What to Eat (and Drink) Now

[Upbeat Guitar Music]

Mike: Welcome everybody. This is Avoiding the Addiction Affliction, brought to you by Westwords Consulting, the Kenosha County Substance Use Disorder Coalition, and by a grant from the State of Wisconsin's Dose Reality Real Talks reminding you that opioids are powerful drugs and that one pill can kill. I'm Mike McGowan.

Mike: Every now and then I have a guest who has done so much that the introduction could take the entire podcast, and today is one of those days. We wanna talk about the federal government's new health recommendations for alcohol and the new food guidelines today. And I thought who better to talk to than Marion Nestle?

Mike: Marion is a Paulette Goddard Professor of Nutrition, Food Studies and Public Health Emerita at New York University in the department she chaired from 1988 to 2003. She retired in 2017. She has a PhD in Molecular Biology, a master's in Public Health and Public Health Nutrition from the University of California.

Mike: Marion is a past senior nutrition policy advisor in the Department of Health and Human Services, an editor of the 1988 Surgeon General's Report on Nutrition and Health. She's the author, co-author. Or co-editor of 16 books, several of them prize winning, most notably food politics. How the food industry influences nutrition and health. Safe Food: The Politics of Food Safety, What to Eat, and her new book, What to Eat Now.

Mike: Okay. I'm gonna stop there. I'll be introducing you for the entire time. Welcome, Marion.

Marion: Glad to be here.

Mike: I contacted you after the new guidelines were put out, so we'll get to that in a minute. But I bet you were thinking that when you wrote your new book, terrific by the way, when you wrote your new book, you go, oh, I'll just update my old book, and then it'd be easy.

Mike: Didn't turn out that way though, huh?

Marion: (laughs) No! It was a pandemic project and I thought, this thing reads pretty well. It's just a little out of date. I bet I can whip this off in six months. (laughs) And here we about four years later and it's basically a complete rewrite. Because so much had changed and I hadn't been paying very close attention. (laughs)

Mike: What's the most surprising change in the food landscape you discovered while writing What to Eat Now?

Marion: I think the online ordering, because it required, that was completely new. A lot of other things are new too. There's bottled waters instead of sweetened drinks. Plant-based is new, ultra processed is new.

Marion: A lot of the international foods are new, but the really huge change is the online ordering, which accounts for an enormous fraction of grocery sales now. And required the reorganization of entire supermarkets to make room for a place to put bags of collected groceries. And you have to get all those people outta the aisle that are collecting groceries for everybody else.

Marion: That's the modern touch.

Mike: I could not do that job. I have no idea how those people with those humongous trailer carts keep track of everything that they're putting into their cart.

Marion: They've got a, they've got a device that they do it on, but the great thing is they know where everything is.

Mike: Yes, they do. Yeah. And I am, you're right about that. I am in their way a lot.

Marion: Yeah. But they're very nice about telling you exactly where things are. (laughs)

Mike: Yeah. Your book is so comprehensive and it has to be. I gotta tell you, it's not easy sifting through dietary guidelines, product labels, company websites, it seems deliberately complicated.

Marion: Yeah, I did the work. I found it interesting, but it's a lot of work. And if you are confused when you go into a grocery store, there's a reason for that. And then the way I put it is if you are trying to eat healthfully in a grocery store, you're fighting an entire food system on your own. (laughs)

Marion: That's a lot to take on.

Mike: Yeah. Do they deliberately not want us to know? Or is it just...

Marion: I don't think about that they think... i'm not a... I like conspiracy theories as much as the next person, but I don't really think that's what this is about. This is about the normal course of doing business. Food companies and grocery stores are businesses with stockholders.

Marion: And their first job is to sell as much as possible. As often as possible. And to as many people as possible and as higher prices as they can get away with. That's the goal.

Mike: Let's narrow the conversation. We could talk all day. Let's narrow the conversation.

Mike: Start with something basic water. Bottle or tap?

Marion: Absolutely tap. If you live in a city that has a decent water supply, I do.

Mike: I think I do too, but it sure occupies a lot of convenience store and grocery store space.

Marion: Yeah, the bottled water industry has gone to a lot of trouble to make you think that the tap water's not safe.

Marion: And that bottled water is better. It's very convenient. It's really handy to have one of those things. It engenders an enormous amount of plastic waste. But what I think it does more than anything is it induces doubt about the water supply. And you could find out about your water supply very easily because every community water supply has an annual report.

Marion: Those are available online. They're really interesting. I spent a lot of my time upstate in Ithaca, which is a small town. I looked up the Ithaca one. It said, anytime you wanna come visit, we'll host you. I was there the next day. (laughs) I thought, wow!, let's take a look. I was so impressed. They care so much about the quality of the water and they do so much to make sure that quality is good.

Marion: I thought, drink tap water.

Mike: Our county even allows you to send in a sample and they'll test it and tell you what's in your tap water.

Mike: Right?

Marion: I did that too.

Mike: Yeah.

Marion: It was fine. I live in New York City. They go to a lot of trouble about tap water.

Mike: Many parts of your book are amusing as well as interesting.

Mike: I'm gonna read this. Ian Williams, who was the former United Nations correspondent for the Nation who said of bottled water that it's ostentatiously useless, environmentally deleterious, and a complete insult to our intelligence. Do you mean I shouldn't pay more for melted glacier water from Greenland?

Marion: (laughs) From Greenland with the body of some explorers still in it? No you shouldn't and you certainly shouldn't buy Fiji water. Which is ridiculous. I found bottled waters that were imported from Australia. Come on. Really? Why would anybody do that? And the other thing was I did this cost comparison. (laughs)

Mike: Oh, that was outstanding.

Marion: This was really fun. In Ithaca, we paid 0.01 cent per gallon at home. That was the price for home tap water. Wegman's the grocery store was selling it for 67 cents a gallon. They had a tap and they ran it through a filter and charged 67 cents a gallon and you could just pour it out.

Marion: And then I found waters that were 30, 40, 50, $70 a gallon. I thought, really? You wanna pay that much for it? Okay. Still water. It's all water.

Mike: And sometimes, when you take something like Dasani, which is Coke, right?

Marion: Yeah. And that's done with city water supplies.

Mike: Right? So if I buy a bottle of Dasani water, that's basically city tap water.

Marion: Yeah. Filtered probably.

Mike: I've always found it amusing that water is as expensive or more so than soda.

Marion: Oh, but the same company owns the bottle. (laughs)

Mike: So it's more expensive.

Marion: They've got a deal going.

Mike: Or they add stuff to it. And that leads me to the new alcohol guidelines.

Marion: Ah, yes.

Mike: What does someone with your expertise, what does limit your consumption, which is the new standard? What does that mean to somebody with your background?

Marion: I don't know. I have no idea what it means. I guess it means less than whatever it is you're drinking. (laughs) No, I guess limit would mean to me, don't drink any more than you're already drinking.

Marion: And then I think it says something about drinking less overall, and that means less than whatever it is you've been doing. This was a big shocker because the alcohol guideline was done in a very different way than the other guidelines. The dietary guidelines advisory committee from the previous administration was told not to deal with alcohol because special committees had been appointed to do reports. One of them was from the National Academy of science, engineering and medicine. One of them was a special committee from Health and Human Services. That was meant to look at the evidence on diet and health as the background for whatever the dietary guidelines were going to say.

Marion: And then surprisingly, there was a third report that actually came out first from the Surgeon General under the Biden administration. These reports came out with different conclusions. The Biden Administration Surgeon General's report said any level of alcohol raises the risk for seven kinds of cancer, any level of alcohol.

Marion: The National Academy's report said low levels of alcohol reduce the risk for heart disease, and yeah, cancer's a problem. The third report came out and said any level of alcohol raises the risk for cancer. It was suppressed. This is now under the Trump administration. It was suppressed and never released. You can't get a copy of it online. It's not available.

Marion: What was the dietary guidelines research committee supposed to do with this? They also did not, there was a committee that was appointed to deal with the research under the Trump administration. This committee didn't have very much time and they didn't deal with alcohol at all.

Marion: They just said they would go with the National Academy's report and ignore the Surgeon General's report. (laughs) So that's what they did. And the big change here is that prior to these guidelines, since 1990, the guidelines have said no more than two drinks a day for men, and no more than one drink a day for women.

Marion: In the previous one, dietary guidelines, there was an attempt to get the recommendation down to no more than one drink a day for men and one drink for women. But that got dropped and the two in one remained. And this one just didn't get into any kind of numerical guidelines at all, which I think is a shame.

Marion: Why don't they just say that any amount of alcohol raises the risk? One drink a day doesn't raise it by very much. Don't drink more than one drink a day. And be done with it.

Mike: Why do you think they don't say that?

Marion: I would say the alcohol industry probably had a lot to do with that.

Mike: Yeah.

Marion: We don't know about that then.

Marion: We don't, there's no, I haven't seen any evidence on it yet, although there's a reporter on the New York Times who's following this story very closely and feels that there had to have been industry influence somewhere along the line. So they just ducked the whole thing. But these whole dietary guidelines are all about personal responsibility.

Marion: So it's up to you to figure out what to do.

Marion: Whatever you figure out is fine.

Mike: Yeah. Dr. Oz joked, right? Oh, just don't drink for breakfast.

Marion: Oh. His comment was astonishing to me. He said alcohol is important for conviviality. And conviviality is important to mental health.

Marion: Just don't drink it for breakfast.

Marion: Really? When alcohol is such a problem for society, not just individuals. Gun violence, domestic violence, automobile accidents, a lot of really ugly stuff. And from a public health standpoint, it's been known for decades that if you wanna keep the problems of alcohol abuse under control, you try to keep the amount of alcohol consumed by the population as a whole, as low as possible. Because the level of difficulty and problems is directly proportionate to the level of alcohol in the population. So alcohols with high levels of alcohol consumption across the board have a lot of problems.

Marion: Those with low level don't, so you wanna keep the problems down as much as possible. And I think it looks, if my reading of the evidence is, if you have a few drinks a week, it's not gonna raise your risk for heart disease or cancer by very much. I just wouldn't... you wanna have wine with dinner? Fine. Not every night and not a half a bottle. Or a whole bottle, I dunno, it just seems pretty straightforward to me.

Mike: And you detail how prevalent it is, how it's moved. When I was a kid, you used to have to go to liquor stores, and now...

Marion: Grocery stores.

Mike: Oh, I live in Wisconsin Marion.

Marion: Ah, yes.

Mike: And it is in the front. Normally produce, right, is in the front when you bring in. Ours, it's alcohol right next to the produce. And then we've seen this proliferation since your first book on what to eat, of all sorts of different beverages containing alcohol.

Marion: Right. Alcohol waters.

Mike: Yeah.

Marion: I was in a supermarket in Arizona. In New York, we don't have, we have only beer in supermarkets. And I was in a supermarket in Phoenix, and it had a bar in it. (laughs) You could just go and sit in the bar in the middle of the supermarket and it had aisles and aisles of hard liquor as well as beer.

Marion: It was very impressive. So it's readily available and, everybody's got it. And the places where you can only drive and you worry about that. So the alcohol industry has done a very good job. Of keeping these recommendations vague. I see it as a win for the alcohol industry.

Marion: The Times reporter interviewed people in the alcohol industry who said they liked the two drinks a day for men and one for women. They could live with that. And that they're a little uncomfortable about this, but I found other people from the alcohol industry saying, yay!

Mike: Yeah. Without a definitive, people are left to their own.

Marion: That's how, that's the philosophy of these guidelines. It's up to you.

Marion: These are about personal responsibility. They're not about policy at all.

Mike: I also like your chapter on CBD and THC. I thought that was just fascinating. We can say the same thing about those, can't we? How do we know what amount of what chemical is in gummies and seltzer?

Marion: We don't have a clue. We don't have a clue. There's a label that might or might not tell you what's in it. Is that label correct? I don't know. (laughs) Most people have looked at them, say, no, the labels aren't correct.

Mike: Because you find what?

Marion: There's more in them, and the THC is more, much more concentrated than it used to be.

Marion: I'm fond of telling this story. I'm one of these people who doesn't touch this stuff because I'm very sensitive to it. (laughs) And when I was much, much younger, I had a hash brownie. This was a classic, nothing happened. So I had another one, (laughs) three days later I think I was finally off of it, and I had a friend who was a pharmacologist who said, Marion there are some people who just shouldn't take the stuff. (laughs) And you turn out to be one of them. So I don't touch it 'cause it does really bad things to me and it's not fun at all. But for people who are taking it and who feel that it makes them feel much better. I think you have to be really, if you go to licensed shops in New York.

Marion: Somebody is supposed to be testing and making sure that what's in the products they're selling is what's on the label. But if you go to the unlicensed stores you have no idea what you're getting.

Mike: Do you think they're actually doing those compliance checks?

Marion: Oh, I hope so. Yeah, they do some, I mean they've reported the results of some but the ones that worry me are the candies that look like commercial candies because kids are getting into them and pediatricians are reporting many more visits of kids to emergency rooms 'cause they got into their parents' edibles.

Marion: Yeah. I think you have to be really careful with them.

Mike: I was asked by a lady if I would do an intervention on her son, her underage son, because he was taking her stash.

Mike: So I'm like... (laughs)

Marion: If she doesn't, if she doesn't want her son taking her stash, there's a simple remedy for that. Don't have a stash.

Mike: That's what I told her. I said, I think I'd be doing the intervention on the wrong person.

Marion: Exactly.

Mike: Who regulates alcohol? THC/CBD?

Marion: Oh, the Treasury Department of course. (laughs) Who else? This is leftover from prohibition. Usually the FDA regulates what's on labels and the Department of Agriculture does meat.

Marion: The Treasury Department does alcohol and I guess CBD and THC as well. Because these are revenue generators. Putting the government in a conflict of interest because the more people use these products, the more money the government gets. But that's how it's worked out since prohibition.

Mike: Yeah. In Wisconsin, we raised more tax revenue during COVID shutdown from the sale of alcohol than when the bars were open, because so many people were consuming at home.

Marion: Yeah. I mean it's a drug that people really like and it's very widespread. Again, I'm somebody that just doesn't fall in that category. I don't have any enzymes. I have the same difficulty that Asians have. Where I have no idea what it feels like to be happily drunk.

Marion: I just don't have a clue. So it's hard for me to... I try not to be judgmental in these situations because I know so little about it.

Mike: You worked for health and human services, back in the day. And it seems like on a lot of these commissions now there's political influence and advisory groups.

Mike: Rather than people looking out for our health, they're looking out for their bottom line.

Marion: So it seems, and th ese dietary guidelines were no different than that. Although Robert F. Kennedy Jr. And Brooke Rollins, the secretaries of Health and Human Services and Agriculture made many promises that these guidelines would be free of industry influence and free of conflicts of interest. That's not how it turned out. So the research report that got turned in on the day the guidelines were released had the names of the people who did the research. We still don't have a clue who wrote the guidelines.

Marion: That's still top secret as far as I can tell. But their names were revealed. And also their conflict of interest statement in which at least four of them had connections to the meat and dairy industries. Eight of the nine people who were on the committee reported financial ties to some kind of food industry that had a vested interest in the outcome of the guidelines.

Marion: The guidelines are very pro meat, full fat dairy, and saturated fat. That's the thing that they did that has everybody's mind boggled is they're really, they're pro natural. If it's natural, it's okay, but they go way beyond that and push meat, full fat dairy and fats like butter and beef tallow, over plant-based foods.

Marion: So the impression that the new pyramid gives you is that this is really about meat. And in fact, I bought a Make America Healthy again t-shirt that has, oh, I just couldn't resist. So it has the upside down pyramid, except most of the pyramid is meat. And it says Eat Food By Local. Completely co-opting the slogans of the food movement.

Marion: So I thought, yeah, I gotta pose with this t-shirt. It's just too ironically funny.

Mike: Think about how all of us grew up looking at that food pyramid. And I know that's evolved over time, but...

Marion: I don't know about you. I grew up looking at a circle.

Mike: Yeah. Okay.

Marion: Seven or the basic four.

Mike: And now it's like you said, it's almost upside down.

Marion: Oh, it is upside down. It is upside down, and even though they say they're one of the guidelines is favor whole grains are at the bottom. Where you're not, the part of it that you're supposed to eat less of, meat comes first. You have to look at the interactive website to really understand what this is about.

Marion: Realfood.gov. And it, as the video on, as the website plays out. Meat is first, a meat and full fat dairy are second, and then eventually they get to the plants and finally they get to the whole grains that are at the bottom. So it's a complete reversal of what dietary advice used to say. Which was low fat meat, low fat dairy, lean meats, none of that. Meat is back. Full fat dairy is back and the secretaries are posing on Twitter and X with milk mustaches. (laughs) It's amazing!

Mike: Yeah. I would assume that you're not a fan of the new guidelines.

Marion: I'm thrown into a quandary over them. I really like the major message.

Marion: The major message is eat real food.

Mike: Eat real food.

Marion: That's not a guideline. But it's the overall message of the guideline and pyramid is eat real food. I'm not gonna argue with that, I've been saying that for decades. And then one of the guidelines breaks new ground because it talks about food processing.

Marion: It says avoid foods that are highly processed, and then it includes sugars and refined grains as part of that. That's a good message. That's a really good message. It's, yeah, they call it highly processed. They don't use the word ultra processed, but they clearly mean ultra processed because they go on to say, don't eat petroleum food dyes or artificial preservatives, colors, or flavors.

Marion: That's the definition of ultra processed. So that part is really good. I'm for it. Totally for it. And then, it's the rest of it that's so weird. A special guideline for full fat dairy. Really? Why? And then the protein thing where they double the amount of protein that they recommend people eat when people already eat double the amount of protein.

Marion: It's not an issue.

Mike: And when people hear meat Marion, don't you think they hear meat, they think red meat.

Marion: Yeah. Protein is a euphemism for meat. Americans are already eating one and a half to two times the amount of protein that they need, and two thirds of that is coming from meat according to the CDC.

Marion: So that's already, you don't need a guideline for that. That's what everybody's already doing. Without being told to. What you really want is people eating more plants, so they'll get the fiber and the nutrients and they won't be getting the calories, but plants are very downplayed.

Mike: As are just what we buy, the middle isles in a grocery store, right?

Mike: All that processed stopped.

Marion: Right.

Mike: Some of the same foods that are available in America are also available in other countries, but they're made differently.

Marion: Yeah. They don't have a lot of the additives that American foods have. The American producers have said they're gonna get rid of them by the end of 2027 (laughs) they'll get rid of them.

Marion: I'm waiting to see what the new cereals are gonna look like without the color dyes. And they probably will, they can, so they will. But the message to eat real food coupled with avoid highly processed foods, raises a whole bunch of issues of how are people gonna do this?

Marion: You have to be able to cook if you're gonna be able to do this. And lots of people, I don't think anybody in government realizes how many people there are who don't have a clue how to cook, who don't have cookie equipment, who don't have kitchens, who don't have refrigerators, who don't have stoves. Who don't have access to healthy food either because they don't have enough money or because it's just not available.

Marion: And they don't have the time to do any of that. So there's not much sensitivity to that in these, and I think there needs to be.

Mike: For those people who are listening and watching who are confused by all the shifting advice on alcohol, food, what are your core principles for what they should rely on?

Marion: I think dietary advice is so easy that the journalist Michael Pollan does it in seven words. Eat food, not too much, mostly plants. These guidelines have switched that except for the eat food. They say eat food as much as you like, mostly meat. Makes no sense to me. Yeah, if you're eating relatively unprocessed foods in amounts that don't exceed your calorie limits and you're eating plants, you're doing fine.

Marion: Stop worrying about it. Enjoy your dinner. I think it would be great if people would stop worrying so much.

Mike: Yeah. I loved your book 'cause you go into such detail of how you do it and I can, I just had this vision of you in a grocery store across the country, just walking up and down the aisles and people, the manager looking at you going, uh oh!

Marion: (laughs) You know, I used to get stopped all the time 'cause I'm sitting here with a notepad and a calculator. And but now since all the people, the shoppers are there doing all this stuff with their phones and their gadgets, nobody pays any attention anymore.

Mike: And there's not that many people working there anymore either.

Marion: There's that too.

Mike: Yeah. So I hear, what's next for you? I hear right that you're working on some with sugars.

Marion: No, cereals.

Mike: Cereals?

Marion: Yeah. The cereal book is gonna come out in September on my birthday. Oh, my birthday present. Yeah, a co-author and I, Lisa Sutherland, who's a former vice president of Kellogg, and I did a book about food labeling policy. Advertising, marketing and food culture in America using cereal boxes as illustrations.

Marion: So I've collected cereal boxes for years, so this was a use of my cereal box collection and the publisher, university of California Press has given us 44 illustrations and they're gonna be in color. I'm so excited.

Marion: It's gonna be a really fun book.

Mike: Talk about something that has gone up, up, up in price too, right?

Marion: I bought a box of Post Mini Wheats in a local supermarket for $7 and 50 cents. I couldn't believe it. Could not believe it. The price of food has gone up so much and I sure notice it. I'm sure everybody else does too. (laughs)

Mike: Yeah, I can't wait to read that as well. I'm so glad that you could take the time with us today to just give us your thoughts. 'Cause when I saw the new guidelines, I've worked with alcohol and the problems with it, my whole life, and it just I always wait for the next step with...

Mike: Like we did with cigarettes to say, Hey, let's just talk truthfully about what it does to you. And we took a step backwards with all of this, so I appreciate your...

Marion: I think so. Not everybody agrees, but I, so I think it's a step back and I think they could have said... First of all, they said nothing about cancer risk at all.

Marion: And alcohol is a really important risk factor for breast cancer.

Marion: Women ought to know that. The Times reporter thinks that men ought to know that more than one drink a day raise risks for all kinds of things. She thinks it's a disservice to men.

Mike: Yeah.

Marion: I think it's a disservice to everybody.

Mike: That's great.

Marion: Too bad.

Mike: I can't recommend highly enough. Get it, it's huge. You'll read it. And here, if you buy the book, I guarantee you'll read it, talk about it, and then give it to somebody. Not that you don't wanna sell more books, Marion. But I've already had three people ask me if, when I was done with this, if they can have it.

Marion: You can pass it along.

Mike: Yeah.

Marion: Oh it comes out in Kindle and Audible too.

Mike: There you go.

Marion: You can have it read to you. I cannot imagine. Oh, I have one more thing to say.

Mike: Yeah.

Marion: Michael Pollan's seven words. Eat food, not too much, mostly plant. He did that in seven words. I took 700 pages.

Mike: Yes. Yeah. When it came in the mail and I saw. (holds up book)

Marion: Show it around the other way.

Mike: Yeah.

Marion: The other end. Yeah, the other end.

Marion: It's a big book!

Mike: Yes. It is a big book. I thought what did I get myself into here? It's great.

Mike: Thank you so much for taking the time with us. I really appreciate it and especially thank you for your body of work over time.

Mike: It's just, it's so refreshing to hear somebody just speak the truth. Appreciate it.

Marion: Oh, thank you very much. I really appreciate that. And send me a link when it's done.

Mike: I will. And for those of you listening and watching, we hope that you find love, courage, hope, support wherever you are. Thanks for listening.

Mike: Be safe, be informed, and be healthy.