Yesterday the U.S. Department of Agriculture released new dietary guidelines. The recommendations emphasize the importance of a diet with lots of fresh fruits and vegetables. The government is also advising Americans to cut back on salt and, in general, to eat less. It’s no secret that our diets are less than ideal. A majority of adults and over one third of all children are overweight or obese. But some question what impact, if any, federal dietary guidelines can have. Join us to discuss the new government recommendations on what we should eat, whether these guidelines can help improve our health.

Guests

  • Margo Wootan director of nutrition policy at the Center for Science in the Public Interest.
  • Robert Post deputy director, Center for Nutrition Policy and Promotion, USDA
  • Dr. Walter Willett chairman of the Department of Nutrition at the Harvard School of Public Health; professor of medicine at Harvard Medical School; co-author of "Eat, Drink, and Be Healthy."
  • Scott Faber Vice President for Government Affairs, Environmental Working Group; former vice president, the Grocery Manufacturers Association.

Transcript

  • 10:06:55

    MS. DIANE REHMThanks for joining us. I'm Diane Rehm. For the first time in five years, the federal government has updated its dietary guidelines. On the list, more fruit, vegetables, less salt, more exercise. Joining me to talk about what's different and what difference they can make in our health, Robert Post, he's deputy director of the Center for Nutrition Policy and Promotion at the U.S. Department of Agriculture, Margo Wootan of the Center for Science in the Public Interest, Scott Faber of the Grocery Manufacturers Association and, joining us from a studio at Boston Bureau Productions, Dr. Walter Willett.

  • 10:07:47

    MS. DIANE REHMHe's chairman of the Department of Nutrition at the Harvard School of Public Health. I hope you'll join us with your thoughts, your ideas. Call us on the phone. Send us an e-mail. You can post a message on Facebook or send us a tweet. Good morning to all of you. Good to have you here.

  • 10:08:13

    MR. ROBERT POSTGood morning

  • 10:08:13

    MS. MARGO WOOTANGood morning.

  • 10:08:13

    MR. SCOTT FABERGood morning.

  • 10:08:14

    DR. WALTER WILLETTGood morning.

  • 10:08:14

    REHMRobert Post, if I could start with you. Tell us about these guidelines. What's changed? What hasn't?

  • 10:08:23

    POSTWell, thank you very much for inviting me to be here this morning. I am happy to say that yesterday we were -- we released the 2010 dietary guidelines for Americans. And what we see with these new guidelines is the focus on a population that is overweight and obese. There's an emphasis on managing body weight through all stages of life -- that's different than before -- so that we're addressing the needs of individuals over 2 years old and, certainly, individuals that are older Americans. There's a focus on children and a concern that children today -- one in three -- are overweight or obese. And that's a serious concern, a public health concern.

  • 10:09:06

    POSTMaintaining calorie balance is a huge message here -- the idea that calories in and calories out, calories used up in physical activity -- very important. And then the focus on consuming nutrient-dense foods is another major theme here. And those foods, of course, are the vegetables and the fruits and the whole grains that we need to consume more of. And along the way, we talk about flexible eating patterns in a way we hadn't before. The flexibility in building an eating pattern, using or choosing a variety of foods, is there. We've actually accommodated suggestions for eating patterns for vegan and lacto-ovo vegans as well. So there's a great deal of flexibility this time around in choosing foods within calorie needs, with -- to meet your nutrient needs.

  • 10:10:00

    REHMYou are also talking to pregnant women.

  • 10:10:05

    POSTYes, there are 23 recommendations. And six recommendations are specifically for subpopulations or specific populations, and a number of them relate to women who may become pregnant or are already pregnant and breastfeeding.

  • 10:10:20

    REHMWhat are the recommendations about salt, in particular?

  • 10:10:26

    POSTWell, the guidelines acknowledged that 50 percent of our population is the part of the population where increased sodium does have a negative effect in raising blood pressure. And so that population includes African-Americans and individuals with chronic diseases -- kidney disease, hypertension, cardiovascular disease -- so, for that population, we do understand that 1,500 milligrams is the target.

  • 10:10:52

    REHMWhat does 1,500 milligrams mean?

  • 10:10:55

    POSTWell, we're talking about two-thirds of a teaspoon.

  • 10:11:00

    REHMTwo-thirds...

  • 10:11:01

    POSTYes.

  • 10:11:01

    REHM...of a single teaspoon. Okay.

  • 10:11:02

    POSTExactly. And now, for the rest of the population, however, the recommendation is that the target should be no more than 2,300 milligrams in a day, which is about a teaspoon of salt. Today, however, we're consuming, on average, 3,400 milligrams. That's obviously a big concern. In some population groups for some ages, for example, if you look at teenagers, teenage boys -- I mean, you're looking at an intake of about 4,000 milligrams a day, far more than the recommendation. So we've got a long way to go. But we've got a very serious consideration that we need everybody working at this lower level, including the food industry, helping us get to foods that are lower.

  • 10:11:52

    REHMHow come teenage boys are consuming so much salt?

  • 10:11:57

    POSTIt's a matter of the availability of foods today that just are higher in sodium. Over time, there's an interest -- or there's, I guess, a desire for salty snacks, for example. And now we know that we've sort of hit critical mass, if you will. We need to take a drastic effort here, a deliberate reduction approach to get to the 2,300.

  • 10:12:25

    REHMRobert Post. He's is deputy director in the Center for Nutrition Policy and Promotion at the U.S. Department of Agriculture. Walter Willett, as chair of the Department of Nutrition at the Harvard School of Public Health, I'd be interested in your overall reaction to these recommendations from the USDA.

  • 10:12:51

    WILLETTThere was definitely some movement in the right direction here, but I classify this mainly as baby steps in the right direction. And the guidelines really fall far short of what Americans should be receiving for dietary advice if we're giving them the best advice based on the best available evidence. And probably one of the biggest problems here is essentially an imbalance in clarity, that the guidelines are very clear about, as Mr. Post said -- what people should eat more of -- but it's very vague about what people should eat less of. That -- and that's a real problem because, if calories are a major issue, then we've got to even emphasize to a greater degree what we should be eating less of rather than eating more of.

  • 10:13:42

    WILLETTFor example, the guidelines are very clear and, I think, good in recommending more fruits and vegetables and whole grain -- absolutely, Americans need to move in that direction -- but it becomes vague when it talks about things we should eat less of. It talks about solid fats and, you know, that's really obscure to most people. I even asked a group of nutrition experts what that really meant, and they were -- they didn't -- they were unclear about that. What Americans really should be told is we need to eat less red meat, less cheese, less ice cream and less refined grains. And, particularly, the refined grains deserves emphasis because that's a huge source of calories, and that means white bread, white rice.

  • 10:14:26

    WILLETTAnd the guidelines are also not clear about reduction of soda. It comes down way at the bottom of a list of tips to consumers when soda is actually the number one single most important source of calories in the U.S. diet and has been directly linked with obesity, diabetes, heart disease, gout and dental cavities. So, unfortunately, I think the fingerprints of big beef, big dairy are still all over these guidelines, and they aren't really sufficiently clear.

  • 10:15:02

    REHMWalter Willett, chair of the Department of Nutrition at the Harvard School of Public Health. He's also professor of medicine at Harvard Medical School, co-author of "Eat, Drink, and Be Healthy." Turning to you, Margo Wootan, baby steps simply not going far enough?

  • 10:15:25

    WOOTANWell, the U.S. Department of Agriculture and the Department of Health and Human Services have been publishing the same sensible nutrition advice for 30 years of, you know, eat less of the bad stuff -- salt, saturated fat and sugars -- and more of fruits, vegetables, whole grains. I think they did do a better time -- better job this time of making it more understandable instead of just vaguely saying eat less sugars, which most people would think they should scour their food labels of bread and ketchup for sugar, which doesn't matter at all. Those are tiny amounts of sugar. What they said very clearly in their message to consumers was, drink less soda. You know, drink water instead of soda and sports drink and imitation juice drinks, instead of saying just eat more fruits and vegetables, which everybody knows are good for them.

  • 10:16:13

    WOOTANAnd people might interpret it to mean, you know, put a slice of lettuce on your burger. They said fill up half your plate with fruits and vegetables. So I think they tried to make the messages more understandable. Also -- and probably even more importantly -- this is the first administration that I can think of that did more than just publish a pamphlet and, you know, cross their fingers and hope that people eat better, that this administration has really made good nutrition and addressing obesity a national priority. They have just passed the strongest school nutrition bill ever. They are getting junk food out of school vending machines. They're requiring menu labeling. They're investing in communities to help support healthy eating.

  • 10:16:55

    WOOTANThey're really trying to help people eat better. And the dietary guidelines acknowledge that if we don't change the food supply, we don't have industry change their practices, we don't change policies, people don't stand a chance at eating better.

  • 10:17:08

    REHMWhat about Dr. Willett's point regarding red meat, cheese, ice cream, white bread, white rice?

  • 10:17:18

    WOOTANThey did address some of those. I think this term, solid fats, is awful. I'm sorry, Rob. I really hate this term, solid fats. It just -- it makes it sound like people are sitting around with a can of Crisco eating it, you know, with a spoon.

  • 10:17:30

    REHMRight. Right.

  • 10:17:31

    WOOTANAnd what they mean by solid fats are the bad fats, the kinds that clog your arteries, the kinds that are in cookies and pastries and cheese and pizza and hamburgers. So they could have been more clear, and they should have said, instead of just eat less solid fat, they should say, eat less cheese, pizza, hamburgers, cookies and pastries. That would have been much clearer. But they do have a good message about soda, fruits and vegetables.

  • 10:17:57

    REHMSo you're saying they've gone partway, but they haven't gone far enough.

  • 10:18:02

    WOOTANI think these are the best dietary guidelines ever.

  • 10:18:05

    REHMThus far.

  • 10:18:06

    WOOTANBut there's still work to do in making the messages clearer -- though they're much clearer than the past -- but most importantly, they recognize it's not enough to just publish this little booklet. Healthy eating in America today is like swimming upstream. We have to change the food supply to make it possible for people to follow the guidelines.

  • 10:18:25

    REHMMargo Wootan, she is director of nutrition policy at the Center for Science in the Public Interest. When we come back, you'll meet Scott Faber. He's vice president of the Grocery Manufacturers Association. Short break and right back.

  • 10:20:03

    REHMAnd, overall, the federal government is telling us all to eat less. Too many of us, both adults and children, are way overweight and into obesity from childhood on. And once it begins, it's very difficult to reverse course. Scott Faber, considering your position with the Grocery Manufacturers Association -- first, let me start with the question about salt because, certainly, sodium in prepared foods is something that people are really wondering about.

  • 10:20:47

    FABERAbsolutely. And it's -- I think everyone was struck by the chart that Rob was referring to, that teenage boys -- that group between 12 and 19 is already well above 4,000 milligrams. And so the challenge...

  • 10:21:02

    REHMHeaded for, probably, high blood pressure...

  • 10:21:06

    FABERAbsolutely. So it's...

  • 10:21:07

    REHM...early heart attacks and all the rest.

  • 10:21:09

    FABERAnd the goals that we've set -- in the DGAs of 2,300 and, ultimately, 1,500 for about half the population -- are going to be big challenges for the food industry and for consumers. We've already begun to change our recipes. We've changed about 3,000 of our products to reduce sodium. And...

  • 10:21:27

    REHMGive me an example.

  • 10:21:28

    FABERYou can't walk down the soup aisle today without finding low-sodium options, but probably, more importantly, noticing a general trend, on the back of the can, of decline in the amount of sodium per serving in many of the soups that you would buy in a household. And you see that across the grocery store, but there's a lot more that needs to be done. There's more that we need to do to reduce sodium. And there's a real effort underway in our kitchens to find ways to produce nutritious foods, foods that are nutrient-dense -- to use the words that you'd find in the DGAs -- but are ultimately foods that consumers crave. And that's something that we're struggling with every day.

  • 10:22:07

    REHMRobert Post, I want to come back to you because Walter Willett raised red meat, cheese, ice cream, white bread. To what extent are they not completely addressed because of lobbying on the part of the dairy industry?

  • 10:22:30

    POSTWell, first, I have to say that at no time can I remember, in the process of the dietary guidelines development, has there been a sense of transparency. I mean, the amount of transparency in this process is one that used today's technology. We had webinar access to all of our meetings. We've had a very well-structured public comment database. All the interactions with the public are available for view by anyone. They're there today. They've been there for the past two years. They will continue to be available. So the transcripts of meetings, the information that the committee -- the advisory committee on whose report these guidelines are based in part or, in most cases, it's a matter of looking at the public record.

  • 10:23:21

    REHMSo the meat and dairy industry was present at all these meetings, contributed, and people can see that online?

  • 10:23:30

    POSTExactly. That all this is available as part of the public transcripts and public meeting comments.

  • 10:23:35

    REHMBut why is there, considering the fact that we have all learned an awful lot about cholesterol, the way red meats affect us and, goodness knows, you know, how we should be eating more fresh fruits and veggies, but less red meat?

  • 10:23:59

    POSTThe science shows us that there's a -- there's support for building flexible eating patterns, however, patterns that are guided by your nutrient needs and within your calorie needs. There isn't -- it's not a matter of dictating one food or other. There's -- in fact, this time around, we've had the ability to craft eating patterns that include opportunities for vegan approaches, as well as milk and egg options as part of a vegan approach. So the idea isn't to eliminate any particular food.

  • 10:24:37

    POSTIt's to look at the dietary components within those foods that contribute to the chronic illnesses and overweight, including saturated fat, including added sugars. More calories are sourced. Thirty-five percent of our calories come from saturated fats or solid fats and added sugars. We need to decrease those calories, which are, on the average, in a 2,000-calorie diet, about 800 of our calories, rather than no more than 5 to 15 percent, which is what they should be.

  • 10:25:05

    REHMWalter Willett.

  • 10:25:08

    WILLETTYes. I think it's certainly true that we need to reduce those sorts of -- those sources of calories. But, as Dr. Wootan said, it's very vague, very unclear when you talk about solid fats, that -- what are the fats in milk, for example? That's a lot of saturated fat there, but it's liquid. Now, the margarines are almost all trans-free in this country. They're actually not too bad in terms of their fatty acid composition, but it's solid. And I think Mr. Post, as you can hear, just has a hard time saying, as the USDA, in general, does -- maybe impossible for them to say -- that we should reduce red meat. There's very clear evidence, actually.

  • 10:25:49

    WILLETTFor example, in a major study in 400,000-plus people done by the National Cancer Institute, higher red meat consumption was directly related to overall mortality, as well as death from cardiovascular disease. And there's whole vast literature supporting that. If you really want people to reduce solid fat intake, you've got to talk about reducing consumption of red meat, consumption of cheese, ice cream and other products like that. And it's -- that's -- that needs to be said clearly.

  • 10:26:21

    REHMRobert Post.

  • 10:26:23

    POSTWell, I would say that the evidence that the committee had available to it and reviewed publicly, on which the guidelines are based, helped us craft these guidelines, this policy. And the evidence, which is available online, by the way, at nutritionevidencelibrary.gov, will show that protein foods are important. And there are many ways to get the protein you need in building a healthy eating pattern. And it could be more seafood, which is what we're advocating this time around. It could be nuts and seeds. It could be beans. But it also could be lean and extra lean meat. It -- these are reliable and effective ways of getting the protein that you need.

  • 10:27:07

    REHMYou did hear Dr. Willett say that red meat is related to much greater incidents of heart disease and mortality. So the question really becomes, is the USDA there to regulate, to oversee? Or is the USDA there to promote the consumption of red meat?

  • 10:27:42

    POSTThe red meat that's advised as part of a healthy eating pattern is lean meat, lean choices for all of your protein choices. And so, in that regard, we're -- we are promoting lean meat. It's -- and...

  • 10:27:56

    REHMWhat about that, Walter Willett? Lean meat, does that make a difference?

  • 10:28:02

    WILLETTWell, I think you can hear the imbalance there. He can say, yes, eat lean meat, but he can't say eat regular meat. That very lean kind of meat is only about 10 percent of the beef in this country. The vast majority is full fat meat, and so that's the imbalance that you hear. You can talk about eat more of the lean stuff, but you can't say eat more of the regular cuts of meat. And the same with dairy. You can talk about eating more low-fat dairy, but can't say eat less cheese, partly because USDA has this major program to promote the consumption of cheese.

  • 10:28:35

    WILLETTAnd, I think, if the USDA really can't provide a balanced view of nutrition and nutritional advice, maybe it's better for them to recuse themselves from this process and just hand it all over to HHS. Mr. Post talks about the open process, and he's right. The committee hearings are there in the public record, but the door slammed after that report was submitted. And everything else, the document that you see, that was just released, was produced behind closed doors.

  • 10:29:09

    REHMThat's interesting. Margo Wootan.

  • 10:29:12

    WOOTANWell, there is a lot of opportunity to comment throughout the process, and I know we, as advocacy -- you know, as an advocacy group, take advantage of that, just as food and beverage companies do, that you can comment on the science through the proceedings. You can listen in to the deliberations. You can send comments after the scientific report comes. I think we do have a problem of the tradition of the dietary guidelines. You know, it's this dense scientific document. I think it's terrific that USDA, this time around, acknowledged that this is a policy document. They don't expect that very many Americans are going to read this 95-page booklet.

  • 10:29:52

    WOOTANWhat they've done is, you know, try to distill that down, and they have this terrific one-page, you know, list of top-line messages to try to help people prioritize. I think one of the things we do with nutrition is we overwhelm people with so many things about their diet that they need to change that people just feel like it's impossible. But if you look at these top-line messages, you know, start with the most important things. Make half your plate fruits and vegetables. Change your grains to whole grain. But, you know, don't overeat grains. Watch out for what you drink. Those sugary drinks, they're making us fat. They're a big contributor to obesity. You start with the most important things, and work your way from there. And, I think, they did a better job at prioritizing than they've ever done in the past.

  • 10:30:36

    REHMAll right. Let me read for you an e-mail from Julia in Grand Rapids, Mich., who says, "I appreciate that the government is all about promoting healthy eating. I'm lucky in that I can afford to eat better than most. How can they throw out these kinds of guidelines while they subsidize the industries that make unhealthy food more affordable? Is the government planning on subsidizing healthy foods, local farms and organic growers?" Mr. Post.

  • 10:31:15

    POSTWell, in part, I can answer that, and, actually, I can't answer a large part of that. I will say that there are many efforts to make sure that people have access, for instance, to fresh foods. There are a lot of federal activities across the departments that promote, for example, more farmer's markets and more access to fruits and vegetables. We are very much interested in that. And I guess I'll leave my comments at that in terms of the...

  • 10:31:47

    REHMAll right. And, Scott Faber, you wanted to comment.

  • 10:31:51

    FABERI think it's a great question because this document is not just a roadmap for food manufacturers or for people who will communicate to consumers, but it's also a roadmap for how we need to reform our farm and food policies to invest in nutrition education and to provide consumers access to more healthy choices. It's great to see people should get -- have half their plate covered with fruits and vegetables. That's not possible for about 10 percent of Americans 'cause they don't have access to a grocery store.

  • 10:32:20

    FABERSo I think the question for Secretary Vilsack and the Congress is, are we going to double down on traditional farm subsidies? Or are we going to divert some of those funds to help people get access to fruits and vegetables and to really make this information -- which is really for policymakers and health professionals -- available and understandable by moms in the grocery aisle?

  • 10:32:41

    REHMScott Faber, he's vice president of the Grocery Manufacturers Association. And you're listening to "The Diane Rehm Show." We'll open the phones now. First to Lansing, Mich. Good morning, Julie Kay. You're on the air.

  • 10:33:01

    JULIE KAYGood morning, Diane.

  • 10:33:03

    REHMHi there.

  • 10:33:03

    KAYI'd like to -- hi. I'd like to share a comment which is mostly filled with frustration because I don't actually think that people don't know how to eat. I work with women who want to lose weight -- and, I, myself, struggle with weight -- and we have read so many books. And we have so much information about how to be more healthy. I think it's that our lives, our environment make it very difficult to make those choices. It's very hard to make the time. And I'm talking about privileged middle class people, right? Never mind what you've just been discussing, that some people don't have access. And I don't think looking at nutrition by itself and pretending like we don't have the information is actually the solution.

  • 10:33:56

    REHMWalter Willett.

  • 10:33:59

    WILLETTWell, I think that's a very good point. And I would echo Dr. Wootan's point that the current administration is actually doing much more than has ever done to try to go beyond just giving dietary advice but to translate whatever the guidelines are -- perfect or imperfect -- into federal policy. We've seen the new dietary standards for schools just put out. And every branch of government is being asked to support healthier nutrition. So it's not just up to individuals.

  • 10:34:34

    WILLETTAnd, I think, to its credit, this new report -- several people have mentioned -- does go way beyond telling -- just providing guidance to individuals. It really identifies actions that need to occur in every branch of government at the national, state and local level. For instance, healthy food should be there in schools. They should be emphasized in worksites. If you go to a hospital, you should see the best possible example of healthy nutrition. And I can tell you, in hospitals in Boston and around the country, you do not see the healthiest food there. Those make it easier for people to make healthier choices rather than having to swim upstream.

  • 10:35:17

    REHMBut, you know, with all the emphasis that we have seen over the years, this isn't the first time we've been told eat more fruits, vegetables, whole grains. Is there any indication that our consumption of those healthier foods has gone up, Margo?

  • 10:35:41

    WOOTANWell, if you look at Americans' interest in nutrition, it has definitely gone up. But if you look at how they're able to act on that interest, we're not doing very well. And it is because our food environment is obesogenic. Our portion sizes are gigantic. We eat out a lot. Soda is everywhere. You know, gas stations, drug stores, Best Buy -- they didn't use to serve food. Now, when you go to checkout of almost any retail outlet, there's candy and other junk food right there.

  • 10:36:11

    WOOTANOur schools have a lot of unhealthy food in the meals and in the vending machines. We send our kids out to raise money by selling candy bars. I mean, all of this stuff adds up together to make our waistlines much bigger than they should be or need to be. We need to change the food environment, and, I think, the dietary guidelines really address that for the first time and that this administration and many of us are working toward that.

  • 10:36:37

    REHMRobert Post.

  • 10:36:39

    POSTWell, I think what we have is a new chapter in this policy that really addresses helping Americans make healthy choices. We address the environment and how complex it is these days. We -- it does require a multi-sector approach -- individuals, communities, schools organizations, business -- to contribute to the solution for getting healthier foods into the supermarket, into schools and across the U.S. So even suggestions -- there are consumer behaviors that are advocated and also strategies in this policy for how to achieve them.

  • 10:37:17

    REHMRobert Post, he's deputy director of the Center for Nutrition Policy and Promotion at the U.S. Department of Agriculture. When we come back, we've got Ed in Floyds Knobs, Ind. waiting, Mark in Finchville, Ky., and Tammy in Traverse City, Mich. We'll take those calls and more. Stay with us.

  • 10:40:02

    REHMAnd let's go right back to the phones to Ed. He is in Floyds Knobs, Ind. Good morning to you.

  • 10:40:12

    EDGood morning. I'm calling about trans fat. You have been talking about solid fats. And trans fats were in the public realm a few years ago. They're made as, you know, by bubbling hydrogen into a liquid vegetable oil turning it into a hard oil -- I'm sorry -- which doesn't liquefy at room temperature or probably even at body temperature. This was promoted by the food industry as promoting shelf life, adding extra flavor, et cetera, which is really not true. The only nutrient value of trans fat is that it stiffens the arteries, and it's slowly metabolized by the body as opposed to olive oil, which is healthy for you in small amounts. I don't know where the industry comes from on this issue, but I feel like the same thing is going to happen with the new revised guidelines. And I'd like comments.

  • 10:41:13

    REHMAll right. Walter Willett.

  • 10:41:16

    WILLETTRight. Thanks. We actually, yes, have done a lot of research on trans fat that identified the adverse effects, and the list of adverse effects has greatly expanded beyond just increased heart disease and also, quite clearly, increasing risk of diabetes, gall stone disease and other problems. But this is actually a success story, I think, that over the last five years, the amount of trans fat in the food supply has been greatly reduced. My guess is somewhere around 75, 80 percent of the trans fats have been limited -- have been eliminated from the food supply, including almost all margarines, cooking oils, many -- the majority of baked goods. It's actually hard to find something in the grocery store that's other than zero on the trans fat line now.

  • 10:42:07

    WILLETTSo our food supply has been invisibly improved in a very big way, and I do want to commend the food manufacturers, the grocery stores and all of the groups and individuals that did contribute to that. And it does indicate, when we're really making a concerted effort, we can greatly improve the quality of our food. We can do that for sodium, but it's going to take a strong leadership and strong commitment to do that. We could do the same things for whole grains as well. So we -- there's still a little bit of trans fat in the food supply that needs to be cleaned up, and we really need the FDA to essentially eliminate it from the category called generally regarded as safe. That would get rid of it overnight. But it's been good in general.

  • 10:42:52

    REHMAll right. To Scott in Toledo, Ohio, on that salt question. Go right ahead. Scott, are you there? Nope. Let's go to Grand Rapids, Mich. Sonny, good morning to you.

  • 10:43:11

    SONNYGood morning. The federal government has little influence with the recommendations that they put out, but they currently spend so much money on food stamps, which is a program they directly oversee. I was recently checking out in a grocery store behind a person who paid for 17 bags of candy and four bottles of pop with their food stamps card. And imagine if food stamps were limited to purchasing more healthy foods and how that would create a demand that would drive healthy foods into inner cities and into the rural areas, to not only benefiting the food stamp recipients, but others in those areas as well.

  • 10:43:43

    REHMSonny, I'd like to ask you a question. Did you actually stand there and count? Is that what you are reporting?

  • 10:43:54

    SONNYThis person in front of me was advertising to everyone around her that she was so excited to be able to purchase these bags of Halloween candy for half off, and her kids were going to be so excited to eat them. And, in my mind, I was thinking, well, of course they will, but how excited will they be when they have to go to the dentist and, you know...But anyway, I just think...

  • 10:44:13

    REHMYeah, it just sounds like -- it sounds like a strange story. Go ahead, Scott.

  • 10:44:18

    FABERWell, you know, there is -- from time to time there are proposals to limit what people can use with their food stamp benefits or SNAP benefits. And what we found over and over again -- what USDA has found over and over again is that it's very ineffective, that people -- if you prohibited certain purchases, they would use cash to make the prohibited purchases. And it would be an administrative nightmare for grocery stores to try to police what people can buy with their food stamps and buy with their cash.

  • 10:44:47

    REHMSo, at this point, they can buy whatever they choose? Margo.

  • 10:44:50

    FABERBut...

  • 10:44:51

    WOOTANThere are some limits. They can only buy foods -- there are certain prepared foods they can't buy. They can't buy, like, paper towels and napkins. But what New York City has proposed is a pilot test to not allow food stamp dollars to be used to buy soda, you know, which is barely a food anyway. And people could buy other foods. There wouldn't be strict nutrition standards, but at least eliminate soda, which is the biggest source of calories, a big contributor to obesity. I think that's very sensible, and USDA should approve their application to try this out.

  • 10:45:21

    REHMI think that the...

  • 10:45:22

    WILLETTCan I...

  • 10:45:23

    REHMSure. Go ahead.

  • 10:45:24

    WILLETT...add in, Diane, too, that I'd really like to second what Dr. Wootan mentioned, that this seems ridiculous that taxpayers are being asked to write checks for soda with one hand and then, with the other hand, being asked to write checks to pay for diabetes treatment. The evidence that soda is damaging to health is crystal clear, and yet we're using tax dollars to support that. And Mr. Post is not correct that this would be an administrative nightmare because of the bar coding system. We all -- as Dr. Wootan said, we already don't allow many purchases at the grocery store, and we just need to change the code in the checkout (unintelligible) no problem.

  • 10:46:06

    REHMActually, it was Scott Faber who said that. Go ahead, Scott.

  • 10:46:10

    FABERYeah, let me add that there are about 300,000 different products that are in commerce, about 40,000 in an average grocery store, and there are thousands and thousands of new products entering the marketplace every year. So the notion that not only are we going to re-code things and provide the information, but also begin to have somebody, I suppose, at USDA -- maybe, Margo, you do it -- start to draw lines between what is a prohibited item, what is not a prohibited item becomes very difficult.

  • 10:46:36

    WOOTANWell, we're just talking about soda at this point.

  • 10:46:36

    FABERYou know, for -- a good example would be -- a good example would be fruit juices, milk, granola bars. Where do you draw the line? You know, I think, on this point, the First Lady has got it exactly right where there is room for indulgences. There's room for French fries in our diets. But that, as the DGA spells out, there are certain things we need to really emphasize in our diets, for example, filling half the plate with fruits and vegetables. And there are things we need to get less off in our diets, things that provide a lot of calories but don't provide a lot of nutrients.

  • 10:47:07

    REHMMargo.

  • 10:47:08

    WILLETTWell, we're just talking about soda here in the New York proposition.

  • 10:47:10

    REHMYeah, just soda.

  • 10:47:12

    WOOTANAnd it's easy to -- it's already coded 'cause a lot of states have sales taxes on soda but not other food items. So they are already doing it.

  • 10:47:19

    REHMOkay. To Finchville, Ky. Good morning, Mark.

  • 10:47:24

    MARKGood morning. Thank you very much.

  • 10:47:25

    REHMSure.

  • 10:47:27

    MARKI find it misleading to group red meat, cheese, ice cream and white bread together as I've heard several times on the show today. Red meat and raw milk cheese are staples of every healthy traditional diet in the history of our human society. Ice cream and white bread are not. And I'd like to pose a related question. How will we gain an understanding of healthy nutrition if we continue to vilify quality saturated fat from naturally raised animals, which, in fact, is the foundation, again, of every healthy human diet that we've ever known on this planet?

  • 10:48:08

    REHMWalter Willett.

  • 10:48:10

    WILLETTWell, that's really not correct that every human diet has consumed those foods. In fact, the majority of the world's population does not consume dairy products and is lactose intolerant. And there have been many studies comparing populations that had high red meat consumption with low red meat consumption or high dairy, both across populations and within populations. And, definitely, there is better health outcomes if people replace some, not necessarily all that red meat, with some fish -- and the dietary guidelines do recommend that -- but also nuts and legumes, the sources of food that have less saturated fat in them.

  • 10:48:53

    WILLETTSo it's, essentially, a substitution moving more toward a plant-based diet. But no one is saying you have to totally eliminate red meat or cheese. But those belong in the use sparingly category, things that are not major source of calories in our food supply.

  • 10:49:07

    REHMAll right. To San Antonio, Texas. Hi, Steve. You're on the air. Go right ahead.

  • 10:49:15

    STEVEHi, Diane.

  • 10:49:16

    REHMHi.

  • 10:49:16

    STEVEI just wanted to ask your guests what they thought corporate lobbying, corporate interest had on the guidelines, I guess, in general. Specifically interested in Michael Pollan's work and the "Food, Inc." movie and all this, where -- how the view is basically that most of the grocery store is basically different kind of rearrangements of, you know, corn syrup and corn products and all these processed foods, these big agrobusinesses, is basically taking control at. I think that's a major part of the nutrition problem in this country, and I'm just wondering what your guests thought about corporate interest and corporate lobbying.

  • 10:50:05

    REHMAll right. All right. Walter Willett, I'm going to come back to you.

  • 10:50:11

    WILLETTBig topic, but it is true that if you look at grocery store shelves, that the vast majority of products are refined starches, sugars, salt -- until recently, high in trans fat also. And from a health standpoint, clearly we need to be shifting those toward more whole grains, more intact foods, less highly processed foods. And our policies have not been pushing diets in the right direction. They have been more supporting this highly refined, highly profitable, highly processed foods.

  • 10:50:46

    WILLETTAnd so it is the kind of area that does need attention to remove the subsidies that promote unhealthy foods and give those subsidies more to foods like fruits and vegetables and reduce the price barrier to purchasing healthy products. Actually, grocery stores have started to do that. The Walmart announcement last week that they would commit themselves to reducing some of those price differentials between sort of the regular and the healthier version. There's a glimmer of hope.

  • 10:51:16

    REHMI'm not sure you answered our caller's question directly, Walter Willett, that is to what extent lobbying efforts play a role in formulating these kinds of reports to the general public.

  • 10:51:36

    WILLETTThat's out of my area of expertise, but it is clear -- very clear that, particularly the dairy, the beef industry and other major parts of the agroeconomic industry have very powerful influences and spend a lot of money on lobbying efforts. And they have results.

  • 10:51:56

    REHMAll right. Here is a question from Kevin in Baltimore. "Please have your panel discuss the advantage of sea salt. It has trace minerals versus table salt, which is only sodium." Can you answer them, Margo?

  • 10:52:13

    WOOTANWe know sodium is one of these issues that's tricky because it's absolutely necessary for life. It's an essential dietary nutrient. It's the amount of sodium that's killing us that we need to cut back on salt to safe levels. We think it's so dangerous at the current levels that the Food and Drug Administration should regulate the amount of salt in foods to keep it at safe amounts.

  • 10:52:35

    REHMMargo Wootan at the Center for Science in the Public Interest. You're listening to "The Diane Rehm Show." Pardon me. To Dayton, Ohio. Good morning, Elaine.

  • 10:52:50

    ELAINEHi. My question is that the public school diet here -- we're in Kettering, Ohio. It's a nice district, but the food offered by the public school lunches is really high in processed grains, salt, sugar, meat. And I was wondering -- I know I can pack my daughter's lunch, but what about people on food assistance? Is there any ways that we can change this? Who do we talk to, to try and get a change in the public school lunches?

  • 10:53:16

    REHMGood question.

  • 10:53:18

    WOOTANWell, Congress just passed, and the president signed, one of the strongest school lunch child nutrition bills ever. And that's going to help parents and children a lot. USDA came out last month with new standards for school lunches, which will increase fruits and vegetables and cut back the salt and the bad fats. And then, also, we're going to get all the junk food, the soda, candy bars out of the vending machines. So these things are coming...

  • 10:53:45

    REHMHow long is that going to take across the country?

  • 10:53:46

    WOOTANWell, that's the thing. It is going to take awhile. The meal standards probably be another two years, the vending machines, another three years. So, in the meantime, parents need to work with their local school district to help them, encourage them, nudge them to serve healthier meals and get rid of the junk.

  • 10:54:04

    REHMWell, and, in the meantime, those vending companies who provide the machines with the not-so-healthy food are also paying those schools to put those machines in there. How do the schools compensate for the money they're going to lose in the process?

  • 10:54:27

    WOOTANWell, what schools are finding, actually, is that they can make just as much money selling healthier options.

  • 10:54:33

    REHMGood.

  • 10:54:33

    WOOTANThe kids will drink water and juice, and then also more kids participate in the lunch program, which is actually more profitable for the schools.

  • 10:54:40

    REHMGood. Robert Post.

  • 10:54:41

    POSTI was going to add that, with the Healthy and Hunger-Free Kids Act, which was landmark, we've got that effort to improve after many years of not having that ability to improve the pattern for school meals. And so that's a significant accomplishment for this administration, and we are seeing a lot of effort to get the foods in those vending machines to be the better choices today.

  • 10:55:07

    REHMOne last e-mail question from Scott. "As foods get lowered in sodium content, their potassium level rises. How does that affect individual health?" Scott Faber.

  • 10:55:26

    FABERYou know, there's a lot of improvement that needs to be made, and can be made, with regards to sodium. And there'll be impacts and some that will affect the taste and some that will taste the nutritional profile of those foods as we find ways to reduce sodium. But I think the key here is not to make it too complicated for people. As we're wrapping up this conversation, it struck me that, I think, we've made it harder maybe, not easier, for people to build healthy diets. And I go back to what the DGAs really say, which are, there are certain things you should really look for in your diet -- fruits and vegetables, beans and peas, lean meats, low fat and skim milk. There are some common sense foods that people should be adding more of to their diets.

  • 10:56:04

    REHMRobert Post.

  • 10:56:06

    POSTYes. With regard to potassium, there is a special recognition in these dietary guidelines that, when you lower sodium, there is a relationship to potassium. It's needed. Well, four of the nutrients that we are not getting enough of include calcium, potassium, fiber and vitamin D. And so more food sources for vitamin -- for potassium should be sourced.

  • 10:56:27

    REHMRobert Post of USDA, Margo Wootan at the Center for Science in the Public Interest, Scott Faber of the Grocery Manufacturers Association, and Walter Willett of Harvard School of Public Health, thank you all so much.

  • 10:56:48

    WILLETTThank you.

  • 10:56:48

    WOOTANThank you.

  • 10:56:48

    REHMAnd thanks for listening. I'm Diane Rehm.

  • 10:56:53

    ANNOUNCER"The Diane Rehm Show" is produced by Sandra Pinkard, Nancy Robertson, Susan Nabors, Denise Couture and Monique Nazareth. The engineer is Tobey Schreiner. Dorie Anisman answers the phones. Visit drshow.org for audio archives, transcripts, podcasts and CD sales. Call 202-885-1200 for more information. Our e-mail address is drshow@wamu.org. And we're on Facebook and Twitter. This program comes to you from American University in Washington. This is NPR.

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