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From The Economist print edition
How bad is American food? And whose fault is it?
AMERICANS are in a pickle over food. Just as a decade of financial optimism has given way to the shocked discovery that people are poorer than they thought they were, so an era of working out in gyms and low-fat dieting has been mocked by reports of the nation's shocking chubbiness and other food-related forms of ill-health.
The figures on fat are striking. The proportion (if not the proportions) of Americans who are obese rose from 15% in 1991 to 27% in 1999. Youngsters show the same trend: 10% of them are now obese. Add in the merely overweight and you cover 60% of American adults and 25% of children. David Satcher, who retired as surgeon general in February, has estimated that obesity contributes to 300,000 of the 2m deaths each year in America. Treating diet-related conditions such as cancer and heart disease cost $117 billion in 2000.
What to do? The Bush administration has launched a $190m advertising campaign aimed at making children more energetic. This week, the Los Angeles school board moved to ban the sale of fizzy drinks in its schools. In May, a Californian state senator abandoned her bill to impose a tax of two cents on every can of pop statewide, but others are still pushing for “sin taxes” on burgers and sugary drinks.
The courts have become involved too. Last month, a New Yorker sued four fast-food chains. He had eaten their food regularly in the course of reaching 272lb (123kg) and notching up two heart attacks. The restaurants, he said, had not warned him that his diet might be harmful.
Meanwhile, another battle has broken out within the fad-crazed health industry itself. The traditional low-fat, bran-and-broccoli dieticians have been challenged by another school that advocates high-protein eating. Beef and lobster, they say, are fine, but you have to stay off carbohydrates such as pasta and bread.
Is the American stomach really in such poor shape? By the standards of most of the world, Americans are fairly healthy. Life expectancy continues to rise; it is bettered only by places that absorb far fewer immigrants from poor countries. Despite jeers from Europe about the number of additives and hormones that go into American food, there have been no health scares on the scale of Britain's mad-cow disease.
Yet Americans are surely right to be agitated about their food. There is an overwhelming amount of evidence that their diet is doing many of them a great deal of harm. The “fat-acceptance” lobby is right that you can be heavy and fit; but without exercise, too much weight makes diabetes and other potentially fatal diseases more likely. Independent of the implications of being overweight, diet also plays a role in other illnesses, such as cancers of the bowel, colon and prostate.
There is also a clear social divide. Both hunger (which still afflicts 10m households in America) and unhealthy excess correlate closely with poverty and poor education. Shops in poor neighbourhoods stock less fresh food (and at higher prices), while fast-food joints proliferate. Poorer people also have fewer parks and playgrounds in which to exercise.
This sounds bad. Yet the food industry is largely giving American consumers (rich and poor) what they want. A pattern of life in which fewer families eat regular meals together, fewer parents remain at home during the day to cook, and increasing amounts of time are spent working or commuting creates demand for convenient, fast food (especially when it is as cheap as it is). Tummy size, then, is largely a side-effect of modern American life—and the choices that Americans make.
That said, there is a debate about how well informed consumers are when they make these choices. Even if you regard the case of the litigious 272lb New Yorker as absurd, America's food industry is particularly powerful and unfettered. In Europe, the most powerful bit of the food-production chain is the one closest to the consumer—the supermarkets. In America, the industry is controlled by food processors. Three facets of the food business are particularly troubling:
•Misleading information. Marion Nestle of New York University points out in “Food Politics” (University of California Press, 2002) that blurbs on packaging are highly selective. Breakfast cereals, for instance, come blazoned with information about how their added minerals and vitamins will strengthen young bones; they have less about what the coating of sugar will do to children's teeth and waistlines.
•Poor regulation. The power of the food lobby extends to Washington. The agriculture department has a huge conflict of interest. It is responsible both for promoting the interests of farmers and for disseminating nutritional information. The Food and Drug Administration has been restrained by Congress, at the behest of food interests, in its efforts to regulate dietary claims.
•Schools. Eating habits formed by children are hard to shake in adulthood: 60% of obese children grow up into obese adults. Fast-food firms often serve as official caterers, while soft-drink firms have installed numerous snack dispensers in schools (especially poor ones), in exchange for providing things like TVs.
Far from representing something new, the current debate about carbohydrates reflects the confusion created when science and marketing mix. While the 1990s fads concentrated on fatty foods and their link to cholesterol, the high-protein dieticians blame starchy carbohydrates. These, they say, produce a rush of sugar in the blood that destabilises the body's regulation of appetite and so lead to overeating.
This does help to explain one mystery of the past 20 years: why “low-fat” food did not work. The low-fat meals that Americans guzzled down were often packed with refined flour and heavily sugared to give them flavour (which the customers also wanted); people who tucked into them kept on wanting to eat more. The food industry did not rush to alert them to this point; nor did its packaging mention the sugar as clearly as the “low fat”.
Yet the more you delve into the issue, the more nuanced it appears. Just as some fatty foods, such as avocados and peanuts, are now thought to protect the heart (not harm it), there are also some sorts of carbohydrates, such as those found in whole grains, that don't encourage appetite. And the newest research seems to imply that people's genetic disposition might matter more than all these things. Variations in the apOE gene, for example, may determine your blood cholesterol level more than your diet. And all that is before you consider things like the amount of exercise people take.
Over the past 25 years or so, Americans have repeatedly jumped at quick-fix solutions for their fast-food habits. In the late 1990s there was a craze for anti-fat drugs, which inevitably led to lawsuits. But in the end nearly all the arguments about food come back to the choices that consumers make.
Americans have got larger because they have chosen (mainly consciously) to eat the way that they do. Millions of them actually eat rather well: these tend to be the richer and better-educated sorts, who go to gyms and buy their vegetables from organic farmers' markets. Their buying power is having an effect: one of the fastest-growing supermarket chains in America is Whole Foods Markets, based in Austin, Texas, which mixes organic vegetables and free-range chicken with a sorcerer's array of vitamin tonics. But, for the moment at least, they are in a clear thin minority.
My recommendation? Go vegetarian!
