eating what and where. So we have all of this data on food production around the world. We have data on trade in many cases, but we don't really know who's eating things. What types of food they're eating, why they're eating it. And so all of these data are essential for us to understand food behaviors, nutritional status, and the emergence of sustainable food systems. Thinking about aquatic foods, we also have these same types of issues. Consumption data is really patchy. We also really don't understand how food is being distributed geographically within a nation by socioeconomic status, age group, or gender dynamics, we really struggle to understand how policies that increase aquatic food production or environmental changes that might shock aquatic food production, might have downstream effects on people's lives.

Nicole - Chris, you already pointed out really crucial gaps. So I would just like to compliment with two more. And the first relates to the nutritional value of diverse types of aquatic foods. Aquatic foods provide micronutrients and essential fatty acids, and obviously in a very different way between these different products. The nutritional value of a white fish filet is very different from the nutritional value of a portion of small dried fish that is consumed whole. And this small dried fish for example, is particularly important as part of the diet of large amounts of people, particularly in Africa, but also in Asia. So better understanding those nutritional values of the different aquatic food products can really make a major difference in ensuring that those who are most in need have access to highly nutritious and aquatic foods. For example, one way to use that knowledge and apply that information is through targeted school feeding programs.

A second data and information gap relates to the origin of aquatic food supplies. We often talk about catch about the production volume but there's less information currently available on the underlying production system. So who is catching that fish and what species is produced by what kind of production system. National catch statistics are usually not differentiating for example between large scale and small scale fisheries. But knowing these underlying production systems is really of crucial importance to inform food security and nutrition sensitive policies. Small-scale fisheries for example, they tend to fish a larger variety of species than industrial fisheries. And this variety then also tends to be consumed while what is coming from industrial fisheries, a good part of the catch is often not used for human consumption.

In 2012, the World Bank, FAO and WorldFish worked together on a study that was called Hidden Harvest: The Global Contribution of Capture Fisheries. And in that study, it emerged that half of the global catch in developing countries is in fact produced by small scale fisheries. Even more importantly, the study found that between 90 and 95% of the small scale fisheries landings are destined directly for human consumption. So this really provides a strong justification to understand what the underlying production system is, because it has policy implications.

Abigail - Nicole I'd like to ask you a little bit more about the Illuminating Hidden Harvest study that you mentioned and the kinds of data and metrics it uses to understand the contributions of small scale fisheries in particular to food and nutrition security.

Nicole - Thanks Abby. In fact, the Illuminating Hidden Harvest study was inspired by the 2012 Hidden Harvest study. It is expanding the scope to better capture the nutrition and food security aspects in relation to small scale fisheries. So we're partnering with WorldFish and with Duke University for the production of this Illuminating Hidden Harvest study. And this is an attempt to contribute to closing, or maybe at least narrowing some of the current data and information gaps by providing more evidence on how small scale fisheries in particular contributes to sustainable development. The methods we have developed consists in data that we collected from 58 countries and territories. We also have submitted a survey that was replied to by over 100 countries, and we're also drawing on existing global databases. So we're combining all of this information in order to better understand the contribution of small scale fisheries to sustainable development.

One of the things we're doing in the nutrition work is building on work that was conducted by Christina Hicks from Lancaster University to model the nutrient content from fish. This is also an attempt to model nutrient content more widely, and this should be helping to value catch in terms of nutrition rather than only in terms of economic value. The catches from small scale fisheries are really very valuable in terms of nutrient richness, especially in terms of calcium of iron and zinc. And these are three nutrients that are often lacking in the diets in particular in low and middle-income countries. So these findings are incredibly important from a policy standpoint because they're showing the need to secure small-scale fisheries production systems in the context of growing competition over access to water in coastal areas, but it really underlines the need to maintain those important food production systems that are servicing so much nutrients to in particular, the most vulnerable and marginalized parts of populations.

Within the Hidden Harvest study, we're also using an indicator of household proximity to fisheries to understand better how the consumption of fish supports the nutritional benefits of the consumers. And this has really helped to illuminate how important fisheries are for the diets, especially for some groups within the population, including children between six and 24 months, which is really critical window for nutrition. So having access to affordable nutritious aquatic food is fundamental and using this indicator of household proximity to fisheries, has really helped us to visualize how the benefits from small scale fisheries are distributed within a country.

Abigail - Thanks, Nicole, that's really exciting. How can listeners access the results when they're available or keep up with the study as it progresses?

Nicole - We have a website and we're also sending out newsletter and we're sharing how the study is progressing. And we are planning to release a study at the end of the year, and it will obviously be available online on the pages of the three three partner organizations, FAO, WorldFish and Duke University.

Sarah - Chris, you had mentioned various databases. Can you explain a little bit more how that's filling the data gaps for diet and nutrient considerations for fisheries and aquaculture? What are we measuring here?

Chris - There are so many different types of databases in different parts of the world being produced by different users and all of them are so important, particularly in the ways that they can be used together. I’m going to list the ones that I've used in my own work or am aware of. The Global Nutrient Database is jointly produced by FAO (the Food and Agriculture Organization) and IHME (the Institute for Health Metrics and Evaluation). And it produces an integrated nutrient supply estimate for all foods that are produced with the expectation that they are being consumed at the national level. And so you have consumption data that is then matched under nutrient composition tables to understand approximately the nutrient supply at the national level. If you do some modeling to estimate how those national supplies are being consumed at sub national level across age and sex groups, you can actually make estimates of nutrient deficiencies at the national level. This becomes really important in terms of targeting what types of food interventions or nutritional interventions need to be undertaken at national scales.

There's also something called the Global Dietary Database based at Tufts University that has aggregated most of the world's 24 hour recall data considered to be the gold standard for dietary assessment and has aggregated all data that was conducted in nationally representative ways, I think it's for more than 80 countries, to understand how food items are consumed, how they're distributed sub nationally. And so the information within that, that allows us to have an idea of how the Global Nutrient Database might be disaggregated at sub-national scales.

There's also a database called GENuS, Global Expanded Nutrient Supply Database. This is a unique database in that it is completely open access, it can be found online in the Harvard Dataverse and it also produces nutrient supply estimates that uses the FAOs food balance sheet data, and then assigns nutrient composition data to the food balance sheet data and corrects for ways in which production might actually be translated into consumption.

The last thing that I'll mention is that we have recently developed something called the Aquatic Food Composition Database. We noticed how important the diversity of production systems of species, of the parts of fish that people were consuming and how little we knew about the nutrient value of those different parts of fish. And we went through a systematic scoping review of all of the data that was available in the peer reviewed literature. We went through all of the national food composition tables, and we wove that together into one integrated database and we called it the Aquatic Food Composition Database. And this has more than 3000 different aquatic food species, inclusive of both plant and animal source foods, an entire suite of different nutrients. From iron, zinc, individual fatty acids, protein, vitamin A, vitamin B12, etc. And then also classifies data based on whether it was wild, farmed, what geographical region it was produced in, and the part of the fish that is being tested. So whether it's the filet, the liver, a whole fish, whether it's dried or fresh. So any processing that is involved before the nutrient analysis was done. I think with all of these different methods, all of these different databases, putting together all of these data and disparate parts, and these unconnected databases will be incredibly important to understanding how we can create more efficient, more sustainable and more nutritious food systems.

Abigail - Chris and Nicole, you both laid an amazing amount of work out on the table. And it's really exciting because it does seem like the field is inching closer to being able to connect some of those dots and do some triangulation on some areas where there's some uncertainty and data gaps. And so yeah, I do want to circle back around to this initial question that we posed, which is so what is the significance of this work collectively for policymaking? What does this data enable us to measure about fisheries and agriculture and what are some of the implications for making better policy?

Chris - I think one of the things to look at is the way that the aquaculture industry is really revolutionizing feed. We know that aquatic foods on average are so much more sustainable and have a much lighter environmental footprint than a vast array of different forms of animal source foods. So when we put it in that context, to think about the way in which feed products that go into agriculture, which is the dominant form of environmental impact for most of them and the way that they're being completely transformed by these interesting tech companies, to look at ways that we can use plant feeds with adopted or generated nutrient profiles that really improve the ultimate end product of nutrition. I think that that is something to definitely keep a lookout for, that will have incredible policy impact in terms of developing sustainable food systems.

And so one of the things that my team has been looking at is the degree to which fisheries management and specifically marine protected areas, could actually serve as a nutritional intervention. Conservation as a process could actually be not only a biodiversity and an environmental intervention, but also a public health intervention. And so the idea that a marine protected area could rehabilitate a fishery, provide spillover and increasing access to seafood to adjacent communities, is something that I think is so exciting to really reframe that mentally. And then to see if we can actually quantify the benefits of conservation to human health.

Abigail - And Chris does that serve as even an additional justification for fisheries conservation? Is it useful in that sense as well to kind of reframe these things like that?

Chris - I think so, absolutely. I think the degree to which we can think of all of these different sectors as serving multiple different purposes of the resource. And so to think of fisheries exclusively in an economic sense, really undermines so much of its true value and might lead to mismanagement from a fisheries management standpoint.

Abigail – Nicole, I want to turn it over to you and ask the same question. What types of policies do you think might emerge from a lot of the work in filling data and information gaps?

Nicole - I fully agree with what Chris just mentioned, and I think hopefully one of the major results of better data and information is that there's more integrated analysis across different policy domains, such as fisheries and nutrition. It would really allow for more coherence also across new policies. For example, these broader livelihood dimensions that are coming from the fisheries are really emerging and are valued. So by having this data, the fishery sector will really gain more recognition because currently we see often that it's overlooked, it's not taken into account even in food security and nutrition strategies in many countries. So by having more evidence about these values and these multiple functions of aquatic food within societies, this really should help better policy making and help to optimize the outcomes of these different policies that are playing together in a more coherent way.

There are a number of new global policy processes and policy instruments developing, taking aquatic foods more into consideration. One example are the Voluntary Guidelines for Food Systems and Nutrition. These Voluntary Guidelines were endorsed earlier this year and they specifically include aquatic foods. And we also see now in the preparations for the UN Food Systems Summit, that aquatic foods is entering more and more the preparatory process of this UN Food Systems Summit. They often call it blue foods instead of aquatic foods. But we see now that the attention is growing and that the number of informal dialogues and the number of events are organized around that theme because there is this recognition, that aquatic food is really part of the system and it generates all of these health benefits, which ultimately play out positively for society.

Sarah – And now one final question. What are you most excited about that's on the horizon for aquatic, or as Nicole said, blue foods?

Nicole - I'm excited about this increasing recognition of aquatic foods, beyond the fisheries policy domain. And one example, there's the UN, they just released for the first time a discussion paper specifically on the role of aquatic foods in sustainable healthy diets. I think that that is really quite important. This paper sets out a number of recommendations on how aquatic foods are part of the solution to really building resilient food systems and sustainable, healthy diets. There's one recommendation that specifically calls to democratize knowledge, data, and technologies, and to co-create meaningful knowledge and usable innovations. And that recognition of the role of data and information in this report, I think is quite powerful. And I hope that it will really kick off more work and more attention, and also the possibility to bring together all of the existing knowledge. Chris mentioned before, there are so many databases already out there, there's so much information, but this might be an opportunity to really connect all of these better and build analysis around it, that then can really be the evidence base for policy making in the future.

Chris - I completely agree with Nicole, this increasing recognition of fish and aquatic food products, it is incredibly important to elevate this recognition of how undervalued aquatic foods have been in the global food system. And one of the things I'm most excited about is not only raising the profile of that, but also integrating it and linking it directly into the terrestrial food system. We can't any longer deal with these two things as separate entities. There are enormous feedbacks in terms of the forage fish that are then used as fertilizer or feeds in terrestrial food systems, and the ways in which terrestrial food production, then leaches into affecting our rivers and lakes and coastal water systems. We can't think of these things as detached. We have to think of them as one integrative and holistic food system.

Sarah - I wanted to mention, Chris, the paper that you noted is called Recognize Fish as Food in Policy Discourse and Development Funding.

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Fish is food, right? Well, it hasn't always been treated that way in policy dialogues and development funding, according to a recent paper in AMBIO. Fisheries management practices and policies most often treat fish as a natural resource or a trade commodity, rather than an important contributor to food security. At the same time, food security policy and funding have focused primarily on agriculture instead of fish. This podcast is part of a series on fisheries and nutrition and a movement to bring fisheries into international food policy and programming.

Interview Summary

Welcome to "The Leading Voices in Food" podcast. I'm Sarah Zoubek, associate director of the World Food Policy Center at Duke University. My co-host today is World Food Policy Center alum and Michigan State University Fishery Social Scientist, Abigail Bennett.

So today we're also joined by two guests. Belinda Richardson, agricultural development expert from the Gates Foundation and International Coastal Programs expert, Elin Torell of the University of Rhode Island. We've asked Belinda and Elin to push and pull on ideas from our recent paper on fisheries policy published in the journal, AMBIO.

So Abby, can you help us lay the scene here before Elin and Belinda jump in? How could fish not be treated as food?

So in our paper, we describe how fish and food security policy are disconnected from one another. Let me give a couple of examples for our listeners. The UN sustainable development goal number two on zero hunger doesn't mention fisheries or aquaculture by name or outline specific guidance for them. The global nutrition report that tracks global nutrition commitments every year only mentioned fisheries for the first time in 2017. And the World Bank, a big player in agricultural development funding, has allocated only around two and a half percent of its agricultural portfolio to fisheries and aquaculture over the past decade, although this has ticked up to above 5% in 2018. So Belinda and Elin, why do you think fish has been so disconnected from the food policy arena and do you see this changing?

Elin: I would say that a major reason why fish has been a bit disconnected is because it's a common property resource. Fish doesn't have boundaries, it moves around. It's not as easy to manage as agriculture for sure. And there's so many different fish in the oceans, everything from our precious coral reef fish to small pelagics and large pelagics and so forth. So it's very, very complicated. I would say that for aquaculture, it's been really contentious both from an environmental perspective and I would say also from an equity perspective. Belinda, I'd love to hear your thoughts.

Belinda: The Gates Foundation is a relatively new donor coming into this sub sector of agriculture. The agricultural development team at the Gates Foundation began looking carefully at fish and aquaculture for its potential to impact poverty and nutrition only very recently in 2017. And we were surprised, frankly, at the size and the dynamism of the sector. So it's the fastest growing food sector, 10% annual growth per year. Demand for fish is growing fastest in South Asia and Sub-Saharan Africa and it's very important nutritionally. An estimated 3.3 billion people get at least 20% of their protein from fish. And as the nutrition community starts shifting from counting calories to tracking dietary diversity and the nutrient density of foods, fish becomes a very important source of essential macro and micro nutrients. And I think part of the challenge as a data-driven organization was really the lack of data and the complexities around data quality and availability affecting low middle income countries are not necessarily specific to the fishery sector. The data are particularly sparse for small scale fisheries and aquaculture. And so I think as more data become available through public and private investment from different innovations, we can see a bit more clearly how many people depend on fish for food, for livelihoods and nutrition and the sectors' impact on food security. And if I can just make one last point here, I think importantly as climate and the environment keep climbing on the global agenda, as Elin said, aquaculture's been very contentious. I think aquaculture and fisheries have their sustainability issues but fish is the most efficient animal protein, so it can really help to alleviate some of the pressure on land agriculture. So as we start to grapple with how to produce enough food within planetary boundaries, fish is going to be a necessary part of that story.

Thanks, Belinda. And you've mentioned funding development projects around fisheries and I'd like to drill down on that a bit further. So have the both of you seen the funding landscape for fisheries and aquaculture, or the narratives and dialogues around fisheries and aquaculture in the funding landscape change in the last 10 years?

Elin: The University of Rhode Island has been implementing international fisheries programs in developing countries since about the mid-1980s. And I would say that until about 10 years ago, our fisheries work was really under the umbrella of marine conservation to protect coral reefs and other important habitats and charismatic species and global marine biodiversity. But over the last 10 years, there has been an increased recognition of the importance of fish for food security in many countries but especially in West Africa and Asian countries like Bangladesh, the Philippines, Vietnam and this has opened up some possibilities for us to work on fisheries from a food security perspective. And to some extent, we are dealing with a different type of species under the food security umbrella. We're looking at small pelagics and other fish that are incredibly important for food security in many countries. And we've seen the US government and USAID fund multiple projects. I'm also involved as the deputy director in the Feed the Future fish innovation lab and there we do fisheries for food security programming in many countries around the world. I think another really cool shift is increased recognition of women's role, both as harvesters of fish and their roles in value chains and the importance of empowering women to participate both in fisheries management and in the production. We do know from our research and implementation of fisheries work that women are critical in the harvesting of fish and in feeding their families. So you really need to have women involved. Those are a couple of the shifts that I've seen. Now, I'd love to turn it over to Belinda.

Belinda: I can really only speak to the last three or four years since we've been exploring aquaculture at the foundation but we were actually really surprised to see the increasing interest in investment into the sector from both the public and the private sector. So it's increasing on countries' agendas, planning and prioritization. That means countries are either allocating money from their national budgets or they're taking out loans against those priorities to develop the sector. As Elin said, looking at not just food security but also economic growth and then adjusting policies to incentivize investment by the private sector. Investment by private sector itself has really been another signal. Industry's responding to the strong demand pool from consumers. So as populations and incomes are rising pretty much across the board, now with some setbacks due to the pandemic but hopefully that trend will get back on track. The demand for fish is also rising and while most of the innovation for high value species like shrimp and salmon has come from the private sector, these companies are really starting to recognize the importance and the opportunity in low and middle income countries and that includes large and small producers who rely on lower value species like tilapia, carp and catfish which we could consider more staple commodities versus like salmon or tuna, which are kind of the champagne of fish. And these lower value species and production systems could really benefit from the innovations that private sector brings in genetics, feed, aquatic animal health. That could boost productivity and profitability and supply more fish.

Thanks, Belinda and Elin. It's really interesting to have both of your insider perspectives on how some of that funding landscape has been changing recently. Are there challenges in development projects that are unique to fisheries and aquaculture, especially as compared to agriculture?

Elin: The fact that fish is a common property resource is definitely an issue because when you think about the geographies and your stakeholders, you know some of the sardinella, for example, in West Africa may swim across five or six countries. So how do you get all the right stakeholders and all the right people to the table? Not only decision makers but private industry and fishers and gear owners, boat owners have to come to the table. So that makes it very complicated. The second issue is the tension between conservation and productivity. We know that we need to have a sustainable fisheries in order to feed future generations. But in order to reach that sustainability, we may need to make some sacrifices in the short term through closed seasons or quotas or total allowable catches or whatever it is. And we could call that a delay in production and during those stoppages, people that are really dependent on fisheries for their livelihoods and for food security may be suffering. So that's a challenge I think we need to look at. How do we address that? What is our arsenal of solutions, whether it's through conditional cash transfers, through importation, private sector engagement? Those are some challenges that we need to address. Now, I'd love to turn it over to Belinda.

Belinda” So from the donor perspective, increasing investment into the agricultural sectors, you always run the danger of unintended consequences but because we've hit or are approaching the carrying capacity limits of our oceans and freshwater bodies, which basically means that over 60% of the world's fish stocks are now over-exploited beyond their biological sustainability limits, there's an instinct to say that we can fill that supply and demand gap with fish from aquaculture which at first glance is true and mathematically, the calculation works out but there are two challenges I want to flag. The one is nutrition and the other one is environment. There are a lot of challenges when we talk about sustainable intensification related to fisheries in aquaculture. You've got effluent hormones, antibiotic use, farmed and wild fish disease interface. But one in particular is the specific environmental trade-off around the fishmeal debate. So, fish for feed versus fish for food. 22% of fish landed in captured fisheries according to FAO is destined for fishmeal. The vast majority of that is human grade food. So if we're looking at the whole system, can we do a better job balancing this equation of where fish is coming from? And also, what are the more nutritious species? So from a nutrition lens, if we look at this problem, smaller marine or indigenous species that people might eat whole, for example, they've got calcium in the bones, vitamin A in the eyes, these are much more nutrition-dense than like a filet that you would eat from a salmon, for example. So just thinking a little bit more holistically about the nutrient content of these fish where they're coming from and the environmental limit.

Elin: I 100% agree with your comments about this debate between pitch food versus people food and where does the fish go? And I think that's why there's a lot of research going into alternate feed for aquaculture as well. And there's also multiple efforts to think about how we can use some of that fish that would go into fish feed and turn it into products that may be used for pregnant women and children in the first thousand days of life.

So I think it's always good to follow up a discussion on challenges with some successes. So I'm curious, what are some of the measurable impacts of the recent funding efforts that can already be seen or that we might be able to soon see from these investments in fisheries and aquaculture sectors?

Elin: I'm really, really proud of the work that we've been doing in empowering women cleaners. This is something we've been working on throughout the world in West Africa, East Africa and Southeast Asia. Some recent successes has been in West Africa, in the Gambia and in Ghana, where we worked with women who were harvesting oysters to both work with them to protect their oyster resources through establishing no-take areas or closed seasons and we've seen some improved stocks. We are seeing that the oysters are coming back and the women we are working with are really encouraged and they're continuing to renew their closed season on their own. We do see that economic empowerment is incredibly important. Some of our research in Malawi found that women who were generating an income from the fisheries sector have a higher negotiating power within their households. And they're more able to participate in fisheries management. And this is something we've seen also again in the Philippines and in West Africa. And our work in West Africa is starting to evolve now, moving from The Gambia and Ghana to other countries in the region. Our work with the small pelagics and a broader ecosystem approach to fisheries management is a lot more complicated. And while we're very hopeful that we're going to see good improvements in fish biomass over time, for now, I feel like our biggest wins have been at the enabling conditions and policy governance sites. For example, our work in Ghana. The government of Ghana has adopted a national fisheries co-management policy. And at the more local level we have community-based fishery school management plans that we feel comfortable that we've contributing to really set a base for seeing great measurable impacts, even though we haven't seen them yet.

So Belinda, I'm curious for you - what are some of the measurable impacts of recent funding efforts you feel like we can already see or that we might soon see in fisheries and aquaculture?

Belinda: So from the Gates Foundation perspective. There are some great technologies and innovations in aquaculture, specifically. We've seen technologies and innovations in aquaculture generate real results for productivity and profitability, even for very small scale producers in field trials. Looking at those technologies, that's really something that we'd like to build on. Take these innovations to scale, create sustainable market linkages for small scale producers, so hopefully increase livelihoods and nutrition. So just an example, with breeding and through new genomic tools, genetic gains result in fish with faster growth rates, more feed efficiency, more disease resistance which will be important with climate change as you get intensification. If you think about the large amount of small scale producers in low and middle-income countries and their low yields currently and then you multiply that by the productivity increases from these technologies, that's a huge potential. So hopefully, if countries can do this well, that translates into income for small scale farmers and better nutrition for a range of consumers. Along that impact pathway, The Gates Foundation is looking to these technologies and innovations to pick those up and disseminate those to small scale producers.

Thanks, Elin and Belinda. It's really exciting and encouraging to hear about those pieces of progress, ranging from technological developments, all the way to setting the policy and governance stage for these things to have impact on livelihoods and food security. So I want to end on a question that's a bit forward-looking and ask what are you most excited about that is on the horizon for fisheries and aquaculture?

Elin: I am really excited about working more on fisheries in ways that strengthens the role of women and youth in marginalized groups. I feel like we've made some headway on gender and I would love to bring some of those experiences into also including youth and marginalized groups and really try to find win-win initiatives where we can promote synergies between food security including nutrition, of course, and conservation outcomes.

Belinda, I'd love to hear your thoughts on this as well.

Belinda: Adaptation to climate change is quickly becoming a top priority for fishing communities and fish farmers. The people who depend on fisheries and aquaculture for livelihoods and nutrition and the majority of which are in these low and middle income countries and often the most vulnerable to climate change. This underlying vulnerability makes them particularly susceptible to the stressors and impacts from climate change. So if we think about this challenge also as an opportunity so everything that Elin mentioned around gender, some of these initiatives where you can have a win-win for nutrition and food security and also conservation and environmental sustainability, this seems like a really opportune time for fish to be getting more of a spotlight.

The paper we've discussed is available on the website that the Duke World Food Policy Center and the title is "Recognize fish as Food in Policy Discourse and Development Funding". Our guests today again are Gates Foundation's Belinda Richardson and the University of Rhode Islands' Elin Torell.

Bios

Elin Torell

Elin Torell is the Director of International Coastal Programs, Evaluation, Livelihoods and Gender at the University of Rhode Island Coastal Resources Center. She provides programmatic direction and selected technical support within her main areas of expertise: monitoring, evaluation and learning, livelihood development, gender mainstreaming, population and environment, civil society, fisheries management and environmental compliance. Elin has more than 15 years of experience providing technical assistance and leading complex and interdisciplinary projects in East Africa and South East Asia. She is an expert in project management and developing and leading strategic planning, monitoring and evaluation systems that foster learning within projects as well as across multiple projects. Elin has a Ph.D. in environmental studies, an MsC. in human and economic geography and a bachelor’s degree in social science.

Belinda Richardson

Belinda Richardson is a Fellow at the Bill and Melinda Gates Foundation, having also worked as a technical consultant for the World Food Program and as a teaching assistant at UC Davis, where she completed a Master’s Degree in Agricultural Economics and International Development.

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Can software help urban planners tackle food access in big cities? The UrbanFootprint organization says yes. Fast Company named it one of the most innovative social good companies in 2021. Our guest today is the company's co-founder and CEO, Joe DiStefano. He's going to explain how city data and geospatial information can inform critical planning decisions about where to invest and to deploy resources to achieve urban food system resilience and to better support communities.

Interview Summary

So, let's set the stage for our listeners. What is your view of the urban food insecurity problem?

Well, today, according to our data, about 19 and a half million, nearly 20 million households, are food insecure today, and that means they don't have the financial resources to confidently put food on the table throughout a week or throughout a month. That is a growth of nearly 50% since March 2020, when the pandemic began. So, we had places that were already significantly food insecure, or households that were experiencing a lot of stress when it comes to food security before the pandemic, but this has been a pretty substantial uptick. In some of the hardest-hit states we're looking at one in five households that are food insecure. I think even more troubling than that is that more than 12 million of these households report what we know of as food insufficiency, and this means not having enough food to eat at some point in the last week. So, some of these places, Mississippi, Louisiana, Texas, New Mexico, Oklahoma, those round out the top five right now according to our data. This is where 20% of households, and in some cases greater, are food insecure. What this striking number suggests is that existing relief programs and the existing kind of complex supply chain on the food insecurity side of things are not quite meeting the needs of some of the most vulnerable Americans.

You know, there's been a lot of attention to food insecurity during COVID, and I sure hope that when COVID is in the rear view mirror, whenever that comes, that people don't forget that it was a very significant problem to begin with. But boy, you make a good point about how it's been even worse during the pandemic. So, how does the data and a geospatial software program help with this problem? Can you describe the platform that you're building and tie that to the challenges that city planners and communities face?

Just as a really brief piece of background, so I spent about 20 years effectively playing SimCity for real; that was my job. Those of you who know that game, we did that for real, right? So, we were out there building data-oriented models of cities, and then experimenting with the impact of changes, so if you put housing here, or a transportation system here, what are the energy impacts, the water impacts, the health impacts. So, come COVID, we really oriented that data facility and that platform in the direction of some of these really challenging resource distribution issues, and this is not something I actually knew a lot about a year and a half ago.

We started doing work in Louisiana right about beginning of the COVID crisis with some folks that we had worked with in the post-Katrina, Rita recovery days in 2005, '06, '07, and one of the first things that we learned is that this COVID crisis is a very complex economic crisis. It was very unevenly distributed across communities, so in many cases poor Americans, non-white Americans were really adversely hit by economic impacts in particular. As those economic impacts started to unfurl on the landscape, we saw some very significant increases in need for things like food, very significant increases in eviction risk, very serious challenges around being able to get to test sites and medical facilities as transit systems that serve the most transit-dependent Americans turned off overnight, or dramatically reduced service. So, when we sat down with officials at federal, state agencies and relief providers in Louisiana, one of the first things we learned is that there was very substantial concern as to how to get basic needs like food to this increasing number of Americans that were needing it. So, we put our data systems to work to begin to understand that, so data that we have traditionally taken for granted as relatively static, like those transit system schedules, for example, those were now changing by the day.

So, we needed to begin to adjust information about transit systems in order to understand how people can reach healthy food. Unemployment, which used to change by 0.1 or 0.2 every six months, was now changing at double digits every week. So, we needed to start bringing in more dynamic feats around unemployment. And then, very importantly, because the COVID crisis was being experienced so unevenly at a fairly detailed level, like one neighborhood versus another neighborhood was experiencing COVID and the economic impacts of COVID very differently, we put a lot of our work that we had traditionally put into developing urban planning and detailed data down to the block level, for example, to work in order to understand how unemployment was ebbing and flowing across the landscape as well. What that ultimately led to was the ability to estimate the need for things like food relief at a much more granular level than has ever been available before.

So, we built these food security insight datasets, if you will, that now can map at the block and neighborhood level the level of food insecurity, the level of food insufficiency, and now, even more importantly, the gap between food distribution and participation in federal SNAP distribution programs, for example, and need. So, what we ended up doing was taking the same tech facility and prowess that massive companies like Amazon deploy in order to get you a toaster or an Xbox eight hours after you order it, somehow this thing arrives at your door. Why is it that that same kind of technology and that same kind of intellectual prowess can't be deployed to get relief to the most vulnerable Americans?

So, I can't tell you how impressed I am by the sophistication of this data and how detailed it can be going block by block, neighborhood by neighborhood. When you started looking at the data that you acquired this way, were there things that surprised you?

Some of the things that were most surprising or most telling, really, was again, at the granular level, the distribution of this crisis really is quite uneven. So, you look within a single city like New Orleans, or Baton Rouge, or any city in America, really, you're actually going to see very substantial differences even within a mile or two in the level of economic stress that's been experienced that was there before, in many cases, but then has really been heightened or been experienced in the COVID crisis.

So, places that have high concentrations of the sectors that have been experiencing such high unemployment are pockets of really, really deep pain and high levels of food insecurity, high levels of eviction risk. These are places that are dramatically less resilient than perhaps a neighborhood four or five blocks away from it. These are places that are least likely to be able to withstand the substantial shocks that have been coming their way, in some cases for decades that have really been sort of heightened and accelerated. So, health shocks like COVID, economic shocks like unemployment.

There are large subsections of cities, large communities that have been living at the edge for a while that the COVID crisis really sort of pushed over that edge, and so now the really substantial challenge is to ensure that relief in the form of food relief and food benefits, but also eviction relief, access to opportunity and jobs that can actually lift people above that edge.

Relief needs to be targeted into these locations, and it has traditionally been very difficult to reach these communities and to target relief to these specific places. You can't just drop relief at the county level; you actually have to really target it, and that's why we've built these datasets and that's why we've taken the detail that, say, an urban planner, or a developer, or an e-commerce company uses to understand the landscape and now begin to apply this to larger resource distribution problems like food, eviction, and other categories.

Let's get even a little more concrete. So, if you were a mayor, you were a city planner, you were a city manager, how would you take this information and do things differently than what's being done now?

Where we're seeing the most value for this data right now is actually at the front line relief providers, and then at the state agencies, and ultimately, hopefully, the federal agencies that are responsible for the distribution of these very substantial benefit programs. So, you think of the SNAP program, which is the federal food relief program, or rental assistance programs that are now coming down and being accelerated by the federal government. This kind of data can specifically do a couple different things. It can help to understand at a very detailed level and a very up-to-date level the scale of this problem. How big is this problem? How is it changing on a weekly basis or a bi-weekly basis? Is our program actually addressing the need? Do we actually see reductions in the need, or improvements in the outcome? Are people less food insecure than they were before?

Traditionally, we were using datasets that get updated every 18 months in order to estimate today's situation. It is not enough to actually understand whether a program is working. So, the first thing is just the scale, but really, the most important piece is that distribution of the problem. So, if you're going to reach the most vulnerable people, you have to understand where they are, and unfortunately, most of these programs are application-based programs. People literally have to fill out an application in order to get relief. If you want to apply for SNAP benefits or WIP benefits, these large federal and food insecurity programs that are then administered by the states, you have to fill out an application. Well, unfortunately, those that are most vulnerable, riding that edge, are not generally filling out those applications. In many cases they don't know about these programs. In other cases it's just really complex. The SNAP application is many, many, many, many pages long. It requires all kinds of information, and it's difficult to do it, so what ends up happening is that states and community-based organizations that contract with states are out there helping to enlist more people in these programs to get them aid. But you need data. You need to understand where these people are, and you need to be able to very specifically map the gap between application flow, in this case, and need.

So, what we're doing is we're mapping not just food insecurity, but we're now working with the first aid agencies. We don't bring in any personal, identifiable information. We bring in where the applications are coming from, and we map that against the need, and now we can clearly articulate where the gaps are. What that means is that community-based organizations and state actors and staff people can be going out and specifically targeting with marketing activities and other activities the locations of vulnerable households.

The real goal is to get more people enlisted in these programs. There is substantial resource out there. The federal government today, through the American Rescue Plan, the American Family Plan, it is dramatically increasing the pool of resources, but that does not mean that those resources are going to get to the right people. I very strongly believe that this is this once in many generation opportunity to use the same kind of data and facility, like I said before, that Amazon uses to get you a toaster, to get these people the resources they need in a very targeted way.

Boy, there's so many implications of this work, and I'm really happy that you could provide some concrete examples right there. So, could this technology be used to do modeling and to predict which neighborhoods might become in special need of services and things? Could you predict changes and factors that are going to lead to more food insecurity or eviction rates, or things like that in a neighborhood?

Yeah, absolutely, and actually, I would say that's much more consistent with the kind of work that urban planners and others do generally, and the kinds of things I've done for the past couple decades. And so if you look at a community, there are factors. For example, access to healthy food, which is a geospatial question. How many people are within a five or 10-minute walk of a grocery store, for example? We can map that, we can articulate that, we can index that across an environment. What are the particular sociodemographic characteristics of this place? What are the other urban characteristics of this place in terms of accessibility to facilities, transit access, access to opportunity?

If you put those things together you can really map... Think about a resilience index, if you will. One of the things that we've been working on is building out a community resilience index for every block in America. What that allows us to do is understand this relative resilience of every place across a city, across a region, across a state, across the country. Those things are really very strong indicators. Places that score low on this resilience scale are places that are more likely to currently have and to have more food insecurity, more likely to have eviction risk, more likely to experience some form of harm in a climate event.

So, for example, we do a lot of work with the energy utilities. This is all kind of in the same basic wheelhouse in order to help them understand where failure to the power grid is more likely to induce harm in a community, places where folks have higher levels of underlying health conditions, very low access to automobiles so those people can't get out of a situation if there's a heat wave, or if there's a fire, for example. These are places where grid failure will have an outside impact. Those are the less resilient places in American, and what I love to see now is at the federal level, at least on paper, we're seeing a very substantial reported investment in the resilience of these places. That is going to tackle the underlying causes of food insecurity, eviction risk, climate risk, which is really unevenly distributed. Certain communities are far more likely to experience adverse impacts of climate than others, and unfortunately, it's mostly the traditionally more disadvantaged communities in America, and so we really have a lot of work to do to rise the resilience of those places in order to address these multitude of issues.

So, one final question. Do you get a sense of how people in the communities feel about this sort of technology, and are there privacy concerns? Are there just things that one might not think about if you're just looking at the overall picture and not going into the communities?

There are certainly privacy concerns with all of this. I think people are rightfully skeptical when any technologist comes in and says, "Hey, technology's going to solve this problem." I absolutely do not believe technology is going to solve this problem on its own. This is a place where technology can absolutely help daylight and target a response, but it's not going to solve all the underlying problems. So, I think it's very important. I'm not saying that we've got some panacea here; not at all. Food insecurity alone has got a very complex supply chain. But what I can say is that we can be deploying some very substantial technology and AI and ML to serve this problem.

On the privacy side of things, yeah, I mean, people are specifically applying, providing personal information on the applications, for example. We go to pains to make sure that our systems never see that information, and that's very important from the perspective of trust, and also to abide by very specific regulations around privacy and security, in particular in states like California that have rightfully so aggressive rules around that. So, our systems never see the name, the address, or anything like that, nor do the systems need to see that. So, we're making sure that that is safe and secure and that we can do this in a way that protects the integrity of data and privacy, and respects those that ultimately are receiving relief.

Bio:

Joe DiStefano is CEO and co-founder of UrbanFootprint, a software company that serves the world’s first Urban Intelligence Platform to public and private-sector organizations taking on the urban, climate, and social equity challenges of the 21st century. UrbanFootprint’s data and web-based geospatial software unifies previously siloed climate, environmental, urban, and socio-economic data and helps governments, utilities, financial institutions, and urban and transportation planners to answer fundamental resource questions—where to invest, where to deploy resources, and where to optimize for risk, return, resilience, and community. Before starting UrbanFootprint, Joe spent more than 20 years as a leading practitioner in the urban planning and disaster response field, working with governments and enterprises across the globe in designing cities and new technologies to tackle critical challenges in climate, land use, mobility, hazard risk, and social equity.

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People who fight against anorexia and binge eating also struggle with secrecy, isolation and shame. Eating disorders such as these are incredibly powerful and relentless forces in the lives of an estimated 70 million people both male and female, by the way, according to the National Eating Disorders Association. For almost 30 years, author and storyteller Susan Burton of the hugely popular public radio program "This American Life" hid her obsession with food and the secret life of compulsive eating and starving that dominated her adolescence. She recently published a memoir entitled "Empty" as a way to confront her disordered eating and claim the recovery that comes from telling her story.

Interview Summary

So having worked in this area for a long time, I can't help but admire your courage and the vulnerability in writing such an intimate book about the struggle of your eating disorders.

I wrote it because I really found that I could write no other book. I started out trying to write a cultural history of the teenage girl, a book that would have intertwined that history with the story of my own adolescence but almost from the moment I sat down to write the first draft, this other story about the eating disorder that started in adolescence came out and was insistent. And I really resisted it for a long time. I was scared to write it but in the end, it was the thing that had the most urgency. It was so clear to me it was the story I needed to tell.

I know hearing the story will do a lot of informing to people about eating disorders and of the ravages that it can have on people. And then also give comfort to people who might feel comfortable coming out and telling their story, given that you have. So let's start at the beginning. How did your struggle with eating issues begin and what did it look like throughout your life?

Among the first stories that my mother tells about me are stories of my infancy, when I was a child who didn't like to eat. So it was always something that was in kind of the background, that Susan has the strange relationship with food. I was an unusually picky kid at the birthday party. I didn't want pizza. I wanted milk instead of Coke. But the way I felt about these preferences and food fears was I think sort of more important than the fears themselves. I had a lot of shame and unease with the fact that I ate in a way that was different from the rest of my friends.

So fast forward to maybe age nine which is when I went on my first diet. I wanted to look like another little girl at my swimming pool. This little girl, her legs were so thin that the legs of her swimsuit kind of gaped around them and that was what I wanted. I can't say exactly why I wanted that but I went on a diet for a week and my mother noticed immediately. She said, "You don't look like yourself. You're too thin." And that was sort of the last time for some years that I intentionally tried to lose weight. But then midway through my adolescence, my parents had divorced. I was sort of struggling to define who I was as many of us are in adolescence and also dealing with kind of the fallout of the divorce and that trauma. I unintentionally lost a couple of pounds in a stomach bug. And I found I had a feeling of lightness that I loved and I sought more of that feeling that I craved. And within a few months, I was anorexic and within a few months after that, I'd started binge eating which is a really typical trajectory: the binging following restriction, though I didn't know that at the time. But that sort of sent me into decades of using eating or not eating to manage uncomfortable feeling.

Wow, that's very powerful. So I think the friends and families of people struggling with eating disorders would benefit from hearing you explain something. Why is it so difficult to talk about this kind of a personal struggle and why is telling the story so important to recovery and survival?

It's such a good question. There's so much shame associated with eating disorders. And I think because a lot of us who have them blame ourselves. Eating disorders are illnesses. They're illnesses that can be treated. I was having a conversation with a fellow eating disordered woman the other day and she was saying, "You know, if you were depressed nobody would tell you, 'get over the depression yourself, treat the depression yourself, it's your fault.'" Actually, there probably are people who've had that message and probably times in our history when we have treated depression that way. But the point is that a lot of us blame ourselves for eating disorders and with, I think, especially binging, bulimia, any of the disorders that involve eating large quantities of food, there's a huge amount of shame, culturally, involved with the feeling of too much, of greed, of overeating. I think there's more shame associated with those than there is with anorexia, which is not to say that there's not also shame in anorexia but I do think that excess carries a particular kind of shame.

I agree with you that public education can be so important in this context because you're absolutely right. For somebody who struggles with eating less than ordinary, people say, well, how hard can it be just eat a little bit more? And then of course, people with binge eating issues, people say, "Well, why can't you just eat what everybody else eats?" And they don't realize how powerful and driven the impulses are that kind of drive this in the first place. And I think some more public education like what your book will do can be really helpful.

I think that that was among my motivations for writing it. I was so desperate for people to understand what this felt like. That it was a compulsion. That it's not easy to wrest yourself from.

So what did it take to motivate you to begin writing this memoir?

I think part of it was the feeling that this was the most important story I could tell but what I didn't realize until I was through writing it was that the most important thing that writing the book would do would get me to start talking about it. Because even though I told my story on the pages of this manuscript, I still wasn't really talking about it with the people closest to me in my life, with the people kind of at the next outer circle of my life. I wasn't even in therapy until I had a finished draft of the manuscript. So the book is the telling of the story and it's my own attempt to understand what happened. But talking and talking about it with others is I think the next step in my recovery and that's where I am now, talking about my story with others and trying to understand it that way.

We'll come back to the issue in just a moment of recovery and whether it's ever complete. But let me ask another question first. So some people think about eating disorders in the context of addiction and believe that curing the disease might look the way that alcoholics might tackle their addiction, let's say. So you've made that point that this analogy misses an important way of looking at things and that the process of recovery is never done. How can you explain please?

For a long time, I was always drawn to stories of addiction because I experienced my binging as an addiction and I thought that that sort of explained the illness. But my solution then, as a young woman in my twenties, was to essentially quit food. Was to become anorexic, which is not a solution. Which is perilous. Which is delusional. Which I was lucky to emerge from into the healthy woman that I did. So you can't quit food. Food is everywhere. We need food for nourishment. We want food for pleasure. Food is something that we can experience with others.

And so we have to find a way to live with this substance and maybe even learn to take pleasure with this thing that we feared might destroy us. But I will say and maybe this is leading to where you're going, for a long time, I was really invested in this idea that my binging had been an addiction and I wanted to sort of tease it out and figure out was the addiction to the substance? Was the addiction to the behavior? And those questions are still of great interest to me. But I think where I am in my process now is I'm extremely interested in, okay, well, what does recovery look like and what does that mean in terms of an eating disorder? What do the academic journals say it means and what do people who've been there say it means? That's the question that's really present for me right now.

So do you believe that recovery can ever be complete?

I mean, it depends on how we define complete. When I say it's a question I'm actively puzzling through, I really am. I think at the beginning of my work in therapy, I would have said I just want to think about food like a normal person. You know? I don't want to be so preoccupied by it. But you know, then as I got a little further into the process I realized, well, recovery is not just about changing my relationship to food, it's about looking at all the reasons that I use food in the first place and developing all of these other ways of coping that I've neglected, so that's part of my recovery too. Will I ever wake up in the morning and eat in sort of an intuitive way? I don't know. Like I said, one of the first questions you asked me was about trajectory with eating stuff and from a young age, I was always weird about food. So if we think of the etymology of the word recovery, it means sort of a return, or going back. And I think I'm trying to make something new. I feel like it's probably not an answer to your question. I mean, I'm actually curious about what you think the answer is. Is a complete recovery ever possible?

It differs from person to person and some people may feel it's behind them and all as well and then behave as such and everything is okay. And other people, it's a constant struggle and they have to really remain on top of things. So it probably varies a lot from person to person but it's interesting that you brought that up because I do believe it's a fascinating issue. Something else you mentioned a moment ago I find fascinating as well, back to the addiction topics. You said you weren't certain if you felt addicted to the food or the behavior. There's some interesting nuance there. Could you explain that?

This is something where I am coming at this very much as a lay person reading stuff in Google scholar. So take it as you will. But as I understand it, there's somewhat of a debate in the field whether the addiction is to the foods themselves, to say sugar, to highly processed foods, or is it a behavioral addiction more in the mode of gambling or shopping? So there's a neurological response of a dopamine hit but is that coming from the repetition of the behavior, or is it something that's coming from the food itself? I'll say for my part, when I was in the throes of binging, I felt something physiological. Like I felt like I needed sugar, I needed it to lift me up. I needed it to move and in that sense, it felt like my body was craving something. But at the same time, I also recognize that the way that a binge often followed a disappointment or just a feeling of unease, that's maybe more of a behavioral compulsion or pattern.

Of course, there could be a combination of the two. Biological things get turned into behaviors that then become compulsive and driven themselves. So, you know, there's work on food and addiction now that I know you're aware of and that combined with your personal experience really paints a fascinating picture. And boy, is there indeed for more people to be looking into this. Let's change tracks here just a moment. So you're a parent now of two sons. Congratulations.

Thank you.

How did becoming a parent add a new dimension to your struggles with food?

I was very aware that I didn't want to repeat some of the things that I'd grown up with. So for instance, I have a very vivid memory of back to school shopping with my grandmother when it was August before I was going to enter fifth grade and my sister and I were in the little dressing room and I was trying out a plaid kilt. And I remember my grandmother clapped her hands together and she said, "I'm so glad I have thin grandchildren." And that was kind of the family we grew up in. And there was a lot of emphasis on body size and on being thin. So I knew that I didn't want to send them messages like that. But what I didn't realize was that I was really still locked inside anorexia in a way that I was kind of blind to for much of their childhoods and I was also anxious and fearful about food in a way that I'm sure that I transmitted to them without being totally aware of it. So now my focus is on being able to talk about these things openly because secrecy was so harmful to me in terms of my eating disorder but also in my family of origin, there was a lot of secrecy that I think perpetuated my own secrecy. So being able to talk about these things together has been a really wonderful and healthy outcome of telling my story.

Bio

Susan Burton is an editor at This American Life. Her writing has appeared in The New York Times Magazine, Slate, The New Yorker, and others, and she is a former editor of Harper's. The film Unaccompanied Minors is based on one of her personal essays. She lives in Brooklyn with her husband and their two sons. Her memoir book Empty was published by Random House.

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Food insecurity strikes all corners of American life including the lives of military families. For the currently serving military families there is a barrier that makes it more difficult for them to qualify for needed assistance from the SNAP program. A person who knows a great deal about this is Josh Protas, Vice President of Public Policy at MAZON, A Jewish Response to Hunger, which is a national advocacy organization working to end hunger among people of all faiths and backgrounds in the United States and in Israel. This is the third in our series of episodes on food insecurity, done in partnership with MAZON.

Interview Summary

So, let's dive in and begin by talking about hunger and food insecurity in military families. So, when did you first learn about the phenomenon in this population?

So, let's just start by recognizing how shocking it is to talk about military families and food insecurity in the same sentence. It's remarkable that we even have to have this conversation. MAZON learned about these issues about a decade ago. We started to hear from a number of our partner agencies, food banks and food pantries around the country about an uptick in the number of military families that they were seeing coming, really out of desperation, for emergency assistance. Around that time also, there was a session at the National Anti-Hunger Policy Conference on military and veteran food insecurity and MAZON'S President and CEO, Abby Leibman and Mia Hubbard, our Vice President of Programs, were at that session and heard about some of the issues that came up. And then people left the session and that was it. Food pantries and food banks were doing important work, serving military families with emergency assistance, but there were some policy issues that were being ignored. And MAZON started looking into these issues to understand what was going on and recognized that there are some separate, and somewhat related issues, for currently serving military families and then the veteran population as well. For the currently serving military families there is actually a barrier that still exists, that makes it more difficult for them to qualify for needed assistance from the SNAP program.

You know, you're right. It's discouraging and depressing that this problem exists, but of course it exists in such a widespread manner, that it's all over. So, what are the challenges and the circumstances that military families face, that can lead to food insecurity in the first place? I mean, I assume not having enough money is the biggest problem, but what else?

So, not having enough money is part of the picture. I think some historical perspective is important here because the composition of our armed forces has changed. Historically it was single individuals who enlisted in the military, and single men really, And the housing for those single men was primarily on-base housing. The composition of our military has changed over time and also the way that we house our troops has changed. So, we have many more military families that serve. It's not just the individual, but it's a spouse and children that serve with them in a way. And at the same time that that's been happening, the majority of our military housing has moved to either off-base, or privatized housing. The reason that this is an issue is because those who live off-base, or in privatized housing receive a basic allowance for housing benefit from the military. The issue around food insecurity is that that BAH, the Basic Allowance for Housing, which is not treated as income for federal income tax purposes and for determining the eligibility for most federal assistance programs, the BAH is treated as income for the Supplemental Nutrition Assistance Program. And as a result, when you take the base pay, which is often low for a junior enlisted service member and you add on top of that their BAH, it makes them ineligible to qualify for SNAP. And the added complications for military families are exceptionally high rates of spousal unemployment. Before the pandemic, the rates were hovering around 22 to 24% and that didn't even take into account underemployment, or employment that was below professional training. Since the pandemic, those rates have been spiking. Close to a third of military spouses that want to work are unemployed. And so, when you just have a single source of income, that low rate of base pay for junior enlisted personnel, it can be really tough to make ends meet.

Well, what a remarkable set of challenges those families face and you can see why food insecurity would be such a big problem. So, can you tell us how MAZON is addressing this issue?

MAZON has really focused on the policy challenges and policy solutions that can make a difference around military food insecurity. Trying to remove that barrier to federal program has been the core of that work. We've approached it on a number of different fronts, both in the Obama administration and in the Trump administration and now in the Biden administration. We've been pushing for administrative changes to get the U.S. Department of Agriculture to exclude the BAH as counted income, so to remove that barrier to access SNAP for military families that really need that help. We've run into a number of obstacles through that administrative course of action, so we've also been addressing this legislatively and have pushed for proposals in the farm bill process. And most recently, the farm bill that was signed into law in 2018, unfortunately did not include a fix for this. As a result, we've gone through the National Defense Authorization Act, which is must-pass annual legislation. MAZON was instrumental in crafting a proposal that would be a bit of a workaround. It wouldn't address SNAP specifically, but the Military Family Basic Needs Allowance, which we helped to write as a provision, is part of the NDAA process that would give some added cash assistance to junior enlisted personnel whose households are at, or below 130% of the federal poverty level. We've had bipartisan support for this provision. It was included in the House version of the NDAA bills the past two years. Unfortunately, there's been some Pentagon opposition to this and the Senate did not include the provision in their version of the bill and it has not been signed into law yet. So, we're continuing to push for that in the current NDAA process and also working on engaging the administration. We've met with the First Lady's senior staff and staff from the Domestic Policy Council and National Security Council. The First Lady has re-instituted the Joining Forces initiative to focus on military families and their unique needs and challenges. So, we're hopeful that there's a growing awareness about this issue and a growing commitment to take some common sense targeted actions to really help those who are serving our country, to make sure that they never have to struggle to put food on the table.

I'm impressed with how sophisticated and persistent your policy efforts have been in both on the administrative and legislative fronts. Are you optimistic that things will eventually change?

I've been working on this issue personally for the past eight years. I've put a lot of time and energy into it. It's been a major area of work for MAZON, so, I'll feel comfortable and comforted when we get it done. I don't want to get too optimistic. This issue is common sense, as it is to address it has been so stubborn, finally get resolved. So, I don't want to be complacent at all. There are some reasons to be more optimistic that we'll be able to push this further. Certainly the change in the Senate, the new administration, signal some better opportunities, so I'm hopeful on that front.

Now, have been some recent stories about food pantries and other charitable organizations providing emergency relief to military families. And this is something you alluded to earlier. How adequately, do you think, they're addressing the issue?

So, the food pantries and food banks that are addressing this issue are really doing that at a surface level and they're doing very important work to respond to emergency needs. But for military hunger and for hunger in this country, in general, the charitable sector does not have the capacity nor was it set up to have the capacity, to fully address food insecurity issues in this country. Only the federal government has that capacity, has the resources, has the breadth and leadership to really address hunger. And we need policy solutions to deal with this. There are food pantries operating on, or near, almost every single military base in this country and there's no reason that should happen. Those who are serving our country bravely should never have to worry about meeting their basic needs. They should be paid adequately and they should be able to access resources in federal programs that are available, to provide some extra assistance if they need it. So, turning to a food pantry out of desperation shouldn't be a routine case. The pantries that are operating near these bases are serving the same families month in, month out, hundreds, sometimes thousands of families, at different installations. And that shouldn't happen. We should be able to make sure that those households, either get additional pay to make sure that they can meet their basic needs, or able to get benefits like SNAP, so that they don't have to turn to the charitable sector. And food pantries are already spread thin. They can't pick up any more slack. Certainly the needs have been spiking because of COVID-19 and the economic downturn. Our federal government needs to step up. The ARP that recently was signed into law is a huge step forward with the, SNAP benefits, but that's time limited and eventually that will expire, so more robust support for our federal safety net programs is critical. And certainly for military families, we need to remove those barriers and fill that gap.

You've been speaking, in a very detailed way, about food insecurity in military families. What is the scope of the problem among America's veterans?

Great question. And the issue for veterans is different than for currently serving families, but related. So, MAZON has been working on this issue, veteran food insecurity, for a number of years as well. We held the first ever Congressional Briefing on veteran food insecurity back in 2015 and invited leadership from the United States Department of Agriculture and the Department of Veterans Affairs to join us. And we learned, at that time, that the VA system was not doing food insecurity screenings as a standard practice. And if you're not asking the question and you're not screening to see who might be struggling, then you can't address the problem. So at that time, MAZON pushed really hard to get the VA system to start asking the questions, to start doing the food insecurity screenings that were so critical to identify those who are at risk in order to be able to connect them with available help. Really pleased to say that couple of years ago now, VA system has started doing these food insecurity screenings which has been an enormous step forward. The screenings that they were doing were just a single question, which probably were insufficient for fully capturing the scope of the problem and identifying all who might be at risk. It looks like the VA system is moving towards a question panel as part of its Clinical Reminder system, the hunger vital signs, which is a validated instrument that includes two questions to really identify who may be at risk of food insecurity and the severity of that food insecurity. Where there's a need now is connecting those veterans who are at risk of food insecurity with programs like SNAP and that's not happening as a routine practice through the VA system. And there's also a need to connect veterans who do not receive care and services through the VA system with resources like SNAP.

MAZON has been working with the VA. We assigned a memorandum of agreement with the VA system this past year and we've also worked with veterans service organizational partners to create resources and trainings. We created an online training course with the PsychArmor Institute, aimed at service providers who work with veterans to make them better aware of food insecurity among the veteran population. Some of the unique challenges, including shame and stigma that might make veterans reluctant to seek help and to direct them towards their state's SNAP agency, so that those who might be struggling in resources that they're eligible for and entitled to. A recent study about veterans who are food insecure, found that of those who are eligible for SNAP, only about one in three actually participate in the program. So, that means that two thirds of veterans who are dealing with food insecurity, are eligible for SNAP, are leaving those benefits on the table and are struggling needlessly. So, there's a real need to help close that SNAP gap for veterans. It's the right thing to do. It will help support better health. It'll realize long-term healthcare savings and it'll help those veterans who are trying to support their families, better able to take care of them.

Bio:

Josh Protas is the Vice President of Public Policy and heads the Washington, D.C. office for MAZON: A Jewish Response to Hunger. In this role, which he assumed in 2012, Josh coordinates and implements MAZON’s advocacy agenda, including efforts to protect and strengthen the federal nutrition safety net, with particular emphasis on the food security needs for seniors, veterans, and military families. Josh has extensive experience working at Jewish communal agencies at both the local and national level including as Director of the Jewish Community Relations Council at the Jewish Federation of Southern Arizona and as Vice President and Washington Director for the Jewish Council for Public Affairs. He previously served as a member of the board of directors for the Coalition on Human Needs and currently participates as part of the Vote Advisory Council for Food Policy Action. Josh earned his M.A. in Western American History and Public History from Arizona State University and his B.A. in American Studies and French Literature from Wesleyan University.

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Today's guest, Dr. Robert Paarlberg, is the author of a provocative new book entitled: Resetting the Table: Straight Talk About the Food We Grow and Eat. The book is presented as a clear-eye, science-based corrective, to misinformation about our food: how it's produced, food companies, nutrition labeling, ethical treatment of animals, the environmental impact of agriculture, and even more.

Interview Summary

So Robert, The New York Times praised your book for - and I quote here - "Throwing cold water on progressive and conservative views alike." What an accomplishment that is, and with an intro like that I can't wait to talk to you today, so thanks so much for joining us. So let's begin here, your new book highlights a number of dietary health shortcomings in America but you say these do not come from our farms or from farm subsidies. Can you explain, where do they come from?

Clearly we have a dietary health crisis. Only 1 in 10 Americans is getting the fruits and vegetables recommended and meanwhile we're eating far too many ultra-processed foods with added sugar, salt, and fat, which is why 42% of adults are now clinically obese. I mean, that's three times the level of the 1960's and one result is approximately 300,000 deaths a year linked to diabetes, cardiovascular disease, and cancers. Now, some food system critics have tried to trace these problems back to the foods grown on our farms. That is, not enough fruits and vegetables and too much corn and soybeans and farmers in America do produce a lot of corn and soybeans but stop and think, nearly 60% of the soybeans are exported. So they never enter our food supply and more than a third of the corn is used to produce auto fuel. So, that's out of our food supply as well. And we've used imports to make an abundance of fruit and vegetables, available in the marketplace. Half of our fruit is imported, one third of our vegetables are imported, often, off season when it's too cold to grow these things in North America. Thanks to these imports, the per capita availability of fruit in the market today is 40% above the 1970 level and the per capita availability of vegetables is 20% above 1970. Actually, per capita, availability of broccoli today, is 13 fold what it was in 1970. So, what our farmers grow, is not the same thing as what consumers eat and very quickly, as for farm subsidies, they're often criticized for making unhealthy foods, artificially cheap but they actually do just the opposite. We have to remember the purpose of farm subsidies is to increase the income of farmers and that is best done, it's usually done, by making farm commodities artificially expensive, not artificially cheap. Farm programs make sugar, artificially expensive by keeping foreign sugar out of our domestic market, raising the domestic price by about 64%. We make wheat and wheat flour and bread artificially expensive, through a conservation reserve program that pays wheat farmers to keep their land in western Kansas idle for 10 years. And we make corn artificially expensive. It's said, that we're living with a plague of cheap corn, but it's just not true. We have a renewable fuel standard, that takes a third of total corn production out of the food market, for uses, auto fuel, and that drives up the price of soybeans as well because soybeans and corn are grown on the same land.

So back to the question then, if the dietary problems don't come from the things that you just mentioned and you make an interesting case there, where do they come from?

I put a lot of blame on food manufacturing companies, on retailers and on restaurant chains. These are the companies that take, mostly healthful commodities, grown on America's farms and ultra process them, add sugar, add salt, add fat, turn them into, virtually addictive, craveable products and then they surround us with them, all day long and they advertise them heavily, including to children. I believe we are drowning in a swamp of unhealthy foods, produced not on our farms, but downstream from farms by these food companies. Now the food companies say, "Oh, well, unhealthy eating, we're not responsible. It's an individual eater's responsibility, to decide what he or she puts in his mouth." But I don't buy that. I mentioned that obesity rates in the United States today, are three times the level of the 1960s. It simply isn't true, it can't be true, that American eaters are three times as irresponsible, as they were in the 1960's.

Companies can't be blamed, I don't suppose, for trying to maximize sales of their products and trying to maximize their desirability. How does it become a problem with the food industry though?

If a shoe company sells us too many shoes that we don't need or a toy company sells us toys we don't need or an auto company sells us a fancy auto with features we don't really need, that doesn't become a public health crisis, but when food companies make products that are almost impossible for most consumers to resist, if they consume them then, in excess and it does become a public health crisis, that's a different sort of problem. In a way, I don't blame the companies because as you noted, they compete fiercely with each other and if anyone were to try to go first to offer product lines, that weren't latent with excess sugar, salt, and fat they would lose market share. These companies actually need the government to step in and provide a common discipline on all of them. Either, in the form of excise taxes on sugar-sweetened beverages or regulations for, at a glance, nutrition guidance labeling on the front of the package or perhaps, restrictions on advertising food to children. If you look at the countries in Europe, 18 European countries have at least one of these policies in place. The continent of Europe has obesity prevalence, only half as high as that of the United States. So here, I think if we can learn something from Europe and use government policy to protect the companies from the kind of damaging competition that they've fallen into.

Given what you said about rates of obesity, it's important for people in many countries of the world to just, eat less food and of course, eating less food creates problems for the industry. So, it seems like, on one hand, the government to say, "Well, listen, why don't you require us all to gradually reduce the sugar in our products or the salt or the fat or whatever, so that we're all on the same playing field." People get calibrated to a lower level of these things and everything will be fine, but everything won't be fine because if those foods become less palatable, people will eat less and the companies will suffer from that. So, my guess is that that's why there's no appetite, if you pardon the pun, from the companies to do this kind of thing and why there's gonna have to be government regulation that overrides the company's political interest or even litigation to help drive this, what do you think?

I'd like to see strong public policies. Whether you call it helping the companies to, avoid their worst instincts and protecting them from damaging competition or imposing on them, a public health obligation to market fewer addictive and unhealthy products. I think, there's a great deal of room for public policy here and no matter what you call it, the companies by themselves, have created a problem that, it's unlikely they will solve, by themselves. In my book, I look at a food service chain, Applebee's, they realized, that their comfort food was not setting a proper health standard for their clientele and they tried to, change their menu, to take the, all you can eat riblets, off the menu and they lost customers. And so they got a new CEO and they went back to the old menu and their profits soared again. Companies sometimes try, they sometimes want to do a better job but in a unrestricted, competitive marketplace it can be suicidal. So, I think we should, in their own interest, as well as in the public health interest, put some restrictions on the marketplace or at least some guidelines

So let's move on to a little bit different topic. So your book questions some popular narratives, including suggestions that there should be more local food to scale up the consumption of organic food or say, to build supermarkets and food deserts.

Well, if you look at them one at a time, you'll see that they probably wouldn't improve our dietary health. If we relocalized, our food system, we would have to replace all those imported fruits and vegetables I mentioned, also seafood. If we tried to, replace those, with locally or at least nationally grown products, it would be possible to do, with enough greenhouses, but it would be very difficult and very expensive for food consumers in Chicago or New York or Boston, in the Northern latitudes, where many food consumers live. So, the price of healthy food would go up in the marketplace and we don't consume very much local food today. Actually, if you look at all of the direct sales from farmer's markets and CSA's and pick your own and roadside stands and farm to table and farm to school, it's only 2% of farm sales. It turns out that, we're not scaling up local. Consumers want more variety, they want more convenience. They want those things year round. I mean, we're actually going in a globalized direction. In 1990, we imported only 10% of the food we consume. Now we're importing 19%. Organic, it's a little bit similar. Currently only 2% of farm sales in America are certified organic products. The number's low because organic rules prevent farmers from using any synthetic nitrogen fertilizers and they're the most important source of productivity in conventional farming. Trying to scale up organic would make healthy food again, more expensive. Organic produce costs, on average, 54% more than conventional produce. If consumers had to pay 54% more for fruits and vegetables, they would buy less and eat less. Now, there are food deserts, where there is a relative shortage of supermarkets but there isn't any good evidence that building a supermarket in a food desert will improve dietary quality. In part, this is because supermarkets sell so many unhealthy foods. The Robert Wood Johnson calculates that only 30% of the packaged products in supermarkets, can be considered healthy. About 90% of the packaged products in supermarkets, are ultra-processed. So, a supermarket is really, a food swamp, surrounded by, a perimeter with some healthy food products and adding those kinds of markets to a poor neighborhood does very little to change a dietary behavior. And it's food swamps that are the problem. And it isn't just corner bodegas and convenience stores that are part of the food swamp. Even pharmacies now, are part of the food swamp. When I go to my CVS to fill a prescription, I have to walk through aisle after aisle of candy, soda, snack foods, junk foods to get to the pharmacy counter. So, I can try to protect my health and spoil my health in a single visit.

Interesting way to look at it. Let's end with this question. So in your book, you have favorable things to say about plant-based imitation meats and you chide the food movement activists for rejecting these new products because they're processed, why do you defend them?

Well I don't defend them on the strictest nutrition ground. An impossible burger or beyond burger isn't much better for you than real beef patty, particularly if you have it with a soft drink and fries, but I defend these products as substitutes for real beef because for environmental reasons, they have a carbon footprint that's 90% smaller than a real hamburger and they use 87% less water, 96% less land and also, risks to human medicine, that come from our current use of antibiotics in livestock production. The problem of antibiotic resistance is a serious threat to human medicine. That problem disappears when the livestock aren't there and also, animal welfare abuse disappears. Now I know food movement activists don't like plant-based meats because they're ultra-processed or because they're patented or corporate or not traditional or artisanal, but these critics have to come up with a better way to reduce our over consumption of animal products, before I'm willing to join them in criticizing plant-based substitutes. I mean, the fashion industry has switched to imitation fur and the shoe industry has switched to imitation leather. So, why shouldn't we allow our food industries to shift to imitation meat?

Bio:

ROBERT PAARLBERG is adjunct professor of public policy at the Harvard Kennedy School and an associate at Harvard’s Weatherhead Center. He has been a member of the Board of Agriculture and Natural Resources at the National Research Council, a member of the Board of Directors at Winrock International, and a consultant to the International Food Policy Research Institute, the U.S. Agency for International Development, and the Bill and Melinda Gates Foundation. He is the author of Starved for Science, Food Politics, and The United States of Excess. He lives in Massachusetts.

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If the world is ever going to end hunger, ensure food security and embrace sustainable agriculture practices, we've got to invest more in agriculture. Particularly, in developing countries. Now, governments and international organizations do invest in agriculture of course, but less than in healthcare, for example. And we wondered why? It turns out it's not so much a question of why healthcare receives more funding, it's how such funds are raised and distributed that makes a difference.

In this podcast, we're going to explore findings from our new report on agricultural development financing and highlight some innovative practices from healthcare sector that could be used to boost resources for agriculture in low and middle income countries. Our guests are global health policy professor Gavin Yamey of the Duke University Center for Policy Impacting Global Health and global health financing and policy expert, Marco Schaeferhoff of Open Consultants.

Interview Summary

Marco, in our report, we explore some of the reasons why ODA, official development assistance, increased so dramatically for healthcare. But first, could you help our listeners understand some of the big differences in development assistance for the health sector as compared to the agricultural sector?

Great question. So, what I would say is that the sheer amount of financing, official development assistance, for health and for agriculture are vastly different. If you look at the last 10, 20 years, agriculture ODA rose a little bit in absolute terms but as a share of total ODA, it remains rather flat. It's about 4 percent of total ODA. In health, you have a completely different picture.

After the year 2000 up until roughly 2012, there was an enormous growth in development assistance for health from about 12 billion up to even 36 billion in 2012. This era between 2000 and 2012 was called the golden age global health financing. Despite the fact that there is already so much development assistance for health, it's still growing. If you look at agriculture, this is a very different picture where you have maybe at 10 or 11 billion, and it's very likely that we will see a decline in 2020 due to the COVID crisis.

In addition, the composition of agriculture ODA is also interesting. So if you look at the ODA provided by bilateral donor countries, like the US, or the UK, or Germany, about three quarters of all agriculture ODA in 2018 was bilateral ODA. In contrast, multilateral institutions, like the World Bank or EFR, only accounted for about a quarter. So, and relatively small share of all agriculture ODA. As a result of that, you have many small projects. So for example, the bilateral reported almost 14,000 aid activities for agriculture alone in 2018. And the average size of these projects and program was less than half a million. This is of course difficult from a recipient perspective, because you have many small projects which cause high transaction costs, and which are often also largely uncoordinated. So that's one thing. In addition, if you look at the distribution of ODA loans versus 48 grants, you can see that about 35 percent of all agriculture ODA came in loans, and 65 percent came in grants, in 2018 again. So, first of all compared to 2017 levels, grantage fell by about 8 percent.

What is kind of interesting is that in the agriculture sector, multilateral funders tend to use loans but bilateral funders, primarily use grants. So what is striking is that in 2018, 80 percent of all multilateral agriculture ODA was provided by loans and only 20 percent in grants. The issue now compare this distribution with the health sector, you will see that exactly the opposite. So in health, about 80 percent of multilateral ODA comes in grants and only 20 percent in loans. What this shows is essentially that there is no large scale multi-lateral funder that provides grants for agriculture.

So during the time period in which healthcare development aid exploded, governments were working towards the UN's millennium development goals or MDGs. Those goals created a focus for donor investment in low and middle income countries. And that's a good segue for my next question to Gavin. What can the agricultural development financing sector learn from the health financing sector?

I think the health sector did very well on resource mobilization. Marco mentioned this term golden era where there was astonishing growth in health ODA. Really remarkable explosive growth, tripling of annual ODA for health. And it's probably no surprise that when you look at where that went to it was for the MDGs for health. Right? So, child health, maternal health and HIV AIDS, TB and malaria. And this explosive growth in ODA for health was targeted particularly to those three goals. And I think what that tells you is health did well at saying, "We need to mobilize and have a clear financing plan for these particular priorities." And that's what happened.

How that happened is another lesson here for the ag dev sector. And that is, it was largely explained by the launch of new kinds of financing mechanisms. I think one of the things the health sector did well was to innovate in terms of the architecture of global health. So you started to see new entities forming that were mobilizing very large amounts of new financing. For example, the Global Fund to fight AIDS, tuberculosis and malaria, Unitaid – so-called innovative financing mechanisms innovative financiers that we're able to mobilize large amounts of new dedicated financing for HIV, TB, malaria, vaccine preventable diseases and so on.

And it wasn't just through traditional means that ODA was mobilizing. If you take UNITAID, for example, it has raised most of its funding, which is for HIV, TB and malaria, through a solidarity air ticket tax. So in about 20 or 30 countries that are members of Unitaid, when you buy an airline ticket, the taxes placed on that ticket and it's used to fund Unitaid programs. And also a carbon tax. And I think the health sector has done well in using these new kinds of instruments: Airline solidarity, levies, vaccine bonds, for example, which turned long-term contributions by donors into immediately available cash. Advanced market commitments where agreements are made upfront, that if a global health technology is developed, they will be financing to buy it.

So there's a range of innovative approaches that have been used in the health sector together with this sort of financing roadmap, a mobilization strategy, and a focus on multi-lateral rather than bilateral financing. All of which the ag dev sector I think could learn from.

So in our report, we highlight several ways to boost agricultural donor support such as innovative financing mechanisms, reforming the aid architecture, coordinating investment through a financing roadmap and shifting more support to multilateral organizations that pool money such as the World Bank. Marco, do you have anything else to add to that list?

Yes, I think it's a great list. Maybe some quick nuances to this. So, one example Gavin mentioned the very important new mechanisms, these were deliberately created as grants based mechanisms. So the Global Fund to fight AIDS, TB and malaria or Gavi, the Vaccine Alliance were grant-based. Because before in global health, when it came to multilateral health finances, what the community realized at that point was that loans might not be the right way to tackle these diseases, especially HIV. So that's important.

The second thing is that the growth in global health financing, to some extent was also fueled by the anxiety of the HIV pandemic at that time. So there was a securitization of HIV, and the Global Fund, for example, was supposed to be an HIV fund first and foremost, but then malaria and TB was added. So I'm saying that because MDG5, which was maternal health, and MDG4, which was child health, was a little bit neglected. And there was a realization that there was a lot of funding for MDG6. And at around 2008, 2009 there was a big discussion and debate about how to increase ODA for maternal and child health. And in that context, there was a very concrete multi-stakeholder effort to coordinate the field, and to raise funding for these specific purposes. And that was a global strategy for women, children and adolescent health. And that was a really important document which also included key indicators and the whole community really surrounded, and it really helped to coordinate the field and to raise financing.

So I think this is a very concrete example to Gavin's point. And then finally we believe in the health sector that is the investments in what we call global public goods investments for example, in data. Data or needs, results, financing best practices, knowledge distribution functions, research, technical innovations. So there were quite a lot of investment, insufficient investment, but still quite a lot of investment into such global public goods. And we feel that such investment paid off based on very concrete data to say, who's putting in money into global health at country level. What is the impact of an intervention? What is the benefit cost ratio of investing in health? So these kinds of data, metrics and research I think that was a very valuable investment. And to some extent, we also see this in other sectors but I would say the focus in health is really unprecedented and that is something that agriculture could also focus on more in the future.

So Marco, I'm curious then, what are the barriers for the agricultural development financing sector to make those shifts, to try to emulate the health sector financing?

So, I would say that overall there is a lot of potential for the agriculture sector to learn from health. Let me maybe just say that we do not want to idolize the health sector. It still has challenges, but I think it moved in the right direction in the past decade. Things like investments in global public goods, grant-based multi-laterals investments in new technologies and innovations, investments in data and metrics. All these things could be more emphasized in agriculture as well.

In terms of barriers, it is true of course, that in health we have seen a number of huge crisis. Gavin and I mentioned the HIV AIDS crisis, or the West African Ebola crisis, that really helped to increase the amounts and development assistance for health substantially. So I think much of what we suggest in the report could be applied to the agriculture sector as well. It's probably true that in the health sector, the technological fixes might be a little bit more important. It’s very hard to develop vaccines, it's hard to develop new drugs, it's hard to distribute them, but we have very good tools and to some extent we do not have that in agriculture. But I think there's still a lot of potential for R&D and innovations.

In addition, I would say that the current context, because of the COVID crisis, we will see a decline in ODA overall, but certainly for agriculture and other areas. We will see to what extent of the health sector will be affected. It might well be the case that we see another increase in health ODA. But the current context is a little bit difficult.

Another thing we found in our study is that there is quite a lot of fragmentation in the agriculture sector. So when it comes to coordination piece, that we suggested a concerted effort to finance agriculture, and that might be fairly hard to achieve simply because you have multiple bilaterals with different perspectives. I think if you look at the Europeans or the US, there is a difference in interests and perspectives. So that is something that would have to be figured out. We have few multilateral financers which sometimes collaborate with each other but often there is lack of foreign action.

So I think these things make the reform of the global architecture a little bit difficult, but to be honest, 20 years ago we faced very similar issues in the health sector. Overall, I do think that what we suggest in terms of innovative financing mechanisms data, multilateral grant funds saying these broad directions should and can be taken on board by agriculture.

Gavin turning to you, you talked a lot about innovative financing mechanisms in the health sector and how they could be applied to the agricultural development sector. I'm curious, what are typical barriers for setting up those types of innovative financing mechanisms that you could foresee?

As the name suggests, innovative, it requires stakeholders to think beyond traditional sources, right? So it requires new ways of thinking. It requires some kind of demonstration project or some at least pathway to seeing how an innovative financing mechanism could work.

So it's often difficult to pilot these large scale initiatives, you know, but at least showing proof of principle, showing the potential investment case can be very helpful. If you look at some of the innovative financing mechanisms that you could argue have been successful, like Unitaid use of an airline ticket tax and a carbon tax. Those are the two sources of financing that Unitaid has used to raise very large volumes of financing for HIV, TB, and malaria. They were actually able to quite quickly demonstrate, you know, how much money could be raised. And they are a very significant player now in the HIV, TB landscape.

I think there is some skepticism around some of the less tried and true ways to raise money that are, you know, still being tested out, if you like. There's been lots of talk for example, about tourist taxes. If, for example, you're a tourist who goes to a malaria endemic region, there's a lot of talk of an innovative tourist tax. You ask that tourist to pay $5 or $10 to enter the country and use it for malaria control. I haven't seen those sorts of mechanisms take off yet. I know they were under consideration, for example for the Island of Zanzibar. And similarly, a lot of talk about using bonds, has been used successfully, I would argue in the vaccine space.

And then the last point I would probably make is, in my mind the most innovative thing we could be doing for global health financing, certainly for mobilizing financing for international collective action and global public goods like pandemic preparedness or research and development for neglected and emerging infectious diseases, would actually be a new kind of global pooled fund or perhaps a global tax. We haven't really ever been able to go there, perhaps because of a general disquiet, a general lack of enthusiasm for a global tax. But I think post COVID-19, I don't really see how we can get away from the notion that each nation is going to contribute according to its means towards, you know, some kind of pooled fund going forward. And there may be that sort of conversation happening around agricultural development financing as well.

Bios:

Gavin Yamey MD, MPH, MA is the Director of the Center for Policy Impact in Global Health at Duke University. Yamey trained in clinical medicine at Oxford University and University College London, medical journalism and editing at the BMJ and public health at the London School of Hygiene and Tropical Medicine. He was Deputy Editor of the Western Journal of Medicine, Assistant Editor at the BMJ, a founding Senior Editor of PLOS Medicine, and the Principal Investigator on a $1.1 million grant from the Bill & Melinda Gates Foundation to support the launch of PLOS Neglected Tropical Diseases. In 2009, he was awarded a Kaiser Family Mini-Media Fellowship in Global Health Reporting to examine the barriers to scaling up low cost, low tech health tools in Sudan, Uganda and Kenya.

Marco Schäferhoff, PhD, is co-founder of Open Consultants. He combines over 15 years of management and consulting experience with in-depth expertise in global health financing and policy. An expert in development economics, Marco has led numerous projects involving benefit-cost analysis. He has worked in a range of development sectors, including health, education, nutrition, agriculture, and energy. Marco served as a member of The Lancet Commission on Investing in Health and has published widely on development financing and policy. He holds an advanced degree in Politics and a PhD in Political Science.

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Hunger affects all communities, but you may not know that 40% of single mothers struggle with food security. Women dominate our central workforce, yet they face persistent structural barriers to food security and economic stability. COVID-19 has only exacerbated these challenges. Today, Abby J. Leibman, President and CEO of MAZON: A Jewish Response to Hunger, discusses the urgent and unique needs single mothers face, and the work she's leading to advance the anti-hunger movement.

Interview Summary

So MAZON has recently started developing this area of work related to food insecurity amongst single mothers. Can you tell us more about it?

Yes, and I think one of the things that has always distinguished MAZON has been our ability to look around at the world of the American population struggling with food insecurity, and identify places where there are populations or communities or issues that have gone under-addressed by other large national anti-hunger advocacy organizations. And the number of people who struggle with poverty in America is, of course, in the millions. A significant portion of those are women who are struggling to take care of themselves and their children. Those single mothers constitute one of the most significant, yet under-addressed, communities in our country when it comes to all kinds of social services or social justice efforts. We felt that it was a moment in time when we could lift this up and we should lift it up. Contributing to that, of course, is that during the pandemic. We know that there are a lot of communities that have been more affected than others, and single mothers are among those. In large part because many of them are essential workers. So they're being pushed in a lot of different directions with little relief that is specifically designed to meet their unique needs.

That statistic that I mentioned in my introduction that 40% of single mothers suffer from food insecurity, boy, what a toll that must take.

Yes.

Can you explain that picture a little more?

I think that in large part, it really takes two incomes to adequately support a household. There's very few of us who can say that a single parent or a single salary in a two-parent household is adequate. And when you begin to look at what the lives of women are like when they are single parents, you can see why there are these pressures that fall on them in a way that's different. We know that in this country, if you are taking care of children, you cannot actually leave them alone when you go out into the paid workforce. So this notion of the relationship between work and care-taking is something that I think a lot of economic structures in this country pay lip service to and do very little to relieve. For better or for worse, the vast majority of those that are the primary caretakers of children are women. So even in a two-parent household, you can see that women are shouldering a lot of the responsibility around that care-taking, but they also have the flexibility and the freedom to be able to work either part-time or afford to have paid childcare for those children. When you're a single parent, you're it. You are the person who has got to provide both, that economic security and the parenting responsibilities. And then we look and we say where women are actually ghettoized in a lot of low-paying jobs, that now, we call essential. But I would say up until the pandemic, we dismissed those jobs as being something that were unskilled or unappreciated. We've suddenly awakened to the fact that these are very vital roles in our economy and in the way we live our lives in America.

So how do programs like SNAP help single mothers, and also, maybe more important, how do they fall short, particularly in the wake of COVID?

SNAP is an amazing program because it is flexible enough to meet the needs as they grow. This is what an entitlement program is, and it's one that has worked beautifully. Now it's underfunded because what we're talking about is not a lot of money. Even with the new increase that we've seen in the American Recovery Act, that number is actually another $28 per person a month, which is not that much money. But when you are trying to feed your family, it's really vital resources. But SNAP itself is not meant to be the full amount of money that anyone could live on. It's the Supplemental Nutrition Assistance Program meaning that the program itself is supplemental. You should have some other kind of financial resources here. So it's already designed to be a program that is not going to be fully funded to create that kind of full budget for your family. Women have these particular challenges about work and feeding families. And the way that the SNAP program has evolved over time is despite being an entitlement, Congress has layered into this requirements that people work outside the home as they struggle to get their footing. So there's something of an unfortunate irony here. I mean, SNAP was not designed to be a work program, but it's functioning that way because there are requirements on recipients that they work or be in some other training program in order to receive benefits. Some of that is waived for people who have very small children, who have dependents at home that they have to take care of, but those time limits don't completely go away. Nor is the requirement that you should be fully engaged in work or the idea that you are looking for work. So a big part of receiving SNAP is showing that you are continuing to look for work and you are trying to better yourself so you can get off of the program. And again, we run into this interesting dilemma of you cannot leave your house to seek work, let alone have work, if you do not have adequate childcare.

So one of the things that MAZON has been very concerned about and tried to lift up is that there is this undeniable relationship between the need for subsidized childcare and the need for SNAP, that these two things are very connected. And in trying to lift up that connection, we hope that we could actually make a real policy connection between the two.

Thank you, Abby. I know you're trained in law, and as a lawyer with a background in women's rights, how does this fit together with the work that you're doing now to end hunger?

So first of all, when you're an advocate, those skills never leave you. In fact, in my family, I was sort of infamously dubbed, even as a small child, to be a person who was very consumed by what was fair and what was not. And trying to argue vociferously for myself about staying up late and eating whatever I wanted. So I've seen myself as a person who had made a commitment a long time ago to working for justice for those who I felt were far more vulnerable in America than others. And there is certainly, as we've discussed, this very strong relationship between the work I did around women's rights, and those who are struggling with hunger in America. When we think about the feminization of poverty, this is not just a slogan. This is a description of what poverty looks like in America. It is dominated by women, and in many cases, women and their children. So it's not that I strayed that far, in my view. I have moved to a different set of issues that has a tighter focus, if you will.

I'm very impressed with the work that MAZON does. And this is actually a nice transition to the final question. So why don't we end on an optimistic note? So what are you most excited about or hopeful for in the coming year?

So this is what I see, which is that the pandemic did something that advocates have not been able to do for generations. And that is it put the issue of those struggling with food insecurity in America on the front page. This has never been a focus of this country. And the stunning images that we can see that dramatically demonstrated that the charitable network in this country is not equipped to respond to the tens of millions of people who need to eat three meals a day, every day. They're not set up for that. It wasn't what the design was. The purpose of government is to step in and be our community writ large in that respect, that we look at government in much the same way as we've now heard our President articulate it, that the government is there to serve, support, and help people.

At MAZON, because Jewish values tell us that very same thing, we've seen this moment where we have not only the need, this incredible challenge facing all of us, but we have opportunity in the administration that embraces the idea that, yes, we as a country are responsible for all of those in our country. And we have political and public will that is saying that, "Oh my God, this is truly an issue. "This is something that we can't pretend "happens in countries far away, it is happening here." And then sadly, I think that those numbers of people who now find themselves food insecure include people who never saw themselves in any way financially vulnerable, that they were people who gave to charity, they didn't have to rely on it. And at MAZON, we shy away from thinking about this as issues of charity for just those reasons because we think of it as justice, which is what the Hebrew word for charity, it's tzedakah and it is about justice. That word translates to being justice. So this is about recognizing that all of us are either in need or could be in need. And then as a community, as a country, our job is to respond without judgment, to give people dignity and respect, but also to treat them with compassion.

Bio:

Abby J. Leibman has been President & CEO at MAZON: A Jewish Response to Hunger since 2011. Prior to her current tenure, Ms. Leibman had a consulting practice to assist social justice organizations, businesses, and public institutions meet the challenges of growth and change, including leadership development, managing diversity, and implementing strategies to respond to discrimination. Among her clients, Ms. Leibman worked with some of California’s most innovative organizations, including Jewish World Watch, Food Forward, L.A.’s BEST, UCLA Hillel, Valley Beth Shalom Synagogue, the Jewish Federation Council of Greater Los Angeles and the Progressive Jewish Alliance (now Bend the Arc).

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The term urban agriculture is becoming more familiar, but relatively few people know how this works on the ground in real world settings, and can fully appreciate the promise it has for the future. Our guest, Rashid Nuri, is the ideal person to explain. In 2006, Nuri founded the Truly Living Well Center in Atlanta to realize a vision for community food, sovereignty, and equity. This urban Ag organization grows tons of chemical-free, nutritious food, provides jobs, and works to educate communities.

Interview Summary

Now that you're the CEO of the Nuri Group, an organization that advocates broadly for urban agriculture at the local, regional, and national levels, you're working to expand equitable access to the tools for success in urban centers through education, and funding partnerships and appropriate regulations for urban agriculture. You're doing really amazing work. You had what you call a burning bush revelation while you were a student at Harvard University. Can you tell us about that and how you came to work in urban agriculture?

Oh, yes. So I'm a child of the '60s, and we were talking about nation-building. Black Power nation-building, and I was trying to decide what kind of work that I wanted to do. My studies as an undergraduate was in national development, how you build countries. I studied the men and women who created the post-colonial world. I was sitting in the library at Harvard, was reading a book by Tom Mboya. I'd already had an interest in health and nutrition. In his book, he said, "With all the technology available in the world today, "there's no reason we could not chemically synthesize "enough food to feed all the people." And that was a shock to me because it was all those chemicals that are killing folk. It was the word of God in my ear that said, "Learn everything about food from the seed to the table "to do it experientially." So that's the work that I am engaged in for all these many years. It's taken me around the world. I've been able to examine local food economies around the world. I've worked in 36 countries and all over the United States.

It's stunning that you've worked in so many countries around the world. So how has your experience outside the U.S. informed the work that you're doing here?

Humankind used to live within walking distance of where their food was produced and this still exists, to a large extent. If you go to Asia and Africa, you will find people can walk to where their food is, but there's this movement towards the cities. The United States now, over 80%, 82% of the people live in urban areas, metropolitan areas. Worldwide, it's predicted by 2050 that 65, 70% of the world's population will be urban. So to see how local food economies actually work the interaction, the sub-text for Truly Living Well was "We grow food, we grow people, we grow community," and to be able to see how this happens around the world has informed the work that I have done in the United States and specifically in Atlanta.

So can you share with us, please, your sense of what urban agriculture is?

I do make a distinction between urban farming and urban agriculture. Urban agriculture is the rubric, the umbrella that covers all of it. You have to be concerned about food, clothing, and shelter. It's not just the growing of food it's not addressing the needs of people in areas where there is food apartheid, is the term that's being introduced now. The USDA calls it food deserts; it's much greater than that. We have to be concerned we live in the richest nation in the entire history of the world, but you walk down the streets, you find people who are homeless, people who don't have medical care, the education system in this country is falling apart. All of these things come under the same rubric and I proffer that urban ag does not solve all these problems but it offers a solution, a solution and approach to addressing many of the problems that we have in the community. Each of the farms that we have built, we've provided employment, and twice now I've built the largest farm in metropolitan Atlanta. We provide employment, we've cleaned up drug and sex trades in the neighborhood, real estate property values go up. We create safe places for people to be able to come and commune with one another, get to know one another. So urban agriculture to me is all those issues that I've just described.

So let's talk a little bit more, if we could, about the farm that you just mentioned in Atlanta. What's its size? What do you grow there, and who does the food go to?

The first farm I built was six acres and we had to move the farm to a better site and we literally took all of the soil and moved it to the new site in dump trucks. And we also took 125 fruit trees, one at a time, and transplanted them in the new site. We move Paradise and they literally put in a parking lot, literally. You asked what we grow. So we have all kind of fruit trees examples of fruits is many varieties of each, apples, pears, peaches, plums, pomegranates, pawpaw, all the vegetables, seasonal vegetables, greens, tomatoes, peppers, cucumbers, squash, sweet potatoes, onions, garlic, turnips, beets, carrots, everything, just depends on the season.

Now, I'm very pleased to see that second part of your question was, "Who gets the food?" And that's the fun part! When it first started, there was one point we were in seven of the Top 12-rated restaurants in Atlanta. And that's a very good way for young people who are just getting into business and get started. So many of these restaurants have farm to table menus and advertising the fresh food there. And that's an indicator of the progress that this work I've been engaged in has made. But at the end of my tenure, that food was getting into the stomachs of the people who really needed it, and I think that that is a significant thing. We had CSA, consumer-supported agriculture, where people would come out to the farms to pick up the food. When I started, it was hard to find a farmers' market. Now you can get one just about any day of the week around town. So it became necessary for us to participate in the farmers' markets.

You mentioned something really fascinating – that you moved the soil from the original location to where the farm is now. Why do that?

All wealth, all health, all life begins and ends with the soil. That's the most important thing. Too many people, when they engage in agriculture, think they're trying to grow the plants. What you really need to do is grow the soil. You want to build the soil. And I'd spent 5 1/2 years building that soil down in the old Fourth Ward here in Atlanta and there was no way in the world I was going to leave that. The mantra as, I began my work in Atlanta and teaching, my mantra was compost, compost, compost. Commercial agriculture looks upon the dirt as a receptacle for the roots of the plant rather than as the source of the nutrients. Their scientists think they know more than God does and how to produce this stuff. All my work is an attempt to emulate nature.

When you and I were chatting, you mentioned the links you see between regenerative agriculture and urban agriculture. And I know the people who do regenerative agriculture care deeply about the health of the soil, but could you explain those links?

Everything begins and ends with the soil. Urban agriculture, we're talking about the location where we grow. The clearest indication of the quality of your soil as well as the first livestock you should have on the farm is earthworm. You don't see any worms in your soil, that soil is dead. All the mycelium, rolypolies, and millipedes, centipedes, these are the things you want to have in your soil. The work we are doing, the demonstration of this work is pre-industrial and regenerative. That is what we're trying to do. So there is no contradiction between regenerative agriculture and urban agriculture. You're really trying to accomplish the same end. And I think that the young people today have picked up this term, when in fact that's the original way that food was grown. This is my definition of organic; it's whole and complete. You go back and look at agriculture, all the waste went back into the soil. Animal waste, human waste, all of it went back into the soil to replenish it so they could grow more food.

Let's talk about the role of urban agriculture in feeding people in cities. So you mentioned when we began about the percentage of people in the world who live in urban areas, so what role do you see for urban agriculture in this area?

Well, substantive. Atlanta is the greenest city in America by virtue of trees and open space. I travel around the country and looking at other areas, there's plenty of land. We can grow all the fruits and vegetables, not meats and grains, but all the fruits and vegetables. There's plenty of land to be able to produce that in the metropolitan area, suburban, peri-urban, whatever term you want to put on the name of the area.

What sort of policy changes do you think could be made to help this move along?

Ah, thank you, Professor, that's a wonderful segue to what it is I'm working on now. America is the greatest agricultural producing country in the entire history of the world. No one's ever produced more food. It's gone backwards because we're putting all these chemicals out here now instead of actually growing food. And the genesis for this leap in ag production came from four bills that were passed within 48 days by Abraham Lincoln, back in 1862. First was the establishment of the Department of Agriculture, he called it the People's Department, which was the first subject matter department of government. And by subject matter I mean, now we have a department of energy, transportation, housing and urban development, health, we have a labor department, you have all these different departments. Back then, they had the Secretary of State, Treasury, and War. These were the principle departments. The second bill was the Homestead Act. The American people paid for folk to come over to the Midwest to homestead. They gave them free land, gave them subsidies for that land, helped them to pay for the land with just the caveat that they had to stay there and do some production. Then you had the Moral Act. All of these have had many different iterations but the Land Grant College Act provided money, land to build colleges, universities to support the agriculture. This is where the extension agents from, this is where the research is done. Big Ag does no research. When I started in this business, it took 12 to 14 weeks to grow a broiler. Now they get it done in six, and it was not the chicken companies that did the research to get this done. This came out of the university, it was subsidized by the United States' citizens. So much of our vegetables all over the country are grown in California. California has no water, at all. It's all imported, which is paid for by the taxpayers. It also promulgated the Railroad Act 1862. There's a whole lot of scandals that were around it, but the equipment that was made out of steel had to be brought from the East.

Point is, I would like us to see now a new modern version of the Homestead Act to support small farms and urban agriculture. That is the policy change. Now you can get elements of this, things that the NRCS as a department puts up hoop houses in urban areas, they got small farms and beginner ranchers' grants that you can get loans from the department, but there's not a comprehensive program to deal with creating an urban infrastructure. Now, Tulsi Gabbard out of Hawaii has just introduced a bill. I think it's HR 25-66, this is just getting started, to provide some support for urban agriculture, and that's the horse that I want to hitch my wagon to. We need to come up with an urban, modern Homestead Act.

Bio:

Rashid Nuri had a powerful “burning bush” revelation while a student at Harvard. The experience set him on a global food odyssey, managing agricultural operations throughout the U.S. and 35 countries in Europe, Asia, and Africa. Rashid saw, up close, the abuses and inefficiencies of what he calls Big Ag. His vision of community food sovereignty and food equity emerged with full clarity. He brought that vision to Atlanta in 2006, founding Truly Living Well Center for Natural Urban Agriculture (TLW). TLW became Atlanta’s premier urban agricultural organization, growing tons of chemical-free, nutritious food, providing jobs, and educating communities about food, nutrition, and self-sufficiency. Now as the CEO of The Nuri Group, Rashid is working to expand equitable access to the tools for success in urban centers through education, funding, partnerships and appropriate regulations for urban agriculture.

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So what comes to mind when you think of these words: life around the table? Do you think of good food or family or sharing maybe? But what about spirituality and faith? So we're continuing our exploration of food and faith issues in today's podcast. And I'm speaking with Reverend Dr. Michelle Lewis, the executive director of an organization called, Life Around the Table, an ecumenical non-profit organization focused on food and on environmental justice.

Interview

Let me begin by asking you, if you wouldn't mind, to describe Life Around the Table, what does you organization do? And let us know how it works to create a diverse and inclusive community.

Life Around the Table is an ecumenical organization, a really good way to understand what we do is we help faith communities think about what it means to be in right relationship with God is our creator and creation and our neighbors. We ask these questions, what does it look like to do this around table? So what does it look like to do this in community and small groups to begin having these conversations? And we do that through our eating together faithfully framework and also through a ministry called Sabbath Life where we work with clergy to live into Sabbath in creation. So we do this on farms, we invite clergy out and they spend a day with us once a month, usually over a 10 month period of time to worship, to work as a part of their Sabbath and creation in these gardens and on these farms and to experience silence. But when we're IN creation, experiencing creation is a part of it. We find that what starts in silence actually ends up being a really beautiful music that's formed by creation.

It sounds so inspiring and interesting, and when you mentioned the eating together faithfully program that you run, it sounds like this is a pretty new thing in divinity circles, but maybe I'm not right with that. And is that true and do you see interest growing?

I definitely see interest growing and Life Around the Table has had a presence in the central North Carolina area for about seven years. But you are correct, these questions of religion and environment and how they merge, it's a relatively new and emerging field. And I say relatively new because it's been around but it hasn't really been something people talk about. When we look at the Genesis story of creation, God created the world and then here come Adam and Eve, and God gives Adam and Eve charge over the gardens. We often talk about creation in a sense of something we have dominion over. But what does it look like to be in community WITH creation? And these conversations have been happening in a number of ways for centuries but we're really trying to take a approach to food and faith and environment and inviting folks to come around these tables together and think about who's not at the table? Who are those people missing from around the table? And how then are we creating tables and communities that really are welcoming everyone? One of the ways that in Life Around the Table, we talk about foods or the food that laughs framework, it's food that's local and affordable, it's uncomplicated, it's good, it's healthy and it's seasonal. And so when food is all of these things for everyone, we end up with healthier communities anyway. But so often it's not all those things for everyone, you know, it may be affordable but not simple. Often one of the reasons you see that people eat fast food as well, it was fast, it was affordable, but it's definitely not simple. When you look at the list of things that are in that hamburger or that cheeseburger or whatever it is that you've chosen, but sometimes chosen because you didn't have other options.

If this is catching on as you say, then I'd expect that divinity schools or theological training, the institutions are beginning to show signs of including these sorts of things in their curriculum, is that true?

That is true. Duke has a certificate program now, I believe and Yale Divinity School actually has a joint degree program that you can do with the school or the environment, where you can think about it and research these things and try to live into this work in a different way. And other seminaries are beginning to ask these questions too and are beginning to shape these programs as well.

So I understand that your ministry doctorate from the Candler School of Theology focused on food, justice and spirituality, and I'm particularly interested in your perspective on what roles, race plays in food access. And also I'd love to get your thoughts on how faith systems address the crisis of food access in the community.

Research shows us that African-American communities are two times more likely to experience hunger than white households, there is an issue with access. I like to talk about what I call food mirages. It's often in communities that you'll see well there are plenty of stores here, there are plenty of grocery stores, there are lots of farmer's markets. And I say that often in those communities, what you have are food mirages. So the food is there, but everyone actually isn't able to get to it because cost is often a barrier. If you've bought anything organic, then you know the price of organic goes up exponentially. Do people have access? And then do they have access to quality food?

And so when I think about the role that faith communities can play, we can find a church in almost every community that has a food pantry. In some churches do food pantries really well, in some churches they're just kind of figuring that out. And sometimes it's not a food pantry, but it's a hot meal, and one of the things that those groups can ask is are we providing the highest quality food? Because often it's not about highest quality it's about quantity, are we sacrificing quality for quantity? Is that something that we have to do or are there partnerships that we can form within the community so that we're addressing the quantity needs while addressing quality as well? An example is that a lot of food pantries will get fresh produce from supermarkets, say fresh and kind of put that in quotes, because when the produce comes in, it's not exactly fresh and it's the stuff that the grocery store couldn't sell so they decided to give it to charity. And recently had so much share with me, they said, "Yeah, well you know, we do get produce "from such and such food pantry, "but when we get it if we don't eat it all in 24 hours, "we have to throw it in the trash." So it's produced that's at the end of its life, that if you and I were going into a grocery store, we wouldn't buy it. And we'd probably complain to the manager because they were trying to sell this end of life, dead produce, not quite fit to eat to us. But we're often more than happy to give that stuff to poor folks. They'll take it, they need food and we can just give them anything, right? And I think that so often at that's been the approach, and I like to think of food ministries as being, we're sitting down to the table and Jesus is at the table with us, which our goal should be to see Jesus in everyone right? Would we feed this to Jesus? Maybe we would, but perhaps we'd look for something else. So that would be the thing that I would encourage churches and faith communities that are really engaged in food ministry to think about. Are we doing the best that we can do recognizing that there are so many people who fall between the cracks, people who need assistance, but don't qualify.

Such an interesting perspective and it's interesting how you and others are looking at the barriers to access to fresh and healthy foods and kind of taking them on one by one. Let me ask you a question about the COVID pandemic, how have you seen community food needs change?

So just in my own community, I've seen the number of families in need go through the roof, and you enrolled food program, their numbers for 2019 we're at about 135 million people were food insecure that year across the world and it's estimated that that number went up to more than 265 million people in 2020. I know people who've shared with me that they've gone to food distributions and food pantries for the first time in their life because of the pandemic. The pandemic has increased the need for food, so many communities already more able to meet the need that was present and then pandemic happened. And often help with food distribution in my own community, we encountered people from other counties who said the pantry in my community just ran out of food, there was not any food in our community lab. They had to drive an hour and a half or an hour and 15 minutes to get to where we were helping with food distribution to get food. The pandemic is in a lot of ways leveled the playing field, food insecurity happens to all households and perhaps the number of African-American households that were food insecure were twice that of white households, but right now, everybody's food insecure. Food insecurity is not race dependent, so there are black people and white people and Asian people and Latino people that are food insecure. And so food insecure has touched virtually every community now and my hope is that with that, the people who previously have seen it as other people's problem will begin to see it as community problem, and we'll want to do the work of addressing food insecurity in their community.

Now I'd like to shift gears for just a moment and talk about the connection between food justice and environmental justice. And I know you've given a great deal of thought to this, how are those two things connected in your mind? And how is Life Around the Table dealing with things like changing climate?

When I think about food justice being connected to environmental justice, it really is about this health piece, because when a community is food insecure, when families are food insecure, lends itself to communities being unhealthy. When people don't have access to quality food, it produces all sorts of negative health outcomes, and so when we think about environmental justice, environmental justice is really about creating healthy communities. Getting the environment to the point where everyone is experiencing good health. And so that's how I see the connection between food justice and environmental justice. Even when we look at how food is grown and processed, the type of resources and energy that it takes to create processed food, versus that energy that it takes to just create natural good food, at Life Around the table, we would call that food that laughs, food that's local and affordable and simple. So are we creating healthy food that is good for us and good for our communities? Those really are issues of environmental justice.

Let me ask a little bit more about the people who take part in the Eating Together Faithfully Program. So the members of the clergy will come and spend time with you, and you mentioned a little bit before about what that was about, how do you feel they're changed as a consequence of that experience, and what sort of things do they do when they get back to their work?

We hope that it causes them to interact with people that they perhaps wouldn't ordinarily interact with, they also have these environmental interactions that they are probably not having on a daily basis. On one of the farms where we meet, there's a goat, that's a very active goat. And we have a couple of participants right now who are like, Oh my gosh: goats. And Kelly, I got to see a donkey for the first time in my life last week. I don't think I've ever seen a real live donkey that was close enough that if I want to touch it, I probably could. But when we see and experience these parts of creation that we have only heard about or read about, or when we experienced being with people that we're ordinarily not with, it changes us. I think it changes our spirits, it changes our hearts, it definitely changes our minds when we're operating out of a place of experience versus out of a place of just, well, this is what I heard, or this isn't something I knew because I've lived it. My experience is that people walk away from it seeing the world differently. And I talked with one former participant in Sabbath Life last week, I said, "Did it change how you practice Sabbath?" And they said, "You know, it really did. "It changed how I practice Sabbath, "but also how I interact with my family "and my community as well."

Bio

Michelle Lewis is the Executive Director of Life Around the Table, an ecumenical non-profit with a mission of "equipping Christian communities to participate in the flourishing of all creation by cultivating practices faithful eating and Sabbath delight." She is also the founder of the Peace Garden Project, a non-profit with gardens in New York and North Carolina with the goal of addressing food and environmental justice while looking at the intersections of food justice with other justice issues. Her doctorate in ministry from Candler School of theology focused on food justice and spirituality. Prior to relocating to North Carolina, Michelle pastored a multi-racial/multi-ethnic church in New Rochelle, N.Y. and has pastored churches on the Outer Banks of N.C., in Catskill, New York and East Berlin, Connecticut. She in an Elder in full connection in the United Methodist Church. Michelle also served as a multifaith Chaplain at Hartford Hospital. As a public theologian, Michelle has produced a podcast and radio show called “Unpacking Faith” that examines how people of differing faiths view national and world events, and the role that faith has in how individuals and communities interact in natural and built environments. Michelle is an Elder in full connection in the New York Annual Conference of the United Methodist Church but is current living and working on the Outer Banks of North Carolina in her hometown (Manteo).

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American Indians and Alaska natives face challenging economic, environmental, and political conditions that are in many ways similar to those experienced in developing countries. About 37%, for example, of Navajo or Dine people live in poverty. Access to preventive services such as cancer screening, immunizations, and early detection is often limited. And patients must travel long distances to obtain medical services. The situation is made worse by the lack of access to healthy foods. As a result, the life expectancy for American Indians is about six years shorter than that for the general population. Additionally, American Indians suffer disproportionately high rates of obesity, diabetes, heart disease, mental illness, and substance abuse. Today, we are speaking with two impressive people working to change that, Dr. Sonya Shin and Kymie Thomas. They run the Navajo Nation Community Outreach and Patient Empowerment or COPE Program. This is a community-based outreach and food security program made possible through a formal collaboration between Brigham and Women's Health in Boston, Tribal Leadership and Indian Health Services to address health disparities in the Navajo Nation.

Interview Summary

So Sonya, let me begin with you. As a physician at Brigham and Women's Hospital and a professor at the Harvard School of Medicine, can you explain why you founded the COPE Program and the impact that it's having?

I started off my work abroad doing global health. And as I began to learn about how to partner with communities to address health issues, I became really interested in turning my attention toward some of the issues that are facing our communities here in the United States. So we were just really excited and honored that about 10 years ago we were invited to partner with Navajo Nation. The idea was to really work in solidarity with the tribal leadership, with community partners, and health care providers to address some of the health disparities that you described before.

Kymie, I'd like to ask you as a member of the Navajo Nation, and the health professional and coordinator of the program, you're in a unique position to help our leaders understand the experience of living in a food desert on a reservation. Can you describe more about this?

I grew up on the Navajo reservation, which is a larger reservation. It encompasses three states, New Mexico, Utah, and Arizona. The distance and traveling between the communities and to the nearest towns is about two hours. So within these communities, there's a limited amount of grocery stores. People purchase foods in the convenience stores. And as you are all aware, most of the convenience stores typically only have processed foods and nutrient dense foods. And they offer little to very little variety when it comes to fruits and vegetables. So with families living in a remote area, the delivery of these fruits and vegetables to these stores drives the cost of transportation to these families. So when they go in to purchase their food, they're looking at foods that will last longer for their families. And some of the foods there aren't very great quality. So most of the families have to travel more than two hours to be able to obtain these foods. My family didn't have electricity until just recently. So in my family, we would have to travel into Gallup, which is for us a 45-minute drive. And we wouldn't be able to purchase frozen fruits or vegetables, mainly fresh ones, but even then it wouldn't last very long. So my parents would have to purchase foods that would last our family longer. So like potatoes and canned meats because you typically don't need refrigeration for that type of food. And so I think for the people who live on the reservation, a pressing issue to not be able to purchase these healthy foods that we tell them to consume when they don't have access to plumbing or electricity. So a lot of those factors combined really play a huge part in some of the challenges that our families face in obtaining healthy foods in a food desert.

So thank you for that description. Sonya, let me ask you, what is the COPE Program all about, and how does it go about trying to close these gaps for proper nutrition and while being centrally located in what's this food desert that Kymie just described?

When we started the program, we weren't actually thinking about addressing food insecurity. I was thinking about, okay, I'm a doctor. You know, how do I address diabetes? How are we going to be dealing with the rising rates of childhood obesity? But it became quickly apparent that a patient of mine with diabetes doesn't need to be told that they're supposed to eat fresher fruits and vegetables. They know this. And so we quickly became aware that in order to start to move the needle around some of these health issues, we were going to have to shift our focus from just trying to increase access to health care to also increasing access to healthy foods and actually making it possible for patients to make these changes that they want to make. We thought about it for some time and we listened to a lot of different partners. And what we heard is that on the one hand, really important to think about these individual families that are living deep in the reservation, oftentimes with very few options, but also to think about how do we create an approach that doesn't just push all of the resources out to the border towns. So creating ways for people to travel outside of the reservation and spend their money, say, at a neighboring grocery store, it doesn't actually change the actual status of the community on Navajo.

So we decided that the Fruit and Vegetable Prescription Program that Kymie runs might be an interesting approach for several reasons. One is that healthcare providers want to do something. When I see a patient in clinic and I know that they often don't have healthy foods, especially after the first week of the month when they have fewer options, no electricity, et cetera, I want to be able to offer that family something. So engaging healthcare providers as implementers seemed very appealing. And then second, the idea of being able to use the vouchers that families receive to also kind of infuse economic stimulation to the local food system and the local economy was very appealing because that meant that over time, hopefully we could actually have a lasting impact on a more kind of thriving and robust food system.

You know, I would invite Kymie to describe a little bit more of that Fruit and Vegetable Prescription Program or FVRx as we call it. To us it seemed like a very interesting model for a cross-sectoral approach to address both the food system on Navajo Nation, and also health disparities.

Kymie, please do tell us more about the program.

We work closely with the providers addressing a family that's in need. So finding that area where there is a need and locating those families and being able to work closely with our store team here in the organization to ensure that our partnering stores where sites are able to redeem vouchers, that they are also fully equipped with a wholesome variety of fruits and vegetables to be able to meet the selection from our voucher program, and not only for our participants, but basically anyone who comes into the stores to purchase food. You know, when they see that there is a bigger variety of fruits and vegetables, they're more than likely going to be able to purchase that as opposed to just bananas and oranges that convenience stores normally have. And then also creating partnerships with our local growers so that families are aware that they can find vendors in their communities who sell locally grown produce. And another big emphasis is also incorporating more of our traditional foods back into our diets. So, you know, corn, fresh fruits, and vegetables like carrots, things that we have normally eaten just re-introducing that back into the diet as an indigenous community.

Sonya, is it too early to know what kind of impact this is having?

Well, we're starting to generate impact. And I can describe some of the data that we're seeing. We're really interested in real world results as opposed to a clinical trial, but what we are seeing are, I think, pretty promising. So to give you a sense, we did ask that all of the clinics prioritize families with young kids. So either families with a pregnant mom or with a child that's under age six. And we did that because we felt that the program would have the greatest impact on the health outcomes of that specific family. If we targeted really early in the life course of the child, it's an opportunity where there's a lot of positive and motivation for change, and families are very excited to make changes for their children. So that said, when we've looked at the families, not surprisingly, three quarters of the families are actually food insecure and that's actually similar to other data that we've seen published about Navajo Nation. And after the six-month program, we've definitely been able to demonstrate that fruit and vegetable consumption is increasing among both the kids and the pregnant moms.

I think one of the things that's most exciting of the data that we've seen is the change in the body mass index among the children. So we know that childhood obesity is associated with food insecurity. So it's not surprising that we're facing high rate of childhood obesity, as you mentioned before, Kelly. Among children who are enrolled with an initial weight that classifies them as overweight or obese, actually 38% of them achieved a healthy weight after six months. And I'm not a pediatrician, but I've been told by my colleagues who are running the program, that for them, it's really one of the most impactful programs that they've had the opportunity to implement with their families. The other thing that we're kind of interested in and we're just starting to see some of this data now is the spillover effect that Kymie mentioned.

So a family can participate in the program for six months, but what we're really after is changing the options out there at the community level for those families beyond the program. And then for all of the community members. So if there's a small little convenience store or trading post, that's really the only thing around for like say 60 miles, we want to change the variety, the options, the quality of the produce that's available in those stores by driving up demand, and therefore bringing up supply. So we've actually looked at shoppers that are leaving these stores and compared stores that are part of this program to stores that are not participating. We're seeing that just generic shoppers, so these aren't people who are actually enrolled in the program, are actually purchasing more fruits and vegetables from participating stores. So our hope is that over time, if we can start to change the food environment at the community level, that we could actually have an even greater impact at the population level on some of these health issues.

You know, the number that you gave, two, or three quarters, rather, of households being food insecure is incredibly discouraging, but it's really nice that you have such encouraging findings. It's very impressive what you're reporting so far. Let me ask you both a question. Sometimes relationships between organizations outside a community, like a university, and what goes on in the community, it doesn't work very well or it's very challenging to work through issues of trust and things like that. I'm curious from both of your points of view, how did you go about establishing trust, developing working relationships, creating a program that the community would actually embrace?

Having Navajo representation within the organization to help deliver the program has been really helpful. So I think with a lot of our families, it's just reassuring to them seeing someone that is the same as them, you know, me being Navajo also, they're comfortable with us coming out to families. And I think just us understanding and having that connection really has allowed the families to become more comfortable with the providers and the outside personnel. And there are some areas where a lot of the health professionals that make it up are also Native American or specifically Navajo. Just having someone similar to them and knowing, understanding where they're coming from really helps them to embrace the fact that we are here to help them. We only want for them to be healthier and that we are hoping to establish a healthier nation. We are trying to change these health disparities. We are not necessarily trying to change their whole lifestyle, but more of just incorporating more fruits and vegetables, slower steps.

And Sonya, from your point of view, how do you see this process playing out and issues like trust working?

I'm glad you bring it up. And I appreciate Kymie's comments because I think it's really key to any meaningful work when serving other communities. And I think Kymie's testament to being a member of the Navajo Nation and being able to, not only build that trust as a frontline staff, but also given that opportunity to advance her own career and have the option of coming back and working in public health has been one of the important achievements of our organization.

I can say from my own standpoint as a provider and as somebody who is not from the community. With patients, it took me about four years to actually get any trust with the patients that I see in clinic because they're so used to having providers come for about three years, which is about how long it takes to pay off your loans, and then to just cycle on out. And so I think there's this important role of just being present, and constant, and really listening.

Most of our programs took a long time to germinate because we had to really just spend a fair amount of time listening to others and make sure that we were finding an approach or a strategy or a program that would respond to those needs and not actually become interventions that sort of circumvent or undermine other movements that are happening. You know, we spent a lot of time thinking about like, well, who's in the food space? Who's doing this kind of work? How can we not be the frontline providers, but how can we be the folks who are kind of infusing additional resources or ideas to build the capacity among folks who are already here in the community? I think that's been a really important approach that we've taken over time. And it's taken us 10 years to get this far. And, you know, I hope that the fact that we do have a fair amount of trust among providers and also with the Navajo Nation leadership with whom we consult quite frequently, is kind of a testament to that approach of partnership.

Well, thank you. Kymie, I'd like to come back to you in just a moment and ask you about barriers that you encountered while the program was being implemented, but before I get to that, Sonya, do you believe that this is a model program that can be replicated elsewhere? And are you two working to get this program to other communities?

Yeah, I think from the very beginning, we were interested in choosing something that had the potential to be replicable to other Indigenous communities. And I should mention that FVRx, this Fruit and Vegetable Prescription Program is not unique. Like we're not the only ones doing it. There are many different communities across the United States that offer prescription produce within healthcare settings. To our knowledge, this might be the only one being offered in a Native community, but from the very beginning, we've really tried to think about, okay, how can we create materials, generate evidence, think about flexibility that will allow the program if it's successful to then be transmitted to other indigenous communities? And I know Kymie's received a lot of interest and inquiries from other Tribes. I think the key take-home for us has been that every community has different strengths and different needs. And we've even seen that across Navajo. If we have 12 different clinics that are running the program, there's a lot of heterogeneity of the program because each clinic has different teams that want to implement. They have different priorities, and they also have different gaps. So I think we've really tried to create a program that has parameters that are core, but has a lot of breathing room for flexibility and adaptation, so that our hope is it will be easier for other communities to take the model and then to say, "Okay, well, what's going to work in our community? "What's my priority here? "Who's the team that I envision doing this work?" So that's a future learning step for us too.

So Kymie, what are some of the barriers that you and your team encountered as you were implementing the program?

So as we are going across the reservation and implementing the program, we have started to notice a lot of good indicators of the work that we are doing. For instance, no bandwidth. Right now, we are a two-person team right now, and we are expanding to three, hopefully in the future. But, you know, with the increase in popularity of the program across the reservation, it's hard to keep up with that demand. So finding the bandwidth to be able to keep the program and quality of the program going, it's been really challenging. But it's good that the program is growing and that we are needing extra hands.

And then also, just finding compatible platforms that work for everyone. So what might work here on a border town, because we have no internet capability, might not work for another clinic or another community health team that's based six hours away, more in the middle of the reservation. So I think just finding compatible platforms to be able to communicate with everybody has been pretty difficult. And then, as the program is expanding, we are coming across other barriers, but they're all a pretty good indicator of the growth that the program is seeing overall.

Bios:

Dr. Sonya Shin, is a physician in the Division of Global Health Equity at Brigham and Woman’s Hospital and professor at Harvard School of Medicine. Her research and clinical experience has focused on relieving health issues among underserved populations. She has been working in Navajo Nation since 2009 and is the executive director and founder of Community Outreach and Patient Empowerment (COPE), a non-profit and Partners In Health sister organization that aims to eliminate health disparities and improve the wellbeing of American Indians and Alaska Natives through community-based outreach and food security initiatives.

Kymie Thomas is a member of the Navajo Nation, a coordinator for the COPE FVRx program and an aspiring Public Health professional. She earned a degree in Health Sciences from Sheridan College, and have 4 years' experience working within the Public Health sector. As the Fruit and Vegetable Prescription Program Specialist for the COPE FVRx Program her work has allowed the COPE Program to help increase access to healthy foods for Navajo families, and improve health outcomes in various Navajo communities that are affected by diet related diseases.

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Today, we're exploring the intricate relationship among African-American politicians, civil rights organizations, communities and the fast food industry. We're talking with Dr. Marcia Chatelain, Professor of History and African-American Studies at Georgetown University. She is the author of a fascinating new book entitled, "Franchise: The Golden Arches in Black America."

Interview Summary

Well, let's begin with this question. Can you tell us about your book Franchise, and why did you believe the story needed to be told?

Well, when I was in graduate school working on my dissertation, which would become my first book, I became more and more interested in issues around the food system and food justice. The film "Super Size Me" had come out while I was in graduate school. And I became more curious about some of the issues around health and nutrition, particularly the disparities along racial lines in terms of access to fast food, as well as marketing and fast food. And as a historian, one of the things I noticed in a lot of the conversations, is that public health practitioners and advocates for healthy eating, rarely contextualized the problems in our food system historically. There was a common sense understanding that some groups of people didn't have access, and some groups of people were more susceptible to diet related diseases, but I didn't hear enough people asking, well, how did we get here? And so with franchise, what I really wanted to think about were the ways that McDonald's, as the leading fast food brand, really pivoted from being a presence in mostly white suburban communities for the first two and a half decades of its existence, to one that became such a presence in African-American communities. And so I wanted to historicize the problems we see today in terms of access to food.

Before you tell us what you found in your historical research, can you tell us how you developed resources for the book?

Oh, thank you for asking that question. As a historian, I love to talk about sources. You know, when I started "Franchise," the first thing I did was I called McDonald's, and they have an archivist and their own research entity, like a library, and I contacted them and I said, you know, "I'm a researcher and I'm interested in this history. Can I have access to your archives?" And they said, "No," which I expected. And so what I started to do is to think really creatively about the various places in which McDonald's first tried to enter African-American communities, and to think about the leadership of various black organizations during the time. So I started to look outside of the traditional sources for business history and for fast food history. And by centering African-American communities, I found a treasure trove of resources about McDonald's marketing strategies from the 1960s and how they started to engage with black consumers.

I have a question about marketing in particular I'd like to ask you, but I'll loop back to that, but let's tell our listeners what you found mainly in your research.

So, essentially what happens is that McDonald's is founded by the McDonald's brother in 1940. And they develop as a Southern California brand, alongside other fast food businesses. But it wasn't until Ray Kroc creates the McDonald's system that we know today. Franchises become the way that McDonald's grows in the 1950s and we start to see McDonald's confronting the reality of America's racial climate, such as confrontations over segregation in the South at McDonald's restaurants.

And then, this period in 1968 shortly after Martin Luther King Jr's assassination, is when McDonald's is starting to pivot to African-American neighborhoods because some white franchise owners no longer want to do business in increasingly black communities. This is when the Nixon administration is encouraging something that they are calling black capitalism and is trying to promote black business ownership in black communities. And leaders of the civil rights organizations are trying to determine what their identities and interventions will be after King. And a number of people who were very much formed by that mid-century civil rights struggle start to think about black economic empowerment and development as the next phase. And so all of these forces kind of come together to create an environment in which the fast food industry can capitalize on federal funds and support from the civil rights establishment as well. And the black consumer market is hungering for inclusion in some of the mainstream marketplaces that McDonald's represents.

Over the years, people, especially the Rudd Center, has done research on targeted marketing of things like fast food and sugar beverages and cereals to people in different demographic groups. And they found a considerable amount of targeted marketing. And there's been kind of a mix of outrage and lack of surprise on this. Some of the lack of surprise comes from people who better understand the history, like you're talking about. They will say things like, “you know, there was a time when communities of color were ignored entirely by establishment companies, in both the products they were selling, in their portfolio and also in their marketing, and it actually came as a welcome change when the community started being paid attention to.” But in the context of your work, does that all fit?

Absolutely. So what happened prior to the late 1960s is reminiscent of some of the conversations that were had after the George Floyd summer in 2020, in terms of how far do corporate commitments to inclusion go. How do we think about business as a lever for social change? And so while there had been companies that were marketing to African-Americans throughout the early 20th century, especially during the Great Migration, with the urbanization of African-American communities and a recognition of buying power in those communities, it wasn't until the late 1960s where you start to see that kind of market segmentation with the specialized advertising, featuring African-American models or celebrities. This is a period in time in which you were seeing the growth of African-American public television programming, shows like Soul! and Black Journal, that are really trying to speak to the concerns of African-Americans. And so after '68, you start to see this incredible creative industry that is built around marketing to black consumers. And for the first time, it isn't just commercials that were once designed for white people, and then there are a few black people in the commercials, these are commercials that are trying to really touch upon black cultural markers.

So it sounds like this movement of fast food, led by McDonald's, into the communities of color was welcome, because what it represented, both in terms of economic development, and then attention being paid to the communities.

Absolutely, and I think it's really a double-edged sword, because on one hand, people are desirous of this type of inclusion. And it is being sold to communities as this great economic opportunity for people to build wealth, to create jobs, to create community. But the hindsight of 50 years has shown us that all of these things come at an incredibly high price. And in the book, I really like to focus on the varying reactions to what kind of presence McDonald's should be in black communities. You know, in places in Chicago, people embraced this idea, and community groups actually tried to acquire franchises so they could reinvest in the community. But in other places, people were skeptical of the kind of corporate-social responsibility talk about diversity that McDonald's was developing the language for throughout the 1970s. And I think the backdrop for all of these conversations and all of these struggles is: can business ever really fully deliver on the promises of racial justice? And I think that the answer is no, because it always comes at such heavy costs to the most vulnerable communities.

I'm expecting that the number of owners of franchises of color has increased over the years. Has that had an impact on the company and the way it does its business?

Well, this is a really fascinating point you raised in this moment. So over the summer, McDonald's was sued by more than 50 former African-American franchise owners. And there's a current lawsuit of a current franchise owner, Herb Washington. And they claim that McDonald's has had a series of policies and behaviors that are racially discriminatory, and that has led to fewer black franchise owners. And so at its peak, it was a little over 300. Now it may be in the 150s, but part of this process of getting African-Americans to franchise McDonald's was successful, in the sense that, throughout the 70s and 80s, you see the building of economic power among this group of franchise owners. And they take a lot of their profits, and they become incredibly generous with historically black colleges and universities. They prompted McDonald's to start celebrating the Martin Luther King Jr. holiday. They are the driving force behind some of McDonald's diversity initiatives within its corporate headquarters, which it was lauded for throughout the 80s and 90s. But these types of changes are sustainable to a point. They are corporate activities that, ultimately, shut out the people who, again, are most needing structural change, and that's the black and brown workers who are working at the fry stations, who are making burgers, who are ensuring that people get fed in the stores. They're very much cut out of this vision as a force for good for racial justice.

Now, I'm going to ask you a question that's more economic in nature. Here's the context. With programs like SNAP, where vast amounts of money are flowing out from Washington into communities, so people have food assistance that they really need desperately, there's concern that too little of that money remains in communities, that it just flows through, as people might leave the neighborhoods to go to places like Walmart or Kroger to buy their foods. And so there's a real missed opportunity for economic development going on. What do you think about McDonald's? Do you have any sense of how much of that money remains in the communities? Tell me what you think about that.

Well, this is an interesting place in which you see the operation of race in the context of a multinational corporation. So one of the reasons why this lawsuit emerged last year and there were different versions of similar lawsuits and similar claims, since the early 1970s, that McDonald's essentially restricts African-American business people to doing work in hyper-segregated neighborhoods. And this is important, because part of the sell of this idea in '68 was that black franchise owners would be like local business people, right? They know the community, they're connected, they're invested, they'll employ people that they know in the community and it'll have great rewards. But part of that strategy means that there has to be a level of exclusion of those business people from expanding into white neighborhoods or neighborhoods with different racial backgrounds. And part of the argument that black franchise owners make is, the name of the game is volume. And so for us to really keep up with our white peers, we should be able to get a whole bunch of stores in different types of neighborhoods, with different types of operating costs, and we could really profit from it, but McDonald's, they alleged, keeps them from doing that.

And so when you talk about local impact and local dollars, one of the problems of fast food is that a good portion of the revenue goes way out past the community, because after you talk about the low wage jobs that it provides, and maybe some of the philanthropic efforts, on the local level, a good portion of profits are going to franchising fees, back to the national headquarters. A good portion of the advertising fund that franchisees have to pay into are going to advertising firms in Chicago and New York City and Los Angeles, that aren't necessarily in the local communities. And the supply chain that fast food relies upon are from vendors and suppliers that are all over the nation, and unlikely to be locally sourced. And so this was one of the critiques in the 1970s, and I think the critique holds today, that fast food does not really circulate money in the local economy, because it is not a local small business, even though there's some aspects of franchising that might mirror that.

That is fascinating. And so when one calculates the ultimate impact of a place like McDonald's on the community, there's the nutrition impact, to be sure. There's the loss potential for economic development within the community, but they're all the sorts of historical reasons that made this possible, and even desirable in the first place. But in your own mind, given that you've thought about this so thoroughly, how do you balance all of this?

Well, I think that this is a cautionary tale about bad ideas, well-intentioned bad ideas, and the sense that we could rely on the private marketplace to mediate the problems of the public good caused by racism and inequality is not sound thinking, it's not sound policy. What it is, is a reflection that communities that are vulnerable are often given constrained choices for survival and for something that mirrors advancement. And so it's kind of strange to think that, in 1968, after all of the grief over the loss of Dr. King, and all of the unfinished business of the war on poverty, of the Johnson administration escalating war abroad, and poverty at home, how is fair housing going to be delivered? The failed promise of school integration. So you have a really, really long list of reasons why people are deeply aggrieved, and the solution comes, well, maybe people could open businesses? Maybe a franchise could come into your community? And this doesn't respond to any of the reasons why people were crying out in so much pain. And for me, it's really hard to see that playbook re-emerge in 2020. You know, in the middle of a global pandemic and a crisis of racial justice, you hear some of the similar things. I was just on a call recently, where someone said, you know, "After the George Floyd summer, we committed our company to more investment in black business." But the reality is that there are nearly 2 million black-owned businesses in the United States. Very few of them have the size, scale, or capacity to provide incredible jobs, and the volume of jobs necessary to really help rebuild communities. And so I think that, if anything, researching this book just made me more certain that big state solutions are the only ways we get on the other side of injustice, and that includes food injustice.

Well, this has been fascinating. So let me end by asking a question about what we can learn from the history of fast food. So what do you think the fast food can teach us about food policy overall in the US, and how do you believe fast food has shaped the relationship to food?

Well, I think that what we need is an end to what I would call passive subsidies for the industry. Because when we think about the fact that we can get this type of food so cheaply and so quickly, then we know that there's a series of public policy failures all along the road to it, whether it is subsidies on corn for high fructose corn syrup, whether it is the lack of a federal minimum wage that allows low wage work to continue, whether it's the fact that we have a lot of the smaller... McDonald's doesn't fit in this category anymore, but some of the smaller fast food franchises that are qualifying for small business loans. And as a result, this becomes a funnel for minority owned businesses, which are more likely to happen in hyper segregated communities. And so the incentives for opening other types of businesses are fewer than fast food. We have all of these reasons why this problem persists. And unfortunately, we live in a cultural context in which the people who consume the food are blamed for all of the problems and not the structures that allowed this food to become available. And so I think that if we really are serious about health and nutrition and all of the complicated issues associated with fast food, then we have to stop allowing fast food to set the tone of the way we live. A lot of people, when I was on the road for this book on my book tour, would say, you know, "This is why I advocate nutrition education or gardening," and all of these things. And I said, "These are great, but we have to ask questions about the quality of people's lives." All the access to fresh food doesn't matter if a person can't pay an electric bill and keep the refrigerator running. And all of the lessons about nutrition and how to prepare food mean nothing, if people are working multiple jobs and don't have time to prepare food.

The reality is that fast food is a rational and reasonable choice for good portion of Americans, because of the quality of life that people are forced to have, because of poverty and being part of the working poor. And so if we are serious about this, then we need to not let fast food dictate the fact that consuming a lot of calories very quickly makes perfect sense in a culture that people are stretched so thin.

Bio

Marcia Chatelain is a Professor of History and African American Studies at Georgetown University. The author of South Side Girls: Growing up in the Great Migration (Duke University Press, 2015) she teaches about women’s and girls’ history, as well as black capitalism. Her latest book, Franchise: The Golden Arches in Black America (Liveright Publishing Co./W.W. Norton, 2020) examines the intricate relationship among African American politicians, civil rights organizations, communities, and the fast food industry. An active public speaker and educational consultant, Chatelain has received awards and honors from the Ford Foundation, the American Association of University Women, and the German Marshall Fund of the United States. At Georgetown, she has won several teaching awards. In 2016, the Chronicle of Higher Education named her a Top Influencer in academia in recognition of her social media campaign #FergusonSyllabus, which implored educators to facilitate discussions about the crisis in Ferguson, Missouri in 2014. She has held an Eric and Wendy Schmidt Fellowship at New America, a National Endowment for the Humanities Faculty Fellowship, and an Andrew Carnegie Fellowship.

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If you go to the website of an organization called GOODR, at goodr.co, you will be rewarded with inspiration to be sure but you'll also find some startling information. While one in seven Americans is food insecure, 72 billion pounds of edible food goes to landfills each year and $218 billion is spent growing, transporting and disposing this food. You will also learn from our guest, Jasmine Crowe and I quote, hunger is not an issue of scarcity, it is a matter of logistics. Jasmine Crowe founded the tech-enabled sustainable food waste management company, GOODR. The ingenious work she has done in Atlanta, which simultaneously addresses food waste and food insecurity, has received national and global attention and is featured in a terrific TED Talk that Jasmine's given.

Interview Summary

What is GOODR and what inspired you to begin this effort?

So GOODR is a sustainable food waste management company. Essentially, we look at ourselves as any waste management company would, a waste management, a republic solid but our focus is on food and we back everything that we do in technology. And I was actually inspired to start GOODR through own personal experiences. I started feeding members of our homeless communities in 2013 and that was really my first exposure to actually fighting hunger on a personal level. So cooking meals for about three to 500 people every two weeks for my kitchen. But I think what really inspired me to get started was when I realized that some of my personal family and friends were either currently struggling with hunger or had struggled with hunger and it opened my eyes to see that hunger just didn't discriminate. Here were friends of mine that I knew were college educated, well-traveled, had led really great careers but just ran into some struggling periods where food became an option and not a necessity. And when I saw that and saw how much food was going to waste, I decided that I wanted to really give my all into solving this problem.

Well, that's impressive that you were cooking meals for so many people. Paint us a picture if you will of what day-to-day life is like for people who struggle with food insecurity.

Yes, so you said it, Kelly. You're going deal with about 42 million people on an annual basis that are living food insecure. And so what that means is that every night, they're going to go to bed hungry, often wake up the next morning, still hungry and not knowing when or where that next meal is coming from. And so when you look at this, you're looking at about 14 million children, 7 million seniors that are dealing with hunger every single month. And when I think of the fact that they have to make these critical choices, especially my senior citizens who really, that's where my heart string lately in doing this work has been greatly pulled towards, because many seniors are receiving just $16 a month in SNAP benefits and they have to make that choice. Hey, am I going to pay for my prescriptions, or am I going to pay for food? And often, so many of them choose prescriptions because they believe that's what's going to help them live longer. But when I'll sit and talk to the seniors and they'll show me their prescriptions, so many of them require them to be taken with food. And so what I see them doing is they're eating crackers. They're eating tuna. It's not a good day for any of them and when they get free food, they clamor to different events and workshops in their senior homes, because that's going to be the only time that they eat. With children, you have kids that are going to get free breakfast and lunch every day at school but what does that mean for them on the weekends? And what you see is that these kids are constantly playing catch-up. So if they get free breakfast, that's great. But if they didn't get free dinner last night or dinner at all, now what you do is you have this breakfast that's replacing the dinner that they didn't get, the lunch that's replacing the breakfast that they didn't get and now you have children that are sitting in class. They can't focus on learning because they're hungry still and no teacher can teach through hunger. You know, I can't tell you how many parents I've met who have said, I go hungry just so my kids can eat. And those are just some of the struggles but these are working people, or people who have worked their entire lives or children of parents that are working that are struggling. It's not just people that are homeless, which is where I started and where I was wrong.

It's really heartbreaking to hear that these stories occur at all in a nation that has enough food and let's get to that now. When you said you founded a waste management company, most people don't associate waste management with addressing food insecurity. So tell me more about what GOODR does.

We basically work with businesses. We inventory everything it is that they sell. So people will think of us almost as like an Instacart or Uber Eats, if you will, in reverse. So we know what the business sells, what their retail costs are and at the end of the night, when they have surplus food that would otherwise go to waste, they can use our mobile app or our web portal to request a pickup. And we created a very easy user experience which allows them to scan items out or click on items and tell us the quantity and our platform calculates the weight value, as well as the tax value of that donation. They can't request pickup. We deploy our network of logistics partners. We get that food delivered very fast to a nonprofit that's within a five to 10 mile max radius of where that business is and that nonprofit receives it. They sign for it like they would a UPS package. A donation letter is then placed into our customer's dashboard. And so that's where we've started with the GOODR hunger. And now we are rolling out to animal feed as well as compost, because we believe that we want to solve food waste just as badly as we want to solve hunger and so while we're concentrating on what's edible now, our focus at whole is to be a full service food waste management company that can go into any food service business and say, we will take care of all your food waste, thus eliminating the need for their daily waste management service.

So is it financially sustainable or financially feasible for say, a restaurant to do this? Because they might pay you to pick up the food and that makes your business sustainable but then they don't have to pay to have the waste disposed of in the traditional ways. Is that the way it works?

That's the way we're wanting it to work. So once we have all of the services in the order where we're helping with compost, animal feed even anaerobic digestion, that is the vision. I mean, it's very much sustainable for them because the thing is Kelly, if you look at it, they're already paying to throw the food away, so that we're not introducing a service that's so foreign to them. Right now, they're just paying a waste management company to throw it away but once they spend that dollar, the only thing that they could do is then write it off as a business expense but with GOODR, not only could they write us off as a business expense if they choose to, now that dollar tells a different story. Now they have a sustainability story that they can tell their constituents. We are improving our carbon footprint by reducing the food waste that our company produces on a daily basis, getting food to people in need becomes a corporate social responsibility story. And then they know everything that they donate that's edible, they get a tax deduction for it. So in essence, we're actually improving their bottom line. So I look at it as a triple win and a very big value add that they once did not have.

I'm glad you mentioned the environmental benefits of this, because many people may not realize that when food gets discarded and goes to landfills, it contributes a lot to climate change. So I'm assuming that's what you mean by the environmental consequence?

Exactly. I think a lot of people don't realize that.

So give us an example. Take a restaurant, or a food business or something like that and paint a picture of what they might have left over at the end of the day and who picks it up, actually and then where it gets delivered to?

I'll use the Atlanta Airport. That's one of our first key signature clients. Our do-gooders are in the airport six days a week. We go restaurant-to-restaurant, so you just imagine a food court, if you will, where you have all of these restaurants connected to each other. They are entering their food for pickup. Our do-gooders enter the airport right at closing time, so we're capturing the food at the peak freshness. We're getting it from each of those restaurants. It goes into our packaging, as well as our insulated bags. We have a refrigerated truck that drives right on the tarmac and then it's delivered to nonprofits every single night. So that's kind of how it works at the airport. We actually do start to help the customers reduce their waste, which is something that I do love about GOODR but it's never going to go to zero. And so we've seen that over the last year working with the airport. For example Einstein's Bagels was one of our airport customers and when we first got started with them, we were picking up anywhere from three to 400 bagels a night because their standard of bagel freshness is fresh bagels every three hours. But once we were able to show them how many bagels they were wasting, they started to reduce their production. And so now we pick up from Einstein's on average anywhere from 40 to 80 bagels per night but we're still there to capture all of it. And so if they didn't know how much they were producing and how much they were wasting, they would still continue to overproduce. And so that's part of what that technology and the data that we collect around this waste does. We're going to pick up sandwiches and salads and meals that weren't sold. So that's what you're going to see getting picked up from an airport. At a customer like Chick-fil-A, you may see all of their salads, all of their wraps, all of their fruit cups and chicken sandwiches and chicken tenders that were prepared, maybe for drive-through or fast food quick service. Someone comes in and gets it, it just wasn't sold. And so those are kind of the items that you're going to see when you take it to the convention center level. You could see thousands of pounds of food, thousands of pounds of produce. It really just depends on what that show is that's taking place but the food that we've seen has been everything from filet mignon to apples.

I fly in and out of the Atlanta Airport a lot and that is a massive airport with an awful lot of food businesses. So I can only imagine the scale of what you're talking about. In addition to the place of serving food at the airport, what are some of the other kinds of businesses that you work with?

So we work with a lot of corporates. So we work with a lot of corporate cafeterias, SAP, MetLife, and Warner Media Group. So those are another kind of client vertical for us. We are beginning to work with colleges and universities, so we're really excited about that and we're onboarding grocery stores as well. So we have several different verticals that we work with within. But if you think about it, Kelly, food exists everywhere. So where we're really coming in now is just becoming a conduit to connect these businesses with all of this surplus, to people with me.

How far away from the place the food gets collected can you distribute food? And I'm thinking particularly about needs in rural areas. Would it ever be feasible to get food out to people who are outside of the city where the food's being cooked?

I think that's a great question and that's something that really keeps me up at night because on a personal level, people email me. I get Facebook messages, I get LinkedIn messages. You wouldn't believe it. And I hear from people in rural communities that are saying, ‘Hey, you know I'm in Macon, Georgia, I'm in Corpus Christi, Texas. Is there any way that you can get food to me?’ And so that's really what's been having my brain spinning, where we are looking at entering this market without being too divulged in where we're trying to go, is as we start working with more grocery stores, we are looking at similar to meal kits, getting food to people in need on next day delivery through say a UPS, where we would get food boxes but that were filled with enough to make real meals. I mean, that's the difference in what you're seeing in a traditional food bank or a food pantry today. I would encourage anybody to go and volunteer at one because I did it myself and I couldn't believe the food that they were just giving people that wasn't going to make any real substantive meal for them or their families but would have lines of people just to have something in their house. And so with GOODR, I'm really concentrating on what does it take to sustainably package food to get to people next day delivery, right to their door. And so that's how I look at the opportunity to solve within rural communities. We are also looking at the expansion of the current franchise model with customers like a Chick-fil-A that are in a lot of rural communities. What does it look like to get food to people in these rural communities from our current customer footprint? We think that there's a big opportunity there.

Are there ever nutrition judgment calls you have to make with the food that you're collecting and who it goes to?

Yes. So we're using a lot of technology machine learning around that space to understand what kind of food we're getting to people. So we brought in a nutritionist and so we're wanting to make smarter decisions. If we say, get a nonprofit Chick-fil-A on a Monday we would want to try and get them a corporate kitchen, cafeteria food, maybe on a Wednesday, if they get another delivery from us. Or like a Sweetgreen, something that's just healthier. So we are trying to make sure that we're not sending them the same kind of food that is maybe considered unhealthy. We're focused on balanced nutrition across the board.

And what are some of the biggest challenges you face as you go forward?

I think the biggest challenge is still getting people past that fear of if I donate the food and someone gets sick, I'm going to get sued. That's a big part of it. We have to lose the fear in the hunger fight. GOODR comes in, we provide the supplies. We provide the liability insurance. You have the Good Samaritan Act. We have agreements in place with the nonprofits. So we've really covered so many of those bases but we still have people that for all intents and purposes are just afraid because they're living in the old guard, in an old mindset of someone's going to get sued. But when they think about it, they do this every single day. They're sending food that people pay for in a car with somebody to someone's house via Door Dash, Grubhub, Uber Eats and no-one's worried about someone getting sick in that route. So we need to stop being afraid of making sure that people eat, because that's when they really get sick, right? That's when they really could get gravely ill by not having food.

The other thing is, GOODR is a business, you know? I thought very hard when starting GOODR, would we be a nonprofit? And what I knew for sure is that if I was a nonprofit, I would spend all of my days really worried about donations instead of getting to the problem. And when you really want to solve hunger and you think that, hey, food banks have been around since 1970 and people are still hungry and the population of people going hungry continues to grow. You have to really look at it as a business, putting real infrastructure behind it. We want to pay our drivers and people that work for GOODR a fair living wage. And we really look at ourselves as a waste management company. Again, which a waste management company is not a nonprofit. This is a service, it's the right thing to do with donating the food that's edible. But as we start to expand it to these other services, businesses have to look at this as a true expense to get to their zero waste goals. And I think what we will see is a tipping point. Right now, hey, this could be foreign to a lot of people. They've never done it before. But what we are starting to see is a lot of shift in policy, where businesses are being required to recycle their organic waste and to donate their food that's edible. And you're seeing this happening all over France and Italy and here, even in the US, in Los Angeles County and Boston and Austin, Texas, these policy shifts are coming.

Bio

Jasmine Crowe, an HBCU alumna, is the founder and CEO of GOODR Co. Jasmine launched her first company BCG in 2011. Thru BCG she partnered with celebrities across the nation in a host of cause campaigns to ensure their star-power was being used for good. Lead by Jasmine, BCG hosted activations in more than 20 US cities and the UK, South Africa and Haiti and has collected and donated over three million items to causes worldwide and fed over 80,000 people through the Sunday Soul Homeless feeding initiative. Jasmine also served as the creator and executive producer of Change Makers a half hour docu-series profiling how celebrities use their star power for social change which premiered on Magic Johnson's network ASPIRE! In January of 2017, she launched Goodr, a sustainable food surplus management company that leverages technology to combat hunger and reduce waste. Today Goodr redirects surplus food from convention centers, airports, and businesses to people who are food insecure.

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Ever wonder how a groundbreaking, pioneering, and award-winning chef and cookbook author came to such a place? Today, we'll find out from Deborah Madison. After working at breakthrough restaurants Chez Panisse in Berkeley and Greens in San Francisco, Deborah Madison made her mark in Rome, opened Cafe Escalera in Santa Fe, and became a prolific writer of cookbooks and articles about foods for places like "Gourmet" magazine and "Food & Wine." Her latest book, which is entitled, "An Onion In My Pocket," is a memoir. It has been very positively reviewed in many places with terms like "beguiling, honest, and captivating." And in the words of Marion Nestle, a well-known figure in the food area, the book shows how the path that carried Deborah to become what Marian said is, "The consummate vegetarian cook and cookbook writer."

Interview Summary

So your book, "An Onion In My Pocket" - that's a really intriguing title. How did you come to that?

Well, there was an onion in my pocket one day. And I just was writing about it, maybe telling my editor about it, and she said, "Oh, we should use that for the title!" There was an onion in my pocket because I had been cooking with a friend and these onions were leftover from a pizza we were making. They were beautiful onions and I took it home with me. And then I went to Spanish class and it was in my pocket along with my pencils and papers and things like that. And I took it out, put it on the desk, and people started to laugh. And I thought, to me it's normal that I have an onion in my pocket or I could have anything in my pocket. I've even had a snake in my purse that I brought home once because it was going to eat gophers, which I really appreciate. So that's how that came about.

Wow, all kinds of interesting things show up in your pocket, in your purse. So in your book, you write about some of your other 14 cookbooks and what was involved in writing and publishing them. Which ones mean the most to you?

Well, I think Local Flavors does, Seasonal Food Desserts and above all, Vegetable Literacy. And they mean something to me because actually the first chant that we learned at Tassajara, which is the Zen monastery I was at was: 72 labors brought us this food. We should know how it comes to us. And all these books are indirectly about how food comes to us and the stories of food. And they're interesting to me and I'm still very interested in that question. So those are my favorites.

So Deborah you mentioned something that I find fascinating about the story of food. Does it seem to you like it does to me that more and more people are becoming interested in the story of their food, and do you think this is a positive trend?

Well, I feel like it's both positive and not so positive. I hope we're not going to lose what we've gained in variety, particularly of vegetables because it's been a long, long fight. You know 40 years ago there was nothing, there was really nothing to eat and now there's a lot. And yet people are going back to old things as vegetables become harder to get. I've even cooked corn dogs for my husband who requested them. And I thought, Oh really? I've never even had a corn dog. What is a corn dog? I had to go online to learn how to make one. I think that there's kind of a retrograde happening right now in the pandemic at the same time I think that people are interested in the story of their food and they have to be because it's disappearing.

As I look out there and I see more and more restaurants have a board on the wall that lists the farmers where the food comes from and you hear people talk about food miles or the environmental impact of the foods they're purchasing or consuming. And you know, people are interested in animal welfare or others are interested in some other issue of theirs, but when you put it all together it seems to me that the number of people care about these things has gone way up. And then I at least see that as a very positive trend. But I appreciate your thoughts on that.

I think it's a positive trend too. And I like it and I hope people really do what they say for here in New Mexico. People would say, "Oh, we use local food" and they'd order a pound of lettuce or something like that. And it would run out. But I think people are doing more. You can taste the difference. You can see the difference customers aren't stupid. You know, especially if they shop at farmer's markets there they're familiar. And if they have gardens and I think more and more people are gardening, at least judging by the seeds and how they're disappearing from companies who take breaks and fulfilling orders and that kind of thing. But I think you're right. I think there is more of a concern than there has been in the past.

So you write about what you call Kitchen Lessons things that you've learned often from customers. Can you share some example?

The one I was really interested in was 'Don't Apologize.' The example I used in the book was with a customer who said he loved the smoky flavor and the mushroom soup we had made. I know I knew there wasn't supposed to be a smokey flavor. So I just said, thank you very much because why make him feel terrible about misjudging or not recognizing that the solids have fallen to the bottom of the pot and were scorched. And that that's what he was tasting. So that was a lesson that I did learn very much from customers.

Other lessons I knew or I learned were to one eat in the dining room. Like a customer is very, very important as a way to getting to know your food treat everybody the same for sure you have to do that. And I mean I learned these lessons in the most painful ways possible. Marion Cunningham taught us a really good lesson when she said, "Debbie, dear do you not believe in salt?" And then she talked about salting food and how you should salt as you go, when you cook. Let's see be gracious always to everybody. You know, people would come into the kitchen and tell me that that was the best meal they'd had. And I'd wanna say, "you're kidding." "What do you eat normally?" You know, but I finally had to learn that their experience was very different from mine and that it was just important to say, "I'm so glad you enjoyed it," and actually mean it.

And the last lesson, wasn't so much a lesson but a hint of things to come, which was; know that the six months in the beginning will be the hardest but you will get to leave one day. And that did happen almost to the day. And I was reflecting upon that and thinking at the time, "Oh six months have gone by, I've made it, we've made it." And now Greens is over 40 years old. It's amazing.

Let's talk about that a little bit. So if you think back to those days when you worked at places like Greens and Chez Panisse, how are those or similar restaurants different today than they were back then? Certainly they're more popular and visible, but beyond that have things changed much within the restaurants?

Oh yes, I'm sure they have especially Chez Panisse because I never, ever could walk in and get a job like I did then. I just wanted to work there so badly and it made so much sense to me, their food made so much sense to me. And I don't think I would have been able to do that today for sure. Alice isn't there so much, like she was then and it wasn't some new greens for one is the dinners are all a carte menus. They're much more expensive. They're beautiful. And menus are printed on heavy paper stock. The waiters know the difference between espresso and espresso, which we didn't really understand, so much then we thought that coffee drink was to get you going. And it is, but it's not an express as espresso is pressed, things like that. So I think they are different but I think in some ways they're the same. Their commitments are the same. They're just many more restaurants that are doing that kind of thing too.

I scanned the titles of your books. Nine of the mentioned vegetables in the title but you say you're not a vegetarian, what is that?

Well, I just find it's too limiting. It's just too limiting. I think I'm probably a natural vegetarian and that's the food I really love to cook and eat. But if we are a nation meat eaters and I really think we are I feel it's important to know what that's about. And that's why I've been on the board of the Southwest Grass-fed Livestock Alliance twice. And if somebody, I know like my husband, for example wants meat and he was raised with meat, I'm happy to cook it for him. I don't like the limits of vegetarianism or any kind of food title. I don't really care to have a label attached to what I eat.

So given that you're so prominent and writing books for people who are vegetarian do you get any pushback yourself for the fact that you're not strictly vegetarian yourself?

That's the strange thing is I don't I have never gotten pushed back. Maybe people are horrified. I don't know, but in my book, 'Local Flavors' I actually did have 11 recipes that were for meat because meat was appearing in the market. And this was about the farmer's market movement across the United States. Nobody seemed to notice nobody commented. I don't know. It's odd. I haven't gotten pushback. On the contrary, I feel that people are sort of relieved with this book in a way. I'm not super strict about anything. I'm just not, I have a hard time being struck. Research about the vegetables I eat, I want high quality.

So what do you really think matters about food and how do you define the concept of nourishment?

Well, food that's cooked with a mind of kindness and generosity, care, thoughtfulness, maybe even simplicity. I think that that's, what's important as much more important than what is on the plate, whether there's a meat or not. And I actually did end the book with a lot of stories about meals I remembered and some of them had meat some of them didn't, but the point was that they were so generously given and prepared for me that I remembered them. Some of them happened quite a long time ago.

You know what's fascinating to hear you use words like generosity and kindness and describing how food can be given and received. How does that come through in the way say a restaurant can provide food to people or how families can do it? Cause it sounds like that's very important.

Well, it is. And I've always found that to be true at Chez Panisse. I love, for example, when people come into a restaurant they're welcomed with kindness with, "hello, can I help you?" And “Oh, you have a reservation with time and please follow me” and there's bread on the table. All those are something good. And that's a kind of food kindness that can be extended to strangers. I was writing in my book about more personal kinds of kindness, but not always. In fact, the first story I tell was a meal in Scotland that I had, and it really pointed me to my 'North star', which was about how food in season and in its place is the best food always. And you know, that was because a woman agreed to feed this older woman that I was traveling with and myself and we was really hungry and we sat and waited and we looked at the garden and we looked at the Lake and pretty soon she came in with a platter with the vegetables, from the garden and fish in the Lake. It was beautiful. It was really quite stunning

Bio

Deborah Madison is an American chef, food writer and cooking teacher. She has been called an expert on vegetarian cooking and her gourmet repertoire showcases fresh garden produce. Her work also highlights Slow Food, local foods and farmers' markets. Madison grew up in Davis, California, and earned a bachelor's degree with high honors in sociology/city planning in 1968 from Cowell College at the University of California, Santa Cruz. She then cooked at Chez Panisse and was a student for eighteen years at the San Francisco Zen Center. She was the founding chef at Greens Restaurant in San Francisco which opened in 1979. She then cooked for a year at the American Academy in Rome, Italy. She has written for the magazines Gourmet, Saveur, Food and Wine, Kitchen Gardener, Fine Cooking, Orion, Organic Gardening and Eating Well, and for the Time-Life Cookbook Series. She has also written for Martha Stewart Living, Bon Appetite, Diversions, Kiplingers, Garden Design, Kitchen Garden, Cooks, Vegetarian Times, Metropolitan Home, East-West Journal, the Los Angeles Times, Home and Garden, and the International Slow Food Journal. When she first moved to New Mexico, Madison managed the Santa Fe Farmers' Market and served on its board for a number of year. Madison has been active in the Slow Food movement, founded the Santa Fe Chapter, was active on the ARK committee and served on the scientific committee of the Slow Food Foundation for Biodiversity. She is on the board of the Seed Savers Exchange and the Southwest Grassfed Livestock Association, and is the co-director of the Edible Kitchen garden at Monte del Sol Charter School in Santa Fe, New Mexico. She is the founding chef at Café Escalara in Santa Fe.

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You may not automatically think of faith organizations as advocates for a stronger food system, but boy are they ever? I'm talking today with Rabbi Joel Pitkowsky of Teaneck, New Jersey. Rabbi Pitkowsky, in addition being a rabbi, is a leader and is on the board of directors for MAZON: A Jewish Response to Hunger. This is a national advocacy organization working to end hunger among people of all faiths and backgrounds in the United States and in Israel.

Interview Summary

I'd like to just say a little bit about my understanding of the work of MAZON which I greatly admire, and then have you fill in and give us a richer view of this. So I know that the organization has worked towards systemic change to address hunger and the root causes of hunger for nearly 40 years now. And I know that the work has focused especially on low income populations of problems that have been previously overlooked or ignored and that could include food insecurity in military families, veterans, single mothers, Native Americans, LGBTQ, and the seniors. So this is the first podcast in a series that we're doing in partnership with MAZON where we delve into these issues. And let's start off with this question. So what is the Jewish connection to ending hunger? And what values and traditions drive MAZON's mission?

We derive our mission all the way back from the beginning of the book of Genesis and from the values that we see as being central to a Jewish view of the world. The Jewish view of the value of each human being and really a vision for what we hope the United States can be. We're a country still in the process of becoming and that idea is really core to what we do. So in Genesis chapter one, we read that as God created human beings. Each human being is created in the image of God, meaning each one of us has a spark of divinity. Each one of us regardless of any particular characteristic about us – not because of our material success, not because of our color or gender, anything, just because we're human - we have infinite value. We believe that idea calls us to justice, calls us to treat all human beings with that notion in mind. And that's where it all begins for us.

We continue by thinking about, by drawing upon sources in the Bible, in the Jewish tradition, we read in the Book of Leviticus that we should leave the corners of our fields for those who are hungry, for those who are poor. We read over 30 times in the Bible that we should protect the stranger, the widow, the orphan. Those were terms that were meant to teach us about protecting those who did not have power in society. Those who were powerless. We think about the Jewish idea of tzedakah, which is often translated as charity, but it really is much closer to justice. Meaning in the Jewish scheme of the world, if you don't give your charitable giving - which again the Hebrew term is tzedakah - then it's not that you're being cheap, that you just choose not to give, it's that you're not giving what you have to give. You're obligated to give to help others.

All of these ideas taken together shape for us a vision of what human beings owe other human beings. And that's why when MAZON was founded, it was founded as a Jewish response to hunger for all people. We work incredibly hard to shape a world, to create a world where people, again, we focus on the United States and Israel where people in the United States are not hungry because no one deserves to be hungry. That's just not the world we think we should live in. And it's not that there's not enough food, there is plenty of food. It's not being allocated correctly, it's not being given to those who need it. So all of these ideas for us come together with those Jewish values, bringing us forward to a vision of what we think our country could be, what the United States could be, how we could be treating each other. And it all comes down to this idea of the value of each human being and a notion of justice.

Thank you for sharing your view of how hunger and food systems and human compassion fit into the spiritual tradition that you outlined. So let's get back to MAZON and talk about its founding in history. So why do you believe a Jewish voice is important in the fight to end hunger?

MAZON was founded by Leonard Fein - may his memory be a blessing - in 1985. And from the start, synagogues were encouraging individuals to donate a portion of the cost of their lifecycle celebrations to address hunger. This was sort of a modern interpretation of the ancient Jewish tradition of not having celebrations in your small towns unless everyone was invited. Meaning the poor, the hungry, everyone was supposed to have a seat at the table, literally and figuratively, everyone should be included.

So we quickly became more and more involved fighting hunger and communities around the country. And we learned that the only way to truly end hunger was to change the systems and circumstances that allowed it to persist. We have come to identify and pursue long term systemic policy solutions so that all people can feed themselves and their families with dignity. We know only too well that we cannot food bank our way out of the hunger crisis in the United States. It's just not possible. The only entity that has the ability to really put an end to hunger, and to give people the ability to raise themselves out of that situation - because no one wants to be there. The only entity that can do that is the federal government. So we are pushing efforts to strengthen the federal safety net because we think that is the most effective and efficient way to prevent people from being hungry in the first place. We also think that that's what our government owes the people who live here. But that aside for a moment, we think it is the most effective way for change to happen.

The comments that you just made speak to this broad issue of whether addressing food security issues is a matter of providing more charity or providing justice. Can you talk about your thoughts on how those two concepts differ?

Sure. So I know from my own personal experience the incredible feeling that I get and I assume other people get too when they participate in food can collections or when you give out food at a food bank to people who come, or at a homeless shelter, I've done all of those things, those are all meaningful, powerful, and very, very important for people who are hungry today. But we also know that those activities while meaningful, powerful and important are not going to solve hunger because those people will just come back another day. COVID-19 has really revealed just how many Americans are living just at the edge of poverty. Before the pandemic, nearly 40 million were facing hunger. That was the number of people that had SNAP benefits. We believe that that number has now at least doubled if not tripled in the past 12 months.

It's become clear if not completely obvious, that charitable programs just cannot address the full scope of hunger. Food Pantries, Soup Kitchens, other distribution sites that operate on a country, they were never intended to meet the needs of all of those facing hunger. They were supposed to be just the last stop when everything else was exhausted. They're not structured or funded adequately to meet the scope of hunger we're witnessing today. And we believe that only the federal government has the resources to meet today's needs. Again, in addition to the idea that we believe that the federal government has a moral responsibility to do that. So charity is wonderful. Charity is one of the ways that as human beings, we express our compassion, our empathy for others. And that should continue. I am grateful that there are people all over the country who give to others, who give to either organizations or direct service, who give food so that someone else, their neighbor or someone down the street whatever it is, can be fed, but charity is just not gonna solve the hunger crisis that we have in our country. The problem is just too large.

We're commanded in Deuteronomy to pursue justice. That's what the book of Deuteronomy says. Justice, justice, you shall pursue. The idea I think behind the repetition of the word, because it's in the original Hebrew as well, the repetition of the word justice, is that we can't just sit back and wait for a charitable organization to take care of someone. We can't wait for the neighbor down the street. We have to see it as our problem and by our, I mean the larger human community but let's just talk about the United States. That is our issue as a United States nation full of citizens and non-citizens, and we need to take a proactive stance. The notion that some people have that we can just sit back and wait for local charities, local food banks, or even much larger organizations to take care of the issue, I think it's really abdicating responsibility. We need to step up and we need to act. And by we, I mean the United States and the organization, the entity that can do that in the best, most financially efficient and effective way is the federal government.

I appreciate your thoughts on that issue of moving from charity to justice, because more and more people are beginning to talk about this. And I suspect that over time, this could lead to some pretty profoundly different ways of looking at the issue. So let's talk a little bit more about what happens on the ground. Can you give us some examples of ways that MAZON and its partners have seen success in fighting hunger?

Sure. In the last year we have employed some new ways, some new ideas to advance our goal of ending hunger. So let me just talk about a couple of those. Back in March of 2020 - it feels like a lifetime ago but it was less than a year ago - when we were just starting to really understand the impact of the pandemic, MAZON moved quickly to create a 50 state hunger resource guide to connect people to vital food assistance programs. Many of which are led and administered by our anti-hunger partners around the country. The Jewish community rallied around MAZON in new and inspiring ways. In November, we held a virtual Jewish clergy justice mission engaging over 75 communal leaders from around the country and speaking our truth to power. We met virtually with more than 50 Members of Congress, their staff to urge immediate action to boost benefits to the Supplemental Nutrition Assistance Program or SNAP formerly known as Food Stamps, which was actually enacted a month later.

Several years ago we created the Quick Reaction Fund, QRF, which enables us to respond to rapid response initiatives that may arise in a moment's notice. For instance in December of this past year in Nebraska was the only state to refuse SNAP emergency allotments. So we worked with our partner in the state to persuade Nebraska state government to authorize the Pandemic EBT program, which provided additional food assistance to 61,000 families. For us these are victories, they're small victories, but they are victories because they point a way forward. That when we work together with either local officials, local organizations in different states, or at the federal level when we go to DC and we lobby, and we let people know about some of these issues, we find that people are very receptive. I've met personally with dozens of members of Congress and staff members. No one wants people in their district to be hungry. That's not the moral character of the people that are in our government. We don't always agree on how to end that hunger but the idea that anyone in their district or anyone in their state is hungry is anathema to them is really terrible. So that's the first step. And the next step is figuring out goals that we can meet, goals that are possible and working within the system of lobbying and advocacy and education to make those ideas into tangible reality and tangible results.

So let me ask one final question. So what are some of the common misconceptions about who faces hunger and how much does MAZON work to combat these misconceptions?

The most common misconception about hunger in the United States is that the face of hunger looks nothing like me whatever I look like. Whoever is speaking, it can't be anyone like me. It must be people who look different or have a different skin color, have a different background who aren't educated the way I am, didn't work as hard as I did. We could list two dozen ways that I could be different than you. All of that is just not true. Hunger cuts across every divide in our country. Hunger is not a red state or blue state issue, it is just a United States issue. Hunger is not for people of one color or another, hunger is not limited to people who have a certain kind of education. Hunger really strikes everyone in our country. And I think that the psychological barrier that people have in not wanting to see or not being able to see that hunger looks just like them, that is very, very difficult to break through that wall that people put up, probably just as a defense mechanism. They don't want to think. There but for the grace of God go I, they don't want to feel that one day they could be there.

Several years ago we created an exhibit called the Faces of Hunger where we had a wonderful photo journalist take a few months, go across the country to food banks, to shelters, and take photos of people. And those photographs formed the basis of an exhibit that we put together called Faces of Hunger which we ended up putting in an 18 wheeler tractor trailer when we brought it all over the country to dozens and dozens of different sites for people to go inside and to see this incredible multimedia exhibit featuring people's stories and their own voices and photographs of people that look just like me. The explicit mission of that exhibit - which again is called Faces of Hunger, and there's a version of it on our website mazon.org - the mission of that was to break down those barriers and for people to really understand that hunger affects all people, hunger affects all of us. I remember these stories, people who are veterans of our armed forces, people with college degrees, and people with advanced degrees, all it takes for some people. And this is I think what I was referring to before when COVID has really illustrated for us, sort of blown open this conception of just how many people live right on the edge. Right on the edge of hunger. All it takes is one unexpected medical procedure or one unexpected loss of a job, or some other unexpected financial challenge that puts people over the edge from living within the ability to have a home, within the ability to pay for their groceries and not being able to. That line is permeable, that line is very hard to see until you're on the other side of it, and that line is I think right where many, many, many people in our country live far more than anyone suspected.

Bio:

Rabbi Joel Pitkowsky has been inspired by MAZON for over thirty years, and has been an active donor for nearly as long. He believes that freedom from hunger is a human right and a Jewish value and that we owe it to every human being to have a vision of what we want our world to look like, and to help make that vision become a reality.Joel is a Conservative rabbi in Teaneck, NJ, and is a graduate of Rutgers College and The Jewish Theological Seminary of America. He is also a Senior Rabbinic Fellow of The Shalom Hartman Institute in Israel. In addition to his work with MAZON, Joel is a member of the Rabbinical Assembly’s Food Justice sub-committee and is a board member of Camp Young Judaea Sprout Lake. Rabbi Pitkowsky and his wife have two children.

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Food insecurity poses one of the most pressing development and human challenges in the world. This has been true for a very long time. And still there is a little social consensus on who ought to do what to solve the hunger problem. Today we're talking with Dr. Michelle Jurkovich, Author of a new book entitled "Feeding The Hungry Advocacy and Blame in the Global Fight Against Hunger." She argues that food is a critical economic and social right, and presents a toolkit of ideas for more effective rights advocacy. Dr. Jurkovich is a Political Scientist on the Faculty of the University of Massachusetts in Boston.

Interview Summary

Let's begin with this: hunger and food insecurity are very often discussed as either distribution or supply problems. Your book encourages a different view. Can you explain?

Often, we hear hunger framed as a technical problem with technical solutions. So, if only we could learn to grow more food with fewer inputs and in more environmentally sustainable ways. And if only we could improve market access to that food, then we could solve the hunger problem. But few benefits in society are ever distributed equally or fairly. Even when scientific advancement allows those resources to exist in abundance and the world currently produces more food than it needs to feed even its ever-growing population. Should new crop varieties and farming methods enable it to produce an even greater surplus, there'd still be no guarantee that that abundance would reach those most in need, the most marginalized in society.

So hunger isn't a supply problem, but the distribution framing of the problem. Saying we just need to be able to improve market access and people's ability to pay for food. So here we have the poverty is causing the problem frame, is also problematic. And here's why. Underlying that hunger is a distribution problem frame is the assumption that poverty necessarily will preclude access to food. And that seems completely reasonable on its face. Let's think about other equally complicated and expensive to solve social problems where we do not make that assumption. For instance, universal access to primary education. So let's imagine a seven year old child has no access to education. Who might we imagine the community would think was to blame for the inability of that child to attend a school? I don't think poverty would be most people's response.

Even in the most politically conservative communities in the US, the state, by which I mean the government, would be seen as to blame if the seven-year-old child did not have access to a free education. Access to primary education is a human right which society has determined and reiterated in law that the state is obliged to provide to children living within its borders. And poverty should not preclude access to primary education. But if you consider the same seven-year-old child and ask who is to blame if that child does not have access to dinner when he gets home, you're likely to get a very different answer. Well, if he went to school, he could at least have gotten lunch. Of course, this doesn't help with food on the weekends or holidays or dinners or should the child not attend school. Or doesn't the Catholic church have a soup kitchen? Or aren't there food banks, which are often funded by private donations? Or, well, if his parents worked harder, they'd be able to afford enough food for their kid.

Providing education is not cheaper or easier for the government to do than providing adequate food for the child. But societies have determined despite this cost, that poverty ought not preclude access to education for the same kid that poverty does preclude access to dinner. And I use that example not to deny the gross inequalities that exist in our public education system in the US, but rather to highlight how it's not inevitable that societies think your access to an essential need necessarily ought to be determined by your ability to purchase it.

I argue that a core challenge for the hunger problem, is consensus on who ought to be responsible for ensuring individuals have access to adequate food and who's to blame when individuals are hungry. And when there's no consensus on who is ultimately responsible for ensuring the right to food, it's difficult to effectively leverage social pressure to compel change. If we don't first reach a consensus on these core questions especially who's ultimately responsible for ensuring people have access to adequate food. Is it the national government, civil society, food banks that are often funded through private generosity, corporations, etc. If we do not have a norm in society then indeed a given actor is responsible for ensuring a right to food, such that if the right to food remains unfulfilled we know which actor is to blame and can effectively focus advocacy on that actor, we should expect hunger to continue much as before.

It's a fascinating perspective you provide. And not one that I've heard discussed in much detail. So this is really a very much needed perspective. So, if there has been a long history of the right to food in international law, and you mentioned that there just aren't enough parties taking responsibility and lack of overall coordination for this, why is that the case, do you think?

Right. And this is a core puzzle - this tension between laws and norms. And the answer is, because laws are not the same as norms and oftentimes we can have existing law, and that doesn't necessarily mean there's a norm in a given society that indeed a particular actor really is obliged to do a particular thing or to behave in a particular way. So in this case, there certainly is international law. And sometimes even domestic law, ascribing responsibility to national governments to ensure the right to food of its people. In a growing number of countries, the right to food is even included in national constitutions. And if we were to look at the first mention of a right to food, we can think back to the drafting of the universal declaration of human rights in the 1940s. It was a unique moment in time because at the time in which the right to food was included in the declaration, it didn't already exist on any national constitution or other international convention. So it was at that moment, a new right. But of course over time, it has been reiterated in other legally binding treaties and conventions including the international covenant on economic, social and cultural rights, as well as other agreements. Some of which the United States have even signed on to like the voluntary guidelines on the right to food in 2004. But, we know laws and norms don't always walk hand in hand in society.

So when I say a norm, I mean, a socially shared standard of appropriate behavior for actors of a given identity. So norms tell you who is expected to behave in a particular way, such that if they don't, you can more effectively focus social pressure. So to take one example here in Boston, if you're riding our subway system, there's an expectation that commuters stand on the right and walk on the left of the escalator going in and out of the station. And if you were to stand on the left, you'll get a side-eye or maybe even a shove or a verbal review that lets you know that you're violating the social expectation by commuters. You ought to stand on the right and walk on the left. And tourists very often get this wrong not being aware of the social norms here in Boston, and Bostonians are quick to clue them in sometimes more kindly than others. But having a norm allows for social pressure to compel an actor who is expected to do a particular thing to change that behavior and make good on that expected action.

But if there's no norm, even if societies agree on a moral principle, that is a shared understanding that something is bad or tragic or wrong, here that children go hungry in the modern age for instance, we shouldn't expect that same social pressure to compel change. Because if there is no norm, then there's no norm violator. Sometimes laws and norms can walk hand in hand. There are laws against murdering people and there are social norms that match those laws, but sometimes they don't. And so my book looks at an important community of international anti-hunger organizations and argues that in this community, there is no norm that any one unitary actor such as the national government really is expected to act in ways that insurance people aren't hungry.

But norms aren't static things, they grow and they change over time and they differ from place to place. So there may be a growing norm of this obligation in India, for instance. And changes in the way the government and media are discussing food insecurity in the US during the pandemic, may itself open up space to build such a norm domestically. But I don't believe we're there yet. And we'll have to see if after the shock of the pandemic subsides, if Americans go back to having a relatively high tolerance for hunger in their country with limited domestic pressure and advocacy centered on the government as a violator when that hunger persists.

I would like to get your ideas on what can be done about this. But before we do that, let's talk a little bit about how you did your research. So you did extensive interviews with staff at top international anti-hunger organizations, and you also did extensive archival research at FAOs archives and the US and UK national archives. What were you interested in understanding as you did this research?

Two tracks of things. For the archives, I was of course interested in the past. So here, I wanted to understand how hunger had been put on the political agenda internationally, as a problem that was to be solved. And so I looked at starting in 1943, the Hot Springs Conference, which took place here in Hot Springs, Virginia. Which was a key moment where States came together at a really interesting time. And you can imagine World War II is still going on. It's a bit of an odd time for the US government to call for an international conference to talk about hunger, but they did. So part of the research was in trying to unpack what made food a salient issue at that moment, such that responding to hunger, not domestically but internationally, would become a core theme for this first conference. And this conference was important too because it resulted in the construction of the Food and Agriculture Organization, the FAO a few years later, which to this day is very important international organization in responding to the hunger problem.

And I also wanted to look at key moments like when food was included in the universal declaration of human rights during the drafting process and in the covenant on economic, social, cultural rights. In particular looking at how both the US and the UK government considered its inclusion. The interviews construct the majority of the rest of the book. And here I'm interested in understanding how senior staff at top international anti-hunger organizations understand blame for chronic hunger. Who if anyone is to blame for the problem and how they believe the problem should be solved.

Your book talks about a new model for dealing with international anti-hunger advocacy efforts called a buckshot model. Can you explain what that is?

To the purpose of the model is to help describe and explain the behavior of international anti-hunger advocacy. So in my own field of international relations, we often assume that when faced with a human rights violation or another bad outcome, that activists necessarily will join together and they will agree on a single unitary actor to target their advocacy efforts, to apply pressure, to compel that actor to change its behavior in response to whatever that violation may be. But in terms of international anti-hunger advocacy, we see a wide diffusion of target actors, not a concentrated pressure on one. So here we see advocacy targeting transnational corporations, international financial institutions, outside states, as well as national governments and others. And the buckshot model helps to map that diffusion. We also assume in some of our prior scholarship, that there's a specific directionality in advocacy work. Namely, that local NGOs often in global South countries will reach out to international NGOs often headquartered in global North countries and invite them to join an advocacy effort. But in the case of international anti-hunger advocacy, that directionality is more complicated, and oftentimes the reverse is also true. So international NGOs may decide abroad contours of an advocacy effort in their own headquarters. Then reach out to local partners to join in. The book probes the causes of that type of advocacy. And it looks to what enables differences in advocacy around food from other human rights and considers what may be some of the limitations of that type of advocacy in holding any one actor accountable.

This work is fascinating and it speaks to how these efforts are financed, who controls the conversation, what nations and the world sees such fundamental rights. So I think your book rates and makes a really nice contribution in that regard. But let's talk about the global pandemic and how that has exacerbated food insecurity, both here and abroad. What lessons can be applied from your book to the anti-hunger efforts that are occurring?

We are certainly seeing, the issue of hunger in the United States receive increased attention both by the media and public officials during the pandemic. And there have been meaningful changes in public food assistance measures during the pandemic. So for example, beginning in March of 2020 and up until now, you have seen some states begin to implement publicly funded food assistance programming that has been rarely if ever seen in US history. So in cities like New York City and in Boston, ready to eat hot meals are being provided to all who need them, regardless of age, income or employment status. In California they implemented a novel reimbursement program designed to pay restaurants for providing free or reduced cost food, I think specifically to seniors. As well as nationwide there've been reforms to allow for online purchase through increased P-EBT credits. Though on this point it's worth noting that USDA has restricted that online benefits in many states like Massachusetts to use an either Walmart or amazon.com. So this does raise some serious concerns about monopolizing benefits to large corporations.

Perhaps the most visible changes, have taken place in modifications to free or reduced school lunch programs during the pandemic. So previously, if American children needed a free lunch, they were required to meet specific eligibility requirements which has to be physically present at school to receive it. And being a hungry child wasn't enough to entitle them to a meal. They were required to perform a service in exchange - this is the attending of school. And in much of America, dinner time, school holidays, weekends, summer breaks, they left the same children without a venue for prepared food and existing WIC and SNAP programming did not adequately fill that void. But the pandemic has resulted in many school districts making lunches and breakfast available for pickup without conditions applied to all children who need them. As we've seen with the rising hunger rates, however, that is not an adequate response, it remains quite inadequate. But it does represent a change in the conditionalities applied for hungry children to access meals. And those are important changes for how public food assistance programs work in the US, and I think they're promising.

And yet, the US has historically shown a very high tolerance for hunger within its borders, at least for specific populations of individuals. So food insecurity rates among households with children headed by a single woman in the US have consistently been between 28.7% and 35.3% every year since 2014. And the USDA estimates food insecurity rates among black households, again, every year has ranged between 19.1% and 26.1%. And among Hispanic households, again, every year between 15.6% and 22.4% since 2014. And this persisted due to the very limited public food assistance available in the US. But of course, this did not get much media attention. And historically, Americans have not been entitled to adequate nutritious food when they're hungry. At least not at the expense of federal or state governments. Public food assistance programs are and have always been limited and supplemental and not designed to cover all nutritional needs. The effects of limited government engagement with hunger have disproportionately affected women and people of color and resulted in a patchwork system of assistance where charities and privately funded food banks attempt to fill the gaps left by the government’s supplemental nutrition assistance program or SNAP.

So the question for us now I think, is whether the increased attention and funding during the pandemic will be short-term responses or whether this might signal a potential opening and reconsidering state obligation to the right to food in a post pandemic world.

Bio

Dr. Michelle Jurkovich is an Assistant Professor of Political Science at UMass Boston and a Visiting Fellow at the Edmond J. Safra Center for Ethics at Harvard University. She is the author of Feeding the Hungry: Advocacy and Blame in the Global Fight Against Hunger (Cornell University Press, 2020). Her research interests include hunger and food security, economic and social rights, and ethics. Her work has been published in International Studies Quarterly, International Studies Review, and Global Governance, among other outlets. In 2020 she was awarded a Kluge Fellowship at the Library of Congress (residency postponed due to the pandemic). Previously, she served as an American Association for the Advancement of Science (AAAS) Science and Technology fellow working in the Office of Food for Peace at the U.S. Agency for International Development (USAID) and a postdoctoral fellow at the Watson Institute of International and Public Affairs at Brown University.

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Knowing that Native Americans were our country's first farmers and have a rich and very special history with the land, one might consider it surprising and of course discouraging that some of the most challenging food and agriculture issues in our country confront Native Americans. Our guest, attorney Janie Simms Hipp is one of the most passionate and thoughtful voices in addressing these issues. Simms Hipp is an enrolled member of the Chickasaw Nation and leads the Native American Agriculture Fund, the largest philanthropic organization devoted solely to serving Native American farming and ranching communities. The Native American Agriculture Fund is a charitable trust that provides grants to eligible organizations for business assistance, agricultural education, technical support and the advocacy services to support native farmers and ranchers.

Interview Summary

Let’s start off by asking how the charitable trust was created and the role that an important class-action lawsuit played in this.

Back in the 1990s there were several companion lawsuits filed at the same time against the United States Department of Agriculture. The Keepseagle case was one of those four cases and at its heart, it dealt with access to credit issues. It challenged discriminatory practices within the USDA Farm Service Agency Loan Program specifically, it sought to get remedies for a history of either denying loans or servicing loans that were granted improperly. The case was specifically focused on experiences of native farmers and ranchers across the country. It was certified as a class which meant it had national implications for people similarly situated across the country. It found its way into the court system into the federal court system as did the other three companion cases. The Keepseagle case was heavily litigated for very long period of time until the case was settled the elapsed period of time was a little over 19 years in the court system. Throughout that time period there were challenges that were dealt with day-to-day by native farmers and ranchers who were trying to get access to credit or trying to be serviced in their loans properly. And at the heart of all of this is the reality that if you are in the business of farming and ranching, participating in agriculture is very credit intensive anyway. And just as a matter of course when you cut off access points to credit so that you can actually maintain and build your business and operate from year to year can severely hamper your ability to stay on the land and stay involved in agriculture.

Janie, let me get a little more concrete about the impact this would have on farmers and what they might be seeking credit for?

Operating capital to buy more livestock, expand your operation or replacing your livestock. It was seed purchases, it was tractors, it was other pieces of equipment. Sometimes credit is needed to establish fencing or to put in conservation practices and just the transportation of food to market. So it's very difficult for anyone not just native farmers and ranchers to actually make a go of it year after year in agriculture if you don't have access to credit when you need it and in a fair way.

One can imagine this would have a devastating impact on the ability of farmers to make a living and also have an impact on the number of such people who are willing to be farmers or remain farmers. Did it work out that way?

If you actually look at the time period in which this case was brought start to think about what the national agricultural census says about native farmers and ranchers. I can tell you it says is that we are, on the whole, approximately four years older than comparable white farmers who are out doing agriculture. So we tend to be a little bit older anyway but then we have this up and coming younger generation of native folks all over the country who are very dedicated and very passionate about carrying on the food traditions of their people. It affects every community differently, but what is important is to stand back and think about is the relative age of farmers and ranchers and how they can bring along the next generation. When you're talking about access to credit issues and how critical they are to building strong agricultural economies it really has an effect across multiple generations.

The Native American Agriculture Fund that you head up how was it going about addressing these issues?

The Native American Agriculture Fund is designed to actually focus on specifically the needs of native farmers and ranchers, and to really help them along and make sure that we deploy resources that can help them succeed. The fund became a part of and really owes its genesis if you will, to the settlement of the Keepseagle case. The leftover funds from the payment of claims to individuals who were affected by the situations that were at the heart of the Keepseagle case became what is called the corpus of the The Native American Agriculture Fund. So those resources are the fund itself but the creation of the fund occurred as a part of the settlement of the Keepseagle case. What were called fast-track funds were meant to get 38 million out the door quickly to organizations that interface with native farmers and ranchers every day. And then the remaining fund approximately 266 million became the center piece the corpus of Native American Agriculture Fund.

The trust agreement that created the fund can be found on our website but it has very specific terms about how we go about doing our business. And that's what we're doing. We're standing up the fund and getting ready to begin making grants for a 20 year period. It's a 20 year spin down trust and as such we very much are keeping an eye on the urgency with which we need to go about the business of moving these funds to assist native farmers and ranchers through the entities that are eligible to receive the funds.

What are some of the ways that you're deploying these funds?

The important thing that we are to do under the trust agreement is to create a grant making mechanism. We are a charitable and educational fund. We also have received 501c3 status but we're also considered a private charitable fund. To that effect we are allowed to provide grants and work in four subject matter areas is what I call them. And they are business assistance, technical support, agricultural education, and advocacy. The backdrop of all of that is the essence of the case itself which is deploying resources in such a way that it helps drive towards the success of native farmers and ranchers. So we can work in those four substantive areas but we also are required to move funds and resources out the door through the grant making process to four types of eligible entity. And those four entities are 501c3, CDFIs Community Development Financial Institutions, educational organizations or institutions as defined by the Internal Revenue Code but also state and federally recognized tribal governments or instrumentalities of those tribal governments. So that kind of gives you the frame, if you will around how we will be moving resources out during this 20 year period

Janie, a term that most of our listeners will be familiar with is food deserts. But I've also heard you in your lectures speak about credit deserts and it looks like this is exactly what you're trying to correct.

If you actually think about moving resources into credit deserts, which are real, I mean, there's many native communities around the country that literally have no banks, but the native CDFI movement has really taken hold over the last, say 20 some years. And they are pushing this envelope of making credit accessible through Community Development Financial Institutions. There's a whole network of native CDFIs that are out there and now there are also a growing network of native banks. So moving resources into those arenas if you remember what I said previously the CDFI entities are one of the four entities that we can move resources through. There's actually a part in the trust agreement that does not allow us to actually fund directly to individual farmers and ranchers either through grants or through loans, but we can move resources of the fund into the hands through grants, for instance, into native CDFIs and then they can turn around and do loans. So there is a mechanism to get those sorts of individualized assistance packages out to people but they have to come through the mechanisms that were created in the language of the trust that gave rise to the fund itself.

Both the aims of this and the scope of your help is very impressive. Let me ask you a different question. How important is food and agriculture, and tribal sovereignty around food and agriculture in the country?

Well, you could ask 100 people and you might get 100 different answers about that, I'm going to give you mine. And I'm going to also paraphrase what a lot of friends of mine say as well, proper leaders, as well as individuals who lead in the native agricultural arena. We talk a lot about how important tribal sovereignty is but being food sovereign and being secure in your food sources and being able to build strong food and agriculture economies is actually critical to tribal sovereignty itself, because if you cannot feed your people and if you cannot actually build that agricultural economy that can lead to a spillover effect, if you will, for other jobs either outside or inside an agricultural sector job then you really are hamstringing the communities themselves and you are impacting sovereignty itself.

There is a growing understanding that food sovereignty is critical to tribal sovereignty. I would say it applies across the board, food security is a huge issue for all people. But particularly if you're talking about rural and reservation tribes and Indian people who live in those places it's just so important that we know where our food is coming from that we have a hand and making sure that we have healthy food available to us. But we also have strong cultural histories around food and creation stories that talk about our relationships with foods and long histories within each tribe around our food sources and the lands and the waters and the four-leggeds and all of the components that sit around who and where we have been forever. The idea that you can separate yourself from food culturally, I'm not sure how peoples ever get to that point but obviously they do, but just recognizing that tribal sovereignty is so intricately intertwined with food sovereignty is something that is of high recognition across all tribes at this point.

The work of the fund will help reverse some of the injustices that have occurred in the past due to government practices and policies. What do you see as the policy priorities going forward for the U.S. government in this space? And are you optimistic that these changes might occur?

I think that probably the most important changes that are going to occur are the changes within us because we have the capacity and the memory and the abilities to feed ourselves regardless of what the federal government does. Obviously they can make it worse on us, but we actually have the inherent capabilities to do this ourselves. And I do believe that regardless of which government is in the office at the time native people find a way to keep going and we are not going anywhere. And we are going to continue to build out and make sure that we have the security generations from now. I'm not going to speculate on what could happen, three years from now or 10 years from now with regard to the federal government - I'm going to look to us and to all the native nations and understand we know that this is possible. But I will tell you though is we also are starting to see some really important things happen. This last farm bill for instance was unique because there were more native focused provisions written into this farm bill than ever before. There was the creation of a Native Farm Bill Coalition which had never happened before, and there was a lot of heightened understanding on the Hill, about what pieces of the farm bill could actually be changed to enable native nations but also individual native farmers and ranchers to access farm bill programs in a better way. So every little bit helps I will tell you, but I think the most important thing we can do is bring along the next generation and make sure that they understand how important this is and that they see their place in food moving forward.

So what are some of the things that people can do to become more involved in assisting native farmers and ranchers?

One of the things that's happened very recently is the creation of the Native Farm Bill Coalition. A lot of folks think that you can just talk about the farm bill once and then it's over but really that's not the way it rolls out. I've been doing agricultural law for a very long time. You can do a lot in food and agriculture without even looking at the farm bill but it does have some moving parts that are important to food production and also the conservation of lands et cetera, et cetera. So I think it's important to actually Google Native Farm Bill Coalition because it does have a place for allies to actually become a part and support.

The other thing is understanding and doing some of your own historical research about which native nations you live around citing things that are happening right now across Indian agriculture kind of writ large. There's some things happening around you that you might want to know more about and reach out to the tribal governments that are there and to the individual native farmers and ranchers kind of around where you are and just ask how you can help. Because some of the things that are happening in Indian country writ large around food spill over into all of the communities surrounding us. So it's just important for folks to do a little bit of digging and self-educate, but there's also some tools out there that we will be putting out in terms of resources. I'm realizing that we're just getting rolling but we intend to have some resources on our website that can kind of assist folks who want to participate.

Bio

Before serving as CEO of the Native American Agriculture Fund, Janie Simms Hipp, a citizen of the Chickasaw Nation, was the founding director of the Indigenous Food and Agriculture Initiative at the University of Arkansas. Prior to launching the initiative, she served as national program leader for Farm Financial Management, Trade Adjustment Assistance, Risk Management Education, and the Beginning Farmer and Rancher Development programs at the United States Department of Agriculture National Institute for Food and Agriculture. She was thereafter selected as the senior advisor for tribal relations to Secretary Tom Vilsack and director of the Office of Tribal Relations. Prior to her work in Washington, D.C., at the national level, she has enjoyed a lengthy domestic and international career spanning more than 35 years in the agriculture sector as an agriculture and food lawyer and policy expert. Her work focuses on the complex intersection of Indian law and agriculture and food law.

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Could there come a day when an optimal diet could be recommended not just for the population overall or for people with special conditions such as diabetes but a diet that would be unique for you? A diet based on your genetics let's say on the condition of your microbiome perhaps? Or on your environmental exposures or other factors? This futuristic possibility may be closer than you think. Thanks to the work of researchers, including today's guest Dr. Steven Zeisel, Director of the Nutrition Research Institute and Director of the Nutrition Obesity Research Center at the University of North Carolina.

Interview Summary

I would like to lead off by asking what you mean when you use the term precision nutrition.

Precision nutrition is really the use of modern day science to be more precise about our diet recommendations for any given individual. In the last decade, we've realized that people vary greatly in their metabolism and many people have roadblocks that certain steps of metabolism.

How far along is the science with us?

Well, I think that in terms of the roles of genetic misspellings on your metabolism, we're really quite far along. Now when I say gene misspelling, each of us has a genetic code and it's constructed of four letters. We inherit our genes from our ancient ancestors and during many thousands of years we have developed alternative spellings in some of the genes I'm going to call the misspellings called SNPs. And these alternative spellings sometimes are in genes that are critical for steps in metabolism and cause us to be more or less efficient at the steps.

Steve, can you give us an example, perhaps even a hypothetical one, of how such information might get harnessed in order to help a certain person? Would a person have a biological deficiency in some way that could be learned from genetic tests that then could be turned into recommendations for specific foods?

Yes, so again from my own research on the nutrient choline - choline is really important during pregnancy to build a healthy baby with optimal brain function. Women were designed to be able to turn on the production of choline in their liver when estrogen levels the hormone that rises markedly during pregnancy. When estrogen rises, they turn on their production to make this choline and therefore are less dependent on their diet. And what we've discovered is that women who come European backgrounds have very commonly a misspelling in the gene that needs to be turned on and the switch for estrogen isn't working right. And so they like men don't turn on this gene. And this is really important because these are the women who have to be really careful about getting a good source of this nutrient during pregnancy, because they don't have the backup insurance of being able to make it by themselves

There are other things like environmental exposures that might lead to specific nutrition recommendations for particular individuals, or maybe the condition of the microbiome, what other sort of factors might be relevant other than just pure genetics?

Genetics is the most ready to go to market because we know so much about these tools but we differ in our metabolism for other reasons than having genetic mistakes. For instance, our microbiome, which are the bacteria and fungi and other microbes that live in our gut sees our food often before we do. And if you have a microbiome that is destroying some of the nutrients you need then you have to eat more in your diet. Alternatively, the microbiome can make some of the nutrients that you need. For instance, vitamin K very important for normal blood clotting, vitamin K is made by the microbiome as is folate. And if your microbiome isn't working well to make it then you must eat more in your diet. Microbiome is another area in which people can differ and that can make them need more or less of other nutrients. Environment probably also can change your requirements. We know for instance that there are environmental agents that emulate, simulate, exposure to estrogen and this can change genes that depend on estrogen and thereby change metabolism. And other foods you eat obviously can be manipulating your metabolism. Grapefruit changes the metabolism of many drugs because it turns on the liver's metabolism system. And what is changing drug metabolism is likely also changing metabolism of the normal components of food that these systems were meant to degrade and excrete.

So this work is very sophisticated and extremely interesting and promising. How do you see as commercial applications for this kind of work?

Right now, on the market, there are a number of gene tests for instance that tell you how fast you metabolize a component of your diet caffeine and there are fast metabolizers and slow metabolizers and it turns out that the fast metabolizers chew up caffeine quickly and therefore the person has to stand in line the coffee shop to get a second coffee while the slow metabolizers after drinking some coffee keep their caffeine levels up for a longer time and don't crave more caffeine so rapidly. That's an example of a gene test you can have to find out if you're a fast or slow metabolizer of caffeine. Of course, most of us know that by how much shaking we do as we stand online at the coffee shop.

So let's turn back to the issue you mentioned earlier, your own work on choline. So you mentioned that it was particularly important during pregnancy. Is it important other times of life let's say for children?

Kelly when I started out in my science career we thought that people didn't require choline in the diet, all the textbooks said that. And in fact, we weren't giving it to people when we fed them intravenously in the hospital and those people got sick. And when I first started out, I thought it was strange that animals required choline in their diet, but people didn't. And so I put people in the hospital, I took choline away and what I discovered was is that most men and most post-menopausal women when deprived of choline developed liver problems, fatty liver and liver damage or develop muscle problems with breakdown of their muscles. And I found that premenopausal women in North Carolina, only about a little less than half of them got sick when deprived of choline. And so choline is really important for maintaining normal liver function and for maintaining your muscle. The premenopausal women that got sick all had gene misspellings that made them unable to turn on choline formation in their liver with estrogen. And so they were reduced to the sad state of men and had to eat choline in their diets at all times or get sick. So that work prove that humans required choline and it led to a recommendation by the US National Academies of Science that all humans get it and we set dietary requirements which are now on food labels. People should eat half a gram of choline a day and as adults a little more when you're pregnant because you use a lot of choline to deliver it to the baby. The choline is used to build a baby's membranes that surround their cells and to build and drive normal development of the brain.

What foods provide choline?

Choline is found in fatty foods often that also contain cholesterol, it's in the membranes of the foods. So eggs and meats are excellent sources of choline. Plant-based sources are harder to find and you have to choose those plants sources that have lots of membranes like wheat bran. For people who want to find out what foods that they eat are the best for getting choline, the US Department of Agriculture maintains a database with thousands of foods in it and tells you what the choline content of those foods are.

In the 1970s and '80s we recommended that everybody cut back cholesterol in their diet to prevent heart disease. The bad part is that we thought we were very smart as nutritionists and nutrition scientist when we did that. But we also cut back choline in the diet without knowing about it. We discouraged people from eating foods with it. And now choline intake is a problem nutrient in the United States. And every year the US government conducts a national health and nutrition survey, and they find only 7% of women who are a pregnancy age are eating the recommended intake of choline and at least a quarter are eating half the recommended and that's true for men. The only group that seems to be eating an adequate amount of choline are young children who are drinking lots of milk.

You mentioned muscle function. Could you tell us more?

So in the adults, when they're deprived of choline about 10% of people develop breakdown to their muscles every time they exercise. And we see that by looking at an enzyme that's released from muscle into blood when the muscle breaks down. This breakdown can be quite severe in some people who were fed a low choline diet. And we find that all of these people have a genetic of variance spelling difference in the gene that transports choline into the muscle cell and in the gene that first uses choline to make the products needed to help the muscle function normal. We can do a genetic test, predict who those people are and when we feed them adequate amounts of choline they do not break down their muscle when they exercise. And this has been of interest in the armed forces where they find that up to 25% of war fighters who are in training have to stop training because muscle breakdown is excessive. And they are wondering whether some of this breakdown is due to these people who have this genetic difference and a higher need for choline.

So thinking of the general public, are there groups of people do you think it would make sense from a public health point of view to be tested for choline and how would people know what their optimal levels are? What would you see happening with that?

I think that in women who are going to get pregnant, who are pregnant, where choline is so important for building a normal baby's brain. In mouse models we can show that the stem cells that are going to form the nerves within the brain, don't divide properly if choline isn't available at a critical time during pregnancy. And the mouse baby is born with many fewer nerve cells in their brain and don't function as well. They are worse at running mazes and at doing cognitive testing. In humans, a group at Harvard School of Public Health looked at women's intake during the first and second trimester of pregnancy and found that women in the lowest choline intake versus women in the highest intake when their children are studied at seven years of age for how well their brain performs cognitive function they find that the women in the lowest intake had children who perform worse at seven years of age than women in the highest intake. In addition, neural tube defects and other birth defects that are fairly common during pregnancy increase among the children of women who were on the lower choline intake. And in a study in Berkeley, California they reported that these neural tube defects, defects of formation of the spinal cord and brain were increased fourth fold in the women who were in the lowest group for intake of choline and this is after correcting for the vitamin folic acid that we know is so important during pregnancy as well. Women during pregnancy I think should have a test looking for these gene differences. And if they have them they should eat a diet more carefully that contains foods that are rich in choline. Because such a test is not been available, I work with a company that's trying to spin out a gene test. We also are working on fatty liver. About a third of the population in the United States as they gain more weight, develop excess fat in their liver that seems to interfere with how they use insulin and makes them insensitive to insulin and this is called metabolic syndrome. And again, people when deprived of choline developed fatty liver, and we find that this is because they have a problem sending fat outside of the liver to feed the other organs in the body. And so fat packs up in the liver whenever they make more of it because they're slow to mail the fat out of the liver. And this is related to having trouble making the envelope needed to mail the fat from the liver because that envelope is made of a choline and some other constituents. And so people deprived of choline develop this, people who have metabolic roadblocks in the metabolism of choline and related nutrients have the same roadblock and problems in exporting fat. And when they gain weight they develop fatty liver more rapidly. We're hoping to develop a genetic test that identifies who these people are and then we can give the nutrients beyond their roadblocks and metabolism and try to return them to normal.

Bio

Dr. Zeisel and his research team focus on the essential nutrient choline and why there are individual differences in nutrient metabolism, using new approaches in nutrigenomics and in metabolomics. The team works with humans, mice and cell culture model systems. Using our human studies we discovered that there are very common single nucleotide polymorphisms (SNPs; gene misspellings) that make humans require more dietary choline and that one of these is in the gene PEMT and prevents estrogen from inducing the gene. We are collaborating in a number of epidemiology studies that examine the relationship between diet, these gene SNPs, and risk for disease. After identifying a SNP of interest in humans we make a mouse model and now have three such knockouts. One of them develops mitochondrial abnormalities and has immotile sperm. We are conducting studies in humans on this SNP. In another study, we examine choline’s role in brain development and discovered that choline is critical for cortical and hippocampal development. We study mouse models and neural progenitor cells in culture to identify the molecular mechanism for choline’s effect on brain.

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At a conference on early child development and nutrition - comprised of leading experts on brain development, child development and public policy - one of the most memorable things said, in my mind, was that “poor nutrition early in life confers a life sentence.” Those striking words were issued by today's guest, Dr. Michael Georgieff the Executive Vice Chair of Pediatrics and head of the Neonatology Division at the University of Minnesota.

Interview Summary

So let's begin with a fundamental question. Why is nutrition in the first thousand days of life so critical for the brain and why are the first thousand days so important?

The brain is kind of an amazing organ. It's the part of the body that probably consumes the most calories and the most protein on a daily basis. So even as you and I are sitting here talking, about 20% of our calories are going to fuel our brains so that they work, right? So the amazing thing here is that for babies, that number is 60%. 60% of the calories that a baby takes in goes to the brain to help build that brain and to help it function. If you look at a map of brain development from early gestation through the first couple of years of life, you'll see much of the construction of the brain takes place in those first say thousand days or so and that spans the third trimester as well as then into the first couple of years after birth. Nutrition, which is essentially the provision of calories, protein, iron, zinc important for building that brain. They have much higher requirements during that time period in order to build that brain normally. People talk about the brain being close to 95% complete in terms of structure by about two years of age. So that's why the first thousand days are so special in brain development. It takes a lot of nutrition, a lot of nutrients substrate to put that brain together correctly.

You alluded to this a moment ago, but what are the nutrients that are especially critical during that time?

The brain is not a single organ. It's actually a bunch of little areas devoted to different tasks that are all on different trajectories. Some are built early, some are built later. Some are built dependent on an early part being built correctly. There are certain nutrients that really are important for structure development. Most people think protein. Amino acids, protein, very important. You need energy to make that brain work and to make that brain connect itself. You need iron because there are iron dependent processes that make what we call ATP (adenosine triphosphate), that's the energy currency of all of our cells. You need zinc, you need iodine. So those are kind of the main nutrients that are important in there. We also know that deficits of other nutrients like what we call fish oils result in significant brain problems. So it seems like there're certain nutrients that contribute a lot more during this period of rapid development.

You made a strong case that it's important to get nutrition right during those first thousand days. But what happens if we don't get it right? What are the short and long-term effects?

I think anytime we talk about nutrition, we should ask that question. Is there an acute effect, meaning an immediate effect of the lack of nutrient on how the organ functions? In this case, we're talking about the brain and are there long-term effects as well. And we want to concentrate on the ones that have long-term effects, right? For example, something as simple as let's say an iron deficiency - you simply give the iron back and everything goes back to normal. That's a pretty easy problem to solve. What we've learned with a lot of these nutrients including iron, is that if we don't get it right, structures that are dependent on that iron don't get built correctly. In addition to number of nutrients, epigenetically change the brain. And what I mean by that is that they change how the DNA, how the genes that regulate your brain's ability to work well are expressed. And these effects both the disordered structure, as well as the effect on the genes appear to last into adulthood. So what you get then is carried forward in society. You have a lack of complete building of the brain that may well result in loss of educational potential and presumably loss of job potential. So it's those long-term relevant health outcomes that are most important when we're considering early nutritional effects on the brain.

All those are pretty profound impacts. So has anybody figured out the costs to society of early life malnutrition?

Sure. I mean there were articles that have been written saying what's the cost of not screening, for example, for the most common nutrient deficiency that would be iron deficiency? What's the cost of having lost an estimated five to 10 IQ points? If somebody has five or 10 points lower capacity do they do a different job? Are they less capable of the job that they do than somebody with a higher IQ? And the answer is yes.

And certainly profound effects on the person's life and their ability to achieve their potential over time. So that statement you made about early malnutrition or poor nutrition conferring a life sentence really is true because of these long-term effects?

Absolutely and the concern that we have is do they go transgenerationally. In other words if you have nutrient deficiencies early in life, let's say, do you, in some way, pass that on to the next generation? And that's an open question. We really don't know the answer to that. But you can kind of see what the societal effects of that might be.

And then it could get passed on to generations beyond that and it could have lasting impacts. Well, I guess that's even more incentive for people to eat a healthy diet because not only does it affect them, but their future generations?

Right. People should consider that it is certainly about healthy diets, starting with the mom. I think we are learning more and more that when we see a nutrient deficit, let's say in a child at birth or in the first few months after birth, that may well have been because the baby wasn't set up well as a fetus, meaning that the mom was malnourished. And when we use the word malnourished, we mean truly in the sense of mal - mal coming from the Latin meaning bad. Malnourished historically for us, of course has been under nutrition, finding enough food. But malnutrition, bad nutrition, can also mean over nutrition. It can mean obesity. Maternal obesity has an effect on the fetus' developing rate.

So when we say malnutrition – this means non-optimal nutritional environment during the pregnancy – that then sets up that kid for nutrient deficiencies afterwards. So I can give you an example. We used to think of iron deficiency as being something that happens to toddlers, why? Because most of the studies that look at iron deficiency notice that toddlerhood, in the nine to 18 month old, is the time when there's a very high incidence of iron deficiency. It is only recently come to light that many of those children actually were born with low iron stores because of mom's problems with iron. Either she had iron deficiency herself or she had some gestational condition like diabetes in pregnancy or high blood pressure in pregnancy that restricted the amount of iron that that fetus got. And so they're already starting behind the eight ball. So we see again this transgenerational effect and much of the conversation for how do we keep our children healthy and therefore our children's brains healthy has turned to: how do we make sure that mom was healthy in the first place so that she will have given that get the best chance?

Michael, you've done some really interesting work in addition to what we just talked about on diabetes in mothers and the impact on their children. Can you explain some of what you found with that?

We were involved in some studies trying to understand the iron status of newborn babies. Newborn babies are not usually anemic. So that doesn't mean that they have enough iron to go around and feed all of the organs. So one of the important principles here is that the red blood cells, that's what determines whether you're anemic or not. The red blood cells will always get the iron. They are very greedy and will take the iron at the expense of the rest of the body. So when you have a fetus who is getting marginal amounts of iron, which is what happens in a pregnancy complicated by diabetes, the fetus has to make choices of where that iron goes. And it turns out that the iron goes into the red blood cells at the expense of the brain, the heart, the skeletal muscle and the liver. So all of those areas don't get their full complement of iron in the womb. And what does that mean? Well, of course we've tested babies as to how much iron deficiency there is in the brain and the number happens to be something around 40% reduction of brain iron. And we have a good marker of whether that baby is at risk for neurodevelopmental or neuro behavioral problems. And again, the issue here is that the mother's diabetes is not well controlled. If a mom controls her diabetes well, none of this happens. But if a mom is not able to control her diabetes as well and there are various reasons why that might happen, then we get a baby who is at risk for brain iron deficiency. So we knew that iron deficiency in toddlers was not good for the brain, but nobody had ever asked the question, well what about a newborn? Would iron deficiency be a problem for the newborn's brain? It's a little difficult to test newborns but you can test memory function and you can test speed of processing in newborn babies using EEG electrophysiology techniques. And sure enough, we discovered that babies who were iron deficient after their moms had diabetes during pregnancy, they had poor recognition memory. They didn't recognize their mom's voice as well as babies who were iron sufficient. And they had slower speed of processing. Both speed of processing and memory are two things that are critically dependent on iron during that late fetal and neonatal phase. So that's kind of how we decided that out and then we followed those kids for 10 years and found that the deficits in memory were still there at three and a half. Interestingly enough, they disappeared at five years of age but then at 10 years of age they were having more processing problems, planning, attention, those kinds of things.

Are there effects with both diabetes and obesity in the mom?

We went back and looked at our infants born to diabetic mothers and separated the babies out based on body mass index. And here we actually put together the babies also in the control group meaning those moms who did not have diabetes but had BMIs greater than 28, so qualified as overweight or and some were indeed obese and there we found similar findings. So in those babies from moms that didn't have diabetes, but were obese pre pregnancy, we did find, again slower speed of processing and poor recognition memory. So whether the effects in the fetus are due to the same reasons, meaning the obesity and the diabetes isn't completely clear. Now, other people have looked at obesity and its effects on the developing brain and have shown that, in fact obesity induces a lot of inflammation in the brain. That's not how the iron deficiency piece works. So that would tell me that there are a couple of different pathologies going on here.

So is all lost if we don't get nutrition right in these first thousand days or are there other sensitive periods for brain development or nutritional work around that might be possible?

You know, I think it seems so harsh that if you didn't do it right in the first thousand days or zero to three, that all is lost. I'm a pediatrician. My whole role in life is cure and hope. So we've been searching very diligently to see if all is lost or not. And I would say the answer is likely, it is not ALL lost. Now that's not a reason not to do it right in the first thousand days but it does speak to tremendous plasticity of the brain. So let me get a couple of examples here. Like I said, we found these memory deficits in these poorly controlled infants of diabetic mothers who were iron deficient at birth. And yet I'd also told you that those disappeared by the age of five. So the area of the brain that actually brokers that that's called the hippocampus has enormous plasticity to it. So clearly some things can get better. Again, the fact that there were later findings in other areas of the brain was still worrisome. Are there other sensitive periods? Yes, I think if you look again at a map of brain development, you'll see that every region of the brain, whether you're talking about the visual part of the brain or the hearing part of the brain, the frontal lobe which is your working memory and your attention, their growth is peaking at different times. Those are probably your sensitive periods and they're scattered really through your first 20 years of life. We think in particular there is a big opportunity during the teenage years. You know, the teenage years is a time when there's tremendous protein turnover in the brain and a tremendous spurt in brain development. It's probably the second biggest spurt of brain development besides what I described in those first thousand days. And so we have researchers who are looking diligently to see if this is a time where we get some catch-up growth and development. As for nutritional workarounds, yes, I think there are possibilities there as well. And let me give you an example in my field which happens to be iron deficiency. So we've shown that iron deficiency changes gene expression through what are called epigenetic effects. Those are modifications to the genes that are reversible potentially by using other nutrients. An example would be choline and those modifications in our animal models do seem to recover some of the lost problems. So yeah, I think that as we learn the biology better, we're going to be able to use nutrients to address that biology.

What do you see as some of the implications of these findings for the way medicine is practiced to the way people work with pregnant moms and dads with public policy let's say?

Two points that I can make here. One, babies aren't small adults. So we have to be sure that we're not applying policies that apply to adults to children.

Secondly, I think policy makers need to understand that reaching your developmental potential through good nutrition is an investment in society because there are these long-term effects that's going to have a ripple effect downstream. And I think the other piece is to realize that this is really a life cycle question. Now we even have studies saying that the mom's nutritional status folate, iron, iodine, zinc, before she even becomes pregnant, affects the brain of that fetus and therefore a newborn that eventually gets conceived. So all of a sudden, we've gone from talking about children's nutritional health to let's have healthy moms who are thinking about becoming pregnant enter that pregnancy with good nutritional status. Then all of a sudden you're talking about nutritional policy for women of childbearing age, you know, age 17 to 44.

Bio

Michael K. Georgieff, MD, holds the position of the Martin Lenz Harrison Land Grant Chair in Pediatrics. He is a Professor of Pediatrics and Child Psychology, the Executive Vice Chair of the Department of Pediatrics, and the Director of the Center for Neurobehavioral Development. He received his MD from Washington University in St. Louis, Missouri. He served his internship, residency and neonatal fellowship at the Children’s Hospital of Philadelphia and a fellowship in neonatology at the University of Minnesota. In addition to attending on the Neonatal Intensive Care Unit, Dr. Georgieff is Director of the NICU Follow-up Program. Dr. Georgieff’s research focuses on fetal/neonatal nutrition and brain development, specifically on the effect of early life iron nutrition and neurocognitive function. He has been continuously funded in this field by the National Institutes of Health for 25 years and has published over 225 scientific articles. He advises the American Academy of Pediatrics, the National Institutes of Health and UNICEF on nutrition and early child development.

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It wasn't that long ago that there was a nutrition free-for-all in schools where sugary beverages, high calorie snack foods, and even things like pizzas and cheeseburgers direct from fast food chains were part of the food landscape in schools. What do you think the situation is today? Has it deteriorated even further? Has it improved or stayed about the same? Today's guest, Dr. Marlene Schwartz, is a champion for improved nutrition and physical activity in schools and one of the leading experts in the field. Schwartz is director of the Rudd Center for Food Policy and Obesity and professor of human development and family studies at the University of Connecticut. She's an expert on nutrition and physical activity policies in schools and preschools nationwide, and has collaborated in particular with the Connecticut Department of Education on their policies.

Interview Summary

Let me ask you about the food landscape in schools. When people generally think of this, they think of school breakfast, school lunch, but there's actually a lot more of the picture of food in schools than just this. And you've talked about this a lot. Can you help explain?

Sure. So the school meals are definitely the most visible aspect of school food. And when I first got into this work, I thought that was pretty much all there was. But once you go into the school, what you realize is that food is available from a lot of different sources. In the cafeteria, there is often food sold outside of the meal program that's called competitive foods. So those are snacks or other beverages. High schools often have schools stores where they can sell a whole variety of snacks and beverages. Schools also have vending machines that sell food. And then there are fundraisers that are often done during the school day where children can buy food. And then in addition to all the food that's sold, there's food that's simply given out in schools quite commonly, particularly at the elementary school level. There is a lot of food available during parties, birthday parties, holiday parties, as well as teachers who use food as a reward in the classroom. So once you go in and try to start changing school food, you realize that there are many, many different places that you have to try to influence.

So when you mention birthday parties and things, every child just has one once a year, and you wouldn't think it really adds up to a lot, but you've made a different argument. Tell us about that.

Well, I think that yes, parents think, "Well, my child only has one birthday a year." But of course your child is one out of 25 children in the classroom. And so my argument was really that you have to look at what's happening in the classroom overall over the course of a year. And I actually made a slide that showed all of the different holidays, all of the birthday parties that take place during the year, so that people could really see that when you started to count, there were parties happening pretty much every single week in elementary schools.

So returning to school meals, and the competitive foods, and things served a la carte and things in bending machines, how the heck did things get to be this way? I mean, were there federal, state, or local policies that permitted or even encouraged this? Were people making money? What made this happen?

It's really interesting to look into the history of competitive foods in schools. What I learned is that there are actually multiple layers of policies. And historically, the main policy was the federal policy, because the school meal programs are federal programs. But in the 1980s, the National Soft Drink Association, which is now known as the American Beverage Association, actually sued the federal government to make the case that they should not be allowed to regulate what was sold in schools outside of the school meals. And that was really the beginning of a very sort of troubled era, I would say, in the school food environment, because a lot of vending machines started going into the schools at that point, selling soft drinks. Companies even had something called pouring right contracts, which were essentially contracts with a particular brand, so Coke or Pepsi, where they would give the school money, they would provide the vending machines, and they would sell their products, and they would let the school have a cut of the profits. On the one hand, it helped the soft drink companies sell their product. They made some money from that. But I think what was probably more important to them is they got their brand in front of the students in that school. And the deal was you couldn't sell other brands of beverages.

I remember when we first started doing this work, I went to a high school in Connecticut, and I remember counting 13 vending machines as I was walking through the halls. So that was 13 times during the day, you know, children would be passing by that huge machine with the logo for that beverage company. There were really limited regulations during that era of what could be sold outside of the school meals. There was something called foods of minimal nutritional value, which was a pretty short list of things you couldn't sell. So it was things like cotton candy and lollipops. And there were also rules about not selling unhealthy foods for 30 minutes before the lunch period or 30 minutes after the lunch period. So you had a situation where sometimes there would be a vending machine in the hallway and they would unplug it for 30 minutes before lunch and then 30 minutes after lunch. But people could go plug in the machine, buy their soda, and then unplug it again. Those are the sorts of stories that you would hear.

So the good news is that things started changing in the early 2000s. People started to realize that it had gotten out of control, and States started passing regulations to get rid of some of these unhealthy competitive foods. And at the time, there really wasn't much promise of making a change at the federal level. So you had dates that were progressive passing laws that you couldn't sell soda or you couldn't sell certain unhealthy snacks in the schools. And then something interesting happened in 2006, which was the federal regulation was updated, basically saying that school districts needed to set their own policies. So it was somewhat of a political compromise. I think that the advocates had hoped that time that the federal regulation would actually say what the nutrition standards would be for competitive foods. But instead of that, they at least got this idea that, okay, you need to set your own policy. You can't just ignore this problem. And so it sort of forced the hand of school districts to at least put down on paper what their rules were for the snacks that they were selling outside of school meals. And so there was this period of time where schools really were responding to three levels of regulation, often. The federal regulation, if they lived in a state that had state regulations, they had those. And then also their own district regulation. It was quite confusing. And I think schools sort of struggled to figure out what they were doing and which regulations they were following. But things have definitely improved.

There are lots of interesting examples of individual parents making a difference in this problem by what they've done within their own school systems. So you don't necessarily just have to think about top-down things, and you're one such person. I remember that as a parent, when you had children in the Connecticut schools, that you made a big difference in the way the school system looked at things. So I'd love to hear just a little bit about how you approached that. What was the situation when you began working on it? And then what happened?

I was one of those parents and have a reputation that continues to follow me to this day. I had, you know, young children in the schools and was not happy with what was being sold in the schools. I wasn't happy with the number of times, as I mentioned, there were parties or teachers were handing out candy or coupons for donuts in the classroom. And so I got involved in my own elementary school with the principal, and we formed what was sort of ahead of its time, but it was essentially a school wellness committee. And we invited the school nurse, the PE teacher, some other parents joined. And we really tried to think about what could we do in our own school to make changes. And given that, you know, my training as a researcher taught me that you want to collect data, you want to keep track of what changes are occurring.

We began with a survey of parents in my school district that the district helped orchestrate. And I was able to document that parents overall really didn't want these unhealthy foods in schools. They didn't really like the snacks being sold in the elementary schools. They didn't like teachers handing out candy. And so I was able to then go back to the board of education with the data and convince them that we should have a stronger policy in our district. Now I will say that it turned out there was mixed feelings about it. Even though the majority of parents felt that way, there certainly were parents that didn't feel that way. And I got a lot of really great research ideas from going to different PTO meetings presenting the research on this topic and really hearing the way parents talk about it.

One of the things I learned pretty early on is that it really seemed like it wasn't so much about cupcakes in the classroom, but the arguments were more about what is the role of government? What is the role of policy? And when do you sort of let parents do whatever they want and when does the school or the school district have the right to say, "No, this is how we want things done in our district."

Well, what you've just said is a great example of how much difference a single parent can make. So let's talk about the federal government and what it's been doing. So a lot happened during the Obama administration on school food nutrition standards, and the Trump administration as well. But there's quite a contrast in the way these two administrations have been addressing this issue. Can you paint us a picture of this?

The Obama administration: I think of it now as the golden age of improvements in school food. You had a situation where States were passing policies. The federal government didn't do too much other than require these local policies. But because of all of that, it became evident that change really could happen. So you had whole States that got rid of all of the sugary drinks in schools like Connecticut. In 2006, K through 12, no sugary drinks could be sold in any of our schools. And essentially we proved as a state that this change could happen, that there wasn't a disaster. People didn't lose so much money, you know, that it was a huge problem. And so all of the arguments that have been made as to why you couldn't make these changes were kind of shown to be false because we were able to demonstrate that it could be done. I think those stories started accumulating. And then of course, Michelle Obama was a tremendous champion for children's health, for nutrition. And a piece of legislation called the Healthy Hunger-Free Kids Act of 2010 went through and I think completely transformed the school food environment. So that acted lots of things that really hadn't been done before. First of all, it revamped the nutrition standards so that they were in line with the dietary guidelines. So we saw things like increases in whole grains, increases in low-fat dairy, also more fruits and vegetables. And in addition to more in terms of larger quantities, also more variety in fruits and vegetables. So those changes were all really important. The other thing they did that was very new is they started setting calorie maximums for school meals instead of just calorie minimums. Those minimums had always been there because the concern was that kids weren't getting enough to eat. Now we had knowledge that we also needed to be careful about kids eating too many calories at school.

And then the other really major change that came with the Healthy Hunger-Free Kids Act is that lawsuit I mentioned from the National Soft Drink Association in the 1980s that prevented the federal government from regulating foods outside of the school meal programs finally was changed. And now the federal government started to set standards for the first time for all foods sold on school campus during the school day. And they developed something called Smart Snacks, which is a set of nutrition standards that went into effect that essentially regulates everything that's sold. So those were all wonderful changes.

I think the USDA did a great job developing the regulations, implementing them over time. It wasn't like everything happened overnight. There were several years where each year different levels of the changes would get implemented. Another important one was sodium levels. There had been very clear research documenting too much sodium consumption and that school meals had too much sodium. So there was a progressive series of three levels of sodium reduction that were scheduled. So then came the Trump administration. And I think there were a lot of concerns about whether things would go backwards because one of the priorities, it seemed, from the Trump administration was deregulation and taking away things like federal regulations. And in the end, some changes have taken place. So there've been a couple of rollbacks. One is the original Healthy Hunger-Free Kids Act regulation for milk said that all milk had to be 1% or fat-free, and there could be flavored milk, but it had to be fat-free flavored milk. And the reason was because that was a way to keep the calories below a certain level. So one of the roll backs was saying, no, you can have 1% flavored milk. So that was a change. Another had to do with whole grains. The regulation that had been implemented over time was that items needed to be what they call whole grain rich. And whole grain rich means more than 50% of the grains in the product are whole grains. And originally 50% of your grains had to be whole grain rich. And then it went up to 100% had to be whole grain rich. And essentially Sonny Perdue, about a year ago, rolled that back so that only 50% needed to be whole grain rich. So that was a step backwards. But I would say probably the biggest problem were the sodium changes. So as I said, there was this progression that had been scheduled pretty slowly to allow the industry time to reformulate to decrease the amount of sodium in schools. And essentially, Sonny Perdue announced last year that they were going to get rid of that third, most progressive level, and they were going to give more time to reach the second level. So it rolled back and then essentially stopped the progression in terms of improving the amount of sodium in schools.

So where do you think the most important advances in policy will be?

You know, I think that it goes up and down, if that makes sense. I think that things begin at the local level, because you have districts that really get out in front and have community that, you know, sort of taking this on as a priority. And then I think when you have districts showing that something can be done, it's more likely to happen at the state level. And then when things are done at the state level, oftentimes when you have a handful of states around the country that have demonstrated that something could be done, it's much easier for the federal government to make the changes. So if you're in a progressive state, the changes come earlier, because they are at those local and state levels. If you're in a less progressive state that doesn't tend to be out front on these issues, you really have to wait for the federal government to step in. That's what we've seen. And I wouldn't be surprised if it continued with that pattern.

So what do you think are the top priorities for what can be done in schools as we look forward?

The nutrition standards where they are, those rollbacks notwithstanding, I think are great. And I think it would be fine to keep them where they are now. I don't necessarily think that there need to be big changes there. What I think is more important now is to work on the culinary skill of people who are preparing school meals and find ways to help everyone make meals that follow those standards, but are also highly palatable and really attractive to the students. Overall, there have been a lot of success stories in terms of students liking the new school meals. I mean, we collected data in New Haven and documented very clearly that there had been no increase in plate waste, that children were eating the meals, they were eating more fruit than they were eating before. And I think that's the story in a lot of the cities and particularly districts that have 100% free lunch, so universal free meals. Those are the students who are used to eating school meals. They've been eating school meals since they came into schools. It's free, it's available for everyone, and that I think is often where you're going to see the most success. I think what's harder are the school districts that have a smaller proportion of students who qualify for free meals and therefore their rates of participation tend to be lower. They're faced with more challenges because they don't have the volume of participation that financially helps them invest in, let's say, new equipment or staff or training. And so they're the ones that I think have been struggling. And so I would love to see efforts to really help those districts learn from the districts that have seen a lot of success and kind of get the training, get the equipment, to really be able to provide meals that all of the students are going to want to eat.

Bio

Dr. Marlene Schwartz is Director for the Rudd Center for Food Policy & Obesity and Professor of Human Development and Family Sciences. Dr. Schwartz’s research and community service address how home environments, school landscapes, neighborhoods, and the media shape the eating attitudes and behaviors of children. Schwartz earned her PhD in Psychology from Yale University in 1996. Prior to joining the Rudd Center, she served as Co-Director of the Yale Center for Eating and Weight Disorders from 1996 to 2006. She has collaborated with the Connecticut State Department of Education to evaluate nutrition and physical activity policies in schools and preschools throughout the state. She co-chaired the Connecticut Obesity Task Force and has provided expert testimony on obesity-related state policies. She also serves on the Board of Directors of the Connecticut Food Bank.

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Food banks and food pantries provide life-saving help for families all around the country. Like other institutions addressing food issues, there is growing focus on providing not just food, but healthy food. There are complex issues in this picture, however, issues we can address with today's guest, Dr. Marlene Schwartz. Schwartz is director of the Rudd Center for Food Policy and Obesity and Professor of Human Development and Family Studies at the University of Connecticut.

Interview Summary

Many of our listeners will know in general how food banks work, but may not know the details. Can you explain in general how these organizations operate? Where do they get their food and where does it go?

There are two terms that you hear a lot: food bank and food pantry. So a food bank is basically a huge warehouse that will get food either directly from a factory, from the food industry, or from a large retailer, sometimes directly from farmers and then sometimes from food drives or other efforts to collect food to donate. Most food banks have an online ordering system for food pantries, so food pantries are much smaller. They are sometimes run by churches or other community centers, and they're typically fairly small places where the staff will obtain the food from the food bank and maybe some also in addition from other local retailers or donations, and then that's where the clients come in. And so the clients will go to the food pantry in their community and that's where they will obtain the food that they can then take home and use.

If there are other programs that help people with food-related needs like SNAP and WIC, how do food banks fit into this overall picture?

So, it's really interesting because when you look at the actual amount of food provided by certainly a program as large as SNAP or WIC, food banks are tiny by comparison. So it's really a very, very small percentage of food that individuals get from the charitable food system compared to SNAP and WIC. However, I think their role really goes beyond the food they provide. Oftentimes food pantries are a place where people can come and get access to other resources in their community. So as I mentioned, they're often in community centers or faith-based organizations that will not only provide the food, but sometimes provide assistance signing up for SNAP or WIC or finding out about other types of social services or resources that are in the community. And so I think that their role can really be measured not just by the amount of food that they distribute, but also the way in which they connect their clients with other resources and really provide a place of support for their community.

You've paid a lot of attention to using the healthiness of the food distributed as an index of success. So how's this different than what's been done traditionally?

Traditionally, the success of food banks or food pantries has been measured in the pounds of food. And it's really interesting because you can see why that was an attractive measure because it's super easy. You basically just put the food on a scale, you measure how many pounds it is, it's a number, you know when it's more or less, and it's pretty straightforward. But as often happens when things get measured is that sometimes the system evolves to really maximize the measure without thinking about the consequences. So really heavy products, like two liter bottles of soda, for example, became very popular to donate to food banks and food pantries because they weighed a lot. And other things like maybe a container of spinach or kale was not very popular to donate because you wouldn't necessarily see a big change in the number of pounds. So I think that we definitely need to start looking at it differently and looking at the volume of food and consider the nutritional quality of food and not just the pounds.

So what sort of things were getting donated that wouldn't be considered good nutrition?

Packaged foods are very popular to donate to food banks. A lot of the packaged snack foods, a lot of canned meals. So things like beef stew or, you know, Beefaroni, or other foods that are shelf stable and heavy and people sort of felt would be filling, those tended to be the foods that people automatically thought would be the best things to donate to food banks.

If people are really hungry and in need, doesn't it make sense just to give them anything that's available? And could you make that argument?

I am sympathetic to the argument that people are hungry and you need to just give them something, and then it's all about the volume and the amount and that's the most important thing. But in really doing research on the people who come to food banks, I learned a couple of really important things. First of all, their rates of diet-related diseases are much, much higher than the general population. So we've seen very high rates of type 2 diabetes, hypertension, and obesity. So you have to really think about the folks that are coming. They're at an even higher risk of those diseases. And the second thing is we started doing research where we actually asked clients, "What would you like to have at the pantry?" And the answers might surprise some people. We found that what was most important to them were fruits, vegetables, grains, dairy, meat. So they weren't really looking for these canned products or these packaged products. And they certainly weren't looking for things like salty snacks and sugary drinks. So when you really listen to people, you find out they want healthy groceries, just like everybody else. And so, in my opinion, if you are taking on the responsibility of running a food pantry or a food bank and providing food, you really need to think about the needs of the people you're serving.

Are food banks generally around the country thinking more about the nutrition quality of the foods they receive and how is this playing out?

I’ve been in this area of research probably for six or seven years now. And even in that short time, I've seen a big change. So when we first started doing work in this area, we did a national survey of people in food banks and we did interviews to try to hear about how they were thinking about nutrition. And I would say there were still a lot that took the position you mentioned earlier that it's about pounds and it's about getting the maximum amount of food out and nutritional quality is really secondary. But I think as the public conversation has changed and people have become more and more aware of the importance of healthy food and the concern of diet-related diseases, food banks have changed as well. And we did another survey last year and really found that a large number of food banks are thinking about these things. They're using nutrition ranking systems, they're developing nutrition policies. And Feeding America is a national organization overseeing a network of about 200 food banks. They've come a long way in terms of thinking about the role of nutrition and how they can really lead that way.

You’ve done some research yourself on food banks and nutrition programs. What sort of nutrition work can be done in the context of food banks? And is there information available on how well these approaches work?

I would say the first step that a lot of food banks have taken is what we're calling nutrition ranking. So it's essentially having a systematic way of scoring the food products that come in. Sometimes they use a stoplight system, sort of a green, yellow, red in terms of the nutritional quality. Sometimes it's a binary system where they sort of consider it like foods to encourage or not. But sort of whatever system you use, I think having a system where you're keeping track of the quality of food in a systematic way helps you in a number of ways. One, you can see your changes over time. Two, you can sort of see which donors are giving you the sorts of foods that you're looking for and which donors are not, and that can sometimes facilitate conversations with those donors. But we did a really exciting study recently, we just finished analyzing the data, where we then had the food that the food bank had collected. So this is a food bank here in Connecticut called Foodshare, and they implement a system called the SWAP system, which stands for Supporting Wellness at Pantries. And it's a green, yellow, red stoplight ranking system based on saturated fat, sodium, and sugar. And what they did is they rank all the food as it comes in, and then when they put it on their online shopping platform for the food pantries, and there are about 150 food pantries that shop at Foodshare for the food that they distribute, we actually showed them green, yellow, red next to the items so they could see the nutrition quality assessment like that. And because we knew we were going to do it, we were able to look before that information was available and after that information was available over about a three-year period of time with it changing in the middle. And what we found was that there was a significant increase in the proportion of the order that was green and a decrease in the proportion of the order that was red. So what this really suggests is that if you communicate that information, you can sort of shift the behavior of the people who are making the decisions. We did another study, then. We basically did the same thing at the pantry level. So we went into a food pantry and we reorganized their shelves so they were clearly labeled with sort of circles that were the color green, yellow, red, but then had words like "Low sugar, good for managing diabetes," or, "Low sodium, good for managing blood pressure." We did that before and after we had collected data with these clients, and again found the exact same thing, that when clients were given the information, they change their behavior and there was an increase in the proportion of what they took that was green and a decrease in the proportion of what they took that was red. So I think there's a lot of promise in this idea of simply measuring and providing that information, I think will nudge people in the right direction.

Those interventions that you designed are very creative and it's really nice that they were so powerful. And boy, that does really speak to what can be done in these settings. So you mentioned Feeding America, a national organization, then you said that they work with 200 food banks around the country. And also I know they work with 60,000 food pantries. So what role do they play in all this?

Feeding America is incredibly important because they are kind of this umbrella organization for food banks nationally. There are some food banks that aren't affiliated with Feeding America, but the vast majority of the food banks in the United States are. One of the things they're able to do is navigate donations from very, very large national donors. So they can keep track, for example, of, you know, if there's a huge shipment of, I don't know, butternut squash, they can sort of figure out where it is and communicate with different food banks and try to get the food where it needs to go by having sort of the big picture of the whole country in front of them. And so they're able to really help a lot with fresh vegetables and fresh fruit and making sure that things get where they can be distributed in a timely fashion. They also can provide a lot of education for the networks and they have a lot of information online to really help food banks and food pantries know the latest science and also have access to different resources. And they also have a lot of national conferences for different segments of the system, where they'll present the latest information and help different members of this system do as good of a job as they can.

If I ask you to peer into the future, what do you think food banks will look like going down the road?

Well, the future in my imagination is that food banks and food pantries will continue to provide nutritious foods and will really focus primarily on providing the most nutritious foods, but will also become places that really serve the communities that they're in. So what I think is the untapped potential of this system is having a place where folks who might not have other resources, let's say because maybe they're not working or they're not in school, to have a place in their community where they can go and get access to trainings and other resources and sort of help them get back on their feet so that they can be successful. And there's a colleague of mine named Katie Martin who has this concept called More Than Food, which is really this idea that food pantries can help people obtain other services, connect them with health care, connect them with educational opportunities. And in that way, I think can really get more at the root causes of the food insecurity in the first place.

Bio

Dr. Marlene Schwartz is Director for the Rudd Center for Food Policy & Obesity and Professor of Human Development and Family Sciences. Dr. Schwartz’s research and community service address how home environments, school landscapes, neighborhoods, and the media shape the eating attitudes and behaviors of children. Schwartz earned her PhD in Psychology from Yale University in 1996. Prior to joining the Rudd Center, she served as Co-Director of the Yale Center for Eating and Weight Disorders from 1996 to 2006. She has collaborated with the Connecticut State Department of Education to evaluate nutrition and physical activity policies in schools and preschools throughout the state. She co-chaired the Connecticut Obesity Task Force and has provided expert testimony on obesity-related state policies. She also serves on the Board of Directors of the Connecticut Food Bank.

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Breastfeeding is front and center in discussions of maternal and child health. But optimizing breastfeeding practices is anything but simple. There's no person better suited to discuss the challenges and opportunities in this area than our guest, Dr. Rafael Perez-Escamilla. Perez-Escamilla is director of the Office of Public Health Practice, and professor of epidemiology and public health at the Yale University School of Public Health.

Interview Summary

I'd like to ask how important is breastfeeding to the wellbeing of the child, to the mother, and to the public health overall?

Yes indeed, breastfeeding is incredibly important not only to the health of the child and the mother, but of course the wellbeing of their families development of the countries in which they live, and also for the health of our planet. We know that with regards to children, for example, breastfeeding protects against the risk of diarrhea, of respiratory infections, of ear infections, and also it protects against the risk of the development of obesity, and leukemia. And at the end of the day breastfeeding makes humans more intelligent because it improves their cognitive development.

When we talk about breastfeeding we also have to take into account that for the mothers it offers major health benefits as well. It reduces the risk of breast, ovarian, and endometrial cancer, as well as the risk of maternal hypertension, stroke, and type two diabetes. So it is not surprising then that for the countries as a whole, breastfeeding not only leads to improve human development but at the end of the day this translates into improved family productivity, and improved national development.

"The Lancet" breastfeeding series estimated that the world loses over one billion dollars per day as a result of lack of investments for breastfeeding protection and support. And last but not least, when we think about the planet, breastfeeding improves environmental sustainability because we know that for example, it takes 4,000 liters of water to produce one kilogram of powdered infant formula. The production of infant formula leaves a major carbon footprint as a result of the fossil fuels that are needed to produce, transport, and also store the infant formula products. And there are hundreds and hundreds of thousands of waste accumulating every year with regards to the disposal of plastics that come from the bottles, the metal waste that comes from the containers that have the formula. And at the end of the day, also we know that dairy cows are major producers of methane or greenhouse emissions. So no matter how you cut it, no matter how you look at it, breastfeeding offers immense benefits from the child, all the way to the health of the planet.

What an impressive picture you've painted, and you have to wonder then why there's not an all out pursuit everywhere in the world to maximize breastfeeding rates. We'll come back to that in a minute. But first let me ask how do rates and duration of breastfeeding vary around the world?

Yes, that is a great question because there is an enormous amount of variability globally. So when we look at the most recent data from UNICEF, we know that with regards to the recommendation to exclusively breastfeed for the first six months of life, that prevalence or the percentage of infants actually being exclusively breastfed ranges from 0.1% in Chad, in Sub-Saharan Africa, all the way to 88.4% in Colombia. And by the way, the US, the prevalence of exclusive breastfeeding among children under six months of age is 25% to put these numbers in perspective. When we look at any breastfeeding, we know that there is also a very, very wide range. So when we look at the percent of babies that receive any breastfeeding up to one year of age, this ranges from 20% in Belarus, to almost 100% in Nepal, Senegal, and Malawi. And to put this in perspective, the prevalence of any breastfeeding at 12 months in the US is around 36%.

Those numbers are stunning, aren't they - in how much variability there is. What are some of the factors that contribute to that variability?

First of all, we have to acknowledge the fact that many women globally are now employed either in the formal or the informal economy. And what this means is that if we don't have strong maternity benefits, and maternity leave legislations, and I'm talking about paid maternity leave, then it is becoming very challenging for women to be able to breastfeed their babies for as long as they want to do. And for as long as it is recommended by the health organizations such as the World Health Organization, UNICEF, and the American Academy of Pediatrics.

We also have a major issue with regards to unethical marketing practices by infant feeding companies. So since the 1980s, the World Health Organization released a very comprehensive code to actually regulate the marketing of breast milk substitutes. And that code clearly forbids the direct marketing of infant formulas and follow on formulas. Those that are being marketed for children between one and three years of age. There are strong restrictions on the use of images or messages in infant formula containers suggesting equivalency with breast milk, as well as the sponsorship of breastfeeding conferences by infant formula companies. And of course the enormous problem of the creation of conflict of interest by sponsoring health professionals' trips, meals, and registrations to meetings. Unfortunately, infant formula companies continue to violate the code, and as a result especially lower income women and very heavily targeting low income countries where the growing market for infant formula sales is, are being very, very heavily exposed to marketing that should not be happening if countries were enforcing these code of conduct with regards to marketing practices.

A third factor that is very important here, Kelly, is the fact health schools are not preparing well — the doctors, the nurses, the midwives - with regards to breastfeeding, and developing their abilities and their skillsets to help support women manage their lactation problems. So we also have the whole issue that we need to have a much competent workforce globally to be able to properly serve the breastfeeding support needs that women have no matter where they live.

Rafael, if we could go back to the issue that you raised about the behavior of the infant formula companies, the science would suggest that their products should not be encouraged. Then what's the option? What can be done to help address this given that they continue their practices in the face of recommendations from places like the World Health Organization?

So two actions are very important to consider. First of all, the implementation, the adoption of the code is voluntary, and essentially relies on self-regulation by infant formula companies. And we have seen already two decades of experience that self-regulation just does not work. So it is very important that actually the governments take on this responsibility and develop the legal frameworks, and develop the infrastructure that is needed for enforcing the code. And it really needs to have attached to it strong penalties for companies that violate it. Right now, the penalties are just not severe enough to dissuade any company from actually violating the guidelines on this code.

In the US, we also have the additional problem that it is the only high income country that never agreed to signed the code. So the US is a very difficult environment to try to enforce this code for that reason. So the other option, which is an approach that I have actually learned a lot from researchers like you, is how to better educate the public at large. So how can we really create the conditions for public itself to demand for these practices to stop? And we know that in the ‘70s and ‘80s there was a huge boycott, for example, against Nestle, of the infant formula companies, because of very very unacceptable behavior regarding the marketing and sales of their infant formula products, especially in Sub-Saharan Africa. And that had an impact that actually brought the whole issue to the attention of the world, and actually really helped this company change a little bit the way they were conducting themselves with regards to marketing and sales of their products in Sub-Saharan Africa.

And I would like to add that I would really love for all the schools of medicine, and nursing, and midwifery, and so on to actually include courses or a curriculum on what conflict of interest means. Because I think for young health professionals who have a debt, or are not making enough money from their practice it is very tempting to agree to accept gifts, trips, and so on from companies. But they really need to understand that it is a huge conflict of interest with enormous implications for the health of the children and families in their countries.

Can you explain the concept of baby friendly hospitals?

So, the baby friendly hospital initiative was launched in 1991 by the World Health Organization and UNICEF based on 10 steps that help improve the ability of women to successfully breastfeed their babies before, during, and after the birth of that baby. So these steps range from having a written policy that the maternity facility is totally in support of protecting, promoting, and supporting breastfeeding to another step related to the fact that all the personnel that has contact with women and families that have newborns, and in fact even women who are pregnant, should be well-trained on how to support their breastfeeding decisions.

And the steps also include physical, structural issues because the babies and the mothers need to be together throughout the hospital. Stay in what we call rooming in, skin to skin contact needs to start immediately after birth so that the babies start breastfeeding within one hour after birth. And then the whole issue of not only telling moms breast is best, but actually helping them latch their babies the first time they offer the breasts, and offering them very good advice on, for example, if they're planning to go back to work how are they going to express milk, the breast pump, to be able to continue implementing their choice, their decision to breastfeeding. And very importantly, at the end of the day, now the baby friendly hospital initiative calls for only advocating for infant formula when it's absolutely medical indicated, if the mother is choosing to breastfeed her baby. No free gifts from infant formula companies, no marketing from infant formula companies in the maternity ward. And very importantly that support and the counseling needs to start prenatally, and also post-natally the mothers need to know where they can find breastfeeding management support in the communities or in their neighborhoods once they go back to them after their hospital discharge.

I have been researching this initiative for 30 years, and there is conclusive evidence that it is very efficacious maternity wards that faithfully implement the 10 steps end up having much, much better breastfeeding outcomes in the short, medium, and long-term. And we also know from studies in the US conducted by the CDC that the higher the number of steps that get implemented, the higher the success with breastfeeding outcomes. So the baby friendly hospital initiative, the guidelines have just been revised by the World Health Organization to understand why coverage has not been as high as it was originally intended. So we're now entering a new phase of what I would call implementation science research in the area of the baby friendly hospital initiative, to actually help each country tailor that initiative to the needs of their context, their economic situation, their maternity leave situation, without losing the essence of what the 10 steps are all about.

In the United States as an example, do you have a general sense of the percentage of hospitals that are baby friendly hospitals? And is that number growing?

The good news is that the numbers are growing. And in fact currently about one third of US babies are being born in baby friendly hospitals. Not too long ago it was about 5%. There is still a long way to go, there is a lot of room for improvement. At the end of the day, the needle is moving in the right direction. So in spite of everything, more and more women are choosing to initiate breastfeeding in the US, and more and more hospitals are choosing to become baby friendly, which is indeed great news.

That's very exciting. So in addition to the advance in baby friendly hospitals, what do you think are some of the other exciting things that are going on around the world?

So I think we have totally entered the implementation science arena. And my research team is very engaged, developing tools for policymakers to actually understand how best to assess the enabling environment for breastfeeding in their countries, so that they can actually come up with smarter policies that can help scale up more rapidly, and more cost-effectively their breastfeeding programs. And our approach is not only generating a number or a score, but actually have the countries run a whole policy development process based on a participatory multi-sectorial approach so that at the end of the day the understanding of the enabling environments help make recommendations that can be implemented in the short term, such as extensions of maternity leave, improving coverage of the baby friendly hospital initiative, improving the pre service training of healthcare professionals.

We have tested this policy toolbox, it's called the Becoming Breastfeeding Friendly initiative in eight countries. And we have actually demonstrated how feasible it is, how helpful it is for policy makers, and that at the end of the day all the governments that have agreed to be a part of it have followed through with some policy development commitments. The key message here is that we understand a lot about lactation physiology, how milk gets produced. We understand a lot how to solve common breastfeeding difficulties, such as sore nipples, breast engorgement, mastitis, and so on. And we also understand pretty well now thanks to the work we have done here at Yale University, which are the key elements that national breastfeeding programs need to have in place to make it work on a large scale, and in a cost effective manner. So here we have a treasure trove of knowledge, and it is really time to translate all this knowledge into practice globally, for the benefit of humankind.

Bio

Rafael Pérez-Escamilla, Ph.D., is Professor of Public Health, Director of the Office of Public Health Practice, and Director of the Global Health Concentration at the Yale School of Public Health. He is the PI of the Yale-Griffin CDC Prevention Research Center (PRC). His global public health nutrition and food security research program has contributed to improvements in breastfeeding and other maternal, infant and young child nutrition outcomes, iron deficiency anemia among infants, household food security, and early child development. His health disparities research involves assessing the impact of community health workers at improving behavioral and metabolic outcomes in vulnerable communities.

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When the food industry promises to police itself and pledges to improve nutrition in public health, can it be trusted to make meaningful change or must government mandate those changes? Our two guests today have done groundbreaking work to help address this very question. Dr. Jessica Fanzo, Professor of Global Food and Agricultural Policy and Ethics at Johns Hopkins University, and Dr. Jennifer Harris is Senior Research Advisor for Marketing Initiatives at the Rudd Center for Food Policy and Obesity at the University of Connecticut.

Interview Summary

So Jess, let's begin with you. You coauthored what I thought was a very important and novel report released by the Global Alliance for Improved Nutrition on product reformulation by the food industry. Would you might explain what's meant by reformulation?

When we think about reformulation, it's really defined as the process of all-terrain a food or a beverage product. You can alter that by improving the products' health profile or reducing the content of harmful nutrients or ingredients. So it's a process of either removing those negative ingredients or nutrients or adding back positive ones into foods. Why is that done? Because people consume a lot of processed foods. Almost every food that we consume has gone through some form of processing, but there's a whole range of that processing from very minimal to very highly processed, what's often called ultra-processed or junk food that doesn't have a lot of nutritional value. In the report, we were looking at what are the challenges with reformulating food? What are some of the opportunities to reformulate food? And in the realm of reformulation, has it had a positive impact on public health? So we were looking at those aspects of the reformulation of processed foods.

So I'm assuming there could be enormous advances to public health if reformulation were done on a broad scale and or if it were done in a meaningful way. So what were your main findings then? Have there been examples of industry being successful with voluntary reformulation?

Somewhat. And absolutely it could have potentially really important positive impacts for public health, but it's also not a panacea for improving diets and nutrition. And while there are some examples where voluntary reformulation has had some impact, the UK with salt and some other examples, overall we found that it's important for governments to mandate reformulation through different tools, whether it's labeling, taxes, et cetera. For foods that are not reformulated, we felt that it was really important for governments to mandate with clear, transparent and direct targets, particularly removing the unhealthy ingredients like added sugars, salts, unhealthy fats like trans fats. The food industry should be involved in implementing reformulation policies but not in their design. And governments need to really step in and step up. But that said, that doesn't mean that reformulation is going to solve all the problems. Governments also need to invest in many other tools to protect consumers and to invest in other ways to improve diets for nutrition. So reformulation shouldn't be the only answer.

So I'm assuming the reason that food industry won't go far enough on their own is that these things that make the food less healthy also tend to make them pretty palatable, or give them long shelf life or properties that make people enjoy them a lot. And that why in the world would they do something that would make their products less desirable? Does that pretty much the case or do you see other reasons why?

That's definitely true. I mean, these highly processed foods are cheap in their ingredients to make, they are very palatable, there's a high demand for them. We're seeing this shift now into low-income countries like with tobacco when consumers catch on that these foods are not so healthy, they go to populations where there's a bit of a lag in that knowledge. But also reformulating foods from the industry's perspective is not so easy. It's quite expensive to do it. It's difficult to reduce salt and sugar, which are vital not only for the taste of foods, but for their composition and shelf-life and texture. So it has a lot of ramifications to remove those ingredients. So meeting government mandates around reformulation can be really challenging and sometimes impossible for companies. So they often will deal with getting a warning label, for the example in Chile, they'll just take the warning label because they can't reformulate some foods. But there's a change in consumer demand and tastes. Consumers like their brands, but the more and more consumers are caring about clean labels, environmental sustainability, their health, people are concerned about the amount of sugar in foods so they're going to have to answer to that, that changing demand as consumers demand better foods whether it's from a health or sustainability or transparency perspective.

Let me ask one more question related to this. Is it also the case that it's pretty difficult for some company to be the first out of the gate if they were inclined to do this voluntarily because then their products would become less desirable and their competitors would be kinda stuck in the old ways? So isn't that another argument for government intervening that everybody is on the same playing field?

Absolutely, yes. I mean, why not hold every player accountable and to the same standards and mandates? It pushes them all to take action. So when we were interviewing some of the industry players, they really struggle because when they did try to reformulate some of the foods, consumers no longer bought them because they're very wedded to their brands, they're wedded to certain tastes, it's a real challenge for them to keep their consumer base. But at the same time, try to adhere to government mandate. And some companies care more about health and sustainability than others. We definitely learn that some companies have no interest in that, because they know they'll always be a big consumer base for these quote less healthy foods. So there's a real issue from company to company of who's willing to take more action to reformulate and who doesn't really care to reformulate at all and they're willing to live with warning stickers and taxes.

So Jennifer, let's turn to you. So you've done really pioneering work on the impact of food marketing on children that began when we were colleagues together at the Rudd Center when it was at Yale University. And there I was witness to the fact that you created a very impressive methodology for studying what's a pretty complicated issue. And you paid a lot of attention to industry promises for self-policing of children's food marketing. Do you mind giving us a quick sense of what's being marketed to who and how, and how much marketing children are exposed to?

Annually, companies spend over $13 billion in advertising food to all consumers. And just to put that number in perspective, the whole chronic disease prevention budget at the CDC is 1 billion. So the companies are really controlling the messages about what people should eat. And most of that money is spent to advertise very unhealthy products. The products that are contributing to poor diet and disease in this country. The biggest ones are fast food, sugary drinks, sweet and salty snacks and candy. Those categories represent about 80% of all foods that are advertised. Healthier categories of foods, if you look at all of juice, water, fruits, and vegetables and nuts combined, it's less than 3% of the total. So they're really pushing these very high fat, high sugar, high salt products extensively. Companies spend most of their advertising dollars on television ads.

On an annual basis, kids see about 4,000 of those ads per year. So almost 4,000 ads, that's over 10 a day for unhealthy food. Kids of color, so black kids see twice as many of those ads. A lot of the worst products, their advertising is targeted to Black and Hispanic communities and especially adolescents. But TV isn't the only way companies advertise. And in the last few years, the ways that companies market just increased exponentially. Now with smartphones and tablets, they can reach kids any place and any time through things like ads on YouTube videos, social media, smartphone apps, with games and ordering programs, even educational websites teachers are using in grade school have ads on them. This kind of marketing is personalized. So what you see depends on what you do online. They know who you are and they can reach you. And unfortunately, this kind of marketing also is the kind of thing that parents can't monitor as easily as what your child is watching on TV. So the companies basically try to be wherever the consumer is to reach them with their advertising.

Well those are really stunning numbers. I know one of the arguments the industry has made for years, and one of the things that you've addressed directly in your research is their claim that this food advertising doesn't really make kids or adults eat an unhealthy diet, it just shifts their preference from brand to brand. So if Coke is advertising a lot, they might say, "Well we just wanna take market share from Pepsi, "but we're not encouraging sugar beverage consumption." What would you say to that?

That is something they've argued for a long time. And one thing that we showed is that just watching a television program with food advertising makes kids and adults eat a lot more both while they're watching and afterwards. And another of our colleagues, Ashley Gearhardt has done some really interesting research showing how the food advertising actually activates the reward regions of the brain and leads to increased consumption. So that's one way that food marketing affects more than brand preferences. There's also been a lot of research showing that if you advertise Coke, it increases consumption and purchases of all sugary drinks. They also affect sales of the categories, not just the specific brands.

So with you and others doing so much work showing how much of the marketing there is and how disastrous the impact is, you can imagine the industry feels vulnerable to the possibility of outside regulation or perhaps even litigation. And so one of the things the industry has done and this links back to what Jessica was talking about in the context of reformulation, is to say that they can police themselves. So can you explain how they've gone about doing that?

Well in the US there's a program called the Children's Food and Beverage Advertising Initiative, which is the food industry self-regulatory program to address food advertising to kids. And there are similar programs in countries around the world. But basically what the industry has promised is that they will only advertise products that meet nutrition standards in child directed media. That sounds really great. They implemented the program in 2007, but you said Kelly, we've done a lot of research showing how many limitations and loopholes there are in this program. One is that they only define children as 11 years and younger. So they only have promised to reduce unhealthy advertising to young children. And more and more of the research is showing that adolescents are just as affected and maybe even more effected by the advertising.

Since their program was implemented, they've increased their advertising to the slightly older group that isn't covered by the CFBAI. Another limitation is their definition of what is child directed is advertising in media where children are the primary audience. So on television that would basically be children's TV. So Nickelodeon, Cartoon Network, those kinds of programs. But children watch a lot more television than just children's television. And so they can still advertise anything they want on programs that are also watched by adults and older children. And then the third major limitation is that they've set their own nutrition standards. So they have defined what is healthy. And maybe not surprisingly, a lot of the products that they say are healthier choices that can be advertised to kids are things like sugary cereals, fruit drinks that maybe have less sugar but they also have artificial sweeteners in them. Things like goldfish crackers, fast-food kids' meals, all of those can still be advertised to children under their nutrition standards.

What we found is since the program was implemented in 2007, food advertising on children's television has gone down quite a bit, 45%. But at the same time, advertising on other types of television that children watch has gone up about 30%. So now kids see almost as much food advertising as they used to, but most of it is not on children's television, it's on the other kinds of television that they're watching. And a lot of the harder things to monitor, things like apps and social media and websites do not qualify as child directed media under this program.

Now the reason I asked both of you to be on this podcast at the same time as I figured there would be interesting similarities, even though you're working on somewhat different topics, and boy does it turn out to be they're real themes weave through this. So let's talk next about what might be done then. So Jessica, with your work on industry reformulation, what have you concluded can be done voluntarily?

Kelly, I think government needs to be much more involved than they are. The challenges that we see with voluntary regulation, whether it's in reformulation or marketing of unhealthy foods to children, we know that voluntary reformulation, industry sets its own agenda, they set their own targets, they have no accountability to meet those targets, they may pledge to reduce harmful ingredients but if the product has a very high level of these unhealthy ingredients, the reformulation may not make much of a difference from a public health point of view. So I think we need much more regulation. Governments need to hold industry accountable and ensure that they are meeting national standards for public health. I think government has been too laissez-faire about industry and the power that they hold. And I think now we're seeing the consequences of that not only in the United States, but everywhere in the world with rising levels of obesity and NCDs and unhealthy diets being a big risk factor with these processed foods playing a huge role in that. So we really need to see government step up in a much more profound way and hold industry having public health goals. It's a little bit of enough is enough.

So Jess, just out of curiosity, let's say you were the government official in charge of taking such action and you have the authority to do it, where would you start? Would you start with particular nutrients across the food chain or would you start with certain categories of food and would you worry first about sugar, salt, fat?

That's a good question. In the paper we outline four types of processed foods. To me I would probably look across the entire food supply chain at those highly, highly processed foods. And it would be good to start with at least the three categories of sugars, salt, and trans fats to even start with and setting key targets for those and marking those ultra-processed foods that go beyond that target. Chile had the great food law that's been enacted that's put warning labels on the front of packages and has regulated I think some of the advertising of those foods. Jennifer you probably know about this. And I think that's been an important case study for the rest of the world to look at of how Chile has done that because sales of those foods that have the warning label have gone down somewhere in the ballpark of I think between 23 and 28%, depending on the population. But I think there's lessons to be learned of how Chile has done that that other governments could learn from.

Now I'm happy that you pointed out the advances in Chile because there have been some very impressive impacts reported from the studies that have been done so far. So I agree that that is really a model to look to. So Jennifer, let's just get your opinion on this. Where do you come down on this issue of voluntary versus mandated?

So we've given the industry 12 years now to show that they can market healthier products to kids. And basically what they've done is they're marketing slightly healthier products to kids but the products they're marketing are not nutritious products that children should be consuming a lot of like sugared cereals. So it's pretty clear that they can't do it on their own and that regulation is required.

In the US, we have a little bit of an issue that not all countries have because of the First Amendment. And advertising is protected speech according to the Supreme Court. So we can't just say companies cannot advertise anything. So we have to be more strategic about the kinds of regulations that we can implement here. If we could do anything we wanted, Chile is a great example. In the next year, they won't be able to advertise any products that are high in fat, sugar and salt before 9:00 p.m. So it's not just children's programming, they won't be able to advertise it. They had to take all their characters off their packages. And so Tony the Tiger can't be on the package of frosted flakes anymore because it's high in sugar. They've done a lot of great things in Chile and sure we can adapt some of what they've done. In other countries also, for example the UK has very strong laws about marketing foods in digital media. So that would be another thing that we could import from other countries.

Bios

Jessica Fanzo, Ph.D., is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies (SAIS) at the Johns Hopkins University in the USA. She also serves as the Director of Hopkins’ Global Food Policy and Ethics Program, and as Director of Food & Nutrition Security at the JHU Alliance for a Healthier World. From 2017 to 2019, Jessica served as the Co-Chair of the Global Nutrition Report and the UN High Level Panel of Experts on Food Systems and Nutrition. Before coming to Hopkins, she has also held positions at Columbia University, the Earth Institute, Food and Agriculture Organization of the United Nations, the World Food Programme, Bioversity International, and the Millennium Development Goal Centre at the World Agroforestry Center in Kenya. She was the first laureate of the Carasso Foundation’s Sustainable Diets Prize in 2012 for her research on sustainable food and diets for long-term human health.

Jennifer Harris, Ph.D., is a Senior Research Advisor, Marketing Initiatives at the Rudd Center. Previously, Dr. Harris worked as Director of Marketing Initiatives and was an Associate Professor in Allied Health Sciences at the University of Connecticut. Harris received her B.A. from Northwestern University and M.B.A. in Marketing from The Wharton School. Before returning to graduate school, she was a marketing executive for eighteen years, including at American Express as a Vice President in consumer marketing and as principal in a marketing strategy consulting firm. Harris completed her PhD in Social Psychology at Yale University with John Bargh and Kelly Brownell.

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In a recently released January 2021, paper, scientists urge global policy makers and funders, to think of fish as a solution to food insecurity and malnutrition, not just as a natural resource, that provides income and livelihoods. The research team argues that fish can play a larger role in addressing global hunger and malnutrition, but fisheries governance would need to change. Welcome to the leading voices in food podcast. Our guest today is lead author, Abigail Bennett, an assistant professor of Global Inland Fisheries Ecology and Governance at Michigan State University.

Interview Summary

So let's dive right in. I've got a clarifying question. The paper is titled: Recognize Fish As Food In Policy Discourse and Development Funding. So what do you mean by recognized fishes food? Isn't fish already a food?

Yes, that's a good question because we do consume most of the fish that we produce. We consume 88% of fish that we produce. So fish is a food, but what we want to say in this paper, is that fish can do much more to, meet the challenges of global malnutrition and food insecurity.

So why do you think that fish is underrepresented in food and nutrition security policy and in funding priorities?

This is something that people who are working on fisheries and issues of food security have been saying for a while - in big global discussions on food security and malnutrition that fish doesn't come up as much as it should. And policies don't deal with the contributions of fish to these issues as much as they should.

What we did in this paper is analyze some food security funding and policy discussions, to actually try to discern is that the case, is fish actually not being discussed as a food, as much as it potentially could be. We looked at funding priorities, by the World Bank and regional development banks. And we wanted to know how much of, funding that's directed towards food. So agriculture or fisheries, aquaculture is targeting fisheries and aquaculture specifically. And so what we found is that the, World Bank on average has allocated about 1.8% of its agricultural funding to fisheries and aquaculture. And that's gone up a little bit, in the most recent five years in our dataset. The regional development banks have allocated a bit more, but again, in many years, those banks don't allocate anything to fisheries and aquaculture. And instead all of their funding goes to terrestrial food production systems. So we think that there's some room there for perhaps more, development resources to be targeted towards fisheries and aquaculture and their potential to meet food and nutrition security goals.

We also looked at some high level policy discussions, around fisheries and aquaculture to understand to what extent were those discussions looking at fish as a food. And so we analyzed the committee on fisheries, reports. The committee on fisheries is a meeting of FAO member countries that happens about every other, year to discuss major policy issues in fisheries and aquaculture. And we analyze the text of the reports from those meetings. And what we found is that issues of food and nutrition are marginally discussed in those meetings, and other issues are emphasized much more such as, economic and trade issues and environmental sustainability issues, which are of course important, but fish doesn't seem to be considered as, a source of food and nutrition in those discussions as much as it potentially could be. So those are just a couple of examples of, the types of venues that we looked at to try to, really ask this question in an empirical way of, is fish being considered a food in these high level policy and funding forum?

So Abby, it sounds like there's, a great role that fish could play in addressing global hunger and malnutrition. And certainly you need to work on, a financial resource support piece and the policy dialogue. What are some other steps that could be taken to advance the role of fish in addressing global hunger and malnutrition?

Yes. So really broadly, changing the way we conceptualize fish to thinking about it as a food rather than just a natural resource that's important for economic development or, something that needs conservation policy can, really lead us to a number of concrete research and policy actions that, I think can kind of pave the way to, raising the contributions of fish to food and nutrition security.

In the paper that you mentioned, we laid out four pillars of, how we might be able to do this. The first one that we discuss, is the need to improve metrics around the contribution of fish to food and nutrition security. Key metrics, information and data that we're missing, include information about the nutrient content of many species of fish. We need metrics to influence policy because we have to be able to demonstrate what the potential impact would be, if we focus on fish as a, contributor to food and nutrition security, and implement policies that target that.

The second pillar that we explored in the paper, is to promote nutrition sensitive fish food systems. This builds off of efforts to improve metrics and understand the specific nutrients and micronutrients that are contained in different fish species. It could allow us to do things like tailoring fisheries and aquaculture production systems to meet specific nutrient deficiencies in specific places or specific populations. Promoting nutrition sensitive food systems also encourages us to, look at the whole food system. And so looking not just at, how fish is produced and, its economic benefits, but also looking at, how it travels through a value chain, how it's processed and what that does to its nutritional properties, issues of food safety and hygiene. And then right down to understanding, how households are able to utilize fish, and actually consume it. By positioning food in this lens of nutrition sensitive, fish food systems. I think there's an opportunity to uncover a lot of different types of policy interventions that can utilize fish that's being already produced, to better meet nutritional needs of specific populations.

Another pillar is governing distribution. Right now we don't know a whole lot about, what happens to fish once it's harvested. We know a bit about the dynamics and direction of, international trade and fisheries, but at sub national, and especially at local levels, we don't know a lot about where fish is going and how the benefits from fisheries are distributed.

The final pillar is to situate fish, in a food system's framework. And the emphasis here is bring fish into this, broader discussion about global food systems, which focuses on meeting the dual goals, of achieving human and planetary health. Ultimately people don't just eat fish, they eat a variety of foods that come from both aquatic and terrestrial food systems. And so trying to see these holistically, I think is the best approach to being able to, ensure planetary sustainability, but also make sure that people, get nutrients they need, especially in places where, who vulnerable to hunger and malnutrition.

Are there any examples from you or your colleagues, that you think represent really promising new directions?

One of the things that my lab is working on currently is mapping the distribution of fish and the nutritional benefits from fish after it is harvested. And so what we've done for example in Malawi is, actually followed fish from the Lake where it's harvested, to fish markets throughout the country. And we've done this for two different species of fish and actually found that their distribution networks are quite different. These fisheries are serving the nutritional needs of, somewhat distinct populations within the same country. And if you couple that with knowledge about the different nutrients, that these different species contain, then you get these really distinctive profiles of how different fisheries are meeting different nutritional needs, throughout a country. So we know generally that fish are really high in, micronutrients and polyunsaturated fatty acids that are crucial for proper development and growth, immune system, lowering cardiovascular and noncommunicable disease burdens, right? But for many species of fish we don't know what their nutrient profiles or, what the content of nutrients that contain are. And this limits our ability to make specific recommendations about the role of fish in meeting food and nutrition security, and also of meeting specific nutritional needs of particular populations.

There are a number of researchers right now who are, working on compiling information about the nutrient content of different fish species, and developing some models to try to infer what the nutrient content of fish species are for which we don't have data. And that work is proving to be really powerful in communicating the importance of fish. Some findings that have emerged from that work are this prediction that 845 million people or 11% of the, global population might experience deficiencies in vitamin A, zinc or iron, due to decline in capture marine fisheries, for a variety of reasons.

Another really interesting study, has translated global fish yields, of different fisheries around the world, into the nutrient yields that they provide. And, this study is really interesting because it highlights, that different species are yielding different types of, nutrients. And that some fisheries yield a lot of Omega three fatty acids, other fisheries yield a lot of different micronutrients. And this doesn't correspond directly to, the volume of fish that's being produced. And what this tells us is that there's room there, for us to look at these different fisheries, and understand their specific contributions food and nutrition security. This study also highlighted that, there are many fisheries that are producing ample, nutrients, but that coastal populations adjacent to these fisheries are still experiencing, deficiencies in the nutrients that these fisheries provide. This raises some interesting questions about, distribution.

Great Abby, and let me ask you one final question. What do you see as the next steps for fisheries management?

It's a really interesting question. I think that we can ask ourselves the question of, how would fisheries management or fisheries policy, look different, if we thought about fish as a food, and try to govern fisheries to better meet food and nutrition security. One thing that may end up changing is we might focus on, managing different fisheries and investing in the governance of different fisheries, right? So fisheries governance is expensive, and we have to think what are the economic costs and benefits, for a country to invest in the governance of fisheries. By looking at the food security benefits, and highlighting those, I think that can provide another justification and basis for investing in the governance and sustainability of fisheries. Not just high value fisheries that may, for example, go to export revenue generation, but also small scale, fisheries that are important for local food and nutrition security. I think also that fisheries governance, that takes seriously this fish as food lens, would also look at connecting, this realm of fisheries production, and managing the fish stocks and production methods, right? The fishing methods, and connecting that to, the value chain and how fisheries is distributed and, thinking critically about issues of, property rights, and markets and the distribution of benefits. So that fisheries can better, serve the nutritional needs of people who need them most, within the limits of sustainability.

Bio

Abigail Bennett is assistant professor of global inland fisheries ecology and governance. She studies the role of fisheries in livelihoods and food security around the world. Her research examines how processes such as governance and trade shape the connections between fisheries and human well-being. For example, what kinds of governance arrangements can mitigate negative social and ecological impacts of global trade pressures? How important are fisheries for addressing hunger and malnutrition globally? And, how can we enhance fish value chains to increase access and benefits to women and the rural poor?

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In today's episode, we're digging into the Good Food Zone Policy that will be implemented in Los Angeles, California. The goal is to expand access to healthy food in neighborhoods considered food deserts and to create economic opportunity and jobs for residents living on low incomes. If you follow food policy work, you'll be interested in the Good Food Zone, food entrepreneurship and Community Development Framework. Guests in this podcast include three people deeply engaged in developing this place based policy strategy: Ronnell Hampton, of the Los Angeles Food Policy Council, Samantha Salmon, of the Local Initiatives Support Corporation, and Community Organizer and Media Specialist, Matt Sanderson.

Interview Summary

Matt, let's start with you. Could you explain the Good Food Zone Policy to the listeners?

Matt: Overall, we want to: increase access and demand for healthy food in food desert communities, which is increasing options for healthy food, especially in areas like South Los Angeles; as well as build demand for healthy food through culturally relevant practices. This also promotes economic development through food entrepreneurship, which is helping healthy food business owners develop strong business acumen, and scale micro and small healthy food business operations.

The Los Angeles city council approved this policy earlier this year and we're working to get it implemented. This will be a three-year program that will provide targeted services to overcome challenges and barriers that micro and small businesses in LA, would experience when formalizing or growing their business. And this is in partnership with the city, private, nonprofit and community service providers. And business owner can get the specialized help they need. Receive help with filing permits, referral to funding programs, discounts on equipment and utilities, and assistance with business training, as well as resources for marketing and financial management. The program ambassador, would facilitate communication with these business owners. Do they need help with business training, or help navigating governmental departments or need help with management or leadership training, product development or even technology adoption? Those who buy into this program, in this pilot, are asked to provide evidence of their commitment to developing and growing a healthy food business through annual reporting, surveys, on-site visits, evaluation of business practices, and more. The Good Foods Zone, sits at this intersection of racial health and economic justice.

That's a very impressive suite of activities that I'd like to ask Samantha a question that came to mind as you were talking about that Matt. So is this program for businesses that are owned and staffed by people in the affected communities only, or could outside people who wish to run businesses in the community receive these services?

Samantha: That’s a brilliant question. I love it so much because the community that gathered to put this policy together, really were interested in the economic development peace within their community. So, the policy brief as it outlines right now, the business has to be in operation for at least three years, in order to qualify for this pilot. So, the business is already a part of that community. And within the pilot, the goal is to hire people from within that community. So it doesn't necessarily block someone from outside of that community from opening a business, but they would have had to been in operation for three years.

That makes sense because then the wealth that might occur from this would remain in the community and not just be outside. So thanks for that answer. So Ronnell, let me turn to you. How did all this come about and what challenges were faced in researching and developing and ultimately getting this policy approve?

Ronnell: The Los Angeles Food Policy Council uses the collective impact approach to developing policy, which makes sure that impacted people are leaders and collaborators in the policy changes that happen in the Los Angeles regional area. So through our working group spaces we're able to facilitate that collective impact. And the work around the Good Foods Zone, was developed by our Good Food Economy Working Group. And so they have been working on this policy and how to organize to get a champion who is Current Price Council District 9 who introduced the good foods on policy and with the organizing of the Good Food Economy Working Group, we were able to get the policy recommended from the Economic Workforce Development Subcommittee for approval to get approved at council. Which happened March 3rd, 2020. We celebrate a policy passing, but the hard work happens when you're trying to get the policy implemented and making sure that the intended demographic actually receives the resources of that policy and making sure that the programmatic framework for that policy actually has the intended outcome that we had from the beginning.

You make an outstanding point about the importance of follow through. And I imagine when the history of this will be written, there'll be a lot to be said about what happens after the policy was passed. So I'm happy that you brought that point up.

Samantha, I'd like to hear your thought on some other key issues. So the Good Foods Zone Policy, is a place-based strategy and recognizes that historic divestment in specific neighborhoods, now requires targeted investment in those same neighborhoods. Can you explain a little bit more about this and who is intended to benefit from the policy?

Samantha: This policy benefits healthy food entrepreneurs throughout the entire food chain, and the community members who are looking for jobs and healthy foods in their neighborhoods. Folks like Celia and Joe Ward, who started South LA cafe because after decades of living a food desert, they wanted fresh affordable and healthy food options for themselves and their neighbors. So instead of waiting for it to arrive, they decided to take a leap of faith and provided themselves. Then you have women like Olympia, who started supermarket, which is a low cost organic pop-up grocers servicing low-income communities in LA. It operates weekly providing a hundred percent organic produce to make great health and healing available to the communities that need it most. And supermarket believes everyone deserves to eat well. Olympia, the founder believes fresh food access is not simply a nice idea. It's a right and a necessity. She said leaving our neighborhoods to get healthy ingredients and healthy meals is a challenge millions of Angelenos have to face. And so when she started supermarket, she felt like this subtle form of discrimination which leads to millions of deaths each year in the country, will hopefully cease to exist. And I wholeheartedly agree. That's the whole purpose of this policy.

You're talking about some very admirable and inspiring stories of people that have started food businesses. Can you explain Samantha just a little bit about why this is necessary and the food place? I mean, we know about what food deserts are but not so much about how they came about and what are some of the divestment that have occurred.

Samantha: Yes. And if I can, I would recommend everyone listening to read two very great books, that go into the details on it, because it definitely deserves more time than we have available on this podcast. The Color of Money by Mehrsa Baradaran, and the Color of Law, I forgot the name of the author, but they basically go into detail on the historic red lining and the holding of investment that was not available for black entrepreneurs and black landlords being able to buy a home and build equity. That way is also part of the piece and being able to get a loan to start a business, you know, have equity, to get appropriate financing. So, it's really intricate and those two books really go into that.

Thanks for those resources. So let's get into some more specific. Ronnell what are you actually asking the city to do in this, and how will you measure success at the end of the day?

Ronnell: In regards to the historic divestment, we have to be able to acknowledge how that looks in the landscape that our communities are living in. In South LA for example, there are more liquor stores than there are grocery stores. We're asking them to acknowledge the historic divestment that created the food deserts that community are dealing with right now.

In regards to the Good Food Zone, we're asking our local government to take action by identifying a timeline, for the feasibility report, and pilot implementation, that reflects the urgency of the public health issues related to food insecurity. We're also asking them to identify budget line items to fund the proposed $3.6 million three year pilot program. We're asking them to prioritize the implementation of the Good Food Zone as a tactic for community and business resilience modeling during and post-COVID. Like we're saying, the Good Food Zone is to address historic impact of food divestment but COVID has exacerbated a lot of those realities. So it's important that we leverage policies like the Good Food Zone, as a way to address resiliency and recovery. And we're also hoping that they consider expanding the pilot to help more healthy food businesses during the pandemic.

Thank you Ronnell. It's really inspiring to hear about these efforts and the passion behind them. Let me ask one final question of you Matt. What does it take to spread awareness of this community and those from there?

Matt: Sure Kelly, thank you so much. I really have to pause first and give a ton of credit to Samantha Ronnell and our team on the working group or hitting the ground running earlier this year to identify potential businesses affected by the lack of investment in these communities in these target pilot zones, which are Council Districts in Los Angeles that we would like to get the Pilot Program off and running. And we began cold calling and cold emailing of business owners who we identified in these zones. And South LA Cafe, is one of the more prominent ones. And really had to just start off with surveys with these business owners and hear their story. And what became markedly clear from the start of our effort, which did begin after the pandemic started. But as the months went on from May to June, June to July, and making these calls and getting the interviews became abundantly clear that yes, these business owners already were having a tough time navigating say government systems, no city systems for just say permitting.

Then, the interviews turned into: “I haven't heard back on my PPP loan.” “Or, one question a couple of months ago could have been how many employees do you have?” And this is a small market we're calling in South LA ‘they’ might just be the business owner, they've been there for 20 plus years, might be family owned. A lot of them are, Mom-and-Pop. And they might just have a few other employees but as the calls kept going, and we were finding out that the business owner could only afford to be their own boss. They were there from open to close, and the questions were they were interested in the incentives that the Good Food Zone and a lot of them wanted to get involved with the awareness campaign. Some were on the fence. They wanted to engage in the interview and I still had some questions and a lot of them were just so busy, you know at the height of COVID-19 where they could only just focus on the day-to-day and it said, you know please keep in touch and that sort of thing.

Through these interviews, we created awareness graphics of the business owners who we did interview. And when you scroll our Instagram page, you will see them. We told their story based on their interviews. And leading from the social media campaign, into the fall, we pivoted to media outreach. And media campaign as well as ask City Council and the Economic Development Workforce to reconvene, to finally implement this Pilot Program. And we've been doing, you know social media activism, getting all the social media posts out there. And I've created our media lists and targeted media outreach. And the efforts are ongoing. We're reaching out to the LA Area Media but also nationally and the Trade Media.

Bios

Ronnell Hampton is the Policy Manager for the Los Angeles Food Policy Council (LAFPC). He serves as the staff liaison to the Food Waste Rescue & Prevention, Good Food Economy, and Urban Agriculture Workgroups. He facilitates these efforts by using a collective impact approach to manage community organizing by cultivating relationships with people, community organizations, and government agencies at the local, state, and federal levels. By leveraging strategic approaches to policy development and implementation that centers racial, social, economic, and environmental justice, Ronnell moves the Good Food For All Agenda forward.

Samantha Salmon is passionate about equitable food-oriented development in communities experiencing food apartheid. She supports the Local Initiatives Support Corporation’s (LISC) economic development, health and housing initiatives alongside communications and public relations as a Program Assistant. Prior to LISC, she managed commercial property, owned and managed a raw vegan organic restaurant, and wrote a book on cultivating a healthy lifestyle on a budget. She holds a Bachelor's Degree from New York University in Economics and Africana Studies, which is the study of the diaspora of African people.

Matt Sanderson is a communications specialist, media consultant and journalist. His passion for real food justice began when volunteering with Southern California fruit harvesting organization Food Forward in 2019 and the groundbreaking Food Leaders Lab of the Los Angeles Food Policy Council. From there, Matt joined the Good Food Economy Working Group of the L.A. Food Policy Council, spearheading social media marketing and media outreach for the Good Food Zones policy implementation. He also volunteers his time with L.A. Compost and grassroots non-profit Farm2People, which formed in 2020 in response to the COVID-19 disruption of the local food supply chain.

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Food justice is a term heard more and more. Captured in that term is a view of how historical factors have shaped inequity in food systems, and powerful ideas for addressing issues such as food security, obesity, and the welfare of farmers. Listen in to a discussion with well-known author Adrian Miller, a very thoughtful voice on these issues.

Interview Summary

Could you begin by describing what you see as the major aspects of food justice activism, especially among African-Americans?

So I think a lot of it is about autonomy and having power to not only grow your own food but have access to healthy food and to really address kind of the dislocations we have in our food system. It's just really crazy that we grow so much food and so many people are not getting that food, and we throw away so much food. So I think people want to have more control over the food choices they have, and to be able to live healthier lives. And you're seeing a lot of activism in veganism right now, and some of it is connected back to an African diet. So you're seeing a lot of ideological and interesting kind of discussions in that way, but you're seeing questions about workers' rights and making sure that people in the food system are being paid a living wage, animal welfare issues. So I think it's an exciting time for food justice, but I think especially one of the most exciting things that I've seen is urban farming. Because a lot of African-Americans are in urban settings now. So how, in an urban setting, can you grow your own food and get access to food?

So this may be a nuance it's not worth making but one could look at the term food justice and think of having a food system that's more just, but you could also turn it around and say that a better food system can create justice overall. Would you agree with that?

Oh yes, I agree with the latter. Yes, absolutely. I mean I'm thinking of justice in a broad sense. We have a fair and inclusive society, and I think having access to healthy food, to good food, leading a healthy life, I think is really key to that. Because if you're distracted with other kind of survival issues, it may affect your ability to participate in other aspects of society. And so much of the work that I've done over time in terms of a policy sense is, how can we get people to just have those basic needs met so that they can be active participants in the economy, our democracy, all of these other things?

I imagine I can anticipate your answer to this but do you see access to healthy food at a reasonable cost to be a basic human right?

Oh absolutely. And it just hurts me that we're not even close to that place yet.

That's for sure. So what institutions are playing an active role in this, do you believe?

Well in the African-American community, I think one of the most viable institutions is the Black church. You're starting to see more African-American pastors say, well, caring for the souls of my congregants is not just a spiritual dimension, it's actually a physical dimension as well. And so they're starting to preach about these things. They're starting to get active in food justice issues. And I think one of the exciting things is, churches for a long time have been very strong on the charity model, right? They have food banks, they have meal programs, other things, but now people are starting to say, okay, so why are so many hungry people showing up at our church? Maybe we need to do something about changing the system so that we can meet the immediate needs, but long-term, we can help these people be in a place where they might not even have to come to a food bank. And African-American pastors are one of the most respected and trusted leaders in our community. So that the fact that they are awakening to these issues and showing leadership, I think portends an exciting future.

So our country has typically defaulted, hasn't it, to charity-based models that, when people are hungry, you get them food, or you try to get them enough money sort of thing and buy the food, but you're saying that we need to go much deeper than that, that we need to ask the fundamental question, as you said about why communities can't feed themselves, and then go in and help solve those problems. What do you think are some of the most exciting things you've said? You talked about urban gardens and programs like that. You also talked about the importance of the black churches. Are there other things that you've seen that you think are exciting?

Yes, and just to add on to that, the way that churches are, I think, are addressing this is, what do churches often have especially in an urban setting? A ton of land. And so we're seeing a lot of churches actually turned to gardening, and not only to supply their own food programs, whatever kind of meal program they have, but also to give this food to people in the community. So there's actually a church in Denver that is actually working the garden. And then when it comes time to harvest, they actually just give away the food for free. So I think that's pretty exciting.

There's a pastor in northern Mississippi, not too far from Memphis, who is taking the question of healthy eating so seriously that he no longer allows his church to have fried chicken for their meals after service. So this is a black pastor that has effectively banned fried chicken. Now he's still alive, nothing's happened to him. But that's the kind of leadership that we need to see. I think another thing that's happening, especially in communities like Detroit, is you're starting to see a lot of collaboration with different aspects of the community. So for instance, you have botanical gardens and societies now realizing that they can connect with urban farming, and they're reaching out to African-American community groups to figure out what are the ways that we can connect.

So, you know, when you think about a botanical garden, you're thinking about kind of upper echelons of white society, right? But they're now looking for ways to collaborate. You have a lot of young people that are also interested in urban farming and growing food, but also reconnecting to nature. So it's not just happening in the urban context, but they're trying to figure out how can we reconnect with farmers outside of our urban setting and maybe even create our own mini food system? You know, we talked about the fact that I'm writing a barbecue book.

Later this weekend, I'm going to spend some time with Ed Mitchell, a long time African-American barbecuer in this area. And he is actually looking into raising heritage animals to get back to the way barbecue was a hundred years ago. So to get away from this kind of factory farm model, and he's looking to create a network of African-American farmers to supply those heritage animals. So we've got just like all kinds of interesting things happening.

So you're really talking in some ways about whether a community has autonomy over its own food supply and its own food system. And that there's lack of autonomy the way things are now. Has it always been that way?

Oh I don't think so. So even if you go back to the Antebellum South, there have been periods where we've had, and especially after emancipation, we've had all-black communities, and really they were agricultural towns that got started. And the whole idea was to, you know, to use a term from the past, pull themselves up from the bootstraps, but often did it through food. And some of these communities thrived for a long time. And it was really external conditions that led to their demise, the Dust Bowl, or other things, even despite active white racism that tried to thwart their progress. These towns really thrived. And then even in the context of slavery, there was semi-autonomy.

One of the untold stories, I believe, from the antebellum period is to the extent that the enslaved were allowed to grow their own food. And they were given a plot of land, they were also given animals to raise. And so even in that horrible context, you do see some enslaved Africans trying to, in a sense, recreate home. If they were in a similar climate from their homeland, they tried to grow those plants, like okra, sorghum, millet, other foods. So we see not only this attempt for autonomy but really an attempt to assert their humanity, even under extremely difficult circumstances. And a lot of times food was a way to facilitate that.

So how do you see people responding to the absence of fresh food?

I see a mixed response. So I think part of it is, people just don't know. They're in an environment where most of the food choices they have are poor. Fast food, convenience food, you know, all these things. And so, without even knowing that there's other food available, that's just kind of the world as presented. I mean, one of the most heartbreaking things that I've seen recently is there was a documentary and the person who was filming it was holding up basically fruits and vegetables to kids. And they had no idea what that was. I remember, like one guy held up a potato and the kid had no idea what that was, and did not know that that's what led to potato chips. So I think it's going to take some education. And I think in the schools, also the edible gardening movement that's starting with schools. I think it's going to take a lot to just reconnect kids to that food story because it got disrupted for whatever reason.

So what do you think of calling such areas food deserts?

I think it's inaccurate for a couple of reasons. First of all, it's kind of a slap in the face to indigenous people who have been living in deserts and managed to survive for thousands of years. And this is, you know, I'm going to do the same thing with this term, but I like the idea of food swamps. The idea that, it's not that there's no food available, it's just that there's a lot of unhealthy food that's available and it's overwhelming. And you know, I'm sympathetic to parents. You know, if you're a single parent, you've got a few kids, you've been working all day, you have got to come home and feed your kids. Instead of making a dinner, I can understand why you might go to a place that is going to offer you really cheap food. If you can feed your family for 10 to 15 bucks, I could see why people make those decisions. So we have to present people with the option that you can feed your family healthy food for a very similar cost, if you do these things.

Another important aspect of this is the kind of highly processed foods that you're talking about. Act on the brain in the ways that create addictive-like properties. And so there, you get a really tough picture, if you get these products being heavily advertised. They may be the only things that are available to people who live in certain areas, and they're hijacking the brain, and that's a pretty bad combination of factors. So how do you see labor issues playing into this picture?

So one of the things that we are going to have to come to grips with, I think, eventually if we're going to be serious about food justice is paying for the true cost of food. And that's going to make some things very expensive. But, again, we're seeing like how this is not playing out very well because we have more and more people who are not making enough money to make their ends meet. And a lot of them are in the food industries. And at some point, we're going to have to figure out how can we pay people in a way that they can be self-sufficient and have a healthy food system, and make food affordable? I don't know if that all works out but I think people of means are at some point may have to just say, you know what, I'm not paying a lot of money for this thing that's being made out of season. Why is that? So I think it's going to be a consciousness among people of means to say, you know what, for the greater good for everyone, and I know that's kind of a tough sell these days, maybe I should pay more for these foods so that the money can flow all throughout the food system.

So if people were to pay the real cost of food, you mentioned the things out of season would go up in price, so there are other things that would probably go up in price?

I think almost all food is probably going to go up. I remember an interview by David Chang, who's a well-known chef in New York City, a very popular chef, and he was talking about within his own restaurant, how much food prices would go up if you actually were to start paying staff a fair wage, a living wage, and really, you know, pass on the cost for the food to consumers. I think he subsidizes some of this stuff in order to be competitive with other people in the market. So I don't think it's just produce and those things, I think everything's going to go up.

So if the price of things going up, go up, as you said, do you think we should have an exemption for barbecue?

I'm all about it.

So I've heard you use the term culinary justice. Can you explain that?

Yes, so one of the vibrant discussions in at least African-American food circles and southern food circles is, how do we account for the people of color who are doing their thing and that's celebrated in food media and other circles? I think southern food is the perfect context for this, because southern food is a shared cuisine. It's the intermingling of West Africa, Western Europe, and the Americas. And what I talk about in my "Soul Food" book is I explain why there's a rupture. So in the 1960s, soul food emerges as this very popular term and it forces a divorce within southern food. So soul becomes black, southern becomes white. And part of that was the efforts of black power, black community, activists, trying to figure out how do we connect disparate African-American communities across the country? And culture is a strong tie. So they really emphasize that narrative. And so southern food became white.

So now, 50 years later, the whites are the ones celebrated for southern food, which has a resurgence Renaissance and the African-Americans are left out, it's kind of a function of that rupture that happens in the 1960s. So I think a lot of the culinary justice term, discussions now, are really trying to figure out how do we reintegrate the context for southern food so that it celebrates the African-American contributions as well as the contributions of all these others.

Bio

Adrian Miller has a very long history in social justice and food. He served as a Special Assistant to President William Clinton and to the Deputy Director of the President's Initiative for One America, an effort to examine and focus on closing the opportunity gaps that exist for minorities in the United States. He later served as Deputy Legislative Director and as Senior Policy Analyst for Colorado Governor, Bill Ritter. He's the author of a number of fascinating books including a book called "Soul Food: the surprising story of an American Cuisine, one plate at a time," and a book entitled "The President's Kitchen Cabinet," the story of African-Americans who have fed our First Families, from the Washingtons to the Obamas.

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Two commonly known words “soul” and “food” capture so much meaning. There are the foods themselves--wonderfully diverse and prepared in homes, churches and restaurants--but there's so much more to this.There's a history, a culture, religion and the blending of cuisines from surprising places according to culinary historian Adrian Miller.

Interview Summary

Let's start with this question: what is soul food?

I believe that soul food is actually the immigrant cuisine of African-American migrants who left the South during the great migration and settled in other parts of the country. A lot of people think of soul food as shorthand for all African-American cooking but I just think it's just one aspect of it. Just a quick overview. I would say the key components of African-American cuisine in a broader sense is you have kind of the food of the interior South which lines between Southern and soul, I think it blurred. Then you've got the low country cooking along the Atlantic coast. You've got Creole cuisine all these different kinds of cuisines going on. So the reason why I call it an immigrant cuisine is because typically when immigrants or migrants leave a place and they get to a new place, they want to recreate home. And the way they often do that is through food. And after they get established and they have a little more prosperity then they started having the celebration food of the old country and much of what we call soul food today is the celebration food of the rural South.

Oh, that's so interesting. So how did soul food get its name?

So the common misperception is that soul food started in the 1960s because you had strong expressions of black identity, black is beautiful, black power. You know, in those days I would have an Afro if I had hair but the earliest joining of the word soul in food in the English language go back to Shakespeare. So Shakespeare's first play of "The Two Gentlemen of Verona" has the scene where two characters, Julia and Lucetta talking about this hunky guy named Proteus'. He walks by and Julia says to Lucetta, "Oh no it's not that his looks are my soul's food."Pity the dirt that I've pioneered in "By longing for that food so long a time." So even in the late 16th century, not unusual for two girlfriends to get together, describe a guy's yummy. That's one thing we can take away from that but going forward soul food in the English language meant anything you did to edify your spiritual life. So listening to a sermon, studying scripture, singing hymns fast-forward to the 1940s you have these basically African-American jazz artists who are very disgruntled because they thought that the white jazz artists were getting all of the publicity and making the most money. So they consciously intentionally took this music to a place where they thought white musicians could not mimic the sound. And that was the sound of the black church in the rural South. So that gospel infused music. They started calling soul and funky. And so soul is the one that caught on and it started getting slapped on to other aspects of black culture. So it was really soul music first soul brothers, soul sister, soul food.

What a fascinating history. So what would a typical soul food meal be?

I think a typical soul food meal would be one of these entrees. So fried chicken, some kind of fried fish usually catfish or even chitlins. You know, chitterlings for the uninitiated which are pig intestines, not for everyone. And then the side dishes would be some type of greens and in soul food, the most popular greens are kale, cabbage, collards, mustard and turnip greens. So I often tell people if you discovered kale in the last five to 10 years, welcome to the party because we've been eating them for about 300 and then you've got black eyed peas, Mac and cheese and then candy jams, sweet potatoes some type of corn bread, even though wheat breads are popular in soul food as well. Corn breads, I think are the most emblematic hot sauce. Then some kind of red drink and in soul food culture red is a color and the flavor. So we don't call things cherry or strawberry that it has hints of cranberries just red and then some dessert, which could be sweet potato pie, pound cake, peach cobbler, or banana pudding. I think those are the most common ones anywhere in the world. It changes when you're in the South. If I was asked what soul food in the South I probably would add okra as a possible element of that meal and maybe change up the desserts. But once you get outside of the South it's pretty much a standard menu.

And how do you distinguish soul food from Southern food?

The short answer is that soul food tastes better but the longer answer is I think it's a lot of it is the performance of these foods. Because there are a lot of techniques and ingredients are shared in common, but I find that soul food tends to be more intensely seasoned. I think it relies much more on variety meats. You know, the odd cuts of meat like oxtails, ham hocks, Turkey tips, those kinds of things. Although that's breaking down now because with the rise of whole animal cooking, especially in a fine dining context, you starting to see variety of meats show up in all kinds of menus but in terms of the wheelhouse of soul food that's one place with the regards to the intense seasoning, you know, just like spicier. And I think the lines between savory and sweet are blurred and soul food. So the perfect example is corn bread. So there's a big fault line, right? Whether you put sugar in corn bread or not most recipes that I've seen for corn bread at least in a soul food context have sugar. And now a lot of white southerners say when you put sugar in corn bread, it becomes cake but you definitely see sugar in corn bread in least soul food kitchens. And then another example of I think intense seasoning is Nashville hot chicken which is a super insanely spicy type of fried chicken. So you have a common ingredient fried chicken but you go way overboard on adding the spice. So those are just two examples I see with soul food.

And what are some of the African culinary influences on soul food?

So one of the things is the idea of kind of one pot meals typically with meat and vegetables mixed together. So, just think of greens and greens is definitely a signature from West Africa. There's a lot of dishes with leafy greens involved but greens typically traditionally would have the greens mixed in with some onions maybe some red pepper, some garlic, and then a piece of salted smoked or dried meat to season the vegetables. And so I think that's an example of West African culinary signature. Another one would be fried fritters frying in deep oil, hush puppies eggs for example, I think is a nod to a West African dishes, something called Akara which is basically taking black eyed peas peeling off the skin and then grinding them together and frying them. And when you look at an Akara and you look at a hush puppy they're very similar in look and feel. So I think that's kind of an idea, but the idea of having some deep fried component to a dish is key. And then definitely involving fish, whether fried or smoked or stewed or whatever is another example in using chilies. Chilies are native to South America. But before chilies were introduced in West Africa there was a lot of warming spices they call them that were used. So ginger, cardamom, you know so you see a lot of this happening in West African food prior to European context. So I think that that was basically showing that the African pallet was hardwired to accept chilies. And then the last thing I'll mention is a prevalence of red drinks. And in West Africa, it's called bissap and it's basically a tea made from the flowers of the hibiscus plant that comes over to the new world. Quote unquote takes root in Jamaica, where it's called sorrel. And then it makes its way around Latin America. So if you go to a taco Rio and you have Allah to hamika you're drinking a West African drink and then the prevalence of okra I think is another binding culinary signature.

So what were typical meals like during slavery? And would you say that soul food is synonymous for slave food?

Let’s just go through a typical day. I would say that for breakfast usually it was just corn bread that was crumbled up and mixed in with milk and it was poured into a trough and then, or the main meal during the mid day, it was pretty much seasoned vegetables. There may be some meat in that trough as well to season the meat but usually seasonal vegetables that were seasoned and maybe a little bit of corn bread and people had to eat out of that. And then supper was pretty much leftovers from the mid day meal. So very monotonous in the sense that it was pretty much the same thing every day. It may be some variation due to season in terms of what vegetables were used but pretty much the same thing every day. But when the work schedule slowed on weekend or for a special occasion then you start to get the more festive, celebratory food the fried chicken, the cakes, biscuits and all of those other things. I don't think soul food is synonymous with slave food because it's a much more complicated story. If you actually look at a typical soul food meal you're seeing influences from the indigenous people in the Americas and you're seeing a lot of influence from Europe. So I think it's really a mixture of a lot of things. Like a lot of the desserts we think of sweet potato pie, pound cake, banana pudding, those have precursors in high-end English cooking, a sweet potato pie. It looks at seasoning and technique is very similar to a carrot pie. So you're swapping out one orange sweet vegetable root vegetable for another. The banana pudding is based on the British trifle which is a bread and cream component. So a lot of these things come into play when looking at soul food.

Well the idea of a trough is just heartbreaking.

I know, and people were not allowed to have utensils because that was a potential weapon. So they had to eat with their fingers or use clam shells or some kind of seafood shell to scoop the food out.

Well, so it's hard to move on after thinking about that, but let's try. So does soul food need a warning label? I mean, people talk about the healthiness of that and possible contribution to things like heart disease and diabetes and things. What do you think about that?

Yeah, I just think that soul food's getting a bad rap. I think let's just back up and think about what nutritionists are telling us to eat these days more dark, leafy greens more sweet potatoes, more fish, Okra is a super food now, hibiscus. So all of these things are the building blocks of soul food. So I think it's a matter of how soul food is performed and soul food is celebration food. It was not meant to be eaten every day. And so we're eating soul food out of context. But given all of that, I think a number of the health problems that are arising in the black community, some may be traced to soul food but I think most of it is traced to convenience food and fast food. I think people are not taking a closer look at the entire diet. And I think that's where a lot of the health problems are arising. So what I tell people is like, understand what soul food is eat it in moderation in a celebratory context but just keep in mind that a lot of elements are soul food. If you prepare it a different way it could really improve your diet. So, perfect example from my book is I have a recipe for Creole broiled catfish. So instead of the typical fry treatment you just get a catfish filet, rub it with some olive oil sprinkle on your favorite Creole or Cajun seasoning, broil it for seven minutes. And that's one of the most popular recipes in my book.

I can imagine that people who've read your book who might've grown up with such food have that experience brought alive in new ways by understanding its history. Have you found that to be true?

I have, so one of the hottest trends right now in soul food is vegan. And for a lot of people that's an oxymoron traditional or the conventions of soul food that's floating around in people's minds. But if you go back to what enslaved people were actually eating seasonal vegetables, not a lot of meat and water, and they only got processed ingredients on the weekends and in celebration modes then you realize that pretty much people were eating something close to what we call vegan today. So I think it just takes a reframing of kind of the traditional diet, but a lot of people have to have their eyes open because there's so much prejudice against soul food. The idea that it's slave food, that it's going to kill you that it's not worthy of celebration. As a lot of my work is trying to undo those misperceptions and put soul food in a proper context and just say, Hey this is something we're celebrating.

So your book, "Soul Food" is organized in a very interesting way. Would you mind describing the way it is organized and why you chose to do things that way?

So when I was researching the book and I did a lot of research from a lot of varied sources I had far too much information. So I was really challenged in terms of how am I going to present this to the reader? Because I did not want to present a plodding history that's going to make people fall asleep. So I a few people pointed me in the direction of a book called "Much About Dinner" by a woman named Margaret Visser. And she did a breakdown of a typical British meal. So I thought, well, why don't I just brew a breakdown of a typical soul food meal? And I decided to create a representative meal. And the idea was, if you're going to have soul food anywhere in the world, what are you most likely to have? And then I wanted to write a chapter about every part of the meal, explain what it is, how it gets on the soul food plate, what it means for the culture. And then most of the chapters have recipes. So I tried to have at least one traditional recipe then a healthy alternative, and then a fancy recipe in case you wanted to show off as a cook.

And one of the chapters, as I recall on fried chicken can you describe a little bit about what's in that chapter?

Right, so in each of these chapters, even though I was talking about the history of that ingredient, I did try to have an overall theme in the black community, fried chicken has a lot of different identities but one of them is called gospel bird and this the idea or Sunday cluck. So it's the idea that as part of the special kind of family meal on Sundays, you would have fried chicken but it had religious connotations as well. So I wanted to explore how does fried chicken become this thing that's completely introduced into West Africa, but it takes on religious associations that come over through the Americas, through slavery. The early ideas of fried chicken and in its native habitat. So what were the cultural and religious and spiritual ideas about fried chicken in Southeast Asia? And then as the chickens move westward and eventually get to West Africa, how those associates is really embraced by West African so much so that the birds in their native habitat, that West Africans had given religious significance to get supplanted by chickens and then those beliefs, and then the timing of that the slave trade happens around that time. Then those beliefs come to the Americas.

We could just talk about these things all day long. It's absolutely fascinating. But let me ask you one final question. Adrian, in 2018 the Southern Foodways Alliance named you the Ruth foretell keeper of the flame for your work on African-American foodways, how did you feel about that recognition?

I was shocked. That was a huge honor because I looked at the other names that had been on that list. You know, people that I admire people like John Edgerton and, you know others who had really done a lot of work. And I was just like, man, this is quite the honor. So it was gratifying in the sense that, you know I write these books I go around talking about these things, you know sometimes I don't know if people dig it as much as I do. So to get that validation from what I think is the preeminent kind of food ways organization in the country I thought was it was just gratifying and it was huge.

Bio

Adrian Miller is an attorney, a culinary historian and a certified barbecue judge who has lectured around the country on topics such as black chefs in the white house, chicken and waffles, hot sauce kosher soul food, red drinks, soda pop and of course, soul food. His book, "Soul Food" the surprising story of an American cuisine one plate at a time" won the 2014 James Beard Foundation Book Award for Reference and Scholarship. He's also been involved with public policy having served as a special assistant to President Clinton among other positions.

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Today, we're celebrating the power of stories in creating shared understanding. We're talking with James Beard award-winning filmmaker Sanjay Rawal. The creative force behind a new movie about Native American food ways called "Gather." Gather is an intimate portrait of the growing movement amongst Native Americans to reclaim their spiritual, political and cultural identities through food sovereignty, while battling the trauma of centuries of genocide.

Interview Summary

So let's begin, would you please describe the Gather film for our listeners and talk about why you took on this very ambitious project.

Gather is a new film released a few months back in September, and it's on the kind of esoteric subject of food sovereignty. What does that even mean? Well, we follow three sets of characters who are all citizens of different tribal nations on turtle Island, what's now the United States. We follow a chef Neefa Craig, who is a French trained Culinary professional who has returned to his home land, his reservation the White Mountain Apache tribal land in Eastern Arizona, to set up a high-end affordable restaurant that will deepen people's understanding of Apache food traditions. We also follow a young Lakota woman who grew up on a Buffalo ranch in South Dakota on the Cheyenne River Sioux nation, Elsie DuBray, and she's a scientist. She's studying the benefits of their traditional food - bison. And we follow a group of young gentlemen on the Klamath river in Northern California as they contend with the presence of a gigantic dam that's decimated the river health and salmon populations that have sustained their people for millennia. So through these interwoven stories I believe we present a very compelling narrative of a movement happening in tribal nations right now to reassert their sovereignty by reestablishing food ways that were taken away from them by the colonial extractive government of the United States.

The early Anglo European economy was based on mono crop agriculture. How did that change what were once profoundly bio-diverse lands? What are they like now?

That's a great set of issues to discuss. We live in an era right now where we are so separated from the food and the land that it's hard to imagine that less than 150 years ago almost the entirety of the American economy was land-based. And when you look at the groups in Europe that were beginning this kind of new wave of colonization and the 1400 and 1500s, you basically had two sets of goals. You had nation States that were hiring call them entrepreneurs, call them state-sanctioned pirates. They were hiring people to go and be the number one find mountains of gold. And there was an another set of nation States that realized that the wealth that they could extract was from the top soil itself. And those were the Anglo European nation States who in the beginning funded Italian explorers to come and make an assessment of the Eastern seaboard of what's now the United States. Those explorers saw that far from being wild terrain, they encountered highly advanced agricultural populations that had a deep understanding of farming animal, stewardship, foraging, waterways, fishing, et cetera. And they began to realize they could use the fertility that natives had built into their farming practices, use the fertility and that land and create economies of scale. They could force natives off their land, essentially keep that land with zero operating costs forever. And eventually they went to West Africa to find bodies, to find agrarian experts as it were, and enslaved those people and brought them to turtle Island. And so in a matter of a hundred years there was a massive farm economy primarily set up to send goods back to Europe. Cash crops like cotton, like tobacco. And the early American economy prized its relationship with continental Europe to a great degree because it relied on the purchase of these export cash crops to generate and maintain wealth in the new economy. The American story is really one of land theft and one of practicing very destructive monocropping practices that would generate as much wealth as quickly as possible for the investors.

So it's tragic what's happened to the native American food ways. And of course, to the people themselves. Based on your learning and creating this film, what observations can you make about how the US supply chain serves people today in Indian country particularly since the COVID pandemic occurred?

I'll go back to colonial history for a second. By the 1760s, the American farming economy had nearly exhausted the health of top soil on the Eastern seaboard. And American farmers wanted to push West of the Appalachian mountain range, and the British forbade that. Now, why would the British even care? Well, to support that sort of - we call that euphemistically exploration - a number of native people would need to be forcibly displaced again from their land. And that would require military support and the British were unwilling to provide that military support. But one of the first things the Continental Congress did was establish the Northwest ordinance which opened up Indiana, Ohio, and those States East of the Mississippi to farmers. Not in the sense of the family farmers that we referred to now, but as folks that were in a sense land pirates. They were going and stealing land with force and then creating economies of scale to sell those goods back to the Eastern seaboard and eventually export that.

So on the Eastern seaboard, with the exception of Florida, there was all an almost immediate displacement of native populations. And with the Louisiana Purchase there was this intention of establishing lands West of the Mississippi for native populations forever. Keeping in mind that there's no such thing as Native American - there's hundreds of federally recognized tribes, and hundreds more people that don't have that kind of political distinction. A number of populations like the Cherokee, And the Seminole, and the Creek were forced marched from the Southeast and placed in Oklahoma in lands that were completely foreign to their practices their science, their way of life, and their creation stories.

But as more immigrants began entering the US and wanting to stake out their own economic claim and not work for other people in cities, the only way to do so was to have a piece of land. A big piece of land to grow enough corn or wheat and to be able to sell it for a profit. That was the push West of the Mississippi. All along this way, native populations were forced into smaller and smaller and smaller parcels of land. And they were being forced to assimilate into the US and to become farmers themselves. Even if they were nomadic. Even if they followed herds of Buffalo throughout the year. Even if they foraged or even if they fished.

At the same time, because the US economy relied so much on the best quality land, Natives were effectively pushed to the worst quality farmable land. And as supply chain systems began being developed and refined in the United States railroads were built from the West back to the East. And the highway system was built on top of those at the same time. Keeping in mind that natives are pushed away from urban centers as much as possible, They remained completely untouched or unserved by the supply chain. So right now in Indian country they are at the end or the terminus of supply chains. Which is why you don't find a lot of grocery stores there. Because grocery stores are expensive to run and they require a lot of people shopping and spending a lot of money. For the most part, people in indigenous communities have to drive 50, 60, to 100 miles to get access to the same sorts of foods that midsize or small sized American cities have access to.

Now, if you wouldn't mind returning to the issue of how people perceive the land. What you brought up earlier was very interesting. You're painting a picture of one group of people who have descended from Anglo Europeans who see the land as something that can be owned and something that is there to be exploited where the Native Americans have a different approach to it. It's sort of a spiritual harmony that they have with the land, and the ownership is perceived much differently. Would you mind expanding on that a bit?

Keeping in mind that the early American economy was based on land and enslaved people, we can see the institutional ramifications of slavery in the way that, for example, law enforcement generally tends to treat African-Americans right now. When it comes to native issues it's important to note that land in North America, on turtle Island, always had a direct value for the economy. And you see the ramifications now in institutions like the USDA, where one of its many functions is measuring the economic output of land, and giving loans and guarantees so that people farming land can hit certain benchmarks. But the system isn't set up to have farmable land fallow it's not set up to allow the land to regenerate.

The native view of land was multi-century long. It was restorative, it was regenerative. It was the opposite, we should say of extractive. It was understanding that the land can only give human beings so much and that humans need to understand the balance. So that generations seven, eight, nine, 10 in the future can have the same unspoiled relationship with the land that generations now have. Now, when it comes to American policy either things are extracted or things aren't extracted, as in farming land versus national forest. There's no sense of the fact that we do need to take, we can take, but everything needs to be in balance. And that's what is missing from an equation, and I don't mean this in a bad way, but in an economic sense there's always a factor of greed. Whether it's unadulterated greed or just wanting a little bit more. And that very ethos has never really been symbiotic with the Native American environmental ethos.

So one part of the gather project focused on journalism and I know that your team hired a number of Native American journalists and photographers to report on some of these issues you're talking about regarding food sovereignty. Can you talk about why collecting those stories was so important and what you did with them?

The practice of documentary filmmaking is inherently - you know, this is a heavy word - it's inherently exploitative where you're going into a community and you're taking stories. And there's a whole series of expectations that people have that might not ever meet together in the middle. When someone comes to you and they share their story it's with the expectation that they could be in your film. But anybody who knows a little bit about filmmaking knows that you have to talk to a lot of people to be able to find the stories that are going to be best suited to the visual medium that film is. You'll come across so many stories that might be better told by photographs, they might be better told in words. And that's what happened to us. In our development of this project we visited a number of tribal communities, came across dozens of stories that had such deep importance and people were offering with their heart and soul.

So as we began to see which stories wouldn't be suitable for the restrictive format of documentary filmmaking, we began look for grants to hire Native American journalists and photographers to write up and tell those stories. And we hired Kim Baca, who used to be the Executive Director of the Native American Journalist Association. And she worked with me on placing those stories in tribal media and in non-tribal media. Hopefully we were able to do the people that we met a service and allow the inspiration that wanted to share with us as filmmakers, be shared in some other format.

So much came of this effort not just the film, which is amazing itself, thanks for sharing that. So when you interacted with so many people in the making of this filming, what are your impressions?

I have made several films that had native characters. My first film was called "Food Chains" and there was about a group of tomato pickers in Florida called the coalition of Immokalee workers. And they're primarily seen as Latino but there are in fact displaced indigenous Oaxaca and Chiapas and Guatemalan migrants. For whom Spanish might be a second or third language. My second film "3,100 Run and Become" was about ultra distance running but we had a sun bushmen Hunter character from the Kalahari and we had a Navajo ultra marathoner from the Navajo reservation. I had already developed, you know, a pretty deep affinity for native American and indigenous culture because it reminded me so much of what I knew to be the village life that my father and my mother grew up in an India. And so going into Indian country, I believe I could relate to people simply because I was a good listener. And I knew I was in a world that would gradually unfold itself to me if I was just quiet, if I just built the trust wasn't loud and gave respect to the fact that the folks I was meeting with had histories on their land of one, two, five, 10, 20,000 plus years. And it's always such an amazing experience to be with people that understand where they are and where they've come from in ways that the rest of us on turtle Island in the United States can't do as immigrants. Whether we're first-generation or 20th generation we don't have the same sort of perspective that the folks in gather do. While some of the characters were younger than me, some of them were older than me. I kind of felt the deep wisdom that they had and really enjoyed learning about their stories by just listening for hours on end.

So what do you hope will come out of people watching your film?

In Indian country, there's been a whole series of reactions and those are the ones that we made the film for, people taking pride in reestablishing the food systems that were in effect destroyed by colonization. And when I say destroyed, I mean directly by the mid-1800s, it became really clear to the US government that the expenditure of military force on native people was too perilous. And it was euphemistically much more efficient to subjugate native people by destroying their food systems. Whether it meant creating policies and procedures to take the massive Buffalo herds from the Midwest from 63 million down to just a handful of individuals, whether it meant burning fields, damming rivers polluting rivers, et cetera. Native Americans are one of the only populations in the modern world to have had their entire food system destroyed as a tactic of war.

Secondly, there was a program for more than a hundred years to forcibly remove native kids from their homes. And in the effort of assimilating them, put them into boarding schools where speaking their language, practicing their culture was forbidden. And so we've come to a stage in Indian country where people are trying to preserve the bits of wisdom, connection, and science that still remains. That wasn't completely destroyed by these two programs. So when they see characters like Twila Cassadore in our film, who is a master forger, one of the most in-tune people with Mother Earth that I've ever met - they're inspired because they realize that their ancestors were exactly like Twila.

Outside Indian country, however, there've been a number of really interesting conversations, both on the foundation level because less than 1% of American philanthropy goes to native led organizations working in Indian country. Even though one might argue that all of philanthropy has come from land-based wealth even tech fortunes came from venture capitalists who come from that sort of old pre-industrial revolution or industrial revolution land-based economy.

But in the farming community, there been really, really deep conversations. Because at some point in the history of the land that we're on whether your family was directly involved or whether we just purchase it from somebody who purchased it from somebody else, the land that we're on was once somebody's home. And chances are the histories of those homes still exist within Native American families and groups that have been displaced. And it's kind of horrific when you think that. If you try to imagine somewhere in your ancestry your grandparents lost their homes, your great grandparents were forcibly removed and maybe passed away. The only modern corollary is the Holocaust. And I don't say that lightly because in the Meinkaupf Hitler does allude to Native American reservations as precursor ideas for his ideas of concentration camps. And so the fact that our history, even though the ideals of America are so lofty, was based on a set of deeply horrific practices: the enslavement of Africans, and the theft of Native American land - has caused people to really contemplate what sort of future they want to live in. And the idea of equity and redistribution of wealth and resources that were taken in a very inequitable fashion.

If you're interested in learning more about Gather, you can find information online at gather.film and you can watch it on iTunes, Amazon, and Vimeo on demand.

Bio:

Sanjay Rawal is a James Beard Award winning filmmaker and the creator of Gather (http://gather.film). He previously made FOOD CHAINS (EP Eva Longoria, Eric Schlosser) which chronicled the battle of the Coalition of Immokalee Workers, a small group of Oaxacan and Chiapan indigenous farmworkers in Florida, against the largest agribusiness conglomerates in the world. The film was released theatrically in a number of countries (Screen Media in the US) and won numerous awards - including citations from the US Conference of Mayors, the Clinton Global Initiative and the White House. The film was also a Winner (shared) of the 2016 BritDoc Impact award and several festival prizes. Sanjay’s last film 3100: RUN AND BECOME won several festival prizes, had a robust theatrical release in the US in 2018 and is opening in traditional theatrical engagements across Europe and Australia in 2020 and 2021.

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What if we cultivated our environment instead of intensive crop planting and animal farming, and in turn created an abundance of food to meet our needs? Is this what First Nations people did here in the Americas? This concept is the focus of doctoral research of today's guest, Indigenous musician, scholar, and community organizer, Lyla June. June is an Indigenous woman of Dine (Navajo), Tsetsehestahese (Cheyenne) and European lineage. She's pursuing a doctoral degree at the University of Alaska Fairbanks. And she's fascinated by the intersection of Indigenous food systems and Indigenous land management.

Interview Summary

So can you begin by explaining how you came to be passionate about food as an Indigenous woman? And tell us some about your doctoral work.

Sure, so as you may know, a lot of Native people are struggling with diabetes and other food-related illnesses and are having a hard time accessing foods. And a lot of us live in what they call food deserts. A lot of our food systems were destroyed in the process of the creation of America. Everything from decimating buffalo populations to burning down orchards and cornfields to ruining the salmon runs by putting dams in all the rivers; and destroying the beavers for the fur trade, which destroyed all the ponds which supported a lot of food systems. So our ways of life, as you can imagine, have been deeply altered, and that has its ramifications on our health.

I think you can't help but be very attuned to food systems as an Indigenous person. I think what sparked my doctoral research is how tribes have, before Columbus and still do today these genius practices of taking care of the land that actually enhance the natural food-bearing capacity of the land. And what really sparked my interest in that was an elder who said to me, "Native people control enough land "to change the way the world thinks about food and water." And that really inspired me because that made me feel like, you know, even though we've lost most of our land base, it doesn't take a very large model to start a revolution in the way people think about things.

So I've been going around traveling as part of my doctoral research, recently reading a ton, but a lot of times just working face-to-face with Native people and seeing the ways in which they take care of the land. That's really how I got into it. This belief that Native people could not only create thriving life for their own communities through the revitalization of our food systems—but that we could actually become leaders once again to help not just our communities, but to help the rest of the world. Although industrial agriculture seems like it's working right now, it's only a matter of time until it collapses. We are on the precipice of a very, I don't think there's any way to sugarcoat it, a very tragic famine. I think there's a way around that with our current food system. And so I would like to work with a number, dozens and dozens and dozens and dozens of Indigenous peoples who are preparing for that, and ready to share our medicine and our knowledge with the world. If it's okay, I'd like to share just a few vignettes of how Indigenous peoples are exemplifying this way of working with the Earth.

I'd very much like that. And what you're saying sounds very concerning and very hopeful at the same time.

I feel that every day, a very strong mixture of urgency and hope all at once, and it's exciting work. And I very much feel guided by the ancestors 'cause the things I'm learning and the things I'm coming across are just way too big for coincidence. But for example, there's a group in British Columbia that I talk about very frequently called the Heiltsuk Nation. They live on a little island called Bella Bella, West Coast of Canada. And they actually have these hand-planted kelp forests that they plant along the shoreline of their islands. And at the right time of year, they go out and put this kelp, it's very fast-growing kelp. And this increases the surface area upon which the herring fish, which is a little silver fish, can lay their eggs. And so they just litter the whole place with eggs, millions and millions and millions of eggs. And that provides the basis for the salmon, the killer whales, the sea lions. The humans, of course eat it. It's a huge delicacy. You can sell it for tons of money, but they don't sell it. They actually use it to feed their island ecosystem. So on up the food chain to the wolves, the eagles. And everyone in the system benefits from this anthropogenic base of calories. And I say anthropogenic, which means manmade.

There are ways to touch the Earth that are very kind and very helpful, not just in the feeding of humans, but of other lifeforms as well. Another example I like to give is the Shawnee ancestors of what we now call Kentucky. What we see is in the fossilized pollen if you take soil cores out of the ponds, you can see pollen that is as old as 10,000 years. And you can see what the forest has looked like over the past 10,000 years. And what we find is for a long time, it was just cedar and hemlock dominating the pollen profile. And then about 3,000 years ago, this is before Christ, we see the Shawnee ancestors move in and we see a huge influx of hickory nut, black walnut, chestnut, acorns, sumpweed, goosefoot. All these edible plant species come into the pollen profile. Which means that somebody, presumably the Shawnee, radically transformed the whole cedar and hemlock forest into a dense food forest. What we also see is the influx of fossilized charcoal, which indicates that they managed this food forest with low intensity, gentle, prescribed burns, where you burn the forest floor, which eliminates competing vegetation. It injects nutrient dense ash into the soil, phosphorus, nitrogen, potassium. It creates the charcoal which creates little apartment buildings for microbes in the soil. So you make a living soil. And this food forest with the charcoal persisted for 3,000 years, up until about 1830, we see the whole system collapse. All the pollen disappears, all the chestnut disappears. This is an example I like to give to show people how longstanding and how sophisticated Indigenous food systems are.

I have also been looking at the Tenochtitlan, which was the original city of Mexico City. They had these incredible waste sanitation systems where they say that human waste was so valuable on Lake Texcoco, way before Columbus was a twinkle in his daddy's eye, that you could actually bring it to the market and trade it. You could trade your own waste for goods and services because they had this waste sanitation system that reinvested all of this so-called waste into their food systems, which were floating gardens they created out of reeds and very special soil systems. Gardens that floated all over Lake Texcoco. So if that's not sophisticated, I don't know what it is.

I'm really very impressed by those stories. And one of the things that you made me think of as you were describing the kelp forest in Canada, was that the food sounds like it's part of the spiritual life of the individuals who were raising it, consuming it, protecting it, et cetera. Is that correct?

Oh, absolutely. In fact, there's one elder I interviewed from the Amah Mutsun Nation who are the Indigenous peoples of what we now call Santa Cruz, California. And they did a similar forestry management strategy where they used prescribed burns. But he said that it was a ceremony. He said the smoke would go up into the oak trees because they're oak people and those acorns form a very important caloric base for the pre-Columbian peoples of California. They were acorn people through and through. The smoke would go up through the trees and would smudge off the trees. It would bless the trees, he said. They had fire-resistant bark because they had co-evolved with human fire for so many millennia. And this smoke would kill all the weevils and bugs and pests. And so you had a really healthy acorn harvest in the fall. And so it was absolutely not just land management, but it was a prayer and a gift. Sort of like Vandana Shiva from India says. She says, "Nitrogen and potassium and phosphorus. "Those are elements in a periodic table "from a Eurocentric point of view." She said, "But to us, these are sacred elements "that we give as an offering to the Earth. "We offer these nutrients to the soil "as a spiritual offering to Mother Earth."

I'm struck as you're discussing these conversations you've had with elders that they must be an invaluable source of information. And your discussions with them must be incredibly interesting, but they also must be very deeply moving, I assume.

Oh yes, absolutely, because we don't have many of these elders left. And many of our elders don't know this information because America very deliberately expunged this knowledge through the boarding school system. My grandparents, for example, full-blooded Navajo, full-blooded Dine, they don't really know this type of knowledge. They were heavily Christianized as children in the boarding schools. They were heavily indoctrinated into this idea that white is right and brown is wrong. And the more like a white American you can be, then the more civilized you are, the more intelligent you are, the more holy and clean you are, which is absolutely what they taught Native children in the boarding schools. And it's just ironic that our food systems were actually very, very intelligent, and very, very advanced.

The work that you're doing including your doctoral work is an effort to protect this information, to preserve it, to communicate it, to amplify it. Are there a lot of other efforts around to do the same sort of thing?

Yes, I am one of many, many, many. It's a beautiful thing that I don't have to do this alone because Indigenous food systems as a movement is really burgeoning right now. For instance, you have a lot of eco-linguistic revitalization. The first Indigenous eco-village ever has sprung up in the South, the Muskogee Eco-Village. And they are a language immersion eco-village. So if you go there, everybody's speaking Muskogee. And they understand that in order to revitalize their food ways, they must revitalize their language. And conversely, in order to revitalize their language, they must revitalize their food ways because their language talks about a certain world. And unless you recreate that world, there's nothing to talk about. If that makes sense. There's also a wonderful film that just came out called "Gather" and it's available on, I think, iTunes and Amazon. And it's all about the fight to revitalize Native food ways. It's really well done, and has a lot of Indigenous speakers leading the charge. There's the Indigenous Food Systems Network, indigenousfoodsystems.org that is really bringing together a number of players in this broad-based movement. There's also this really interesting phenomenon popping up, the popularization of Indigenous culinary arts. For instance, you have The Sioux Chef, which I imagine many of you have heard of. He's a Lakota chef, and Sioux is spelled S-I-O-U-X, which is one of the names for Lakota. So The Sioux Chef has written a book called, "The Sioux Chef's Kitchen," all about natural Indigenous-based dishes that you can make. There's also Taste of Native Cuisine, Carlos Baca, based out of Southwest Colorado, who has his own farm. And he's been foraging and creating these amazing culinary dishes, like top-notch, five-star, but he's bringing all of that to the people. And he's been bringing food boxes to people on the Navajo Reservation during the COVID crisis to give them real medicine, not just food, but also plant, different medicines to help. And then there's Yazzie The Chef was a Dine, a Navajo chef who's really been talking up our food ways. Rowan White, who's based in Northern California, but she's a Mohawk woman. She is leading the effort in seed rematriation, and she calls it rematriation instead of repatriation, kind of as a feminist take on all of that. But what she does is she gets all of these Indigenous seeds and she grows them, and replicates them, and proliferates them on her property. Everything from heirloom corn to heirloom amaranth to heirloom squashes and different Indigenous sage, tobacco. She builds up this seed bank, and then she gives it back to the Reservations. She gives all the seeds back to the people. So she's doing incredibly important work to preserve the genetic integrity of our food systems by saving and proliferating the seeds.

Those are really interesting examples. And it's inspiring to hear about all the activity in this area, and gives us some hope for the future that we can learn from the past. So let's turn back to your doctoral work. Tell us a little bit more about what you're doing in the context of your doctoral work.

I just finished my last course. So I'm now embarking on the dissertation writing and sort of taking the writing I've already done and synthesizing it and getting it ready. I won't claim to have an answer of what my dissertation is exactly. I'm kind of right in the middle of the process. But what I'm thinking is really taking all of these different case studies, which include the Heiltsuk, the Shawnee, the Amah Mutsun, ancestors of Tenochtitlan, the Menominee Tribal Enterprises where they have this amazing Indigenous forestry program where they've managed a forest for a hundred years and logged to the forest for a hundred year, and yet it has increased its biomass. And I'm hoping to generate some theory out of that, to do grounded theory, you know, where you look at what you see. You find commonalities. You find common denominators among all of these food systems and you develop some characteristics of Indigenous food systems. You develop some basic foundational principles. So that's my current strategy for now.

I just went to some land in Kentucky, and we're thinking of actually recreating some of these food forests. And that's my ultimate goal. Whether it's a part of the dissertation or not, we're absolutely going to be putting all this knowledge into practice, because as I said, control enough land to change the way people think about food and water. My task, I feel, is to create these models, and have them be living, breathing systems that people can come and visit, and see, and taste, and feel, and say, "Hey, another way of food is absolutely possible. "Let's do it." You know, one that is not monoculture. One that not just honors biodiversity, but cultivates biodiversity. One that recharges the soil instead of depleting it. One that really honors the ceremonial aspect of food. One that doesn't call it food anymore because food is like a lifeless object, but honors the fact that it's a living, breathing being that gave its life so that we can live. You know, that's what food really is. One of the common denominators among all these food systems which I find incredibly fascinating is the construction of habitat. That is what a lot of our food systems seem to be about, where we actually construct an environment that is hospitable to certain species that we eat. And then those species come to us.

Lyla, let me ask you one final question. This has been a fascinating discussion by the way. So one argument that you hear in defense of industrial agriculture practices is that they can be done to scale. And so the traditional practices that you're describing, people might support even in principle, but say you just can't do enough of it to feed the world. What is your reaction to that idea?

It's a little bit contradictory because the more you create monoculture industrial agriculture at scale. The more you deplete the soils. The more you compromise the genetic integrity of the plants and animals. Because if you have all monoculture then you have narrowed the genetic pool. And that all has a whole cascade of negative consequences. So you might say it's scalable, right? But at what costs and for how long? That's the real question.

People think that there weren't that many Native Americans here in North America. Well, we densely populated the land, and we managed the land extensively with these food forests, My point is, if we have these food systems, right? These food forests, for example, they actually strengthen the ability of other food systems to exist. Diversity creates diversity. So they're not just scalable, it's actually required to scale up in order for there to be a complex, multi-bioregion ecosystem. You need to start building up these polyculture food systems. You need to start building up the biodiversity. So to answer your question, not only are Indigenous food systems scalable, but they're the only thing that's scalable. They're the only thing that's going to last.

Bio

Lyla June is an Indigenous musician, scholar and community organizer of Diné (Navajo), Tsétsêhéstâhese (Cheyenne) and European lineages. Her dynamic, multi-genre presentation style has engaged audiences across the globe towards personal, collective and ecological healing. She blends studies in Human Ecology at Stanford, graduate work in Indigenous Pedagogy, and the traditional worldview she grew up with to inform her music, perspectives and solutions. She is currently pursuing her doctoral degree, focusing on Indigenous food systems revitalization.

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As the governments the world over try to solve the thorny issue of equitable food access in underserved communities, the state of Virginia is trying something new. Led by Dr Jewel Bronaugh, the only black woman agriculture commissioner in the United States, Virginia passed legislation this spring, to establish something very special. The Virginia Food Access Investment Program and Fund. Dr Bronaugh is here to join us today to speak about this.

Interview Summary

So can you briefly describe the Virginia Food Access Investment Program and Fund?

This a statewide program and it focuses on equity and justice in local food systems, expanding food retailers that address food access throughout the Commonwealth of Virginia. So basically it's an opportunity to offer grants that are going to fund the business development, construction, rehabilitation, equipment upgrades, or expansion of grocery stores, small food retailers, or innovative food retail projects. And it focuses on historically marginalized communities and particularly BIPOC communities, black indigenous people of color. So it's a very unique program. We're very excited that the Virginia general assembly, saw this as a priority and established the funding for what we call the V Faith brand.

That is very exciting. So you mentioned grocery stores as an example, and small food retail establishments. Are there other sorts of businesses that might be relevant in this context?

I'm super glad you asked this question. The legislation that established V Faith, comes from previous legislation. There was a proposal about two years ago called the grocery store investment grant, and it focused on allowing grocery stores to change their infrastructure so that they could offer different foods to the low access communities. But now, you see a lot more in terms of other types of establishment who can be a little bit more nimble and get into communities very closely, to make the impact on food access. And so now, in addition to the grocery stores, and other small food retailers, I mentioned innovative food retail projects, mobile markets, including food trucks, that have the ability to reach communities that really need the food. Community gardens that actually work with others, to sell that food within the local community, like a local church is another idea. Restaurants or cafes that have a direct food retail component, may also apply. We're also looking at food hubs and farm stands and small limited resource, socially disadvantaged farmers and ranchers and farm co-ops and even veteran farmers, who have a retail sales component, can also apply. So we greatly expanded the individuals who could apply for this grant because we see that a lot of people have very innovative ideas. It's not just grocery stores, it's not just small food retailers, but a variety of individuals who have some novel ideas of how to get good, healthy food into low access communities. And we wanted everyone to be able to apply for the funding.

So why is a fund like this needed? Can't people just get loans in their local communities, to start up such businesses?

That would be wonderful if that was the case, but that is very challenging. And one thing the pandemic has done, is that it has shed light on our issues in terms of the food supply chain and issues of food access. And it just also shed light on hunger. And so you have BIPOC communities who are impacted at greater percentages, in terms of hunger and food access issues, than others. But you've also had BIPOC owned businesses that have struggled to obtain funding, when they had an idea that they wanted to bring to fruition, in terms of a small retail food business, they could not get traditional loans. That has been an issue that we have heard about in agriculture, for a long time with farmers. In those who are in the food based business. So they often don't qualify for commercial credit, get turned down at higher percentages. So they need different sources of funding. When we were talking about getting this fund established, we talked about the idea of low interest or no interest loans, and then we said, you know, COVID has, really impacted a lot of communities, all across the United States, all across the world. And so if we're going to get money like this out and available to BIPOC audiences, this needs to be a grant, without the expectation of repayment, because a lot of people need an infusion of funding, in order to get started. And the grants mean they don't have to worry about paying the funds back. They can get going, or if they're already going, they can get a little bit of money to push them further down the road, to really get established within the local communities. So we are excited about this being a grant, as opposed to a low interest or no interest loan.

You know, the issue of people and underserved communities not having access to capital to begin businesses, is something that we're hearing a lot in our work in North Carolina and people around the country are hearing too. And so it's definitely a problem. It's been a problem for a long time, and it's really wonderful that you're finding ways to solve the problem. So let's talk a little bit more about the nuts and bolts of this. So how are you structuring the program and the funded ministration, to achieve equitable community led development?

We didn't quite know how we were going to do this. So when the legislation was passed, someone was very thoughtful in including that the fund would need to be established by an equitable, food oriented, development work group. And that last sentence in the legislation, is probably the most important part of the legislation. Because of EFOD, it designated the unique way that we were to establish this grant, based on those EFOD principles. We established an EFOD work group, to develop the grant proposal and the guideline. We had to get connected with folks who knew what they were doing in terms of the EFOD background, Trisha Chakraborty of Dice Enterprises and Rudy Espinoza of Inclusive Action, worked with our work group who had a little bit of background EFOD, but not as much as they do, in order to establish the grant. So to answer your question, someone who receives the grant, has to be substantially run by BIPOC leadership, or be working in active partnership with a BIPOC run organization. They have to demonstrate a history of community engagement and work in the community and have community support for the project. They have to directly serve residents in low food access and underserved communities, and even integrate community culture and artistic expression in their business model. Truly work to develop some new markets and enterprises and create some real and sustainable economic opportunities. And it's really important to engage the community, in terms of how are you going to invest in future leadership, education, work development, job training and et cetera. So those are elements that we have included in the grant guidelines that an applicant has to meet, in order to be able to successfully receive the funding, because we didn't want this to look something like EFOD. We really wanted to make sure that we integrated the EFOD principles within the grant guideline.

Well, thank you for that background. And also just for the sake of our listeners, we have recorded a series of podcasts on equitable food oriented development, including podcasts with some of the individuals just mentioned, and they're really, very informative. So one of the things that impresses me about the work you're doing, is that you're avoiding what typically happens, which is institutions, like government or foundations or universities, have ideas for what might work in a community and then give out money to make those things happen. But it sounds like you're not predetermining what the community solutions will be. You're letting those being driven by ingenuity in the communities, is that correct?

Yes, one of the things that I said early on, to the work group, to my staff, was that I wanted to stay true to the EFOD principles. I said that early on because again, I didn't want this to look like what I call, traditional economic development. We do great work in that area, at the Virginia Department of Agriculture and Consumer Services, but I wanted to be truly community based. And I was fortunate enough to have a work group who were so passionate about also doing that. And my work group had individuals from a variety of backgrounds, including, you know, state government people, to church leaders. Those who had a background in Snap and Virginia Fresh Match, et cetera, was a broad variety of folks. But everyone early on, stayed committed, as much as we could, to the EFOD principles. And in working with Trisha and Rudy, they pressed us to make sure that we did that. When we were veering off the path, they would remind us that you have to think about this. You have to think about that, including the position announcement for the program coordinator, and so we have tried to really stay true to those principles. And that's what I think is really going to make this a unique opportunity, here in Virginia.

It’s really a pretty profound issue, isn't it? These are vexing, difficult challenges in communities and they require ingenuity. And the profoundness here comes from, where's the ingenuity expected to be found. And it's not necessarily from the top down as we just said, but from the communities themselves and just like you, we've seen all sorts of amazing ideas come from people in the community. And we've, reconceptualized our role from thinking about what solutions might be, to finding ways to support solutions that are community driven. And that sounds very consistent with the way you're approaching it.

Yes and for me, I come from a university background. I have experienced that Virginia State University. That's Virginia's 1890 land grant institution, and I love young people. And I would often work with young people who, when you didn't have the idea, if you just listen to them, they had incredible ideas. And that's how our world is. We have to listen to people sometimes, when we don't know. We have to first admit that we don't know. And then we have to give others an opportunity to share what they do know, because people in these communities all across our country, they live these lives. They deal with these issues, they deal with the hunger issues. They deal with issues of racial equity, discrimination. They deal with the marginalism that so many of our communities are challenged by. Why wouldn't they have the answers? So if we give them an opportunity to show us, to create those answers for their community, and have others join them in also saying, yes, we support them in this business idea. We think this could work for our community. We have to be successful. Now, of course, this is a little chancy because the interesting part about it is, this funding has come out from the legislature. So they're going to want to see some impact. We have to show some impact, and if we don't show impacts, there may be no more funding from the state level that comes to this. So it's a mix of how we can get some early impacts, but how can we rely on people from local communities, to show us that they have great ideas to address issues related to food access, and therefore, really help us as the State of Virginia deal with that issue of hunger and food access.

So let's follow up on that issue of impact. So how would you envision success in this context and how do you judge progress over time?

It's going to be interesting, it's going to take some time and I really have to compliment the state of Virginia and even the office of the governor. And it's not just our current governor, but our previous governor who both of them focused a lot on food access issues. And in October, the governor launched the roadmap to end hunger. And that's a tool that in essence, creates a roadmap over the next five to 10 years, of how we're going to address this issue. And having a project like V Faith, it's embedded into this roadmap, that's pretty exciting. And so we really have a tool now as a state, to look at a lot of different things that we can do, but the identification of success is going to take time. So as an immediate success, we hope that the general assembly will see that this project can be utilized, to really get money out to communities and help with this issue. So that's kind of the first order of success, but we hope to start to begin to see more communities have access to fresh foods. We want to see more leadership and business opportunities come from historically marginalized communities. And we want these communities to get the support they need for business development. And we're really hoping to see some creative ideas come about. Those are some of the things that we're looking at, to begin to measure the success. How many new businesses are going to come from this, or how many businesses that weren't going to make it, are going to start to become successful. That's what we're looking for. We're looking for that transformation, at a community level, over time. So it's going to start small and hopefully we'll begin to see, one by one, more of these opportunities and more of these businesses and more wealth and leadership created in communities that really need this infusion of resources.

Bio:

Dr. Jewel H. Bronaugh is the 16th Commissioner of the Virginia Department of Agriculture and Consumer Services. Prior to this position, Dr. Bronaugh served as the State Director of the USDA Farm Service Agency and as the Dean of the College of Agriculture at Virginia State University. In her earlier career at VSU, she was the Associate Administrator of Cooperative Extension and a 4-H Youth Development Specialist, where she developed and delivered programs that addressed issues of bullying among today’s youth.

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This podcast focuses on the need for a national food strategy and why now is the right time to fix the US food system. I'm talking today with two food policy experts who have collaborated on an effort with an ambitious title of Blueprint for a National Food Strategy. They argue it's time to coordinate policymaking that identifies national food systems priorities, and develop a process that gives the public an opportunity to weigh in on the trade offs inherent in food policymaking. Emily Broad Lieb is the Faculty Director of the Harvard Law School Food Law and Policy Clinic. And Laurie Beyranevand is the Director of the Center for Agriculture and Food Systems at Vermont Law school.

Interview Summary

So let me ask you both, can you help our listeners understand what you mean by the term National Food strategy? Emily, let's begin with you.

Our food system - it's incredibly fragmented in the way that it's regulated because there's so many different agencies that are regulating different aspects of food safety, and production and workers. So what we define as a national food strategy would be a set of food system goals and a coordinated approach that would foster consideration of these goals in law and policymaking that affects the food system. We call it a strategy because it would be setting a roadmap for the long-term goals in terms of health and food safety, food justice, environmental sustainability. Others have written saying, "We need a national food strategy or national food policy, and here's what it should do." The aim of our project has been very much process-based. And we need to set out a process to bring together these different agencies and coordinate them. And especially to make an opportunity for voices from outside government, those of key stakeholders and also of the general public, to participate in that process in saying what the goals should be, so that then government and the agencies regulating the food system can be responsive to that.

Laurie, I'd appreciate your input on that same question, and it's interesting that there's not a national food strategy. And I'm wondering if you're getting traction for the basic concept of having such a strategy?

Yeah, that's a great question. Emily laid out really well why we focused on a national food strategy and our emphasis on process. It's probably easier for people to connect around the notion of process rather than substance. A lot of the calls on a national food policy were so heavily focused on substance, it allowed people to think about where there were conflicting interests and not get behind it - because it didn't represent everyone's interests. Our focus on process is really to think about how do you have all these various stakeholders come together so that they can develop a National Food Policy, if that's what we want to call it, or a written document that reflects all of these varied interests? And in getting behind the process, it's a matter of saying, "We're committed to figuring out how do we coordinate all of these various law and policy instruments across the food system, in a way that's going to achieve better food system outcome?"

So Laurie, let's follow up on this a little bit. So in 2017, you Emily and others created a blueprint for a National US Food Policy, and you've chosen to update it now, in a document that you just released. Back in 2017, you said that the American food system, and I'm quoting here, "Is a poorly coordinated patchwork of federal, state, tribal and local laws, administered by agencies with overlapping duties that results in inefficiencies and unintended consequences." What's happened in the interim that made you want to update it now, and is COVID a player in this?

COVID is definitely a player in this. Not a lot has happened in terms of improving this situation, which was why we renewed our call for a national food strategy. A lot of how COVID demonstrated these inconsistencies, the lack of coordination and the really poor food system outcomes that we saw as a result of COVID. But in part it was also due to the upcoming election and an opportunity to get this in front of whichever administration was going to be in office, as a way to start thinking about how to coordinate food law and policy. What's interesting about this as a concept is that it's not unique to the food system. The food system is certainly where we focus but it's not that that's a unique situation in the United States. I mean, we often think of laws as having a discrete focus and then we have agencies that are also similarly discretely focused on the subject matter areas. Where they regulate, we don't have a lot of mechanisms in the US to think about how to account for the possibility that those things might not only be uncoordinated, but they also might be in conflict with each other.

Emily, what are some examples of how a national food strategy could work and provide benefits to the food system?

I'm glad you asked that, because I think a lot of the work that we've done has been really trying to paint a picture for readers about how it would be unique to have a national food strategy in the US. But national food strategies themselves are not unique, lots of other countries have these, and that was a big piece of our research. But then we also looked at in the US, we've created national strategies on countless different things, and so we examine eight different ones in the US that include everything from the National Strategy for HIV and AIDS, with the National Strategy on Antibiotic Resistance, the 9/11 Commission, which was congressionally created strategy after 911, really to say, what were the lack of coordination or other weaknesses that allowed 9/11 to happen, and then how do we plan going forward?

There are lots of examples of other issues in the US where we've said, "This is a complicated topic with real impact on society, and we need to have a mechanism for coordinating amongst agencies to facilitate the best outcomes possible." And I'll just say a little bit about some of the findings, and really what we recommend. Since 2017, there have been a lot of cross agency strategies announced that impacts small specific areas of the food system. So there's been more coordination, in particular memorandums of understanding between USDA and FDA, for example, as the two agencies really share oversight over food safety. And then there's been, for example, a multi-agency initiative on reducing food waste, which was those two same agencies and also the EPA.

Leadership & Coordination: Our recommendations from 2017, which were really derived from six different national food strategies in other countries, and eight different national strategies on other topics in the US. And I think that the main recommendations that stand first is around coordination. So, addressing one issue might also have equity problems, or lead to more food and security issues or things like that. And I think we really need to kind of have these regulations that impact the food system being dialogue. So coordination, really having an inter-agency working group. One thing we added on to that recommendation, this time around was leadership. Knowing that there's not really an office or agency out there now that could manage this holistically, and leadership and having an office either within the White House or somehow within the executive, that is managing the process of getting input, putting together a written plan, and then following through on it is crucial. I mean, this really wouldn't be successful without that.

Participation: every single strategy that we found that was successful, it was because they did a really great job of realizing that voices from outside government were needed. And again, as we know in the food system, it's so complex, so many different stakeholders are implicated, and having producers, environmental advocates, affected communities that are really struggling with food access and food insecurity, and giving all that input and then seeing where we wind up with goals.

Transparency, accountability & enforceability: The last two are one is transparency and accountability. And that is putting something in writing, saying these are our goals, and then following up with regular reporting from agencies to say how they're moving towards those goals. And we added on this time around, this real concept of enforceability as well, giving some authority to the office that's managing the strategy and making sure that they can follow through.

Durability: And then lastly, durability. And there's lots of ways to do this, but really thinking about ways to make it flexible and update. And as an example of that the National HIV/AIDS strategy was so successful. After it was released in 2010, then an updated strategy was released in 2015, that really brought in a lot of new goals and built on the foundation of the first strategy. And I think something like that could be really beneficial here as well.

Thanks, Emily. So Laurie, are there countries that you think have done especially well at this and what have they done to make their work impressive?

One of the countries that we focused on in the original blueprint was the UK. At the time when we were doing our research, they had a really interesting Cabinet Office that was called the Strategy Unit. And the whole purpose of it was to achieve joined up policymaking in the UK, it was doing exactly what we're suggesting would be really useful is looking across all these different agencies, looking across all the decision-making that they're doing and then thinking, "How do we join up their efforts? How do we get them to work together in policymaking so that we're not creating these conflicts and we're avoiding redundancies. And at the time, the UK was in the process of developing what was called Food 2030. And that was their original food strategy paper. They initially intended to have that released over the summer, but because of COVID, they essentially broke that process into two parts, and they created part one of their strategy. And released that this summer when direct response both to COVID and also to Brexit. Their intention is to then release part two of their strategy, which is the big picture National Food strategy in the UK within the next year. So that'll be a really interesting process to follow.

Sadly, the strategy unit in the UK fell apart, but a lot of it had to do with agencies not being used to coordinating with each other, and then facing some difficulties really getting past those obstacles and differences in agency culture and agency budgets and getting them to start thinking about coordination as something that they would do regularly.

The other country that we focused on, Canada announced their national food policy, after many, many years of grassroots efforts to push the government to create a National Food Policy. Emily just mentioned a few minutes ago that one of our recommendations was around participation. And I think Canada provides a really great example. A bunch of different types of participatory processes were fully designed to elicit comments from a broad range of stakeholders. There was a convening of different types of stakeholder groups. So it included industry, food security, advocacy organizations, and a bunch of different stakeholders that you might not normally see at the table together. And as a result of that came out with a shared set of interests, which I think is so important.

In the US, we similarly have a wide variety of stakeholders in the food system, and trying to get them to come together on a set of goals and priorities could be really difficult. And having a process that helps to facilitate those conversations, helps to get people on the same page about what the major goals and priorities are, would be so beneficial. And we have some really good models of that.

Well, now that we're thinking about some of the obstacles, you mentioned that there are lots of stakeholders with different interests. And earlier, you both discuss the issue of the responsibility within government falling across lots of different agencies. So are there other obstacles that exists for thinking about a national strategy in the US?

Agencies have different mandates, different cultures, different budgets, getting over that hurdle, and trying to get agencies both to appreciate the value of coordination, but also just embracing that as something that's valuable, that's going to require a big shift in the way that agencies think about their jobs. I see that as an obstacle that's certainly not insurmountable, but that would require some work. How to get stakeholders engaged in a way that's really meaningful, that's an obstacle that we need to be really thoughtful about. And how to make sure that we're enabling people that often lack of voice in law and policymaking. And then figuring out how to get them to identify common ground to come together around a shared set of goals and priorities. And then lack of political will. And also there are certain people that benefit from the lack of coordination in the food system. Trying to get to a place where they've perceived benefits in a process like this, that that's going to take some work. And allowing them to see the benefit in airing the trade offs that are inherent in food system on policymaking and allowing for greater public input, that all of that can produce outcomes that are beneficial for everyone.

You were talking about issues of territoriality in a way that parts of different agencies are handling things and they have different budgets. And so in some ways, one of the obstacles I'm imagining is that people are people, and people don't want to give up territorial power or authority or whatever you want to call it. So that's one issue. And I'm wondering, does a new structure needed? Should there be some new agency where this work is better consolidated or takes all the work on a specific issue like food safety and parks it in a particular agency rather than divides it? So is there some structural change that you think might be helpful?

There's a way to do this that doesn't require agencies to give up authority, but it's more in alignment and some long-term decision making. And I think actually, for some agencies, it might be somewhat relieving to say, "Okay, we know that right now we can't adequately handle certain concerns because they're not really within our mandate, but we feel uncomfortable with the fact that when we're regulating for food safety, that food security isn't really part of that." And then I would say on this question of institutional design and agency building, my take on it would be, there's been a lot of proposals to put all of food safety into one food safety agency.

This definitely gets that some of the lack of coordination, particularly across the Food Safety and Inspection Service within USDA, which is in charge of safety for meat, poultry, and some eggs. And then the FDA, which is in charge of food safety for the rest of the food supply. So there's been proposals in the last two administrations, both Trump and Obama, there's been introduced in Congress on this, if the whole endeavor is just to create one agency to just handle food safety, it would be a lot of energy, maybe not worth the cost. That said, I think you kind of hinted at this, Kelly too. But just if the endeavor is to say, "We need an agency that looks at food safety, but also is equipped to balance, food safety and regulations with some of these other issues, like broader food safety, safety on farms, and in food production and food security and food assistance programs, I mean, if that's the endeavor then, I would wholeheartedly support it, because right now, the lack of coordination on these things means that we aren't really able to plan for the long-term.

Two other quick things, this point of political will, and circling back to an early question you asked, about the way that COVID has shown and exacerbated these challenges in the food system, I think also makes this a moment where perhaps there is political will. So many people that weren't thinking every day about where their food was coming from, are thinking about it more now. As heartbreaking as it's been, it also gives us a moment, hopefully, we can generate some political will around figuring out how to get out of this crisis, but also plan a little bit for the long-term.

So Laurie, what are your feelings about whether structural changes might be necessary to help address these issues?

One thing that we suggested is having a lead office or agency that would be in charge of the coordination efforts. But where would the best place be for an office or agency like that? Certainly, there would be some jockeying for position, I would assume between USDA and FDA over something like this. And I don't know that there's a clear or natural leader among either of those. And so maybe it is that there's a different office that gets created that would be responsible for this that could be thinking about all these different agencies that would be involved here. And also would come from a perspective that would be somewhat less entrenched in the agency positions that they already have. But I would agree with Emily, I don't know that you necessarily need an entirely new agency to do something like this. One of the other suggestions that we had, was to think about something like a law similar to the National Environmental Policy Act that requires agencies to be thinking about the environmental impacts of their actions, to have something like the National Food Policy Act that requires agencies to be thinking about the food system impacts of their decision making. And to have an agency that would be responsible for implementing that as a law. So that's certainly another tool that we've thought about as a way to carry forward a strategy like this.

Bios

Emily M. Broad Leib is a Clinical Professor of Law, Faculty Director of the Harvard Law School Food Law and Policy Clinic, and Deputy Director of the Harvard Law School Center for Health Law and Policy Innovation. As founder of the Harvard Law School Food Law and Policy Clinic, Emily launched the first law school clinic in the nation devoted to providing clients with legal and policy solutions to address the health, economic, and environmental challenges facing our food system. Emily focuses her scholarship, teaching, and practice on finding solutions to today’s biggest food system issues. She has published scholarly articles in the Wisconsin Law Review, the Harvard Law & Policy Review, the Food & Drug Law Journal, and the Journal of Food Law & Policy, among others. She was named to 2016’s list of Most Innovative Women in Food and Drink. The list, released by Fortune and Food & Wine, highlights women who had the most transformative impact in the last year on what the public eats and drinks. Her groundbreaking work on food waste has been covered in such media outlets as The New York Times, Los Angeles Times, Boston Globe, The Guardian, TIME, Politico, and the Washington Post. Emily has appeared on CBS This Morning, CNN, The Today Show, and MSNBC to discuss the clinic’s efforts to reduce food waste.

Laurie J. Beyranevand is the Director of the Center for Agriculture and Food Systems and a Professor of Law at Vermont Law School. The Center for Agriculture and Food Systems trains law and policy students to develop real-world solutions for a more sustainable and just food system. Beyranevand received a BA from Rutgers College in 1999 and a JD from Vermont Law School in 2003. She clerked in the Environmental Division of the Vermont Attorney General's Office and also served as a law clerk to the Honorable Marie E. Lihotz in New Jersey. Prior to joining the faculty at Vermont Law School, Professor Beyranevand was a Staff Attorney at Vermont Legal Aid where she represented adults and children in individual cases and class action litigation advocating for access to health care, education equality, and civil rights. In that capacity, she appeared in state and federal court, as well as before administrative adjudicative bodies, and served as an appointed member of the Human Rights Committee. She is an appointed member of the Food and Drug Law Institute and Georgetown Law School’s Food and Drug Law Journal Editorial Advisory Board, a founding member of the Academy of Food Law and Policy, and the Chair Elect of the Agriculture and Food Law Section of the American Association of Law Schools. She is admitted to the New York and Vermont State Bars, as well as the U.S. District Court, District of Vermont. As a first generation American with Iranian and Appalachian roots, diverse food and culture have always been prominent in Professor Beyranevand’s life symbolizing the power of food in bringing people together.

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Soda taxes now exist in about 50 countries around the world and in a number of US cities. They raise lots and lots of money. How would you suggest that the revenues be used? This podcast focuses on the connection between sugar-sweetened beverage taxes and racial and social equity. We're speaking today with a champion of community-driven approaches to health equity and environmental justice. My guest is Xavier Morales, the executive director of The Praxis Project, the national organization headquartered in Oakland and dedicated to supporting communities, building power for health.

Interview Summary

I've been very impressed with the ideas that you have on this topic. So let's just dive right in. Could you explain a little bit about the work that you and your colleagues do as part of The Praxis Project?

Yeah, at Praxis, we're really focused in on helping communities power to improve health. And the way we see it is that a lot of these negative health outcomes that we're seeing in communities are really driven by inequitable processes. And so what we do is we help organizations to build power to be able to address and transform these processes that lead to these inequitable outcomes. You can look at equity as a verb, or you can look at it as a noun. Both are very important. The noun, which is basically the outcomes, are very important to address, but Praxis really tries to home in on the verb space, the process of equity. And we do that leading with community power.

Thanks for that background. Now let's get on to the soda tax. So the nation's first soda tax was done in Berkeley, California. And you played a really important role in this, thinking especially about the use of the revenue. So let's begin with this. Why is it so important that that community voices be heard when these policies are being considered?

I kind of consider myself a second-tier invite to the core group that had already conceptualized soda taxes. And people like Josh Daniels, Vicki Alexander, Laurie Cappotelli, Linda Mayo, Martin Bork, those were like the real core folks that were thinking about it, but they had the foresight to go and talk to others who had tried to pass a soda tax, people like Jeff Ritterman in Richmond, and folks from down in El Monte, Southern California, and people like Harold Goldstein, who had been championing this. But they'd been running up against very stiff industry opposition. And so the thing that Ritterman especially told this core group was you need to make sure that you have the communities at the table from inception, from as early on as you can because if you don't, the beverage industry will come in, and they'll start to organize. And so they brought in myself as a member of Latinos Unidos de Berkeley. And at the time, I was also the executive director of Latino Coalition for a Healthy California. And I happened to live in Berkeley. Vicki Alexander was brought in, and she was a very strong advocate for the African-American community in Berkeley.

What we were able to do working together was to design, again from inception, a soda tax that would benefit all aspects of the Berkeley community. So the initial reason for passing the soda tax was to fund our cooking and gardening programs in the schools. And we wanted to make sure that we could continue to do cooking and gardening programs in the schools. But knowing what we know about who pays soda taxes, and it's typically folks who are lower-income, more recently arrived, and folks of color, that's what the research shows us, we said, this is great to do cooking or gardening programs in the schools, but really we know that there's some educational outcome disparities. So we want to make sure that there's a focus on those children that may not be receiving the full benefit of the program. And secondly, we also know, given the population that I just mentioned typically consume sodas and is going be paying the soda tax, we wanted some funding to go directly back into the communities. We want a direct benefit because otherwise the beverage industry comes in and really does use this regressivity argument very effectively, and if anything, that's beat back a number of these initiatives before Berkeley. By bringing the community in, we were able to say, yes, cooking and gardening program in the schools, that's great. But, we also want to make sure that we're doing programming in the communities to transform the conditions, increase knowledge, and make sure the infrastructure is there for people to be able to, when they know what the healthy choice is, have the healthy choice available.

Wow, that's really impressive. So let's talk a little bit more about specifically what the monies are being used for in Berkeley. So you mentioned that the basic overriding aim, which is to help address equity issues, but what are some of the ways the money is being used?

We've been really fortunate in that we've been able to use about 40% of the funds to support cooking and gardening programs in the schools. We love that we can do that for all of our children. But, the other part is going into some of these more vulnerable communities that have experienced higher rates of obesity, heart disease, stroke, and tooth decay. We've been able to work with community partners to deliver health programming. We were very happy that we could target the funding into the communities that have experienced the worst outcomes related to the over-consumption of sugary drinks.

We've been able to invest quite a bit in Healthy Black Families, the Multicultural Institute, East Bay YMCA, that actually runs a Headstart program, and then also Berkeley Youth Alternatives. Also we were able to fund another program called the Diabetes Education Prevention Program through the YMCA. All of these programs, serve the populations that the beverage industry actually targets. And research shows that they target brown and black communities. And there's research that shows that African-American children, brown children, actually see two to three times more ads for sugary drinks than their white counterparts do. So this starts to show in some of the behavior patterns and consumption patterns.

What we're doing with this funding is trying to change norms, and we do that through education. Healthy Black Families, what they do is they have a cohort of mothers-to-be, and they do nutrition education. They all go to the grocery store together and shop together. They look at products, they read labels, and then they bring the food back to a kitchen, and they actually cook together communally. And there's a lot that's happening there. It's not just the education. It's also like a support group. If there's any issues that are coming up, there's need, assistance that's needed, there's referrals that are made. It's a big program.

And then also the East Bay YMCA, the work that they do with the Headstart. They've hired a couple of musical artists to come in. And these musical artists use song and dance to teach the children about what is nutritious and what is not nutritious regarding beverages and foods. It's really great when you see these little kids all doing these little dances and singing these songs. And the feedback that we've seen, their parents are coming back and saying, what are you guys teaching our children? This is great. Because the children themselves are now starting to hold their parents accountable, trying to teach their parents about what's a healthy beverage. And then also this site is leveraged. The trusted relationship that these teachers have with the parents, it's a safe space, and it's also used as a food distribution site, and that's ancillary benefit that's available.

And then the last group I'll talk about real quickly is the Multicultural Institute. Talk about vulnerable populations! They work with day laborers. These are the folks that are hired by the day. They typically stand on street corners, and they're picked up to go do construction or gardening, but they're hired by the day. And these folks almost never receive any programming or any education on healthy beverages. And so the Multicultural Center staff do trainings with these day labors as they're standing on the corners to talk about what's a nutritious drink and what's not a nutritional drink and why it's so important to make sure that they are consuming healthy beverages. And we've seen over time that we're seeing thermoses filled with water and coffee. Because of the trusted relationship with these trainers from the Multicultural Institute, they're also able to refer them to other services that they might need, whether it's dental or primary care. And then the Institute also does programming for the children of these working families. They use art. They do nutrition education. And they have the children do art projects based on what's healthy and what's not healthy. And we're getting the same kind of feedback. These kids are going home, and they're having an effect with their parents as well.

So, what we're seeing is that these funds are changing the norms with the children, their families, but also the trusted relationships are being leveraged to provide other beneficial services for these populations.

Well, what an impressive array of efforts are being funded by the revenues from the soda tax. One thing I'd like to ask is something you alluded to earlier, which was the beverage industry behavior and reactions when soda taxes get introduced. Could you tell us a little bit more about that?

It's incredible the opposition that the beverage industry mounts against, not just soda taxes, even warning labels, anything that seems that it will diminish their sales. In Berkeley, I remember the first time I saw someone from the beverage industry because we had our first public meeting. Our strategy team had been meeting for a number of months, designing the soda tax, deciding what was going to be taxed, what wasn't going to be taxed. Was it going to be an excise tax or a retail tax? Was it a specific tax or a general tax? So we were meeting for months debating all of those things. And then we decided we were going to have our first meeting. We were going to open it up to community, and there was this really helpful young man that was helping us set up tables, take down tables, and was really nice to everyone. I mean, the guy was just so personable and so charming. But at the end, Sarah Socar, our campaign manager, started to wonder about him. Like, who's this guy? We've never seen him before. And he's really trying to become central to what we're doing. It turns out the guy was beverage industry. He ended up becoming the main operative in Berkeley. He kind of tried to sneak in and be part of the conversation.

When it came to advertising, oh my God. They bought up almost every bus shelter, every public space. And so everywhere you saw no-on-D advertisements. So on the sides of buses at the bus shelters, we have a metro station called the BART, Bay Area Rapid Transit. And so every possible space they purchased, including when you walk up to buy your tickets, they had huge 20-by-20 stickers on the floor, no on D. They overwhelmed us. It was shock and awe the way they were doing it. They filed a lawsuit on some of the language in our measure.

But you know, the interesting thing is that when they wanted to file the lawsuit, they didn't have any standing because they didn't have anyone living in Berkeley. So the same young man that was helping us at that first community meeting, he actually moved to Berkeley so that they could file this lawsuit. I think one of the more insidious things that they do is, because they really try to drive wedges with communities of color on this issue and talk about the regressivity and try to sow distrust that the city's not going to use the money the way they're saying, very misleading. And they do that primarily with communities of color while they hired folks of color to come in. And most of these guys were from out of town. And they hired them to canvas in our neighborhoods. So they would be at the farmer's market, and they presented it like they had a petition against this soda tax. And the interesting thing is, you know, we had very committed folks to get this soda tax passed. Our folks used to go and engage with them, and they almost ended up feeling badly for the person because for the person that was doing this work, it was just, they needed a job. They weren't very deep on the issue, but they were just there to get these signatures. And it was overwhelming what they did on that. But they spent about $3.2 million here, which a lot of places that may not seem like a lot of money, but for us. That was the largest amount of money that was ever spent on trying to pass a local measure. It was just crazy.

But the way we fought back was through house parties. We call them house parties. They mean a different thing than what they meant back in the '90s when I was growing up where folks would bring their neighbors together. And we'd come in and we'd do presentations to talk about what this soda tax was. And it was neighbors talking to neighbors, and it meant something different when I came to the door, and I said, hey, I'm your neighbor. I live over here on the corner. And they're like, oh yeah, we knew the person that you bought the house from. This is great. How do you like the neighborhood? So we would engage in those kinds of conversations. Then I'd talk through exactly why we were going after a soda tax, what we were going to do with the funding. And then I also talked about how we expected the beverage industry to respond and then what the beverage industry was going to say. And then we would answer those questions right there at the door with them. This is what the beverage is going to say, and this is the response. This is the truth here.

Originally when we did our polling, Berkeley polled at about 66% that we would pass this tax, but that was before the beverage industry came in with all their funds. But the best thing was that at the end of this all, after all was said and done, because of these neighbor-to-neighbor connections, we actually won at 77%, completely due to the trusted relationships. And also because there was no way for the beverage industry to get a foothold and drive wedges, especially with our communities of color, because we had been at the table from the very beginning.

Well, what a great example of community organizing and hearing community voices in this process in a way that could overcome that massive spending by the industry. So Xavier, you and I have spoken before about the four-point plan that you have that I think is really pretty inspiring to think about how to address these issues in places that might be considering such taxes in the future. Could you describe the plan?

Yes. Since we were able to win in Berkeley, other municipalities have actually followed the same pattern, an excise tax, a general tax, having a community advisory board that advises the city on how to invest funds. And so there's been a lot of learning on my part that when we talk about equity, what does it really mean? I wasn't always in this space. I also looked at equity as outcomes. I'd never thought, and this is a no-brainer. I don't know why I'd never thought of this. But if we really want to change things over the long-term, we really have to change the systems and practices and environments that are leading to those outcomes. When you go up against a very deep-pocketed and moneyed opponent, it's like the health advocates on their own can't win this. We really have to partner with community, but the community has to see what's in it for them.

So again, there's been a lot of learnings. This was 2014 that we won this Berkeley soda tax. And since then, I've been working on some other initiatives around soda taxes around the country. And what I've really landed on when we talk about equity and soda taxes is these four points, that, one, we really need to make sure that we're investing the funds in the areas that have the highest need. And to me, highest need means the areas that are experiencing the worst outcomes related to the over-consumption of sugary drinks, be it type-two diabetes, obesity, heart disease, stroke, tooth decay.

And then the second one is invest in the priorities that the community sets across the determinants of health. Maybe the issue in that community isn't water, but maybe the issue in that community is that they don't have access to full-service grocery stores. And maybe what the community wants is some kind of farmer's market or little pop-up produce stands in their neighborhood or even some of these mobile vendors that sell vegetables and fruit. So really what we need to do is figure out what the community's priorities are and invest in those.

And then third, it's really important to fund the actual groups in the community that have the strongest relationships with the target communities to be the deliver of programming and services. We have to bring them in because not only do they have the pulse of the community, but they also have the needs, and they also know the context, and they'll know what types of programming will work best. And then the fourth one is that when we make these investments, we should try to make the investments in a way that, yes, not only addresses the community's priorities today in a way that uses community infrastructure to deliver the services. But how can these investments actually increase the capacity of the broader community, the infrastructure of the community in a way that transcends the life of the grant that we're giving them?

Again, those four points are invest in the areas that have the highest need. And then second, invest in the priorities that the community sets. Then the third, utilize the community groups, the ones that have the strongest, most trusted relationships with these priority populations to deliver the programming and the services. And then fourth, try to include funding for things that increase this health infrastructure that will transcend the life of the grant.

Bio:

Xavier Morales is the Executive Director of The Praxis Project (https://www.thepraxisproject.org/). He is a longtime advocate for community-driven initiatives to achieve health equity and environmental justice. Taking an expansive view of what constitutes good health and community wellness, he diligently works in partnership with community, professional and academic allies to improve health and justice. Xavier currently serves on the board of the Urban Peace Initiative, on the advisory board for Boston Medical Center's Vital Village Network, and sits on the City of Berkeley's Sugar Sweetened Beverage Panel of Experts. Keeping community health equity and justice at the center of his work, Xavier is a leader in campaigns to pass legislation to create a dedicated revenue source to combat diabetes and other preventable chronic diseases. Xavier is a frequent speaker for legislative briefings, health conferences, health justice gatherings, and in college/university settings. Xavier, a former Peace Corps volunteer (Hungary), is originally from Sanger, California and studied environmental sciences at the University of California, Berkeley and city and regional planning at Cornell University.

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This is the final podcast in a five-part series focused on Equitable Food Oriented Development, a growing movement to promote food projects and enterprises as vehicles for building community wealth, health and self-determination. With us today are two leaders in this movement: urban planner Rudy Espinosa, the executive director of inclusive action for the city in Los Angeles and community activist and organizer, Camryn Smith, the founding member of Communities in Partnership, the Grassroots Organization in the old East Durham, North Carolina.

Interview Summary

So the movement as it's called is a systemic approach to wealth building through community projects. So let me ask, how would you each describe your vision on how EFOD can best be advanced and how do you feel of EFOD can be pathway to lasting and sustainable change in the community. Camryn, why don't you go first.

I think the beautiful thing about EFOD is that it is being led by specifically people of color who have been directly impacted by food issues. For most of our cultural dynamics, we are very circular in how we view the world. EFOD is not just about food; that it's about healthcare. That it is about over policing, under policing. That is about education, that it is also about housing and that it is about entrepreneurship and job development. It is even about the tech boom. Looking at how everything is intersectional with each other and understanding that communities of color, specifically those who have been intentionally divested from that we have the tools, we have the knowhow, how to rebuild and take care of ourselves. And I think EFOD is a way forward in decolonizing that language that we use and those mentalities and those structures that we've created that have actually built and upheld the system of inequality that we're currently experiencing today. I see EFOD as a way of educating people, of having a wake-up call, so to speak and also challenging the business as usual, those that have the power have become comfortable, to challenge in ways to be who we say we are because oftentimes I think we believe a narrative about who we are in this nation. That when you look at what we do and how we operate—it is a very different identity that we have versus the one we want to portray. I challenge us to use EFOD as one of the multiple tools being created by communities who've been intentionally moved to the side, and silenced, and marginalized. I challenge us to basically reclaim our humanity as a nation and to reclaim some sort of moral compass, so we can move forward with some thread of integrity of caring for every single person and every life, so that everyone can have what they need to thrive.

And Rudy?

EFOD is trying to plant seeds, no pun intended, of the practices that we think can really support community in the brilliance that exists in community. And I think people can help spread EFOD by learning about it, by connecting with organizations like Camryn's, and learning about the approach, but not only learning. I think it's also about doing. And the more that we can raise our voices together and demand that the industries that have arisen in front of us—the industry of CDFIs and the industry of philanthropy, or even the industry of the nonprofit sector—that we demand that, hey, we're losing sight of the goal here. And the goal is to work ourselves out of a job. The goal is to eradicate poverty, and to eliminate racism, and to make sure that everybody has an opportunity to prosper. So, I think that that's a good way to spread EFOD.

Now related to this issue are what are known as CDFIs, community development financial institutions and also foundations and philanthropy can be an important set of players here. Can you see them shifting their practices to make capital more accessible?

now, I will say that related to CDFIs, I may have a heretical perspective. Full disclosure, my organization just applied for CDFI certification, so if the treasury is listening, I hope they don't, you know, judge our application.

So Kelly, I feel like the CDFI industry has lost its way. And I think that generally speaking, a lot of CDFIs have become part of the problem. They become an extension of the financial institutions that have kept capital from us. The examples that I hear often is the cumbersome process to get capital from a CDFI, from, you know, some of the more traditional CDFIs. And I think what happens is that over time as an organization gets bigger, you get more money, more problems and you start to realize that these institutions forget that that they were created as an alternative to the mainstream banking sector.

And they become in existence to protect themselves. I've heard even recently with this pandemic that's going on, a CDFI saying, ‘well, you know, we have to help people. We also have to make sure that we're protecting our systems.’ You know, my view on that is that that's not the purpose of what you're doing. The CDFI movement was meant to be a movement, not an industry where we are here just to protect ourselves and protect our paychecks. You're trying to get capital out to people and we are here to facilitate the brilliance that already exists in our neighborhoods. I think that there's an opportunity to change that and that I hope that this pandemic reveals, you know, much more of how we can get capital deployment in a faster way and there's a lot of hope for CDFIs.

That's why we want to participate in that work because we want to demonstrate a different way. Philanthropy can also help though, Kelly. And I think that from my experience, working on this loan fund for Inclusive Action, philanthropy has stepped up. We've had funders that have stepped up when banks didn't want to lend to us to, to seed our loan fund. Philanthropy came in and said, hey, we'll give you a program related investment. We'll help you out. Let's put some resources behind that because we see the value of this. And what I would hope is that philanthropy also recognizes that their role is to work themselves out of a job. And so, that also means not being afraid to spend down endowments and to take risks. Because I think sometimes I see some of our funding partners also become really risk averse. And they're worried about protecting what they have as opposed to getting resources out to people and working themselves out of a job. And that's really the bus that I'm on is like, we need to work ourselves out of a job because we have a mission and let's accomplish this mission and then find something else to do.

Camryn, what are your thoughts about how institutions like CDFIs and philanthropies can help out with these things?

I 1000% agree with what Rudy has just stated. The biggest issue that I have with CDFIs is their ability to receive grants and to be in competition for philanthropic dollars with communities who actually know what's best for themselves. And oftentimes, the CDFIs have the infrastructure, they have the staff, they have the capacity, they're a finely tuned machine and engine this running, it just kind of runs over communities. And so when small community organizations like myself go to major national funders to get our initiative just to get it off the ground, from a community rooted perspective, oftentimes they lead us back to the CDFI that's in our community. Because that's where the money has been going. I have an issue with that because if that system worked, we would not be experiencing the huge disparities that we experience right now. And so I would challenge CDFIs, to make Rudy's point even more valid, to kind of come alongside of communities and to decolonize their construct and how they actually operationalized business. Because I think in a lot of areas, they have become part of the problem. I think they are trying to kind of pivot, but there's some difficulty because when you've been doing what you've been doing for so long, you create systems that you lean on and that make people feel comfortable and secure in those systems who have the access and power.

But on the flip side of it, yet again, their own data is telling them what they're doing isn't working. And for philanthropy to reach out, number one, to hire program officers that actually, they themselves have been directly impacted—as Darren Walker from Ford Foundation said at Duke a few months ago—and have a very clear conversation about how the money came to be in the first place. And to realize oftentimes, from our viewpoint, we cannot separate our privilege and our access and our resources from the historical context in which that was created. So having a very clear conversation of understanding that people of high wealth and privilege often do not know what's best to remediate the issues of communities that have been impacted by the very system that they've benefited from. And so, having those conversations and being bold and brave. It's not because we want all the wealth to come into our communities. What we want is for everyone to thrive. We want everyone to be strong. We want everyone to have everything that they need and we have more than what we need to make that happen in the United States. It's just that there's a very small percentage of people who are dictating that. And often, they lack the capacity and the intellectual knowledge and the know how to do it. And again, the data is proving what I'm saying to be crystal clear, because if we were doing such a wonderful job and moving in the right direction, we would not have the deep disparities that we have.

Rudy, would you like to comment on this?

I really agree with what you're saying, Camryn. And I find it like really odd that we forget the history behind this work and the origins of these institutions. Like, literally capital was stolen from us. And what we're asking for is just that, you know, can we just have it back please? And so, I find it so odd when CDFIs and even philanthropic partners, essentially hoard the resources in some way. When the intention and the history of this is like, no, this money was taken from us and you have to give it back to where it should go—as opposed to creating systems to decipher, well, I don't know, are you worthy of this grant? Or, I'm not sure if you're too risky to take on this loan. It's just, I don't get it. My team and I always kind of go back to the history of this because it grounds us into the purpose of this work.

Bios

Rudy Espinoza is the Executive Director of Inclusive Action for the City and an urban planner with a passion for neighborhoods, entrepreneurism, and financial empowerment. He specializes in designing and managing place-based initiatives, identifying profitable investment opportunities in low-income communities, building private/nonprofit partnerships, and training the working poor to participate in the socio-economic revitalization of their neighborhoods. Rudy holds a Masters Degree in Urban Planning from UCLA and a B.S. in Business Administration.

Camryn Smith is a proud resident of Old East Durham and a community activist & organizer. She has been serving in place-based development work for over 18 years both stateside and abroad. Camryn is a founding member of Communities In Partnership, a grassroots community organizing and education group based in Old East Durham. As Executive Director, she oversees and assists in developing community-based education processes, community development, and implementation and organizing for addressing policy and systemic inequity for communities of color and materially poor peoples within Durham. Camryn’s focus centers around social determinants of health and the intersection of economic development, gentrification, displacement and housing, and food access/justice.

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Progress towards Sustainable Development Goal 2: Zero Hunger is stalling, and the Covid-19 Pandemic is erasing the progress of the last decade in many parts of the world. Is it possible to re-energize on this issue? Could a new commission make a difference? Today, we’re talking with the authors of a new report entitled "High Level Commissions and Global Policymaking Prospects for Accelerating Progress Toward SDG2." Geoff Gertz is a fellow in the Global Economy and Development Program at the Brookings Institution. And Sarah Zoubek, is the Associate Director of the World Food Policy Center here at Duke University.

Interview Summary

What was the original idea behind studying the potential and the limits of a new High Level Commission Focus on Sustainable Agriculture and SDG2? Sarah, let's begin with your thoughts.

Sure. In the summer of 2019, there was a group of agricultural development experts that came together and they said, global progress is stalling for achieving Sustainable Development Goal Two. So what can we do to catalyze action? What is something different we could try? Someone pitched the idea of a high level group of individuals coming together in sort of a commission style. And they had seen some success by high level groups like the Lancet Commission on investing in health, for example, and wondered how that could apply to the food security and agriculture space - if something there could be successful.

So, Geoff, what are your thoughts on this? And what do we mean by high level? Does this mean experts on a topic? Does it mean heads of agencies and countries? Does it mean heads of States? What does this mean, high level commission?

That's a great question. So the commissions we're talking about are made up of individual participants. We're not looking at groups that are business corporations or international organizations that are part of some sort of national coalition. Individuals who participate are individuals who are prominent enough that they have some professional reputation outside of their immediate sphere. So this can be heads of state or former heads of state cabinet level members, heads of large businesses, heads of international organizations. That's really the type of person that we're looking at here.

And Geoff what roles and functions do high level commission serve?

So the key point in understanding the rules these commissions play and how they really work is that the commissioners themselves have no formal authority. These commissions are not issuing grants. They're not implementing their own projects. Really what they're doing is working through communications and advocacy, to convince other people how to act. In the report we go through several different ways that commission have functioned.

This role we see is that they focus on promoting normative change - really trying to change how policy makers and the public think about important transnational challenges. They also generate and sympathize new knowledge. This is bringing new research to bear on the questions and right synthesizing what else has been done by academic experts. The third function we look at is catalyzing political action through short-term focus on how to convince policy makers and other people who have political power in these arenas that they need to take action on certain challenges. Fourth, they also facilitate coordination among actors. And then finally, all of these commissions can serve as a test run for international negotiation. In a commission, you'll a lot of the politics in a less high stress, less high stakes manner that can then inform subsequent formal international negotiation.

Sarah, back to the point that you made when you let off this conversation, is it fair to say that given that agriculture development is not having as much impact as a needs to, if SDG2 is going to be accomplished, that the only way to do this is to get people at the very highest levels together in order to create visibility and impact ultimately, do you think that's fair to say?

Well, I think that was one idea, and there's clearly many levers that you can try to pull. Certainly there's an attempt to try to have more bottom up inclusive approaches to fixing problems now. But I think the idea was let's try this as another tool in the toolkit and see what could potentially happen. And that was the idea behind Brookings and Duke coming together to try to investigate.

Geoff, I'd like to also hear your thoughts on how these commissions have impact. And can you give an example of a commission say that was successful, maybe one that wasn't so successful?

So that's a real tough question. One we kind of grappled with a lot at work, because tracing the impact of these commissions is difficult. It's hard to know how the world would have looked differently if these commissions didn't exist. One thing that we found is that for a lot of commissions, there's not huge evidence of impact at all. Commissions involving quite high level people come and go, and don't really leave much evidence in media mentions and citations in policy and academic literature. A lot of commissions seem to be quickly forgotten after they wrap up. In some ways, this reflects with one of our interviews head of this project told us, which is that a high level commission is what you want to do when you want to look like you're doing something, but don't actually want to do something.

For a lot of these commissions, what we found is that they didn't necessarily have a real, clear theory of change for how they're going to have an impact. Some of them were more successful, and some were very successful. So I think Sarah already mentioned one that was very successful was the Commission for Investing in Health. That's the only one. It is a very interesting case. Probably the most famous one of the most successful commission ever is the Brundtland Commission, which was a commission back in the 1980s, organized to the UN that really defined and popularized the concept of Sustainable Development. And so it’s this idea that now just completely permeates international development landscape.

Commissions that were maybe less successful are those that face real challenges. It's often because they didn't have a clear political strategy from the get-go. We looked at the report from the Aspen Food Security and Strategy Group as a useful discussion forum. A lot to participants found it useful in that sense, but they never really had a clear strategy for how they're going to take the discussion that they're having within that commission to a broader political and public audience. And that's where we see a lot of commissions fall short.

So after all the research that went into this report, is it possible to know, is there a recipe for success and what can help make a commission successful in the long run?

There's definitely not a perfect recipe because there will always be things like world events and timing creating impact. And so you could have all the recipe correct and it's good, and you could still get thrown off. But there are some things you can do to increase your chances of a commission being successful.

Geoff mentioned one of them was just starting with a clear mandate and problem statement. And that sounds like a no-brainer, but there were certainly some commissions we saw that when it's not clear - you just actually spend the majority of the time agreeing on the problem statement instead of doing the work. And then also making sure that it is demand driven - that people actually really see a need for the commission and it's not just three people behind closed doors deciding that this would be a great idea.

Beyond that, it really hinges on the identity of the chairperson. You could have more than one, but they are really this kind of gravitational force that attracts other members to join. Who you invite really should be your theory of change as well who serves on the panel, because they're going to be your best ambassadors. You really want to hink of those individuals as representing networks of people to try to increase their reach. And then certainly you need adequate funding because you're going to need people to travel and you need, since these are often very people that are on the commission, you're going to need staff to support them and do some of the research.

And then beyond that things just like clear deadlines, benchmarks, in-person meetings to do some of that relationship building and get people's attention focused. Although that's a little harder now in a zoom only pandemic world. But then also getting buy-in from relevant stakeholders throughout. We definitely saw some examples where that didn't happen. Like the World Commission on Dams, for example. Initially they involve developing countries like China and India, but then as the work progressed, those countries weren't really pleased with the direction. Then they backed out and it wound up being a very sort of NGO and civil society-led process. And so they didn't really have a good process for managing internal dispute. Then ultimately two countries that were super critical to making change didn't pay attention to the commission's recommendations. So the internal politics piece and having processes for getting through that is pretty critical.

You also really need to say something new and we heard a lot, nobody wants another review of the evidence. You’ve got to say something clear and bold and different. And then lastly, there's a great quote by Gro Harlem Brundtland who said, "A good report is not the end, but the beginning." A lot of these commissions put together recommendations in a report and then leave it there, but the impact is better achieved if you really have a long follow up period. And like Geoff mentioned again, the Atlantic Commission on Investing in Health, they planned two years of follow-up. So lots of communication strategy, hosting events all over the world. There's definitely a number of things you can do to make it more successful.

Sarah, some of the things you just mentioned that would be pertinent to commissions of any sort. So let's talk a little more specifically about what a commission could do to help catalyze action in the food and agriculture space. So what are your thoughts on that?

Well, there are definitely some cautions. There are a large number of actors in the space. We're also moving into a time, like I said, where people are demanding more bottom up and inclusive approaches rather than ones that could be perceived as really top down and elite. We're trying to think more holistically about development agendas. There's definitely a danger of biting off too much, but keeping all of these in mind, we ultimately decided based on our research and our interviews, that if you did it properly, a commission actually really could be helpful. And we came up with a couple ideas. One is that there's a UN Food System Summit planned for 2021 and really was all the other events being canceled for the foreseeable future because of the pandemic. It's kind of the go-to event for food systems and a huge moment for focusing energy and attention. The summit really is going to try to drive a change in the discourse, but also really get political commitments from countries. They've already developed a group of champions that are individuals who represent large networks, but we really think launching some kind of commission in tangent with this and coordinating closely with them could really help to forward the Summit's outcomes.

Another option would just be proposing reforms to the institutional setup for food security and agriculture internationally. It's kind of a high risk high reward proposal because it would really be a massive lift and you'd need to have buy-in from the UN Secretary General and some other powerful government. But so much of what we hear in the food and Ag space is how fragmented it is, how there's so many overlapping mandates of different agencies and the financing needs to be better targeted and coordinated like the World Food Program, starting to do more development oriented work instead of just emergency relief. And that's really the role of some of the other roam based agencies traditionally. We kind of need a step back and an examination of who's doing what and how to better specialize amongst those groups. And a lot of those groups were launched around emergency events. The massive shifts in the world that we're seeing through COVID may actually open people up to thinking differently about how those institutions are structured.

Finally we think a more narrow focus on a Sustainable Development Goal Two at a global level could be helpful. Some sort of specific topic with a defined problem statement and theory of change could maybe produce some traction. Two ideas that came up for us were a focus on food security and conflict, especially since some of the latest FAO reports show that conflict is one of the key drivers of food security globally. The other one would be making a political case for increased investment in agriculture.

Bios:

Geoffrey Gertz is a Fellow in the Global Economy and Development Program at the Brookings Institution and a Research Associate at the Global Economic Governance Programme in Oxford. His research focuses on international political economy, including the politics of trade and foreign investment, geoeconomic competition, investor-state dispute settlement (ISDS), commercial diplomacy, and private sector development in fragile states. He earned an MPhil and DPhil in International Relations from the University of Oxford, and a BA in Economics from DePauw University.

Sarah Zoubek oversees the execution of the WFPC’s strategic plan and daily operations, including managing the global portfolio of projects. Sarah is an experienced research analyst, project manager, and strategy consultant whose work has concentrated on food production value chains and producer incentives for sustainable business practices. Her previous work includes identifying potential levers to aid adoption of sustainable practices within the Iowa corn and Brazilian beef value chains, designing economic case studies featuring Midwestern producers who successfully employ soil health practices, and aiding the launch of a nationwide soil health campaign. She earned a Master of Environmental Management degree at Duke University’s Nicholas School of the Environment in 2013. Prior to her graduate studies, Sarah worked at New York Sun Works (NYSW), a non-profit organization that teaches environmental science through the lens of sustainable food production. She also holds a BA in English from Yale University.

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Five times more US children are food insecure now than before the COVID-19 pandemic.

This podcast is part of a series focused on the far-reaching impact of the COVID-19 pandemic on the food system. Today we’re looking at how responses to the pandemic have affected food availability and nutrition for one of America’s most vulnerable populations – young children. Joining me is Eleni Towns, the Associate Director of the No Kid Hungry Campaign at Share Our Strength.

Interview Summary

Eleni, before we dive into questions about COVID-19 and children, could you help our listeners understand better the work of the No Kid Hungry Campaign overall?

Sure. The No Kid Hungry Campaign is a campaign of Share Our Strength, a national nonprofit. And we're working to ensure that kids in the country have the food they need. We do a lot of work through access to the federal nutrition programs because we know there's significant barriers between families and the programs that can help them. And we work to make sure they have access to the support they need so that they can have the nutrition and the health that they deserve. We believe that hunger is a solvable problem in America. So that's our guiding principle and mission of the campaign.

So COVID-19 is not just a health crisis, but it's really ripped a hole in the American economy. So what impacts that had on children?

Unfortunately, childhood hunger was a problem long before this crisis, but we've seen that exacerbated the need and also made it far more visible. You know, last year our country saw the lowest food insecurity rate since before the Great Recession. And then the pandemic hit and really undid a decade's worth of progress in child food insecurity. And the scale of that change is astronomical. Previous numbers from a few months ago showed that as many as 14 million children in the U.S. are missing meals and not getting enough to eat. That's five times higher than the numbers reported this time last year. So numbers are continuing to come in, but we know that this is still a crisis today. We also know that this is a problem that won't easily go away on its own. As communities open and then close back again, as industries face the long-standing impacts of this economic crisis, we're seeing millions of lost jobs and lower wages. We have families that are facing both poverty and hunger for the first time and having to navigate the federal nutrition programs and support systems. And then we're also seeing those families that were already facing poverty and food insecurity fall into greater hardship and even farther behind.

Five times the rates of food insecurity - and that's just taken place in less than a year - is really a pretty striking number. So of course with the economy in such tough shape and given the numbers that you just talked about, many families are having a very tough time affording food, and of course food banks are there to help, but are there other programs that can be helpful as well?

Yes, even in this crisis, we still believe childhood hunger is a solvable problem, and that's because we can leverage this federal safety net and support system to help families and kids get the nutrition that they need. We think of the federal response more of a sort of network of supports that can meet different needs of a family depending on their dynamic, and can really ensure that no kid, no individual, slips through the cracks. I think of two programs I'd love to mention because they're so critical in this response is SNAP and P-EBT. They both are great examples of how the programs work together effectively. As you may know, SNAP is the Nutritional Assistance Program and it provides families with the grocery benefit they can use to purchase food for themselves or their families. Pandemic EBT was developed in response to this crisis to provide a benefit to replace some of the meals children would have received from school, like their breakfast or lunch program if they were in school. So the programs work together to provide families that blended support that is needed. School meals is another critical resource for families during this crisis. These programs work together to support households depending on their makeup and the needs that they've been facing during this hard times.

And does it go without saying that additional support for these programs is very important?

Yes, it's really critical. The need isn't going away. As we get further along in this crisis, food insecurity rates are not decreasing and in some places only increasing, and to the scale that I said before really requires a federal response. So we have been advocating for additional benefits for the SNAP program. We advocated successfully for the continuation of the Pandemic EBT program. And so really thrilled to see that extension through the end of this school year.

If you could say there's one thing that you wish more people knew about the issue of hunger in the U.S. what would that be?

I wish especially that our political leaders and local decision makers understood that food insecurity is more than a single instance of feeling hunger, right? We've all felt hunger in our lives. We know that sensation, it's not an enjoyable one. And we know some of those impacts it can have on our day to day. But food insecurity is a much more lasting and harmful situation. And research really backs that up, especially among kids. Those that face insecurity can have long-term impact. Kid has trouble learning, paying attention in school. Insecurity and worry about where your next meal can come from can have emotional and traumatic instances for a kid about their feelings of safety and security. And we know from our health experts, that food insecurity is associated with poor health outcomes that exists not only in childhood, but beyond. Food insecurity is an immediate problem, but it's one that if we don't solve can have long lasting impacts.

Let's speak a moment about school meals. You know, it's such an important resource for kids in need, but with so many schools now going to virtual or hybrid schedules, how are kids getting these meals?

School meals are incredibly important. They always have been. It's been a key piece of our work here at the No Kid Hungry Campaign, and with the increased need and the uncertainty that the school year has brought, we think it's more important than ever. It's been a real challenge, and I think the school districts and the new school nutrition departments that have been running these programs in new ways since school's closed in March, are the unsung heroes of this pandemic. They have done phenomenal work working through a health and an economic crisis to meet families with the meals that they need. And they face a lot of challenges this fall as school has returned.

We know that school meals are important for kids to learn, and so that's important whether they're in the building or if they're learning remotely. And so many school districts have these hybrid or these complicated models of some kids being in school at different hours, different days, some being at home. And so that's really required school districts to come up with innovative solutions, which often requires more staff time, different technology, transportation systems. School districts are offering grab and go meals for families to drive by and pick up. They are developing really robust transportation systems using their busing to work in reverse and send to meals from the school out to communities for families. So much of school meal programming is focused around a cafeteria, which in many schools does not align with social distancing needs. School nutrition departments have had to get really creative and thoughtful about how do you take meals outside of the cafeteria? How do you serve meals in the classroom? How do you make sure you have the labor and the food safety concerns in mind when you bring meals outside of the cafeteria and deliver into the classroom? So a lot of changing dynamics, a lot of additional barriers and challenges for them, but they're doing phenomenal work to reach those kids.

Are there other things that No Kid Hungry is doing to make sure that kids are fed?

Yes, I think the school meals, as I mentioned, is a key piece of the response. Also charitable support is critical. Since March, we have granted to over 1,200 organizations to help with their response. We distributed 32 million in funding that went to schools, to food banks, to other community-based organizations. And we're actually going to be providing an additional 29 million before the end of the school year. And really the granting system is to help schools or community organizations buy the equipment that they need, the safety resources, the transportation, whatever is needed to really make sure they keep their staff and the communities they are aiming to serve healthy and meeting them where they're at. But in addition to funds, we're working across the whole spectrum of the federal response. So how can we both advocate for federal programs and the changes that might be needed during this time, as well as provide technical assistance to providers so that they can do everything in their power in this changing dynamic to support their communities. So we engage elected officials about what they can do to support families facing food insecurity, raising awareness among the public about the problem and the need to take action, getting information and resources out to families so they know where they can get the support that they need. It's a critical problem, it's all hands on deck.

All the work is going on with policies and practices at the federal and local levels is really very impressive. Let me ask about next steps. So what do you think are the best next steps that the nation can take to better safeguard children against hunger and malnutrition?

For all of us, I think there's a piece about raising awareness. We often don't think of hunger as an issue in America because we have such plenty here, but in terms of the federal response, what we've been really working towards and support moving forward is making sure we have robust programs. So I've mentioned the SNAP program is a really critical response, but we believe more benefits are needed for families during this time. So in urging Congress to take action, to support an additional stimulus bill so that families have the benefits and resources they need, as well as other key programs, the WIC program, we talked about school meals, really making sure that these systems are able to expand in a moment of crisis, which we are in, is critical.

Bio:

Eleni Towns is an Associate Director of the No Kid Hungry Campaign at Share Our Strength. The campaign was launched in 2010 and aims to end child hunger by increasing participation in federal nutrition programs. In this capacity, Eleni manages a portfolio on No Kid Hungry state campaigns and has most recently led the organization’s work in Georgia, Tennessee, Ohio, Alabama, and Pennsylvania, working with state agencies, school districts, and nonprofit partners. Prior to Share Our Strength, Eleni has worked as a policy analyst at Feeding America and Center for American Progress.

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This is a fourth podcast in a five-part series focused on equitable food-oriented development. This is a growing movement to promote food projects and enterprises as vehicles for building community wealth, health, and self-determination. With us today are two leaders in this movement, and it is my pleasure to welcome urban planner Rudy Espinoza, the executive director of Inclusive Action for the City in Los Angeles, and community activist and organizer Camryn Smith, the founding member of Communities in Partnership, a grassroots organization in Old East Durham, North Carolina.

Interview Summary

So the EFOD movement as it's called is a systemic approach to wealth building through community projects, and both of you, I know can help explain how capital access and redistribution in low-income communities can build strong, vital and sustainable neighborhoods. So let me ask you both, why does EFOD place such importance on community-led funding, and why is this necessary? And Rudy, why don't we begin with you?

It's a good question. I think that the organizations that have been involved in the development of this field of practice, equitable food-oriented development, came together because they realized that the work that they were doing on the ground in their communities across the country was unique because they weren't simply underwriting loans for new restaurants or food projects. They weren't simply delivering food to people that were hungry. They were approaching their work in a different way. That way was really manifested in their pursuit of building power in changing the systems that kept capital away from their communities. The beginning of EFOD was really these people, these organizations, these leaders coming together to say – hey, you know the way that we're approaching this work is a little bit different. We are recognizing inequality and inequities in our system. We're recognizing that the systems that govern our society need to be transformed. And we want to not only talk about these things, Kelly, we want to practice them. And we want to really demonstrate that in order for us to really build power, and to build wealth in our communities, we need a different structure to build our businesses and to build our communities.

Rudy, you used the word power several times. Can you explain more about how that term is important in this context?

In the communities that we work with, certainly here in Los Angeles, we see black and brown people have about 1% of the wealth that their white counterparts have. And to us, that is a result of intentional design in our systems that has kept capital away from people. When you keep capital away from people, you also keep power away from them. So when I think about power, I also think about resources and making sure people have the resources so they can really exhibit the power that they have.

Camryn, it's nice to talk to you again, and I want you to know how much I admire the work that you're doing in Durham. It's nice to be neighbors. much of your work focuses on addressing policy and systemic inequality for communities of color and materially poor people here in Durham. How does EFOD create community wealth, and can you give us some examples of your work in this area?

Thank you, Kelly. I'm glad to be neighbors as well. Our work is primarily rooted in helping build capacity and also using the tools and the resources that we have to figure out what our community needs. This is being led by people who have been directly impacted by institutional systemic racism. And as Rudy said, a lot of these systems, especially in urban communities in city-centered neighborhoods, there has been intentional divestment that was predicated on the racial makeup of communities. And the divestment that followed brought about unfortunate circumstances for a lot of folks that were directly impacted for multiple generations.

So we believe that community wealth can be recreated again, especially for black and brown communities. We do have histories of when we were not only surviving, but also thriving and our outcomes were far better than they are currently now, even with all the education and some of the technology we have been afforded, We still have worse outcomes in Durham than we did during Jim Crow, and even further back in our history. We believe that the people most directly impacted have their own humanity and their ability to be brilliant, and to be resilient. But we also understand that we need to be given the access to capital, the access to technical resources, and to administrative supports that oftentimes middle class and upper middle class communities and organizations take for granted. It puts a constraint on our community to be able to rebuild and move forward.

We believe that those are the strongest ways for us to rebuild ourselves. We take a multi-pronged approach. We have a food co-op that was created by people that have been directly impacted in terms of their food insecurity. This was a group of people in our community who work minimum wage jobs and oftentimes two and three minimum wage jobs to make ends meet. And who were suffering from consistent food insecurity, had very highly negative health outcomes. As a result of that, we came together, decided that we wanted to create a food co-op with a sole purpose of building capacity, building leadership within the people that are actually running the food co-op.

Now we've had to kick it into what we call is ‘charity mode’ so to speak, because people have had the rug pulled out from under them again in terms of economic stability, which is actually dwindling in Durham. We have had to supply food for people who have been directly impacted. At the same time, we as a team came together and said we are highly vulnerable because we do not own our own food system. We don't own our own land. We don't grow our own food. We don't transport that food back and forth, and how can we, as black and brown people who live in a city-center urban context, connect with food systems because who owns the food systems is able to dictate health outcomes in their own community.

We've kicked it into gear and are formulating a strategy to partner with black and brown farmers, which we have been doing. We have increased purchasing from them for our co-op over 70% since the COVID-19 pandemic. And so we're trying to build a system where we get to know the people that are in the rural context—that we belong to them, and they belong to us. How can we create a system where we're actually funneling resources, we're purchasing our fresh and local food from them?

Young people are wanting to know how food is grown, so now we're interfacing our young people with the farmers so they can actually learn how to connect with the land. So oftentimes people in the city, the connection to land, what we know is oppression. We've been able to decolonize that narrative for ourselves and for our people and actually reintroduce to a whole other generation what it means to be connected to the land. What it means to own your own land and grow your own food and create a system that you can take care of your people and yourselves.

Thanks, Camryn. Well, what great examples of what can be accomplished with ingenuity and passion and caring. Rudy, you've done some very inspiring work as well in Los Angeles, and I know that in your work, you've developed a revolving loan fund that supports small and otherwise unbankable food businesses that are owned by people of color. How is EFOD creating community welfare?

You know, Kelly, I don't think that EFOD in and of itself creates community wealth. I think that the idea of this field of practices is developing systems that facilitate people building their own wealth. That's really the energy that we put into the design of some of the initiatives that we worked on in the last few years. It is about us facilitating the leadership and the ideas that already exist in our communities.

I work at an organization called Inclusive Action here in Los Angeles, and we do policy advocacy because we believe that the systems that we currently have are not serving us. And so we need to advocate to change those. We also do a second thing, which is administer economic development programs because we believe that cash is everything around us, and we really need to think about how money moves in neighborhoods and how it helps or harms people.

One of the projects that I have been really privileged to have worked on over the last 10 years has been the effort to legalize street vending in Los Angeles. Over 10 years ago, we began doing some research, talking to entrepreneurs that were building businesses on the sidewalk, and one of the key things that they said was, hey, you know, we're doing this because our day jobs are not enough to take care of our families, but what's happening is we're criminalized. We're getting citations, we're getting our equipment confiscated, and we're getting misdemeanor penalties. What we recognize was that L.A. was one of the only major cities in the country that didn't have a permit system for sidewalk vending. So we worked for years to legalize street vending. We were successful with our coalition in doing that in 2018, and we're still very much involved in the implementation of that policy, but it out of that policy came the economic development intervention. We were hearing from vendors themselves saying, ‘hey, we're working really hard to legalize street vending, but Rudy, this is not enough.’ We have to think about capital because if we legalize street vending, who's going give us a loan to buy the cart that we need, who is going look at us and think that we are worthy of taking on some debt and that we could pay it back. We saw that they were right and we began to work with them to develop a microloan fund that was specifically designed to underwrite loans, to entrepreneurs like street vendors, folks that perhaps were undocumented or, you know, have never formalized their businesses and got their licenses or done their taxes.

And we realize that despite the absence of those traditional measures, that they can take on debt and they can build businesses, and so we built this loan fund. We've deployed a little over half a million dollars in micro loans, the average micro loan is about $8,000. In addition to the capital, we also provide business coaching to each entrepreneur, and it is customized, and it is one on one tailored business coaching because we realize they need support, and it's a little bit different than everybody else. To us, this is equity in practice, and I think that that is why we were excited to be part of developing EFOD because we saw that it is not simply about churning out new loans, it is about meeting entrepreneurs where they are. It is not about them meeting us where we are, it is the other way around, and that's what EFOD talks about. EFOD is really about community-centered approaches to capital into economic development.

You're also working with other community organizations to create a commercial real estate trust. How was EFOD creating community wealth there?

We were hearing from small businesses, especially in neighborhoods that are changing in L.A. Many big cities in the country are facing gentrification issues and displacement issues, and we recognize that a lot of our mom-and-pop small businesses didn't have leases. They were in these spaces for many years and they were on month-to-month leases and their neighborhoods were changing, and without rent control and tenant protections for small businesses, they can be displaced immediately. As soon as somebody else comes and says, hey, I'll pay double the rent that you're paying, the landlord will likely take that deal. Camryn talked about this earlier, when she mentioned that we do not own our food system, which I thought was really moving and powerful. We also don't own the land and we don't own the buildings that we operate, and so the idea was how can we begin to acquire commercial real estate in neighborhoods that are changing? How do we take these buildings off the speculative market and put them in a place where they are protected, and they're driven by community members, and the businesses themselves have an opportunity to be part of the ownership group? In that spirit, Inclusive Action partnered with two other organizations in Los Angeles to establish this initiative called CORE, which stands for community-owned real estate. Last year we acquired five buildings on the east side of L.A., and the goal here is to take these buildings off the speculative market, cap the rents of the tenants there, sign them up for long-term leases, and to develop a system over time where they can join us in the ownership group.

Camryn, Rudy's done a very nice job of talking about some of the barriers for people getting capital to do their work. Is there anything that you would like to add to that from your perspective in Durham?

Yes. Because of COVID, we have fundraised for our Thriving Community Fund, which is geared at entrepreneurs of color. Specifically those who have had a difficult time accessing capital for multiple reasons. Part of the reason or the impetus for this is because we have seen over and over again the cycling of certain people who have access to capital. It disproportionately is going towards white-founding business owners.

But every once in a while someone who receives it is a people of color—one of my co-founders calls it the pipeline baby syndrome. She says that she's a part of that phenomenon of people who their parents have been able to give them access to the right educational systems, such as graduating from Duke or Kenan-Flagler at UNC. A person who now has access to some of those social networks, although not on the same level as their white counterparts. But oftentimes they're held up as a model of what it is to be successful.

In the entrepreneurship ecosystem in Durham, those are the types of people of color who receive access to the funding, to the technical support, to space. These people become well-connected, they're introduced into certain social networks and business networks that can actually propel your business and make it more sustainable. And what we're saying is we want to bust the pipeline. We don't think it should be predicated upon class, and who you have access to, and what school you were able to go to, or what school you were not able to go to. We believe it needs to be predicated on one's ability to manage a business. It be able to understand the systems as they are in place, and to be able to support and love and use their business as a part of a nurturing system in their own community. For the benefit of everyone, not just for the wealth-building strategy of one individual only. And so we like to think of it, while people are building individual wealth, because it's a both/and from our perspective, we also like to look at it as building collective wealth as well. CIP, along with four other organizations and faculty members at NCCU have been working to formulate this strategy and we'll keep you posted as we progress moving forward.

What you're both saying is so powerful and what I'm hearing is power in ideas and principles. And I'm hoping each of you might give a few more examples of the type of businesses that people are opening in communities and Camryn, you mentioned that food co-op previously, but what are some of the other things that people are doing related to food and economic development?

Durham is been dubbed the foodiest city in the South for quite some time, which has brought a lot of well-deserved attention, I think. But it has also created a lot of the disparity. A lot of African American businesses that traditionally we had, 40 and 50 years ago that were a staple in our community, over this past 20 to 30 years have disappeared since. So I think there's a re-emerging of black entrepreneurship where people are trying to start the same mom-and-pop-type corner store businesses. They're trying to start catering companies. We have more and more African American folks who have been trained in culinary arts, and so they're coming out with their own types of fusions, folks also that are creating their own products to have value-added products on store shelves. We've seen people come up with their own farmers' market systems, CSA boxes, trying to actually connect farmers out in the rural counties. Specifically targeting buyers of color to try to heighten their awareness on the responsibility that we have to buy black and brown. And now we have cooperative collaborations that've come about with groups of black and brown women entrepreneurs who are coming together to try to not only build their own individual businesses up, but bringing in farmers, people that know how to do the value-added food systems, people who want to produce and sell baked goods, and things of that nature. They're trying to build a collaborative. There's a lot of brilliance bubbling up in the midst of all this uncertainty, so it's really great to see

Thank you, and Rudy, can you give us some more examples of things in Los Angeles?

Yeah, the stories and the examples that Camryn just shared with us—she used the word brilliance, and I think that that's really what our systems should be designed to do. To highlight the brilliance that already exists. There isn't anything special that we're doing necessarily. We're not building the businesses ourselves. We're just facilitating brilliance that already exists.

Our loan fund and the work that we've been doing, we work with a variety of different businesses. I'll share one story that comes to mind because EFOD focuses on food. A couple years ago, there was a client that came to us, and he was a street vendor. He was selling tacos at farmers' markets, and he was doing that for many, many years. He came to us because he was seeking a loan to move into a brick-and-mortar restaurant. He had identified an opportunity to do that, but he needed the capital and he was struggling to find the capital in traditional places. The story behind this is a couple actually, it's Ivan and Rafaela, and they've been married for a long time. We learned that they had a restaurant many years ago, and they basically diluted all their assets because one of their kids wanted to go to college. Because of immigration status at that time, they were going have to pay a ton of money, thousands of dollars to help their daughter who was accepted into a university to go to school. So they made the decision to essentially put everything behind their daughter to help her get to school. They did, she was able to graduate, and then she came back and they were basically trying to rebuild. They're like, okay, how do we get this done again? They were working out of the farmers' market. They were able to get a loan through us. We helped them get into this brick-and-mortar restaurant, and recently, Ivan came to make his monthly payment. He said, hey, I think there's an opportunity to buy the building that we operate in, and to me, I was just so inspired by this guy. This man works really hard. His wife is such a fierce leader in the family and they are totally building this. And it's like so inspiring to myself and to my team because we're simply just observing and facilitating resources for them, and they're doing everything. And I wonder how many more Ivan and Rafaelas exists in our neighborhoods that don't have the opportunity. Don't have the connections, and they have the same brilliance, to borrow Camryn's word. That's just one example that I'll share with you.

Bios

Rudy Espinoza is the Executive Director of Inclusive Action for the City and an urban planner with a passion for neighborhoods, entrepreneurism, and financial empowerment. He specializes in designing and managing place-based initiatives, identifying profitable investment opportunities in low-income communities, building private/nonprofit partnerships, and training the working poor to participate in the socio-economic revitalization of their neighborhoods. Rudy holds a Masters Degree in Urban Planning from UCLA and a B.S. in Business Administration.

Camryn Smith is a proud resident of Old East Durham and a community activist & organizer. She has been serving in place-based development work for over 18 years both stateside and abroad. Camryn is a founding member of Communities In Partnership, a grassroots community organizing and education group based in Old East Durham. As Executive Director, she oversees and assists in developing community-based education processes, community development, and implementation and organizing for addressing policy and systemic inequity for communities of color and materially poor peoples within Durham. Camryn’s focus centers around social determinants of health and the intersection of economic development, gentrification, displacement and housing, and food access/justice.

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This is the third podcast in a five part series, focused on equitable food oriented development. A growing movement to promote food projects and enterprises as vehicles for building community wealth, health and self-determination. With us today are two leaders in this movement. It is my pleasure to welcome Rashida Ferdinand, a fifth generation, lower ninth ward homeowner in New Orleans and an organizer of the Sankofa Community Development Corporation and Lorena Andrade, the executive director of La Mujera Obrera in El Paso, Texas.

Interview Summary

The EFOD movement is a systemic approach to wealth building through community projects that help lift up community identity, build on the power of community identity and sense of place. So first, let me ask you both: how does equitable food oriented development help create or strengthen the community identity and sense of place? Can you help our listeners understand why these things are so important? Rashida, how about if we start with you.

Community identity is what makes people feel comfortable and connected to the place where they live, where they work or where they raised their families, have lineage and longevity and sustainability. It is important that we address our work around people who live there and censoring the work around their needs. What EFOD has done is bring in the capital investment, resources and finances to support the ideas, thoughts that we have planning work that we are doing into development to meet the needs of the people who live in this space.

Thanks for the explanation. Lorena, what are your thoughts on this?

EFOD allows us to defend our community, to stay in our community and it also helps us be creative, develop and construct the community that we imagine. EFOD comes in different forums, it's not just one thing, one project. When we defend community and when we build community together, we cannot only just focus on one program, it has to do with food. It has to do with what our culture looks like. It is sharing of our knowledge, of our elders and of community members, taking care of our children with building restaurants, with music. We need to be able to carve out a little space to be creative and to build, but to do it together. And that also takes resources, collective labor and collective thought.

Thank you. You both painted a wonderful picture of what EFOD is meant to accomplish. Why don't we get a little more specific about what this looks like. Lorena, what sort of things are going on in your community?

Here in our neighborhood in El Paso, Texas, many of us have been pushed out of our countries, pushed out of other communities. We have been an immigrant community for several generations and we are a garment worker organization. We were one of the communities that was most impacted by the North American free trade agreement.

So one of the things that the workers had always wanted to develop are social enterprises. We have a daycare center. We also developed a restaurant. We have a community farm. We have a network of indigenous women's cooperatives that we help coordinate. And it's always thinking about how can we be creative in those economic projects? You know, how does this serve the community? How do we learn to work together in those?

We're in the neighborhood to see who's growing food. What is the knowledge of our elders? How do we share it together? We have festivals in the community where we exchange food. The women give workshops themselves. When we have music and when we have art, anything creative that the women want to share with each other. And, it's a way of having that community pride and also creating that sense of community and saying, hey, my community has the knowledge that we need to build a community that we would like to see. We're already building it together.

It's very important to believe that we can build this ourselves. Another area of work is called familias unidas, to fight against the school closures. Right on the border, there's a lot of sources of contamination through the diesel trucks, through the recycling facilities. And so we're also trying to push those out of our community as well. It's always kind of a two-part thing to defend against the contamination, the gentrification, the Penn defending for better education, but it's also the building and the creative and the celebration of who we are.

Well, what a wonderful picture you've painted of programs to address, things that might be hurting in the community like food insecurity and contamination and also celebration of things that are important to the community. So thank you, I appreciate that explanation. Rashida, can you give us some examples in New Orleans.

We live in a neighborhood that has been under-resourced for decades. It was once a thriving working and middle class neighborhood around the 1940s, ‘50s, and ‘60s. A place where you had the highest rate of black home ownership once in the country, actually. Many people who moved into this neighborhood came from rural areas and had vision to create a space for their families to live in and sustain themselves. There was just a lot of decimation from hurricane Betsy in 1965, the redlining, and movement of people from the neighborhood who could not afford their homes. Next is hurricane Katrina that has affected the neighborhood and it still hasn't fully recovered. We used to have more small businesses. Most of the homes in the area are properties that are blighted and caught up in many different types of legal binds—issues such as succession, taxes, or liens on the properties. Families own them but are no longer in a neighborhood. What it has created is a space where there is a lack of economic development. Resources that could drive people to live in a neighborhood, as well as an impetus for businesses to want to be in a neighborhood.

We try to address this through a community marketplace, through the lens of culture and art and food. So we had music, traditional, cultural programs, formers and craftsmen at crafts ladies. It was really a great gathering space and people were actually seeing each other who hadn't seen each other since they had to evacuate and weren't able to return home. Some people were not actually returning home to stay, they were just coming to try to check on what was remaining of their houses and property.

From that, monthly community marketplace, we evolved into projects that focused on health-centered development for sustainable use of land and what resulted are planning and pilot projects. We are beginning to implement a wetland park and reusing the beautiful spaces that were used for generations, where people use the natural areas and felt comfortable doing it. But that's been lost over generations where it hasn't been accessible to children and they're not growing up understanding the importance of that. So we are restoring land and its use in that way.

We are also trying to restore the access of fresh food as a normalcy in our neighborhood there. A lot of people grew up with the tradition of backyard gardening, and they brought from their rural routes into the lower ninth. Corner stores had fresh produce and what we have now are a lot of gas stations or outlets that sell more processed foods, more fried foods, foods that are heavy and salt and sugar. And it contributes to that high propensity of cardiovascular and chronic diseases that we have in our community. Lack of healthy access becomes a normalcy in a way and it really changes the approach to what we think what we should have. Children who grew up in this type of environment don't know what the past was or what they should have. They think this is a normal approach to living.

So what we're trying to do is just lift a scale and create resources that affirm that we can have something better. What makes us strong and able to build out a wetland park, 3,000 square foot wellness center with academic partners, business owners, community residents and stakeholders, where we'll have fresh food, we'll have a coffee shop. We'll also have health education classes, but it'll be a one concentrated area. What's really great about this, it's also going to be a part of my initiative to develop our boulevard, our avenue where there was once commercial spaces. It is investment of time and labor and working with community members to do some intentional planning. We are trying to be a space of leadership and stimulate growth by working with our municipal representatives and officials and just keep being that squeaky wheel. But we've been doing this for about 15 years and we are hoping that this is a time where we can see some really clear results and get some substantial resources to move this plan into implementation.

It's heartwarming to hear from both of you about the examples of things that are going on in your communities. And I can just imagine the vitality this helps build in the community and it must be wonderful to see it in action. One question I have is I imagine funding is probably not the easiest thing to obtain and you probably had to be pretty creative with that. So what are some ideas for other people that might be considering this? What are some things that have worked for you in order to raise money and put these projects into play? And Rashida, why don't we begin with you.

It's important to look at different approaches to fundraising. We started the work with small seed funding with a heavily volunteer-oriented approach. It was important to start that work and not just wait till we got the big funding because we know funders want to see that you have partners and other funders and support of what you're doing and you have models and best practices. Most of our funding over the course of our work has come from philanthropic sources. We do have some governmental funding from EPA, USDA and other groups. It took a lot of effort to start with a few grants that were maybe $1,500, $2,000. We had second jobs while we started this work. But what we have been able to do is create pilot projects, measure our results and our outcomes and approach major funders to expand the programmatic work. It was also important for us to be ready to either grow the program and expand it further or shift it to what the need was. We are building partnerships so that having these relationships with our municipal representatives, we can be included in long term, sustainable state and federal funds that trickle down to the local resources. We also are trying to sustain ourselves and our capacity through a donor base—because we have been just doing the work. We have not focused on donations directly from private supporters, but we now have a person who is more dedicated to that approach.

Thanks for that background. Lorena, what about in El Paso? How do you and your colleagues go about trying to generate funding?

It's a scramble sometimes, especially at the beginning. I mean, we're a group of displaced women workers from the garment factories and we want to develop all these economic projects. We did need a lot of assistance in helping us develop the plan. And then for the people that we were presenting the plans to believe that we were able and had the capacity to do this. It also is a difficult situation sometimes when we have a plan for our neighborhood and the powers that be, sometimes in the city, basically said, no, your neighborhood is not going to be funded in these ways. That's not worth investing in, in so many words. And so, there's that constant back and forth in negotiation with some of those things. We also almost have to cut and paste, piece together different sources of funding, so that our entire program can be designed the way that we would like.

For example, if we run our business and we're able to get, let's say workforce development funds at the beginning, we don't have those anymore. But how do we bring in resources in order to be able to develop the leadership within the programs for them to carry over the community, to contribute to the community, to work in the business more creatively. And sometimes when resources come in, they're just specifically to learn this or specifically for this purpose. And so, we have to be able to be creative within that space. Our funding comes from many different areas, especially nationally and we've gotten some support locally. But most of it has come from national funders and even the federal government, when we need the big money for the building infrastructure.

You both painted a picture of having to scramble, but have done it successfully. Like to come back to a topic that we've discussed a little bit and it's the issue of community ownership and why that is such an important part of this work and Lorena, let's begin with you.

So, what does ownership look like? You know, it could be that we own our homes, but it is also, we want to stay in this community. Almost like a communal kind of sense of space, right? We do not own every piece of land in our community, but we've lived here for generations. We contributed to it and we have a right to stay here. We have a right to form our relationships with the land, with each other here in this space, to not get pushed out, to not be forced to migrate again. Whether it is buying buildings physically and defending those spaces. It also looks like a space like in the park where we create a festival where we form our local school, defending that space and having a sense of ownership of that school. It belongs to our children and to the future generations, that type of thing. That is where the organizing comes in and that's where our economic work in our businesses, for example, our daycare center informs our organizing to defend our schools. And then the work of defending our schools informs how we work in our daycare centers and how we create community and what kind of environment and space we want to create for our children here in our daycare centers, the same with our restaurant. So that ownership is like money. We own this building and we own this space, but also sense of ownership, like I want to belong to this community, making a commitment to this land here.

Thank you, Lorena. So Rashida, what are your thoughts on that issue of community ownership?

I really believe that the work that we're doing, investments that we're making would continue. Even if I'm not sitting at this table doing the work or the staff members or even people who are volunteers, that it's a part of an institution. And it's an institution because the people who live in a neighborhood are invested and they're part of it and not just on the planning portion or the implementation, but they are the benefactors directly. And we know that there are things that people need to feel safe and secure. They need clean neighborhoods and safe neighborhoods, a healthy place to live and they need money. They need resources. They need to be able to pay their bills and take care of themselves and take care of their families. We envision that this work becomes a space where people see themselves as a part of it. That they do not see it as a, ‘they doing this for us’, but we are doing this all in this together. That there's a connection that the people who are a part of our community feel to the market, not just because it's there and it's a great place for them to shop or have coffee, but because they were a part of the building of it, they were invested in making it what it is today. They are the owners of the spaces, not just in a deed or the title, but because it would not be that way and exist, if it wasn't for them. It is important that the work that we do has some economic trickle down value to people. That there's some opportunities that people see from what we're growing in our gardens, the okra that we’re growing, the basil, even the flowers that we're growing becomes something that people may want to develop into a business for themselves and grow in their own backyard or use our community garden spaces or have land to do this. So we see that ownership also in system change and a way that people can actually access land to do more of this work if they so choose or grow their business, that's connected to some ideas or resources that we've already put into the community.

Thank you, so I'd like to end with one final question. Do you feel that EFOD can be a pathway to lasting an sustainable change? Rashida, let's begin with you.

I do believe that the energy and the thought partnership that is with the EFOD team is a place of equitable consideration for what we need in our communities. And it's also an approach to looking at the systems in which we're working, which are made to support vulnerable populations or under-resourced spaces or people who may have limitations and barriers to actually moving out of that cycle of poverty. The focus of EFOD on community leadership as the core of development is significant. I think the foundation of EFOD around collaboration and equity and honestly and authentically looking at how we live and what systems we are living in is significant, would be net sustainable community change.

Thank you and Lorena, what are your thoughts on that?

Well for us and the organizations that are a part of it, work cannot be imposed from the top down. It has to be created from the community, right? There's obviously leadership involved in that and work that needs to be done. We are integrated directly into the community. EFOD also allows for what that looks like in every community is different. There are some basic principles, but the way we go about being creative, the way our community looks and the way the community response is different and it allows for that creativity. It allows for those different strategies that emerged from the organizing of many years and in a certain community. That is why it allows for this long-term sustainability because sometimes when you do economic work, it can be so overwhelming. With the EFOD resources, the way we are imagining them, you would work on the economic, but it also allows you to creativity and the growing community and the organizing out in the neighborhood and defending against the gentrification, celebration and the art and the music and everything that comes along with building community. It will be sustainable at the long-term because the people themselves are participating in it.

Bios

Lorena Andrade

Lorena Andrade is Executive Director of La Mujer Obrera (LMO), a community- and women- led organization in El Paso, Texas. La Mujer Obrera was founded in 1981 as a garment workers organization. When factory jobs were lost due to NAFTA in 1994, community members began to develop their own economic alternatives. Today, they organize for a food system that is informed by ancestral traditions and by local practice. LMO advances food access work through its restaurant, community farm, daycare center, cultural festivals and Lummetik Trading Company.

Rashida Ferdinand

A fifth generation Lower 9th Ward homeowner, Rashida Ferdinand organized with community stakeholders in the Lower 9th Ward during 2008 to form Sankofa Community Development Corporation, with a commitment to providing resources that address social challenges related to urban revitalization, youth enrichment and education, health and wellness, and economic development. Sankofa CDC works with residents and other stakeholders to identify locally-felt social challenges and address them in thoughtful, culturally-competent ways. Sankofa's ultimate goal is to support the creation of a local environment that promotes positive health outcomes and builds healthier communities for generations to come.

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Food insecurity in children is a tragic issue around the world and in the US. In America, the issue is especially changing in rural areas. Rural faith communities often play a central role in addressing rural child hunger, and the support needs and desires of these organizations are nuanced by their faith tradition. This is the subject of a report done jointly by the Duke World Food Policy Center and the No Kid Hungry program of Share Our Strength. It is entitled, Rural Child Hunger and Faith Community Engagement. Joining us today are three experts on this issue. Emma Lietz Bilecky, the chief author of this report, received her graduate training at Duke University and is now Research Fellow with Princeton Theological Seminary’s Farminary project. Norman Wirzba and Robb Webb are some of the nation’s leading thinkers on issues of food and faith. Norman Wirzba a faculty member of the Duke Divinity School and has written some of the most influential texts on food and faith, and Robb Webb is Director of the Rural Church Division of The Duke Endowment and Chair of the Rural Life Committee of the North Carolina Council of Churches.

Download the report at: https://wfpc.sanford.duke.edu/reports/rural-child-hunger-faith-community-engagement

Interview Summary

Emma, let's jump right in and I'll ask you if you might provide a quick overview of the report. Let's take it as a given that rural child hunger is a very important problem and that faith institutions hold considerable promise in this context. What are some of the things you found in your research that might be especially promising?

Thank you, Kelly. Rural child hunger is obviously a really big problem, but it's a problem that's bigger than just access to food. There's a spiritual and a moral dimension to hunger that many religious traditions understand and can speak to. And when we're speaking about rural child hunger, we also need to pay attention to the context in which it exists within families, within communities and within rural food environments. This is often the motivation for the work of faith communities on this issue. Hunger also points to and encompasses bigger issues and systems which perpetuate inequality and injustice. Religious language can help us see this more clearly. The second overarching theme in the report is this movement from charity to justice. And this has a lot to do with the histories of food aid involving religious communities. It's so far haven't solved underlying problems. That doesn't mean that it's not important, but we're thinking about root causes. A lot of the experts we interviewed for this report spoke to that. So the report really focused on and identified justice-centered solutions, which tend to be community-led and defined. The report also talks about mindsets of scarcity versus abundance, which come to bear on this work. So just solutions really recognize abundance. They recognize the human, spiritual and shared resources that communities have already and are distinct from approaches that start by identifying what rural communities lack. And this relates to the final theme of the report, which is all about context and contextual analysis. Just solutions to rural child hunger are really contextually specific, meaning they might not look the same everywhere and they take into account a community's history, assets and unique challenges. This one can be difficult when anti-hunger efforts prioritize big impact and scaling up. But again, why it's important that just solutions be led by rural stakeholders.

Thanks for that overview. Robb, you've done such extensive work in faith communities and rural areas. Why are faith community so important in rural America, and how does food insecurity fit in here?

Kelly, thank you for the question and for this time. I also just want to give a plug for Emma's report, which I think is terrific. And she hit on a number of the reasons that I might use to answer this question. I think in rural communities, churches are anchor institutions. They are the place that remains. One thing I like to point out, at least in rural North Carolina is we've had school consolidation. And so in many communities, the school might not necessarily be local. We've had work consolidation where the meals may have left. Even those that farm may have to have a second job in order to make things happen. What's remained, and what's been at the center of the community, has been the church. And the church has a number of assets, many of them are picked up in the report. I want to emphasize resilience. I think rural communities, rural people in rural churches are incredibly resilient and creative, and that's an important asset. They also have a tremendous amount of available land. Buildings that can be put to use, kitchens and a volunteer-base that has local knowledge, energy, and is solution-oriented. I think what you have in churches is this unbelievable ability to mobilize, to address the deepest challenges and communities and rural child hunger is certainly among those.

Robb, thanks for that. Let me ask you one follow-up question. Given that you're in the world of philanthropy, what role do you see philanthropy's playing in this area and how can they be more active?

Our traditional role is as grant makers, and I think we have an expanded role. One, I think as conveners, we can take the good examples that are in this report and creative programs that are happening across the country and make those more well-known with the groups that we typically work with. We can convene and lift up projects. I also think we can think about the way in which we invest our money so that we're investing in ways that help families advance. So what I think philanthropy needs to do is ask the question, why are people hungry problem is bigger than access to food? I think we have a role in the way that we invest, in the way that we give and the way that we convene that can help begin to address challenges in rural child nutrition.

So Norman, one can think of faith communities as places where services and aid can be delivered, but you've written extensively that food and faith are connected in theological and spiritual ways. Can you explain?

Sure. I think what's really important to understand is that we're living in a fairly new time in the history of the world where food appears for many people as a commodity. And so the most important concern is whether we can get it as cheaply and conveniently as possible. And that's done a lot of good in the sense that it has provided a lot of calories, but I think it's also left people with an impoverished understanding of what food actually is. Because when you think about food from the perspective of some of the world's great religious traditions, or even the spiritual traditions of indigenous peoples, food registers primarily as a gift rather than as a commodity. And when you start to think about food as a gift, that opens up different ways for thinking about how we're going to grow food, how we're going to process and distribute food, but also how we're going to consume food. And so for me, one of the really important things is to engage some of these faith traditions or these traditional indigenous cultures to see what difference would it make if we thought about land, not simply in terms of how much yield we can derive from it, but also think about land from the perspective of how do we participate in this sense that food exists for the nurturing of people's lives. It exists for the purposes of building community. It exists for the purpose of helping people understand more deeply their place in a world with a bewildering array of creatures, whether those are plant or animal creatures, but also then how these faith traditions can be the places where by people can be inspired to think about growing food in different ways, but also sharing and distributing that food.

You've written about this in very powerful ways. Are there signs that thinking more about food and food systems is happening on the ground in faith communities?

I think so. And one of the reasons I think that is when I first started working on these kinds of themes, there would be a handful of people that I would consider allies or even people who took much interest in it. And what I have seen is that the interest has simply exploded. There's now a proliferation of books about this. There's a proliferation of leaders now in different faith organizations, institutions who are understanding that food ministries and by food ministry I mean something much more than simply a pantry or a soup kitchen, but actually getting people involved in food production, trying to form connections between institutions and producers, right? They're understanding something about how food and the way we eat can be a profound witness to what we value in life. And so rather than just being something like a boutique side item in the life of a faith tradition, food can actually become something much more central, perhaps even indispensable in certain contexts for living out what the values are of that faith tradition.

Norman, if you look at different religious traditions, which of course have profound differences in the way some things are viewed, are there common themes that weave through these traditions with respect to food and land?

Yes, I think that's certainly the case. And I think one of the general ways that we might describe it is to say that food is not simply a mundane reality. There's something sacred about it. And this is not just a sort of warm and fuzzy notion of sacred because most people from a historical point of view have understood that for anybody to eat, others have to die. And that means that the gift that we call food, that we consume is a really costly and precious gift. And so to affirm something about the sacred character of life, means that we should not presume to think that food can be taken without a sincere effort to be morally in right relationship with the land and with creatures. And most basically what that has meant is that you take care of the sources of food that nurture us, right? So that means you respect the life of animals and plants. You respect the integrity of fields and watersheds, and then you also respect the eaters of this food by not producing food that's going to make them ill. So it really becomes a way of affirming life as not just some sort of mechanical motion or eating as some sort of fueling operation, but to really think about eating and food production as ways of helping us understand life in a much richer, more profound, what I would call sacred sense, which is to say it's affirmed by the divine and should be also affirmed and nurtured by us.

Emma, one of the topics I'd like to ask you about this new thinking that's being done about the use of church-owned land. Can you explain some of what's been done on this issue and where things are going?

Sure, Kelly, I really love this idea and this work that seems to be happening more and more in rural faith context. Moving from thinking about access to food, to thinking about access to land for food production. And it really relates to this school charity to just this theme, specifically a community's capacity for self-determination and self-preservation, which comes out in a lot of recent work, both practical and academic. That really draws from this history of land dispossession, which has disproportionately hurt and affected communities of color and also disrupted cultural food systems like in indigenous communities. And land is the root of this inequality of this disconnection from food. A lot of people also have been saying for a while, this idea that land really is just the most important thing in determining a community's food future and food security. It's a bigger issue of access to the capacity of a food production, as well as economic, social and ecological health and resilience. So one example I can look up is that the Black Church Food Security Network, which is engaged in these kinds of asset-based community development projects. And while they've been working primarily in urban spaces, they're also starting to work more rural and thinking about church-owned land or food production, but also for reparations.

So Robb let's have you weigh in on this. I know that when we talk about church-owned land, there's the physical property the church happens to be on, but it's a bigger picture than that isn't it?

Yes, it can be. And the audit that I mentioned, what we found is that a number of people have donated land to a church or a church has purchased property. For example, in the half of North Carolina, from Greensboro to the Tennessee border, there are about 7,500 available acres just in the United Methodist Church. And that's from accumulation of parcels that have been donated, requested across time, or that that church has bought up. That then presents an incredible opportunity to begin to ask questions about what would it look like for first-time farmers or early farmers to give them a way in which to start their work. One of the ways that we've been thinking about this is... And this is a question, so I don't have an example, but the question is, Could you create a supply chain for a business that was food-oriented in a rural place? For example, the central kitchen model, which comes out of the Child and Adult Care Nutrition Program offers some reimbursement for low-income children when they're in a licensed childcare setting. Well, what if you could take a commercial kitchen in a church and build out along with all of this available land, a whole supply network. So you're putting people to work. You're creating some economic opportunities and you're preparing food that's fresh, local, nutrient-rich. I think that's the kind of creative thinking that we're looking for in churches. And that available land is out there, but it does require taking the time to do the audit. I think that's a challenge, but it's another way in which philanthropy can help churches begin to think about what they have, specifically that would be at the denominational level. So at the adjudicatory level. We've done it with Methodists. Others might want to look at other denominations to see what holdings are available.

So I'd like to ask each of you, what do you think are exciting and important developments around rural hunger and faith communities? Norman, let's begin with you.

Norman Wirzba: I think one of the very exciting things is that we're seeing a number of people first of all, who are coming into rural communities. I know that in many parts of the country and there will be regional variations we know that there's been an exodus of people out of rural communities moving towards urban. But we're also seeing that some places, people are moving back into rural communities and they're wanting to invest in communities. And the way they're doing that is often going to be through a rehabilitation of a local food economy. And it takes a variety of forms, right? On the one hand, it might be that you've got a proliferation of CSA's in the area and congregations are partnering with these farmers directly to not just provide food for congregations or for families, but it's also becoming a way then of connecting people to the sources of their food, by connecting them to the farmers. Sometimes people in these congregations will go work with the farmers. Or sometimes it'll take the form of more niche kinds of ventures. I'm thinking here about the form of a local brewery, local cideries, right? These become ways that local efforts around food often supported by faith, traditions or faith communities become ways to rebuild something like a community center. A sense that what you really have is not just a conglomeration of people living in their disparate houses, but are actually trying to come together and create a sense of fellow feeling. Because, as my students will often say is after they've been thinking about food for a while, they realize that food is really an expression of fellowship, right? It's a way of people knitting their lives into the lives of each other. And I think what we're seeing is that communities are trying to do more of that kind of work. And that's really exciting because that means that food and eating can be ways of community development. And this is a vastly different model than we might have thought about 10 or 20 years ago, where congregations might host a meal from time-to-time, or they might have a food pantry where they will give out food. But none of those were really about establishing relationships with many community members or just thinking about the betterment of the community as a whole. So I would say that's one of the real exciting things that I'm seeing happening in many parts of the country now.

Robb Webb: I think one of the most exciting changes is the change in orientation, the real desire to move to justice-oriented solutions. And what I see over and over again is churches who are engaging their community, who are asking the question behind the question and then are beginning to think about how to engage. So rather than simply moving to a distribution model, they are asking how to alleviate hunger right now in the distribution model, and then change the economic situation for people long-term through the food system. And I think that long-term will have an important impact on rural child hunger and hunger in general. I'm excited to see where this is going and it's built on a lot of good work that's gone before.

Emma Lietz-Bilecky: I think of two things. First, I'm really excited about the ways that I see all kinds of religious communities starting to engage with their traditions differently and reinterpret them for the purposes of health and justice. One example is Adrienne Krone writes about the Shmita year, the year where land is given rest. And this isn't a practice that Jewish communities have been practicing, but she asks could they be. So mining our traditions for these practices and these ideas that can be used in the present moment to solve the problems that are before us. And then the second thing, I really am excited about the ways that faith communities are drawing on principles of community organizing at many levels. And we talked about asset-based community development and that how churches are thinking about what resources they have available, but it's also about what resources are available in the wider community. A faith community might not have everything it needs to solve these really complex and embedded problems, but by joining with other organizations and institutions at many levels, some really cool things can happen. And that's what I see as pretty exciting in this work.

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This is the second podcast in a five-part series, focused on Equitable Food Oriented Development. EFOD as it's called, is a growing movement to promote food projects and enterprises as vehicles for building community wealth, health, and self-determination. With us today, are two leaders in this movement, and it is my pleasure to welcome, Neelam Sharma the Executive Director of Community Services Unlimited a nonprofit based in South Central, Los Angeles and Trisha Chakrabarti who manages EFOD work at the DAISA Enterprises. We will discuss a field scan of 80 organizations dedicated that EFOD principals and sample EFOD projects, to explore the lasting impact.

Interview Summary

Can you both help our listeners understand what makes a project EFOD or not? And why does it matter so much? Trisha let's begin with you.

What's unique about EFOD work, is that in addition to highlighting local, culturally appropriate foods, their health impacts, and the ability of a food system to sustain a local community and economy—these organizations are committed to community organizing. They prioritize and develop community leadership. They have a long history and connection in that place and in that community. And then they are building locally and people of color-owned economic opportunities in the food system. EFOD organizations are different from other projects that are pretty common in many of our communities like coffee shops, food halls, community gardens, school, nutrition programs, and emergency feeding programs. You can find more details about those five EFOD criteria, on the www.efod.org website.

Thanks Trisha. Neelam, what are your thoughts on this?

To just share by talking a little bit about the example I know. The best, which is the Paul Robeson Community Wellness Center, built by Community Services Unlimited in South Central LA. Before we thought about buying the building, we had an existing relationship within the broader community that building fans in, we had been working in the local schools, had partnerships with all the local organizations. We knew the owners from having been around and working in that neighborhood for so long. And we were very intent on promoting the history of the space. As we began to work on the budget to buy the space, we launched a community fundraising campaign. This wasn't just simply because we needed money, but also because of how we work. It's important to us that, the work that we do the community around it feels part of it. On this campaign, we raised the money, people donating $5, a dollar, $2, $20, $100. And it's that campaign that actually raised our down payment for the building.

We worked with a local person of color as the agent through whom we put the offering on the building. We worked with the previous owners, to secure a mortgage. And even before ownership house to us, we held our very first event on the lot, to learn what people wanted to see happen there. This grew into a fully-fledged research project to see deep into what did local community wanted to see happening. We put the word out. We were looking for an architect and somebody came forward who had worked with us for years, as a Korean drummer at our events, but she was also an architect. She began to design a participatory process. The community at large was able to give its input in a very creative way. And while all this was happening, we were holding monthly events, selling produce, hosting information tables about other organizations locally, carrying out alternative wellness demos with our partners.

We then do events to highlight the importance of the building, historically. We worked with a construction company, created and run by a person of color, who understood our desire to salvage as much as we could from the original building. And we were open and transparent at every single stage of the work. Once construction was finished, we had a huge event that showcase the work of all our partners and neighbors. And even when we opened our market on site, we intentionally did so with a limited inventory, seeking input from community members, as they came in, as to what they wanted to see in the market. What we do have in the store is, purchased from small regional and local farmers, or purchased from businesses with whom we've had long-standing partnership. And who represent not just quality of product, but also really care about the overall impact of what they do on the planet.

We have always done and we continue to hire locally and train locally. And as we have begun to develop programming at the center, we seek local partners to bring and to implement those things that community members have let us know they want to see.

Now, none of this is easy, right? It would have been much, much simpler for us to not seek input, to not take the time, to build with people and to do all the research that we did over many years. But in the end, this is what an EFOD project looks like. We pay attention to every aspect and every detail of what we sell, and every single thing that we offer from that building. So that we are in fact desired and wanted by the community. And in a moment when gentrification is beginning to rear its head in that neighborhood, we have very clearly placed a flag in the dirt and said, "This is what development can look like." It doesn't have to be about displacing traditional long-term residents. They can bring people with it and it can remain affordable.

And now that we have the center, and we have the commercial kitchen, we're able to develop other programs to help other young entrepreneurs, begin food-based businesses, that will again bring even more value to that community.

Neelam, thanks so much. That's an incredible description of something that took great care, insight, wisdom, ingenuity, all of those things rolled into one in order to bring something so important to the community. So I appreciate that description. Trisha let's turn to you. We mentioned before that a field scan had identified over 80 organizations, whose work qualified as EFOD align, do you think there might still be more EFOD related projects out there?

The purpose of that field scan was to document, to better understand and define what that kind of work looks like throughout the country. How many organizations are using these kinds of principles in the way that they conduct their food systems work and how can we better connect and network these organizations as well.

During the course of this field scan, DAISA has analyzed over 800 organizations, that had received USDA grants, including the Community Food Projects grant, Food Insecurity Nutrition Incentive grants, and other programs. We looked at organizations that had attended conferences and summits that are hubs for equity and justice forward organizations. We looked at organizations that had received grants from some of the bigger foundation players in the food system space, as well as organizations that had received Healthy Food Financing Initiative grants from the federal government.

So in looking at those over 800 organizations, we came down to 88 that we qualified as EFOD aligned. We then did an in-depth exploration of those organizations, looking at community demographic indicators, looking at organizational metrics, their online presence. We did interviews with staff at those organizations and stakeholders and community development financing and policy throughout the country to further develop out the criteria. But also to get a sense of what they saw as the impact and the power of this kind of work happening throughout the country. We're still learning about new projects and organizations using an EFOD lens, through which they do their work, would love to bring them into the collaborative and network them with others.

Well, the scope of the work is impressive. And the number of organizations. Neelam, I'd like to ask you, how do you think the impact of EFOD work is unique and different from conventional things people do to work on food-oriented development?

This is an interesting question because it is precisely our struggles as practitioners with measurement and evaluation as these things currently exist. That was one of the things that initially brought us together. The EFOD work is by definition, committed to creating long-term and sustainable change that has multiple impacts. Very often EFOD projects themselves are multilayered. It is much more complicated and difficult to measure the impact of these types of projects.

For example, a traditional food-oriented project, might look like building a school garden. Now the particular project that I'm thinking of had some gardening experts from outside the community, build roughly 30 four-by-four boxes, that they are then filled with purchase soil from bags. They planted food in some of these with students at the school and did some lessons with students, using set lesson plans approved by not only the school, but by the school district, by the USDA and by the funder. So we're talking about things like, whatever at the time was the equivalent of the 5-A-Day Program, or harvest of the month. And then it comes time to do their reporting. And it's very easy for them to tick boxes and write numbers because essentially what they're reporting on are growing boxes builds, number of type of plants grown, students who participated in growing and took part in the lessons. It looks incredibly successful, but guess what? Two years after it started that project no longer exists, that school garden is not there.

I can also tell you that prior to that specific project, another growing project at that school site had been there for almost a decade. It began with a mini assessment to look at what students, parents of the students and teachers who taught at the school, wanted to see in the way of this type of project. Planting areas were built by students themselves with open volunteering sessions that involved parents and families. The garden areas created included a very lovely little apple orchard with hard to find varieties of about 30 apple trees and three roughly 20-by-40 plots of land, farmed with multiple crops year round. Classes where the teachers had opted themselves to work on these spaces with their students. The work was also done by an after school gardening club that students came to because they wanted to. Students were taken through every single task of growing food, then performed the actions involved. So the students tested and amended the soil. Designed and built a trellis for grapes. Researched plants and decided which ones to grow and which ones grow well together. And their current everyday experiences with food become an incredibly important part of their experience.

So for example, one early project with every class is photographing everything you eat and drink over four days, that we can then sit and look at, and have some laughs about, and analyze what eating and consuming that food and drink means. A very important part of the curriculum is cultural and is about family history, and cultural practices with food. Another activity is cultural food history. Students are asked, what is a favorite dish in your family? Who usually makes it? Where does the recipe come from? And they're asked to interview the person who usually makes this dish at home, and to work with them the next time that they make this dish and to write down the recipe. Very often, this is the first time the students have ever had a conversation with anyone in their home about cultural food histories or about this dish that all of them love. And they're finding out some incredibly interesting stories about their food ways.

The crops that the students grow are based on the emerging cultural food histories that the students are learning about and engaging in, and on native plants. So they're also then learning about native history. Students learn about how many of these foods are connected to the survival of their people historically. So it's not this dead learning that's imposed from institutions. By the time students have been with us for a year, they speak with deep pride about their family histories, about their cultural heritage, about their food pathway. Now, how do you measure that? How do you measure the multiple impacts of the fact that students became so involved in this, this work that they were doing? That all their families were excited about it, the parents would be coming and shopping at our local produce stands. They were also getting involved in our earth day, South LA event. Their older children would apply to our youth internship program.

We really, as an EFOD collaborative are beginning to delve into what can measurement and evaluation look like to imagine how we measure our impact into the future.

I'm imagining that in the context of this EFOD work, that finding ways to support emerging leaders in organizations will be especially important. Trisha is the EFOD collaborative attending to this issue?

The collaborative has really been built by the members of the steering committee. And when we were doing research, we found that there was a real need amongst EFOD organizations, for both a peer learning space where they could network with other organizations that had the same commitment to equity and justice that they did. But also learn from the experience of more established EFOD organizations, who maybe have had success in working with local officials to zone their projects correctly, or had developed rigorous business plans, had gone through lending processes with local lenders or CDFIs in their area. So we want to create the collaborative as a space, both for that peer-to-peer community building, but also for providing technical support to more emerging EFOD organizations. We really want to specify that the best TA providers are those EFOD leaders and organizations that have gone through this process already. They already know what more emerging organizations are going to be experiencing and will be facing and can really provide the rigorous, expert and contextual support that more emerging organizations will need. We really hope to build that kind of a network within the collaborative. Of course, the collaborative is also doing other things around our continuing field building work. In addition to supporting EFOD organizations, we are really hoping to influence change within the philanthropic space, within the investment and Community Development Finance space. We really are building our field as a way of promoting change within those two sets of organizations as well.

Well, I could see this being one of the most important impacts, in terms of supporting new people and then come and take the flag and carry it forward. So thanks for that description Trisha. But Neelam, I'd like to end with one final question. What are your thoughts on how institutions like funders or city governments or university researchers—how can such people and institutions support the work that EFOD represents?

First of all, we should talk about the context of this moment that we're in.That it's kind of no accident that EFOD is also emerging at this time where we've got this general shift. We're delving deep into building on historical movements that have challenged structural racism and the barriers that it wrecks to prevent the equitable kind of development of our communities. And so similarly EFOD builds upon decades and decades of hard on the ground work that has been challenging the accepted ways of doing things. That has challenged so many racially motivated assumptions about why some communities have access to good food and others don't, Taken away that sort of blaming. When I first became active in the Food Justice Movement in the US, there was this very real sense where it was a generalized belief that poor oppressed communities had less access to good food because that's what they wanted. So there's been incredible shift already. And at its core, the work that we're doing is about continuing to dismantle brick by brick, the systemic embedded walls, that have been built over hundreds of years of racist ideology.

And that's not easy. So I would say in terms of how folks can help us do this, we want this to be beyond surface changes or beyond just changes of language. We want this to be about real shifts in power dynamic. What we're saying is that as practitioners with decades of experience and having actually built this on the ground work, that we are the ones who are the experts. We are the ones who know how to do this work, who know how to do it in ways that are relevant in communities, who know how to do it in ways that leave behind real resources and long-term brick and mortar facilities in communities that will continue to serve for decades to come.

We've seen in the Food Justice Movement, so many millions and millions of dollars being spent on projects that come and go and leave nothing behind. What we want to do is remove all the redlining, the legalized theft that goes on around land, the use of coercion of laws to continue to prevent us from having access to resources with which we can rebuild. That's the first thing. And it's not easy because it requires a shift in how you think about stuff. When things have been done in a particular way for so long, not about individuals necessarily being racist, but it's about racist structures that have been around for so long, that folks who've worked within them often, don't actually realize that the structures themselves are problematic. What we're saying is that they are.

See us as the experts. Say, "No, no, no, you guys, you've got this right? What all we need to do is to put the resources in your hands and let you do what you do so well.” The first thing is about access to capital. For those who are out there, who get this, we're asking you to work with us, to support us both financially. But also to become champions for this work; to really understand it's not just another project. It's not just another fund. What we're doing is about changing the very fabric of the way that this work is done.

So one way is coming in with resources, with money, another way is helping to spread the word, in whatever format that might be. And there are numerous ways of doing that. And many of those are detailed in our brown paper. But something as simple as what you folks are doing, by helping us create this podcast and get the word out, hosting a webinar, having us do an article in your publication. Fundamentally it's got to be about a shift in resources and how they're allocated.

Bios:

Neelam Sharma serves as Executive Director of Community Services Unlimited Inc., a non-profit based in South Central Los Angeles. For the past two decades, CSU has created community programs and organizing campaigns like the early Safe Seniors to the more recent Free Medical Screening Program and the most recent From the Ground Up. Neelam was a founding member of the Healthy School Food Coalition, as well as the Los Angeles Food Justice Network (precursor to the LA Food Policy Council) and the California Food and Justice Coalition. Neelam is recognized as a national leader on the intersection between community economic development, youth empowerment and food justice.

Trisha Chakrabarti leads DAISA Enterprises' work to support Equitable Food Oriented Development as a practice and the organizations that do this work on the ground. DAISA Enterprises works alongside community organizations and social entrepreneurs that are innovating to build a better, more equitable, food system, and their investors. Trisha has worked in community food programming, statewide policy advocacy, and has led participatory food access research initiatives with restaurant workers and systems-impacted youth. She grew up in the South Asian diaspora, and sees a community-owned food system as a key indicator of political and economic self-sovereignty.

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This podcast is part of a series focused on the far-reaching impact of the COVID-19 pandemic on the food system. Today, we're looking at how the pandemic is driving up numbers, children experiencing or at risk for malnutrition, for wasting, and for possible death. Our guest expert is Dr. Saskia Osendarp, Executive Director of The Micronutrient Forum in Washington, DC.

Interview Summary

So Saskia, you and your research team recently published an article in the journal, Lancet where you presented deeply troubling data on child malnutrition, wasting, and potential death, as an impact of the pandemic. First, can you explain to our listeners how COVID-19 directly contributes to child malnutrition and child deaths around the world?

The way COVID-19 impacts child malnutrition is so unique and complex. We are actually facing a triple threat for malnutrition. COVID is putting an extra burden on the health system. In many countries, health system interventions have been stopped or been disrupted. So essential nutrition services that were normally being delivered through the health system—and this includes multiple micronutrient supplementation during pregnancy through antenatal care, vitamin A supplementation to children under the age of five, and the prevention and the treatment of acute malnutrition. We also have a crisis in the food systems that has caused food prices to go up and reduced availability of particularly nutritious foods on the markets. Then, we have an economic crisis on top of all that which has caused incomes to fall. So all of this had had severe implications for the quality of the diet that children can consume, and for the delivery of essential nutrition services.

Okay, let's, let's talk numbers. Can you describe the forecasted impact of COVID-19 on child malnutrition and child deaths?

Yes. Before this crisis, we had 48 million children that were wasted. We have projected that an additional 6.7 million children under the age of five would become wasted this year alone. So that is in 2020. And that's an increase of 14%. That is an increase we really haven't seen during for decades. In addition to that, wasted or acute malnutrition, (that is low weight for height), is an important cause of child deaths in the world. We also see an increase in child deaths under the age of five of an estimated 130,000 in 2020 alone. That would mean 10,000 children per month in this year alone, who would die due to COVID-related increases in wasting and disruption of delivery of these essential nutrition services.

I imagine, most of our listeners are familiar with the term wasted. But when you say a child is wasted, what exactly do you mean?

With wasted we mean that the child is too light for its height. It is a low weight for height. This is an acute form of malnutrition because when this is quite severe, it is actually immediately life threatening and these children need to be treated. It can also be moderate, and then, children can suffer longer-term consequences. I think that's also the reason why we are so concerned about this increase because we know it is just the tip of the iceberg. First of all, this crisis will last longer. We will see other forms of child malnutrition increase, and we are currently projecting what this means for the immediate years to come.

So to give you an example, when mothers who are pregnant now suffer the impacts of the COVID crisis on their nutritional status, they will deliver babies that are born low birth weight. Those children then are themselves at higher risk of developing stunting in the next coming two years. But we also will see an increase in micronutrients deficiencies, micronutrient malnutrition. All of this will have impact for children in the future, and for the next generations, as well. When children are malnourished early in life, this affects their cognitive development. It will affect their school performance, and eventually, their future productivity as an adult. It will also affect their nutritional status, and their disease risk as an adult. Eventually, when these children who are malnourished now turn into women, they have a higher risk of delivering children with low birth weight again. That's why the next generations are at stake, as well.

And is the increased child mortality, primarily, from the children being too weak to fight off diseases they may have been exposed to anyway? Or are there new things that come into the picture?

Almost half of all child deaths are due to child and maternal undernutrition. We knew that already before COVID. So with an increase in child malnutrition, we can, to some extent, also expect this increase in children's deaths. We also now see a disruption of essential nutrition and health services that are affecting child mortality. In many countries, vaccination programs have been suspended. Growth monitoring and promotion programs and essential services, such as, vitamin A supplementation are directly, also related to a child's mortality have been suspended. As well as, of course, the promotion of breastfeeding practices. All of this impacts the child's nutritional status, and also its ability to fight off infectious diseases. And in many of the low-income countries, these are the common infectious diseases, which is diarrhea, measles, that are the biggest killers among these children.

Thank you. Those are, those are several of the best explanations I've heard of a definition of wasting, and that also, what puts a child at risk for mortality and morbidity. So thank you for that. So Saskia, you're a champion of nutrition-specific and nutrition-sensitive approaches to evidence-informed policy. So let me ask you this. Knowing what we now know about the impact of the pandemic on child nutrition and development, how can we overcome this crisis, and build back even better?

Yes. So I think, as you rightly say, we need combination of nutrition-specific and nutrition-sensitive interventions now. And we always knew that we needed that, but particularly now, with this crisis being not just a crisis of the health systems, but also of the food systems and an economic crisis, we really need countries to step up efforts. And that has been summarized in a call to action that was published along with our paper by the four directors of the UN, of UNICEF, the WFP, WHO, and FAO.

First, you know, we need to make sure that families and children can keep access to safe and affordable diets. And that, at the moment, is at risk. But, for instance, we need to at least make sure that nutritious foods remain available on local markets. And that the supply chains are not being disrupted despite maybe, local lockdowns to mitigate the spread of the virus. That's one.

Second, we need to make sure that all these essential services that are being delivered through antenatal care, or through child growth monitoring programs will need to be continued, and even scaled-up or intensified, while at the same time, of course, ensuring that health workers can deliver these services in a safe way. So they need to have adequate protection themselves.

Third, we need to ensure that we continue the detection and the treatment of child wasting. So the children that become acutely malnourished, they need to be treated. The provision of school feeding needs to continue. In many countries, obviously, schools were closed during lockdowns, and that meant that children are derived from these essential, additional meals. And if schools remain closed, we should look for innovative ways to deliver these additional meals to children.

And then lastly, but not least importantly, is that we need to step up social protection efforts, and make sure that they include nutrition. So, for instance, that they include cash transfers or vouchers that families can use to buy nutritional foods on the markets.

With what you just said, you reminded me of several things that you'd mentioned earlier. One was that this is a complex problem. And second, that there are a large number of international agencies and organizations involved in addressing this. So is it possible to reach consensus on what should be done? I mean, is there agreement across the international landscape about how we should be approached?

Yes, and that's actually what we have achieved. You'll see that across the board that this crisis has also resulted in unique forms of collaboration that didn't really happen before. And we see the same here in nutrition, I think, where for the first time, actually, food systems, health systems, economists, and nutrition experts have really come together, and have said, "We really need to, first of all, identify what this crisis means for malnutrition in all its forms, and for the next few years." And second, to speak with one voice on what we think needs to happen now, in order to, as you say, mitigate these impacts for the longer term when we need to build back better. We really need to invest in sustainable and resilient solutions to make food systems more resilient for these type of shocks in future, to make sure that health systems are not going to be disrupted to the extent we have seen in this crisis. And having said that, mind you, that there's many, many countries out there now that are really making enormous effort of restoring some of these services, but I think we have to make sure that this doesn't happen again. And this type of unique collaborations really should continue even when this pandemic is over, because that's the only way we can tackle such a complex issue. So in that regard, COVID has accelerated this type of innovative collaborations.

So what are the implications now, and also in the future, if we don't act?

Yeah, so the implications are, if we don't act, that we really lose an entire generation. And that sounds very dramatic, but I think that most of us who have worked in nutrition for decades have never really seen such a rapid projected deterioration. I think if we don't act now, we run a risk that we lose the progress that we've made in the last two decades. And for these generations of children that, that are being born now, there's no time to waste because we also know, as I just explained, that the nutrition in the first 1000 days, so basically, during pregnancy and the first two years of life, is determining the future of these children that will eventually determine the GDP of countries. We know now that malnutrition can cost several percent points of a country's GDP per year. These children, in the future, will have a higher risk of having chronic diseases and obesity in life. So it is really a generation's social capital that is at stake here.

Bio:

Saskia Osendarp is the Executive Director of the Micronutrient Forum, an international expert organization and knowledge hub on micronutrient malnutrition, based in Washington DC. She has more than 25 years of experience in international nutrition research, in the public and private sectors and is a visiting associate professor Nutrition and Health at Wageningen University in the Netherlands. Dr. Osendarp is the founder and former co-chair of the Netherlands Working Group on International Nutrition (NWGN), a multisectoral working group to promote the inclusion of nutrition-specific and nutrition-sensitive approaches in evidence-informed policies. Recently, she has been a co-founder of the Standing Together for Nutrition Consortium, a collaboration of experts working in nutrition, foodsystems, health and economics analyzing the impact and responses of the COVID19 crisis on malnutrition.

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This is the first podcast in a five part series focused on equitable food-oriented development. EFOD, as it is called, is a growing movement to promote food projects and enterprises as vehicles for building community wealth, health, and self-determination. We will be delving into the origins and the unique outcomes of equitable food-oriented development projects, the role of the community identity in this work, and the potential for re-imagining capital access and wealth-building immunity food projects. With us today are two leaders in this movement, and it is my pleasure to welcome Neelam Sharma, the executive director of Community Services Unlimited, a nonprofit based in South Central Los Angeles, and Trisha Chakrabarti, who manages EFOD work at DAISA enterprises

Interview Summary

Neelam, can you help our listeners understand what equitable food-oriented development is, and how it's become such a central part of thinking about food systems these days?

EFOD, as we call it, is a community development strategy that is targeted at historically and currently oppressed and neglected communities of color in the United States. It is a strategy leveraging food and everything to do with food as an entry point through which to bring economic development to these communities. It's rooted in a practice and understanding of history and cultural context of the community, and EFOD projects are defined and driven by those communities. EFOD projects are grounded in a very clear analysis of the current mainstream systems, such as capitalism and racism, and how these work to systematically prevent the kind of equitable development that EFOD is all about. It emerged from conversations and dialogues amongst grassroots practitioners that the mainstream organizations and funders misunderstood things like our very systemic approach to the work that we do. Our commitment to creating long-term lasting changes in the communities we work in. Like the way that we define assets and benefits of a project in a very, very different way to how they're conventionally defined in funding and granting agencies. And the fact that every single time that we, as practitioners, come together to define new language--we found that that language was then being taken and used by others who didn't actually represent it. But, who were much better resourced to look as if they did. This is why we came together, and what has emerged from that is the Equitable Food Oriented Development Collaborative that now exists.

Can you help our readers understand, in your opinion, why is EFOD needed?

I think that some of the reasons that EFOD is needed are, for example, the history of exploitation and oppression of the communities we work in, the historical and ongoing extraction of wealth and knowledge and culture that is stolen and removed from these communities. But also, it's needed because it's an example of those of us who are doing this work deciding to come together ourselves from the trenches, naming what we're doing, defining it ourselves, and publishing ourselves. We are the ones who are deciding what our priorities are. And very importantly, we are the ones deciding how we want to enact the work that we've decided to do.

By working together we get to learn from each other. We get to advance and improve our work. And very importantly, we get to do that in the ways that we want to. By creating this very intentional practitioner-led and defined field of practice, we are essentially collectively leveraging our work to create power for the communities that we work in. And for the organizations that do this work.

EFOD is needed because it challenges the deeply racist and hegemonic ideas that exist in our society around things like understanding money and finance and ownership of land and property. There is this pervasive myth that many people of color also buy into that understanding money and owning land is something that is the domain of rich white folks. That people like us simply don't get into that, don't understand that. We want to break down those ideas and to show that actually, when we come together and we decide to do something, we can make really big things happen. By coming together, we are exponentially increasing the impact of our individual projects.

The current pandemic shows with extreme clarity that our current systems do not serve the vast majority of us, even in the most basic ways of food provision. EFOD is needed because from some of the most oppressed and impoverished communities that we as practitioners are working in, we are effectively able to use our collective work to show that alternatives to the current system are not only possible, but that they actually work, and they often work better than the mainstream system. Essentially, I'll finish by saying that EFOD is doing what Paulo Freire described as building working models of new systems within the one that we all feel needs to be gone that is not working for us. We are creating a proof of concept that then we can use to build and to create more power and more leverage for our communities.

Neelam, you were the founding member of the Healthy School Food Coalition, of the Los Angeles Food Justice Network, and the California Food Injustice Coalition. Boy, that's a lot to do. And you're a recognized leader on the intersection between community economic development, youth empowerment, and food justice. So how did you come to be involved in EFOD work?

In serving Community Services Unlimited as an executive director for many years, what I have really clearly seen play out time and time again is how in the current system that we're in--even though there are a lot of well-meaning people in the funding world, in the foundation world, in the nonprofit industrial complex--systemically it exists in a way that essentially keeps people like us in communities like the ones that we serve dependent. I'll give you a very simple example of that. So very early on when we were building the Village Market Place, which is our local, beyond organic local food system-based market, very early on in building that we wanted to purchase a truck to do deliveries, to do pickups. We had managed to secure some grants and funding from different government agencies. I was really astonished, honestly, to find that even though it was cheaper for us to buy a truck, we were not allowed under the confines of the grant, We were only allowed to rent one.

That is just one really small example. But in a bigger way, what I found in doing this work is that there's lip service given, and there's a lot of talk and bells and whistles around projects that look sexy, that look good in photographs. There's often a lot of money spent by people to do these kinds of projects, but they're projects. What we've seen time and time again is that when these projects go away, there is no benefit left to the communities that these projects were based in.

I feel a deep sense of urgency around the work that we've collectively come together to do in EFOD, because if you know what's going on in the world, then you know that there are some very harder storms coming that really we haven't even truly felt the economic impact of the current pandemic. Also, there's everything that is going on with global climate shift. So I feel very urgently the need to build solid ownership of land of property, to build sustainability, to build local food systems, to build resilience in our community so that we can feed ourselves, so that we can have potable water, so that we can have systems where we can take care of ourselves. Those concerns drove me to really become involved in EFOD in the way that I have.

Trisha, I'd like to turn to you. As a former program director at Mandela Partners, who alongside with organizations like Community Services Unlimited and several others, were the first champion EFOD, you have deep experience in important things like community food programming, policy, and advocacy. I know as well that you've led participatory food access research initiatives with restaurant workers and youth. So how did you come to lead the DAISA Enterprises work to advance EFOD as a practice?

I initially came to the work of EFOD through working with Mandela Partners in West Oakland. The work of Mandela grew out of a community needs assessment that was done by women in West Oakland talking to their neighbors, talking to folks in the community that they knew. The things that were uplifted as desires that people had to strengthen and build many of those resilient systems that Neelam is talking about, came out through that process. So those were things that included long-term and supportive work opportunities, business ownership opportunities, ways of connecting with other communities that were experiencing systemic exploitation and marginalization. The community itself was at that time a food desert. There was also a wish to create a more thriving network of economic opportunities by being involved in a locally-owned food system.

So the work of Mandela grew out of those priorities that were uplifted throughout the community process. But I remember something that Dana Harvey, the organization's founder, would always talk about, which was that if people in West Oakland had said, you know what, actually the issue that we think about the most is waste collection and sanitation management, then that would have been the work that Mandela was doing. So we took whatever the charge was from people in West Oakland about what they felt they could contribute to, could own, could thrive within their community, and just promote the idea that even within a community like West Oakland that has borne the brunt of decades of exploitation and systemic marginalization, that it is a health-promoting community and health being really expansively defined.

I think when you look at the food system as a way of creating health and economic opportunities, it really makes sense to develop a community-owned and controlled food system because of all of the intersecting value that it brings to a community. So being at Mandela was really my first introduction to thinking about food in that way. As you mentioned, I had been working in food systems work from a variety of different angles for many years. But this was the first time that I really thought about food as a way of promoting community economic development. So it was a very purposeful decision as I was transitioning out of Mandela to want to continue to coordinate and help support the practitioners that were leading this work. So it was very intentional that I chose to then join DAISA and continue doing this work around EFOD.

The EFOD collaborative seems like a pretty important development in where EFOD is going in the future. Can you tell us more about what this is?

Sure, the EFOD collaborative is a practitioner-led space for both building the field of EFOD, as well as strategizing and creating shared connection around challenges and opportunities amongst practitioners around the country that are working in an EFOD framework. The steering committee of the collaborative has grown to nine organizations around the country, and we've developed the common values and defining criteria for EFOD work. We produced a research paper about our findings, which you can find on our website. We've also just released a pilot funding opportunity because we do want to model what a new way of supporting and resourcing this kind of work on the ground could look like. As we spoke to field leaders that were doing EFOD work on the ground in various different communities around the country, many of them described lacking an adequate field of practice to further their work, or that they felt that didn't yet exist a specific space for their needs for pure learning or shared identity. We are building out the collaborative as a model for practitioner-led democratic field building work that we're using to spread and highlight the visibility of EFOD as it's being done around the country. Then also, we are building a funding vehicle that can demonstrate a better way of making grants and patient debt capital available, and you can see our work on our website at efod.org.

Author Bios:

Neelam Sharma serves as Executive Director of Community Services Unlimited Inc., a non-profit based in South Central Los Angeles. For the past two decades, CSU has created community programs and organizing campaigns like the early Safe Seniors to the more recent Free Medical Screening Program and the most recent From the Ground Up. Neelam was a founding member of the Healthy School Food Coalition, as well as the Los Angeles Food Justice Network (precursor to the LA Food Policy Council) and the California Food and Justice Coalition. Neelam is recognized as a national leader on the intersection between community economic development, youth empowerment and food justice.

Trisha leads DAISA Enterprises' work to support Equitable Food Oriented Development as a practice and the organizations that do this work on the ground. DAISA Enterprises works alongside community organizations and social entrepreneurs that are innovating to build a better, more equitable, food system, and their investors. Trisha has worked in community food programming, statewide policy advocacy, and has led participatory food access research initiatives with restaurant workers and systems-impacted youth. She grew up in the South Asian diaspora, and sees a community-owned food system as a key indicator of political and economic self-sovereignty.

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This podcast is part of our series on racial equity in the food system. Today, we're talking with Alison Conrad, a research associate here at the World Food Policy Center. She has just published a research brief on identifying and countering white supremacy culture in the food system.

Interview Summary

Big picture. What did your research on white dominant culture in the food system reveal, and why does this matter?

Well, I think first and foremost, it revealed that whiteness and white supremacy are deeply embedded in the food system, but that their presence goes unnamed and unnoticed by white folks. And it's something that shows up in basic beliefs about the food system. And so you'll hear some of these narratives that I've identified and be like, "Those make sense, "what exactly is wrong about them?" But, in reality, many of these narratives stem from the bigger white supremacy culture that fuels how we discuss what's happening in the food system, how we want to reform the food system, and what we consider healthy food.

Tell me what you mean by whiteness and white supremacy culture.

Whiteness is a social construct that has very real and violent effects, and it's not just a reference to lighter skin color, but it's an ideology that is based on beliefs, values, and behaviors that have resulted in the unequal distribution of power and privilege based on skin color. Whiteness is invisible to those who benefit from it, but it has this immense power because it's held as a norm. It justifies and binds together the white supremacy system inherent in all institutions of American society. And so as a result, attitudes and behaviors steeped in white supremacy culture can be found in any individual group or organization, whether it's white-led, predominantly white-led, BIPOC-led, or has a predominantly BIPOC staff.

So Ali, I love that you've named some specific narratives that show up. Can you talk about what some of those are?

I identified eight messages, and these may seem really familiar to you, and it's because many of our core beliefs are driven by a lot of these narratives and they can have an influence on how we go about addressing issues through food policy and programming.

First, I'll start with If They Only Knew, and this is really about healthy food and cooking education. It's this idea that if you only knew what healthy food is or how to cook healthy food, then you would go out and buy it and cook it, and therefore be more enlightened and be healthier. It tends to ignore a lot of the more structural issues that come along with what is healthy food and who has access to it?

The next one is Vote With Your Fork, which is this idea that we can somehow signal our preferences for healthy food, for more sustainably grown food, through what we purchase and what we buy.

And next - some more paternalistic narratives - one of which was that Communities Can't Take Care of Themselves. And this justifies why it's okay not to involve low income and/or black, indigenous, or people of color, BIPOC, in decision-making around programming and policy.

The next narrative of Failure to Listen draws off of this and shows how institutions, especially funders or government agencies, push solutions onto communities rather than supporting agendas established by individual BIPOC communities themselves.

And next is Build It and They'll Come. This is a food retail sort of market approach to food access and quote/unquote, "food deserts," but it doesn't really address anything around community wealth-building strategies or looking at systemic racism that has to do with what is a food desert and talking about food apartheid.

And next narratives are more focused in neo-liberalism, one of which was Pull Yourself Up By Your Bootstraps. It blames poverty and hunger on the individual—that individuals are just simply not working hard enough to get themselves out of poverty and out of hunger. And because of this, we have the next narrative, which is, a Focus on Food Charity, which results in us over-relying on food distribution and charity as the solution to hunger, instead of thinking about creating more sustainable, structural change, like higher minimum wage, increasing SNAP benefits, and really, anything that just goes beyond food distribution and charity.

Lastly, one that I find very interesting is how we define Good Food Versus Bad Food. And this tends to be more as universally held belief of what is good, healthy food and what is not, and how that can apply with whiteness and white supremacy. So I think it's really helpful to think of kale versus collard greens as an example. Kale is considered a very common, healthy food. And the other, collards, it's not often talked about, even though they have the same health benefits. This is because collards were considered the food of the poor Southerner and because of sort of like the classism and the racism of that depiction, collards are not seen on the same level as kale.

So now that I've gone through these, you're probably thinking, "I've heard some of these before, and "I believe some of these, what exactly is wrong with them?" They tend to put the emphasis on the wrong place and on the wrong things because they stem from this white supremacy culture that's focused on the individual; that's focused on prescribing solutions; that's focused on this neoliberal idea that it's only about personal responsibility.

We can't really move to creating longer lasting change if we're continually wrapped up in perpetuating these narratives in the policy and programming that we're doing. We're coming at it from this lens that's not focused on long-term change, and is focused on a lot of these bandaids to a bigger problem than say, addressing poverty or racism.

For example, you could take the Vote With Your Fork narrative. It sounds like a great idea. Why can't we signal to companies that we value more sustainably grown food? But the problem is that it leaves out who is able to participate in that, and why are they unable to participate. You have to have some sort of purchasing power in the first place because if we're talking about sustainably grown beef--that's not exactly cheap. And that's going to leave out anyone who can't afford to make that purchasing decision, even if they may value more sustainably grown foods. It ignores this idea that maybe we need to come together as a collective to put pressure on the government to pass laws, to regulate companies, and to help move us along to a more sustainably grown local food system.

There's a lot of nuances that go into these narratives, but you have to start by recognizing how they influence policy and programming, even if you're not even realizing that you're doing it, no matter how well-intentioned you might be.

You mentioned food deserts and food apartheid. How are those concepts different?

Thanks for asking this, Jen, I think it's a really important distinction to make. So food desert is a term that was created by the USDA to define a geographic area without access to grocery stores. The term desert looks at communities from a deficit perspective and it implies that food access and insecurity issues are a natural phenomenon instead of something that was created through generations of divestment. Food apartheid, on the other hand, directs the conversation to systemic racism resulting from policies that created a system where predominantly black neighborhoods on average have fewer grocery stores and poor quality food than predominantly white neighborhoods. And so, food apartheid looks at the food system as a whole and calls out the systemic injustices and inequities that result from racist policies and practices, such as neighborhood redlining. By reframing the issue as food apartheid, food system actors can shift the conversations to systems of injustice in ways to combat them.

So Ali, I'm curious, why did you as a white woman decide to pursue this project?

That's a really great question. I was worried at first, I will say. I was questioning if I should be the one doing this. As a white person, is this a good place for me? I don't have that experience with discrimination. What does it mean if I try to take this on? And am I taking up space that someone else should be filling in? But I've come to realize that you can't say, "I'm white, I don't really have a stake in this," and therefore it's on BIPOC individuals "or low income individuals," or really any group that's facing discrimination "to advocate for justice and equity." The point of this project is to say we're talking about white narratives. We're talking about systems built on white supremacy, and therefore white folks have to come in and understand how that's impacted their thought processes, their work, and how they're putting out policies and programming that then goes on to influence what happens in the food system. Even if you're not intentionally acting from a white supremacist standpoint, the system is white supremacy, and you have to learn how that whiteness impacts the work that you're doing.

Going through that myself, going from a place of not really knowing if this is the right thing for me to do as a white person, to understanding that all white people have to do this. Without addressing the part that we play in white supremacy in the food system, you're not going to understand how that's influencing the policies and programming you're putting out. We can't reform a system that has 400 plus years of white supremacy without confronting white supremacy.

Ali, I really think you're bringing up a number of critical aspects in terms of how much whiteness shows up in the work around policy and practice in food systems. But also the fact that everyone has a stake in dismantling racism. That this should not be something that is the work of one group or groups, that there is a role for each individual in identifying the aspects of the work that they can do in dismantling racism. I really appreciate you pulling that out, and for that being such an integral part of this research. So I'm interested to know now, what surprised you the most over the course of this research?

Once I had a basis of what the narratives were—I was surprised at seeing how intertwined all of it was. Each individual narrative is really informative, but also looking at them all together and looking at the broader structures of white supremacy culture of that focus on individualism, paternalism, neoliberalism, and seeing how that really is so pervasive in so many types of policy and programming. And now, taking what I've learned and going into other conversations and listening—listening to how other people talk about things. Seeing how that white supremacy culture and that approach is just so embedded and that people don't even realize it. And that if I hadn't done this project, I also wouldn't have realized it.

That, in and of itself, is just so helpful to switch the way that you think about things. It is unnamed, and you're not really gonna notice it until it's like a light bulb goes on over your head. And you're like, "Oh wait, that's problematic," or, "That just reinforces trauma on communities "that have had 400 years of white supremacy," "and we don't even realize that we're doing it."

One of the narratives that really sort of resonated with me in this way was this idea of, If They Only Knew. I've thought about policies and programs from this If They Only Knew perspective, I've definitely been guilty of perpetuating that. And so realizing that was really helpful. It's not that nutrition education is bad, it just ends up being a replacement for thinking about things like structural inequality that's inherent in the system. Things such as who is able to access locally grown food, who is able to afford quote/unquote, "healthy fruits and vegetables," who is able to get transportation to go to the grocery store, and who has time to cook their meals every day.

There's a lot of these sort of nuances that I think we tend to ignore. And a lot of these things have to do with white supremacy and structural racism that's built into the system. The problem with these narratives is that they make it easy to ignore the structural issues and asking- Okay, so what will move us to the point where we're creating a more equitable food system for people to actually access healthy food and more sustainably grown food? And so you really have to start digging into that structural inequality and the racism that creates these disparities. And by just talking about education, you sort of allow yourself to not have to do that.

Ali, you point out how hard it is to see these narratives. I'm curious then, what work needs to happen next for individuals and organizations working to improve the food system once they're recognizing these white supremacy culture narratives that continue to show up?

Yeah, you make some great points and I'm glad that you've asked this question. As I've sort of alluded to a little bit, it starts with learning. It's learning how whiteness is influencing your work. It's analyzing your thought processes. You can't really make forward progress if you don't understand how you might be contributing to the problem. This involves asking yourself some basic questions to challenge how you're thinking about the food system. So are you discussing at all in your work and in your individual learning how structural racism has impacted the communities you're serving? Are you moving beyond talking about food access and food deserts to have conversations around food apartheid? Have you looked at your budget, either your organization's, or even your own personal finances to see if you're dedicating any money and funding to BIPOC organizations that are already doing work on the ground?

We've been socialized to believe a lot about whiteness, about race, about the history of the United States. You really have to start digging in and finding those gaps in your education. You can't make progress without first learning and unlearning, and then as white folks, as white organizations and institutions, to take action to combat it.

I think it's important to note that nobody alive today created the current systems of oppression, but they still exist. And many of us benefit from them and perpetuate them. So while we didn't create the system, I want to acknowledge that some individuals and institutions are today still actively working to strengthen systems of white supremacy and further solidify it in laws and institutions and norms. If we don't learn how it's harmful and how we can take action to counteract it, how we're complicit in it, then we are definitely still complicit in continuing to uphold it.

I think it's also important to note the power dynamics at play between institutions and communities. Often white institutions and organizations get to come into communities and set the agenda for what is needed and what will happen in those communities. And so organizations need to think about how they can shift from doing the work on behalf of BIPOC communities to supporting community-defined agendas and working with communities. And this really requires organizations to unpack how they are exerting power and influence, and understanding who is benefiting from that power. Is the community really being helped by your programs? Or is your organization the one that's benefiting from having a program in that community? White institutions and organizations can stifle the ability for BIPOC individuals and communities to use their own power to assert their own agendas, and create systems that benefit them, instead of being forced to participate in systems of oppression.

So Ali, you've spoke to learning at both the individual level and the organizational level. It sounds like what you're explaining is really about this journey, both of learning and of unlearning. So I'd like to know how our listeners can learn more about white narratives and white dominance in the food system.

So our research brief, which is posted on the Duke World Food Policy Center website (wfpc.sanford.duke.edu), outlines the eight narratives that I've gone over today, as well as some examples of how these beliefs play out in policy and programming. We invite you to read our research brief, start internalizing the information there, and thinking about these broad white supremacy cultures. And then look at your own work in the food system and see what narratives do you identify? Do you find others outside of what I identify? Or can you apply the ones that I identified to a different part of the food system that you may work in? We've included a bunch of resources within this brief that can help you with that learning and unlearning process.

Bio:

Ali Conrad is a Duke University Sanford School of Public Policy Master of Public Policy graduate. Her research focuses on social determinants of health and food access policy. Prior to joining the WFPC, she interned at the Government of District of Columbia Office of the Food Policy Director researching food is medicine in the United States and opportunities in the District for addressing food as a social determinant of health. Before coming to the Sanford School, Ali worked on Medicare Part C and D policy and data analysis at Acumen, LLC after receiving a B.A. in Economics from UC Berkeley. After graduation, she would like to pursue a career working on food policy and its connection to the built environment and social determinants of health issues.

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This is the second of two podcasts with the authors of the new book Sugarproof, The Hidden Dangers of Sugar that are Putting Your Child at Risk and What You Can Do. Our first podcast offered a fascinating view of the effects of sugar on children and this podcast will discuss what might be done. University of Southern California's Michael Goran leads the program in Diabetes and Obesity at Children's Hospital of Los Angeles, his co-author Emily Ventura is a nutrition educator, public health advocate, writer and cook.

Interview Summary

So Emily let's begin with you, so some families might feel overwhelmed about where to start because there's sugar reduction because sugar is in so many things and it's kind of a perplexing topic for many so why don't we start with your thoughts on how much sugar a child can safely consume.

Just to validate with what you said, it is completely overwhelming. We try and simplify things and make it less overwhelming by giving practical solutions and also by giving some more specific guidelines on what would be ballpark range for safe levels of sugar. We're not suggesting that families take out all sugar because that's just not realistic and not going to work but we do give some age specific recommendations that are all based on the guidelines of roughly 5% of your daily calories from added sugar.

The recommendations we came up with kind of echo what the World Health Organization has been promoting for a long time which is 5% of daily calories. The problem is in children, a one year old is very different from an 18 year old so how do we come up with recommendations along that spectrum? And so we came up with age specific recommendations based on the needs of a one year old versus an 18 year old. What we recommend--which is now looks like it's going to be recommended in the new Dietary Guidelines--is that for zero to two years of age, zero added sugars. Then from two to 18, it depends on the age, and it goes from about five grams or a couple of teaspoons of added sugar per day up to about 15 or 20 grams per day depending on age. So there's room in there for added sugars and like Emily said, we're not suggesting that we completely eradicate had sugar out of children's diets. We think that's just completely unsustainable and not going to work in the long run but reflecting back to those recommendations from the World Health Organization and now the new Dietary Guidelines of America those translate to roughly 5% of daily energy coming from added sugars as safe levels.

So given the recommendation of our around 5% of calories contributed added sugar, how does that compare to what children are actually consuming now?

Yes, well, currently that number for added sugar is probably around 15 in some populations up to 20% of daily calories so we have a long ways to go in terms of producing added sugars back down. And by the way, just to clarify what we mean by added sugars, this does not include natural sugars in fruit or natural sugar in milk or dairy products, we're talking about sugars added to food in processed foods and more so things like soda but also many, many other different type of processed foods and snacks. Juice is a little controversial because the Dietary Guidelines and the FDA don't count juice as added sugars so they would not count juice technically towards those 5%. We think that the sugars from juice is just as harmful to the body as the sugars from soda so we do count the sugars from juice against those 5%.

Thank you. The context really helps here because given that the average intake is three or four times what's recommended this is a really pretty serious challenge to bring those numbers down. So Emily, where would you suggest that parents focus first?

The first thing we suggest to look at is beverages. The reason for this is because when you have sugar in liquid form, it delivers such a quick dose and a big dose of sugar all at once. A lot of these beverages are also very high in fructose which is especially harmful for the liver and for the body in general, especially for growing children. So we suggest that families take a look at switching from drinking juice to having a glass of water and whole fruit, for example, at breakfast. Or, gradually reducing the other sweet drinks like sodas both regular and diet sports drinks, other juice drinks or coffee drinks, all of the things that are popular that are just full of sugar and really unnecessary sources of added sugar in the diet.

And are there some other strategies or swapping things that families could do to help reduce sugar?

Definitely, so putting some of these sugar guidelines and recommendations into perspective, some of the recommendations depending on the age might be to limit your added sugar to say three to seven teaspoons of sugar a day, it is helpful to realize that you could easily be getting that amount of sugar in your breakfast cereal alone. Things like staple cereals that families might buy that are really convenient and the kids like are ones that are good to take a look at because if you make a simple swap in breakfast. Or, even if you do want to stick with cereal just changing the type of cereal that you buy. Those kinds of changes can have a big impact on the overall amount of sugar that kids get in the given day.

It's interesting that you mentioned sugar and I was reminded of a study of that I was involved in, led by my former Yale colleague Jennifer Harris. They randomly assigned children to different conditions to test whether they needed sugar in breakfast cereals in order to enjoy them. So half the kids got a low sugar version of a cereal—say cornflakes rather than frosted flakes—and the other got a high sugar version. What the study found is that kids who got the low sugar version of the cereal didn't add much sugar to sweeten it up. They added fruits voluntarily to sweeten it up, and it ended up having a much better nutrient profile compared the kids who got the high sugar version of cereals. So the industry's chief argument for sweetened these cereals is that they deliver a lot of nutrients--which is true—but the kids won't eat them unless they have a lot of sugar and that apparently is not the case. And that's consistent with your recommendation.

Yeah, I love that study, it was very influential in some of our work and I think it makes a very clear point that kids will adapt to what you put in front of them. They will still eat the little sugar cereals and in fact, opt to put fruit on top of it as natural sweetness. The opposite is true that with the high sweet cereals because kids have a higher preference for sweetness, they will also opt to eat more of it because they want more sugar so if you put the high sugar in front of them they will probably serve themselves more of it.

So let's ask about non-calorie sweeteners or low-calorie sweeteners even including natural ones like Stevia and monk fruit, are these a good idea for children?

No, we don't think so. For sure, the more conventional synthetic sweeteners like sucralose and aspartame we just don't know enough about the long term effects in children. We're beginning to realize some of the short term effects and you know, they're not good, we don't recommend them for children. A lot of food companies and parents are turning to natural sweeteners like Stevia and monk fruit, we just don't know enough about how the affect of body and to be honest, I think we'd rather sweetened with natural food. What we recommend is if you are going to cook or bake is to use natural sweeteners and by natural sweeteners I don't mean honey or maple syrup or coconut sugar, those are all added sugars. What we recommend is using whole fruit or dried fruit or dates or frozen bananas. There's lots of inventive ways that you can get sweetness into foods while maintaining a natural sweetness and get the nutritional benefits of the whole fruits.

Emily, are these sort of low-calorie sweeteners showing up in lots of processed foods and what might parents look for?

It can be so confusing especially with all the claims on the front of products that say no added sugar or all natural. And you think that you're getting something that's good for your kids. But, then when you start investigating at the back of the label and looking at the ingredient list you realize that some of these artificial or even all natural low-calorie sweeteners are showing up side-by-side with regular sugar. Or sometimes they're in there alone and you just don't realize it. It is important to note that sweeteners are much sweeter than regular sugar. What they do is this sort of reinforce a sweet taste preference that kids already have. So, it makes it harder for kids then to enjoy, you know, more subtle version of sweetness if they're used to the amplified tastes. We give ideas for how to read labels and avoid them but also to help your kids gradually reset their taste preferences and be more happy with things that are naturally sweetened.

Also it sounds like you're saying that if kids get used to a very high level of sweetness because of either added sugar or even these non-calorie sweeteners but then that could generalize to preferences for highly sweetened versions of other foods in the diet and it could have a cascading effect, is that right?

Exactly.

Yep, exactly right Kelly.

What about the problem that some parents might worry about, this over restricting kids and causing a backlash about sugar?

We all know stories of certain kids that you may have known when we were growing up, or kids that you see now whose have parents just forbid sugar entirely. You see the after effects when those kids on their own eat as much as they can. Or they're really confused or they become afraid of eating things with sugar in them and we certainly don't want any of that. So kids to have some sugar in their diet, what we suggest is for dual pronged approach, just think about your home food environment and think about the staple foods that you have there for your kid. The idea is to create a safe, healthy food environment where kids can't go wrong. Whatever they're going to choose from the pantry to eat—as part of their staples foods, their breads or snacks or cereal or whatever it is—you want all those things to be good, healthy choices so that kids aren't accidentally getting a lot of sugar in there. The other thing is to raise kids with awareness about sugar but also giving them some autonomy to make their own decisions. Take for example, maybe you go to a party and there's juice and there's soda and there's gummy bears in a dish and there's cake and there's ice cream. What we suggest is raising kids with an awareness that maybe they don't need all of those things. They can choose what would they most like to have at that party so that they still have a treat but they don't have to sample everything all in one day.

Well, it sounds like very helpful and concrete advice. Well, let me ask both of you about your opinions of our policies. So many policies could be affected by the sort of points that you're making. You mentioned earlier the Dietary Guidelines and how that might change things—especially no sugar added at all for kids zero to two. But what are the implications on other things like getting rid of soft drinks in schools or changing what's in vending machines or offered through school lunch programs and I'm wondering what you both think about that? Emily, we'll start with you.

Well, we've seen some examples that can be effective, we would like to see more of them more changes in the school lunch programs and access to healthy foods for kids that live in areas where there aren't any grocery stores or markets with healthy things.

Thanks, so Michael what are your thoughts on that?

Research actually shows that kids and teenagers get most of their soda at home which is kind of a little surprising and this gets you pretty quickly into talking about marketing and advertising. Other countries are starting to do more in terms of advertising and marketing policies, especially when it comes to targeting their of children so I'd like to see more of that. I'd also like to see better warning labels especially on things like soda and very high sugar items that are marketed to children, we ought to have warning signs on some of those products so that consumers know more directly what some of the health effects are.

Speaker Bios

Dr. Michael I Goran is one of the world's most widely recognized experts in childhood nutrition and obesity research, with more than 30 years of experience as a researcher, mentor, and educator. He is a Professor of Pediatrics at the University of Southern California, Keck School of Medicine, Co-Director of the USC Diabetes and Obesity Research Institute and leads the Program in Diabetes and Obesity at the Children's Hospital of Los Angeles. He holds the Dr. Robert C and Veronica Atkins Endowed Chair in Childhood Obesity and Diabetes. Michael is a native of Glasgow, Scotland, and received his Ph.D. from the University of Manchester, UK.

Dr. Emily Ventura is an experienced nutrition educator, public health advocate, writer, and cook. After working in writing and public relations in the arenas of environmental protection and food, she completed her Master's in Public Health and Doctorate of Philosophy in Health Behavior Research at the University of Southern California. She was selected as a Fulbright Scholar to teach Public Health Nutrition in Italy and now lives in California and works as a writer, recipe developer, and mother to two young boys.

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This is the first of two podcasts with the authors of a new book entitled, Sugarproof: The Hidden Dangers of Sugar that are Putting Your Child's Health at Risk and What You Can Do. This podcast will cover the wide-ranging effects of sugar on children, and the second podcast will address what can be done in the home and with policy. University of Southern California, Michael Goran, leads the program in diabetes and obesity at Children's Hospital in Los Angeles. His co-author, Dr. Emily Ventura, is a nutrition educator, public health advocate, writer and cook.

Interview Summary

So let me ask both of you this question, what was your main motivation for writing this book Sugarproof? Michael, let's begin with you.

Sure. Children in the US are surrounded by sugar everywhere they turn in today's food environment. Really what I wanted to do was get this message out to a broader audience of people so that the public could better understand the sources of sugar and added sugars and all its different disguises. And, more than that, we wanted to create a guide that families could use, practical solutions that could be broadly applicable to help them protect their kids and their families from the effects of excess sugars.

Thanks Michael and Emily how about your motivation for this, writing this book.

Well just like Michael said, it feels so good to have everything in one place, and to compile all this research and the practical solutions. These themes that we talk about in Sugarproof are all ones that I've been working with families for 20 years I'd say. Just keep coming up against the same topics and the same challenges. And then after I had kids, I have two young boys who are four and seven, I realized even more so, just how tricky this is to navigate.

Thank you, so the book sounds like a very nice blend of the most recent science on the topic with some very practical, helpful solutions for people. Michael, what are some of those surprising ways that sugar affects the health of children?

So it's clear that sugar has profound effects on the body, and this process begins before birth. Sugar literally affects children's bodies head to toe. So this could be effects on brain development, cognitive outcomes, or learning ability. And as you work your way through the body effects on the GI system, gut microbiome development, digestive problems, and then longer term risk for things like diabetes and fatty liver disease, which often will be asymptomatic and progress silently. But these effects are seated in childhood with early risk factors. And then there's acne and skin health and other inflammatory conditions as well which are all related to increased sugar consumption.

Well that's a pretty wide ranging set of impacts. And let's talk a little bit more about how sugar can impact mood and focus and concentration. Can you tell us more about this and how these things might turn affect academic performance?

There's no a ton of research on this but a large study out of Australia, 4,000- 5000 children showed that children who had higher consumption of sugary beverages which includes sodas and juices, et cetera, perform more poorly in academic tests of math and verbal reasoning and reading and so on. Also, in addition to that, the whole question of whether sugar affects mood and behavior, studies do show that sugar consumption in the short term can affect mood and concentration, disrupts energy levels. For example, we talk in the book about whether or not increased sugar consumption spikes energy levels. The research on this is pretty mixed but overall, what we see is that there is an acute relationship between sugar consumption and energy levels to do with blood sugar concentration. So, we'll see a spike in energy levels and then sudden crashes as blood sugar falls rapidly affecting mood and focus and concentration throughout the day.

Emily, let me ask you this, my guess is that these effects aren't very widely known, especially among the public, but even among scientific professionals, is that true?

One thing that we talk a lot about in the book is about breakfast—and how your choice of breakfast really does shape your concentration and your mood throughout the morning. It's interesting that you ask if parents realize that. I think a lot of us parents don't see some of those effects because we feed our kids breakfast and then we send them off to school. But now that a lot of kids will be home—more often homeschooling, especially now with the COVID-19 situation—it’s going to become even more apparent. and we talk a lot about how you can change what you give your kids for breakfast and reduce the sugar and increase fiber and protein and healthy fat, and how that'll give your kids more steady energy and a better focus and concentration throughout the morning.

So, why is sugar so problematic for children relative to adults?

I think there's a couple of issues here at play. Babies are born with an innate preference for sweetness. A child has a much higher liking or preference for sweet foods. So, given the opportunity, children are going to consume more of those sweeter foods than adults. This is the first stage of the perfect storm. They're primed to consume more sweet food and 70% of processed foods and 80% of snack foods have added sugars, and so they're going to want to consume more of those. But it's more than that. What we're seeing now is that during the developmental process, the body is more vulnerable, susceptible to the effect of those sugars. I'll give you a couple of examples. One is a very tangible example and that is tooth decay. We know that sugar causes tooth decay. Why is that? Because sugar feeds bacteria in the mouth and those bacteria produce acid and that acid breaks down teeth and ruins them. Why are children more vulnerable to that? That's because teeth are still developing and during that stage of tooth development, they don't have the enamel to protect the teeth from the acid produced by the bacteria that are eating off of sugar. Also, infants and children tend to consume food more frequently throughout the day compared to adults, so there's more exposure.

So it's a very tangible example of how tooth development makes kids more vulnerable to the effects of sugar but there's other more subtle examples as well. Because organs are being built. Brains are being built. The pancreas is being built. The liver is being built. And during this process of building, excess sugars can basically disrupt that process of development. And another example, not really been proven yet in adult models, but in animal models, in terms of brain development, if you expose rats to high sugar during the adolescent period of brain development, it can basically hardwire their brain to disrupt memory function long term. And studies have shown that it's only during the period of adolescence, when that damaging effect of sugar has its long term hardwiring effects on the brain. If you give a rat sugar during adolescence, and then take it away and study it six months later when it's an adult, the effects of that sugar are hardwired. And that's because sugar in some way is disrupting the building blocks of the different organs during growth.

So, Michael, what's the difference between sucrose and fructose and how is it important in this context?

So sucrose is ordinary table sugar that you buy at the grocery store. It's two sugars connected to each other and those two sugars are glucose and fructose. Glucose and fructose are very similar but have different properties in the body. So, glucose is what every cell of your body uses for energy to support its function, whether that's brain function or the energy in your muscles to move around or your heart beating, that energy comes from glucose. Fructose, on the other hand, which is twice as sweet as glucose by the way when it's consumed by itself, is taken up by the liver and converted to fat. And that fat can cause fatty liver disease, which is now increasing in prevalence nationally, including in children or the fructose can be converted into fat and released into their circulation. And that's where we get the connection between sugar, mostly fructose, and cardiovascular risk, and that's to do with the conversion of that fructose into fats that then circulate in the bloodstream.

So is fruit juice a problem?

Yes . Fruit juice is, in our view, a problem because it is concentrated sugars. Eating fruit is not a problem because there's much less sugar. So for example, if you took a glass of apple juice, you would be consuming the sugars in concentrated form from about three apples. So it's fine to eat an apple, nobody's going to eat three apples in one go. But drinking a glass of fruit juice will give you the sugars all at once. And that's important because not only do you have more sugar, but, it's very rapidly consumed. And it's that rapid consumption and rapid uptake into the liver that starts this whole cascade of problems. So yes, drinking fruit juice is a problem because it has just as much sugar as soda, sometimes more.

Speaker Bios

Dr. Michael I Goran is one of the world's most widely recognized experts in childhood nutrition and obesity research, with more than 30 years of experience as a researcher, mentor, and educator. He is a Professor of Pediatrics at the University of Southern California, Keck School of Medicine, Co-Director of the USC Diabetes and Obesity Research Institute and leads the Program in Diabetes and Obesity at the Children's Hospital of Los Angeles. He holds the Dr. Robert C and Veronica Atkins Endowed Chair in Childhood Obesity and Diabetes. Michael is a native of Glasgow, Scotland, and received his Ph.D. from the University of Manchester, UK.

Dr. Emily Ventura is an experienced nutrition educator, public health advocate, writer, and cook. After working in writing and public relations in the arenas of environmental protection and food, she completed her Master's in Public Health and Doctorate of Philosophy in Health Behavior Research at the University of Southern California. She was selected as a Fulbright Scholar to teach Public Health Nutrition in Italy and now lives in California and works as a writer, recipe developer, and mother to two young boys.

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This podcast is part of a series on the impact of the COVID-19 pandemic on our food system. And in this interview, we'll be exploring how one North Carolina farming business has coped with the unique challenges of the pandemic and particularly disruptions to longstanding markets and supply chains for farm products. Our guest is Jim Warenda from Wilson, North Carolina. Jim runs a diverse organization that includes Fresh-Pik Produce, the Southeastern Growers Association and Dean’s Farm Market. He's also the President of North Carolina's Strawberry Association.

Interview Summary

Jim, help our listeners understand a bit more about your enterprise.

I’ve been in the farming industry since I was 14 years old, talkin' tobacco. One of the last people to hand crop tobacco, probably. Kind of goes back that far, and then we got interested in produce. We've grown and diversified from farming and the nursery business and a direct store retail business to the actual consumer and started a marketing association where we market for several other growers here.

Jim, I'm curious about how diversified your organization is now. And I'd like to know a little bit more about how you pulled all that together.

So Fresh-Pik Produce was the first farm that was created, where we direct store delivered to Piggly Wigglys, IGAs. We helped create Southeastern Growers Association in 1997, where we put together a grower base, started a marketing co-op that's still in existence today, so that we could distribute to direct store chains to their distribution centers so that we could grow, get larger, and not have to have the infrastructure to direct store deliver. So, it allowed us to gain more volume and more market share. We grow about 20 different commodities, strawberries, watermelons, cantaloups, lettuce, sweet corn, collards, and cabbage are our main commodities. So, we distribute watermelons pretty much East of the Mississippi from Florida to Canada. Whereas our strawberry marketing is from our area here to Philadelphia, to South Jersey. Our lettuce goes to chop plants to your bag salads, to retail vendors, Food Lions, Harris Teeters, those types of chains also.

I want to focus now on the impact of the pandemic. So earlier this year, food supply chains were disrupted as many cities and states went into lockdown trying to slow the spread of the COVID-19 virus. So what was that like for your organization?