The Obesity Epidemic – Part 2

I’m Dr. Michael Greger and this is Nutrition Facts.

There’s one thing we’ve been thinking about a lot lately, and that’s how to stay healthy in the middle of a global pandemic. Especially since we’ve learned that those with underlying health problems like obesity, hypertension, diabetes, and heart disease are more likely to have serious complications if they contract COVID-19. So what do we do? We try to stay healthy with evidence-based nutrition.

Today, Part Two of our Obesity Epidemic Series. We start by looking at the role of processed foods in the obesity epidemic.

The rise in the number of calories provided by the U.S. food supply since the 1970s is more than sufficient to explain the entire obesity epidemic. Similar spikes in calorie surplus were noted in developed countries around the world in parallel with, and presumed primarily responsible for, the expanding waistlines of their populations. By the year 2000, the United States was producing, after taking exports into account, 3,900 calories for every man, woman, and child; nearly, twice as much as many people need.

It wasn’t always this way. The number of calories in the food supply actually declined over the first half of the twentieth century, only starting its upward climb to unprecedented heights in the 1970s. The drop in the first half of the century was attributed to the reduction in hard manual labor. The population had decreased energy needs, so they ate decreased energy diets. They didn’t need all the extra calories. But then, the so-called energy balance flipping point occurred, when the “move less, stay lean” phase that existed throughout most of the century turned into the “eat more, gain weight” phase that plagues us to this day. So, what changed?

What happened in the 1970s was a revolution in the food industry. In the 1960s, most food was prepared and cooked in the home. The average “not working” wife spent hours a day cooking and cleaning up after meals. (The husband averaged nine minutes.) But then, a mixed blessing transformation took place. Technological advances in food preservation and packaging enabled manufacturers to mass-prepare and distribute food for ready consumption. The metamorphosis has been compared to what happened a century before in the industrial revolution, with the mass production and supply of manufactured goods. This time they were just mass-producing food. Using new preservatives, artificial flavors, and techniques such as deep freezing and vacuum packaging, food corporations could take advantage of economies of scale to mass produce ready-made, durable, palatable edibles that offer an enormous commercial advantage over fresh and perishable foods.

Think ye of the Twinkie. With enough time and effort, any ambitious cook could create a cream-filled cake, but now they are available around every corner for less than a dollar or delivered straight to your door for 30 cents! If every time someone wanted a Twinkie, they had to bake it themselves, they’d probably eat a lot less Twinkies. The packaged food sector is now a multi-trillion dollar industry.

Or, consider the humble potato. We’ve long been a nation of potato-eaters, but they were largely baked or boiled. Anyone who’s made fries from scratch knows what a pain it is, with all the peeling, cutting, and splattering. But with sophisticated machinations of mechanization, french fry production became centralized, and could be shipped at negative 40 degrees to any fast food deep fat fryer or frozen food section in the country to become America’s favorite vegetable. Nearly all the increase in potato consumption in recent decades has been in the form of french fries and potato chips.

Cigarette production offers a compelling parallel. Up until automated rolling machines were invented, cigarettes had to be rolled by hand. It took 50 workers to produce the number of cigarettes a machine could make in a minute. The price plunged, and production leapt into the billions. Cigarette smoking went from relatively uncommon to almost everywhere. In the 20th century, the average per capita cigarette consumption rose from 54 a year to 4,345 cigarettes a year by the time of the 1964 Surgeon General’s report. The average American went from smoking about one cigarette a week to a half-pack a day.

Tobacco itself was just as addictive before and after mass marketing. What changed was cheap, easy access. French fries have always been tasty, but they went from being rare, even in restaurants, to omnipresent access around every and each corner (likely next to the gas station where you can get your Twinkies and cigarettes)..

In our next story, we ask why are U.S. taxpayers giving billions to support the likes of the sugar and livestock industries?

The rise in calorie surplus sufficient to explain the obesity epidemic was less a change in food quantity than in food quality, with an explosion in cheap, high-calorie, low-quality convenience foods. And the federal government very much played a role in making this happen. U.S. taxpayers give billions in subsidies to prop up the likes of the sugar industry; the corn industry and their high-fructose syrup; and soybean production, about half of which is processed into vegetable oil, and the other half used as cheap feed to help make dollar-menu meat. Why do taxpayers give nearly a quarter billion dollars a year to the sorghum industry? When was the last time you sat down to some sorghum? It’s almost all fed to livestock. We’ve created a pricing structure that favors the production of sugars, oil, and animal products.

The farm bill started out as an emergency measure during the Great Depression of the 1930s to protect small farmers, but was weaponized by Big Ag into a cash cow with pork barrel politics—including said producers of cows and pork. From 1970 to 1994, global beef prices dropped more than 60 percent. If it weren’t for taxpayers sweetening the pot with billions of dollars a year, high-fructose corn syrup would cost the soda industry about 12 percent more. And then; of course,  we hand them more billions through the “food stamp” program to give sugary drinks to the poor.

Why is chicken so cheap? After one of the farm bills, corn and soy were subsidized below the cost of production for cheap animal fodder, effectively handing the poultry and pork industry about $10 billion each. That’s not chicken feed or rather, it is!

This is changing what we eat. Thanks in part to subsidies, dairy, meats, sweets, eggs, oils, and soda were all getting relatively cheaper compared to the overall consumer food price index as the obesity epidemic took off, whereas the relative cost of fresh fruits and vegetables doubled. This may help explain why during about the same period, the percentage of Americans getting even five servings of fruits and vegetables a day dropped from 42 percent to 26 percent. Why not just subsidize produce instead? Because that’s not where the money is.

To understand what is shaping our foodscape today, it is important to understand the significance of differential profit. Whole foods, or minimally processed foods, such as canned beans or tomato paste, are what’s referred to in the food business as “commodities.” They have such slim profit margins. Sometimes they’re even sold at or below cost as “loss leaders” to attract customers in hopes they’ll also buy the “value-added” products. Some of the most profitable for producers and vendors alike are the ultra-processed fatty/sugary/salty concoctions of artificially flavored, artificially colored, and artificially cheap ingredients thanks to taxpayer subsidies.

Different foods reap different returns. Measured in profit per square foot of supermarket selling space, confectionaries like candy bars consistently rank among the most lucrative. The markups are the only healthy thing about them. Fried snacks like potato and corn chips are also highly profitable. PepsiCo’s subsidiary Frito-Lay brags that while their products represented only about 1 percent of total supermarket sales, they may account for more than 10 percent of operating profits for supermarkets, and 40 percent of profit growth.

It’s no surprise then, that the entire system is geared towards garbage. The rise in the calorie supply wasn’t just more food, but a different kind of food. There’s a dumb dichotomy about the drivers of the obesity epidemic: is it the sugar or is it the fat? They’re both highly subsidized, and they both took off. Along with a significant rise in refined grain products that’s difficult to quantify, the rise in obesity was accompanied by about a 20 percent increase in per capita pounds of added sugars, and a 38 percent increase in added fats.

More than half of all calories consumed by most adults in the United States were found to originate from these subsidized foods, and they appear to be worse off for it. Those eating the most had significantly higher levels of chronic disease risk factors, including elevated cholesterol, inflammation, and body weight.

Finally, today we discover how the rise in the power of food marketing aligns with the blastoff slope of the obesity epidemic.

In the 1970s, the U.S. government went from just subsidizing some of the worst foods to paying companies to make more of them. In the 1970s the farm bills reversed long-standing policies aimed at limiting production to protect prices and instead started giving payouts in proportion to output. Extra calories started pouring into the food supply.

Then, Jack Welch gave a speech. In 1981, the CEO of General Electric effectively launched the “shareholder value movement,” reorienting the primary goal of corporations towards maximizing short-term returns for investors. This placed extraordinary pressures on food companies from Wall Street to post increasing profit growth every quarter to boost their share price. There was already a glut of calories on the market, and now they had to sell even more.

This places food and beverage CEOs in an impossible bind. It’s not like they’re rubbing their sticky hands together at the thought of luring more Hansels and Gretels to their doom in their houses of candy. Food giants couldn’t do the right thing if they wanted. They are beholden to investors. If they stopped marketing to kids, or tried to sell healthier food, or anything that could jeopardize their quarterly profit growth, Wall Street would demand a change in management. Healthy eating is bad for business. It’s not some grand conspiracy; it’s not even anyone’s fault. It’s just how the system works.

Given the constant demands for corporate growth and rapid returns in an already oversaturated marketplace, the food industry needed to get people to eat more. Like the tobacco industry before them, they turned to the ad men. The food industry spends about $10 billion a year on advertising, and around another $20 billion on other forms of marketing, such as trade shows, incentives, consumer promotions, and supermarket “slotting fees.” Food and beverage companies purchase shelf space from supermarkets to prominently display their most profitable products. They pay supermarkets. The practice is also evidently known as “cliffing,” because companies are forced to bid against each other for eye-level shelf placement, with the loser being pushed “over the cliff.” With slotting fees up to $20,000 per item, per retailer, per city, you can imagine what kind of products get the special treatment. Hint: It ain’t broccoli.

To get a sense of what kind of products merit prime shelf real estate, look no further than the checkout aisle. “Merchandising the power categories on every lane is critical,” reads a trade publication on the “best practices for superior checkout merchandising.” They were referring to candy bars and beverages. Evidently, even a one percent power category boost in sales could earn a store an extra $15,000 a year. It’s not that they necessarily don’t care about their customers’ health; publicly traded companies, like most of the leading grocery store chains, are said to have a fiduciary duty to increase profits above other considerations.

Tens of millions of dollars are spent annually advertising a single brand of candy bar. McDonald’s alone may spend billions a year. The food industry now spends more money on advertising than any other sector of the economy.

Reagan-era deregulation removed the limits placed on marketing food products on television to children. Now, the average child may see more than 10,000 food ads a year, and that’s on top of the marketing online, in print, at school, on their phones, at the movies, and everywhere in between. Nearly all of it is for products detrimental to their health.

Besides the massive early exposure and ubiquity, food marketing has become highly sophisticated. With the help of child psychologists, companies learn how to best influence children to manipulate their parents. Packaging is designed to best attract a child’s attention, and then placed at their eye level in the store. You know those mirrored bubbles in the ceilings of supermarkets? They’re not just for shoplifters. Closed-circuit cameras and GPS-like devices on shopping carts are used to strategize how best to guide shoppers towards their most profitable products. Behavioral psychology is widely applied to increase impulse buying. Eye movement-tracking technologies are utilized.

The unprecedented rise in the power, scope, and sophistication of food marketing starting around 1980, which aligns well with the blastoff slope of the obesity epidemic. Some of the techniques, such as product placement, in-school advertising, and event sponsorships skyrocketed from essentially zero to multibillion-dollar industries since the Eighties. This led one economist to conclude that “the most compelling single interpretation of the admittedly incomplete data we have is that the large increase in obesity is due to marketing.” Yes, innovations in manufacturing and political maneuvering led to a food supply bursting at the seams, with close to 4,000 calories a day for us all, but it’s the advances in marketing manipulations that are used to try to peddle that surplus into our mouths.

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For recipes, check out my How Not to Die Cookbook. It’s beautifully designed, with more than 100 recipes for delicious and nutritious meals. Speaking of new books, I have a new book just out – How to Survive a Pandemic – now out in audiobook, read by me, and e-book with physical copies out in August. Pre-order the physical copy now or download the e-book and audiobook now as well.

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Thanks for listening to Nutrition Facts. I’m your host, Dr. Michael Greger.