Health
3:10 pm
Sat October 15, 2011

Eating Healthy: Whose Choice Should It Be?

Originally published on Sun October 16, 2011 4:16 am

On a recent visit to McDonald's, Christie Coleman, a mother of two boys, was surprised to find that her kids' Happy Meals included fewer french fries and something new: apple slices.

Coleman says her boys are extremely picky eaters, so she was not happy with the change.

"When they do want to eat, they will eat all of their fries, and I don't think that they should get 15 or 20 less fries because McDonald's thinks that they need to eat apples as well," she says.

When it announced the new Happy Meal, McDonald's said it was aiming "to help customers, especially children and families, make nutrition-minded choices for their daily lifestyles."

Coleman thinks her choice is being taken away.

Can people make the right decisions when it comes to what they eat, or should restaurants and institutions do their part to help people make better food choices?

Rising obesity rates are cited for these and other nutritional changes. But Julie Guthman, author of Weighing In: Obesity, Food Justice and the Limits of Capitalism, is not quite convinced that obesity is the problem that it is being made out to be.

"The way many of the statistics are constructed seem to overstate the problem," she tells weekends on All Things Considered guest host Rebecca Roberts.

For example, the body-mass index that is commonly used to measure obesity and obesity prevalence is inaccurate, says Guthman, a professor at the University of California Santa Cruz. A person's BMI is essentially a ratio of weight to height, but the problem is that bone and muscle tissue are heavy as well.

"So if somebody has a big bone structure or works out a lot or has a lot of muscle mass, they will have a higher BMI," she says.

For those who truly are overweight, Guthman says, choosing among problematic options isn't the answer.

"By the time people walk into that McDonald's restaurant, they've already decided that they want a burger. So many of the problems really stem from the way we produce food," she says.

Whether it's the agricultural chemicals or hormones and antibiotics used in producing beef, Guthman says, these things warrant discussions about food production.

Food Decisions And Choice

Dr. Brian Wansink, the author of Mindless Eating: Why We Eat More Than We Think, says we're not even aware of most of the choices we're making about food.

"Regardless of how tuned in we think we are to the food decisions we make and how much we eat, we're a nation of mindless eaters," says Wansink, the director of the Cornell University Food and Brand Lab.

Wansink says the typical person makes more than 200 decisions about food every day — but is not even aware of most of those decisions. Often, he says, environmental cues nudge us into eating more or worse than we otherwise would.

Listing calories on menus doesn't have the impact that healthy eating advocates are necessarily after, he says.

"If you're going in with just a couple bucks in your pocket, you're going to see calories and you're going to say, 'Oh, great, what's going to make me the most full for two and a half bucks?' You're not going to say, 'How can I minimize calories.'" he says. "In that case, something like calorie labeling can actually lead somebody who maybe should be eating fewer calories into actually ordering the most caloric thing."

With all of these food decisions, it might seem that McDonald's is taking some of that choice away by including apples in Happy Meals. But, Wansink says, the choice has always been there.

"I think making it really obvious to people that they have the latitude to come up with the different combinations is good," he says. "In the past you could do that, but mainly only if you knew you were able to do that. Now, they're making that very bold and clear to people."

Balancing Burgers With Broccoli

Given adequate information, can we be trusted to make healthy decisions about what we eat?

Marion Nestle is a professor of nutrition and food studies at New York University and the author of three books, including her most recent, What to Eat. She says there should be a common American interest in making sure all our food options are healthier.

"People don't really have a lot of control over what they eat," Nestle says. "So the idea of trying to get people to ... change their behavior around diets is to try and make it easier for people to eat more healthfully."

Studies show that nutrition and food labeling don't make a lot of difference in what people buy on average, Nestle says. But, she says, it does make a difference to people who pay attention.

"What that means is, the next step on the education side is to try and get [more] people to pay attention to calories," she says.

Nestle says what needs to change is our default eating habits.

"Right now, the default is junk food. How about making the default healthy food?" she says. "People can always order junk food if they want to; nobody is stopping them from doing that."

Of course junk food has its place in American diets, Nestle says. What we want is healthy foods to be most of what people are eating, and junk foods to be an occasional treat as originally intended.

"Nobody ever thought that fast food would be what people ate every day," she says.

Helmet and seatbelt laws were created to help people not make the dangerous choice of not wearing them. With food, Nestle says, there's no reason why that regulation should be any different.

"We do things as a society to try to help people make healthier choices," she says, "and that works for food as well as for all of those other things."

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

REBECCA ROBERTS, host: From NPR News, it's WEEKENDS on ALL THINGS CONSIDERED. Guy Raz is away. I'm Rebecca Roberts.

CHRISTIE COLEMAN: My children, you know, they're 2 and 4, and they're just normal active kids. And, you know, I'm really active. I, you know, work out every day and run on my lunch break, but we eat McDonald's once a week. I don't think that's going to hurt my kids in particular.

ROBERTS: That's 28-year-old mom Christie Coleman. She lives in Stafford, Virginia with her two young boys, both extremely picky eaters. Christie often has to fight with them to eat anything at all. So the fact that they like McDonald's, especially the French fries, is a good thing. It's not their daily fare, just a weekly treat before church on Wednesday nights.

On a recent visit, when Christie opened the boys' Happy Meal, something was awry. The small carton of French fries had gotten even smaller, tiny, in fact.

COLEMAN: When they do want to eat, they will eat all of their fries. And I don't think that they should get 15 or 20 less fries because McDonald's thinks that they need to eat apples as well.

ROBERTS: Apple slices, that's what McDonalds has added to every Happy Meal. At the same time, the company has decreased the amount of French fries in the kids' meals down to nearly one ounce.

COLEMAN: And just to be nice, I said, please keep the apples. My boys won't eat them. They're just going to get thrown away. And they said, no, we have to put them in the box. And I was like, really, because I'm just going to walk over and put them in the trash can. And that's like what really started it. And I was really mad. I was upset because they not only make you take apples, but they're taking the food away that my kids actually do eat.

ROBERTS: When it announced the new Happy Meal, McDonald's said it aims to help customers, especially children and families, make nutrition-minded choices for their daily lifestyles. But whose choice is it, really? That's our cover story for today. Christie Coleman feels her choice is being taken away.

COLEMAN: If a parent really wanted their kids to eat apples, they would say, no, my child cannot have French fries only. Let them substitute the apple, or don't let them eat at McDonald's at all, you know, if your kid has an obesity problem.

ROBERTS: That obesity problem, of course, is what's behind these and other nutritional changes.

JULIE GUTHMAN: Well, I'm not quite convinced that obesity is the problem it's made out to be.

ROBERTS: Julie Guthman is a professor at the University of California, Santa Cruz and author of the book "Weighing In: Obesity, Food Justice and the Limits of Capitalism."

GUTHMAN: The way many of the statistics are constructed seem to overstate the problem. I'll give you an example. The body mass index that is commonly used to measure obesity and obesity prevalence is essentially a ratio of weight to height. So if somebody has a strong, big bone structure or works out a lot and has a lot of muscle mass, they will have a higher BMI.

ROBERTS: For those who truly are overweight, Guthman says, choosing among problematic options isn't the answer.

GUTHMAN: By the time people walk into that McDonald's restaurant, they've already decided they want a burger. And all power to them if that's what they feel like eating. So many of the problems really stem from the way we produce food; whether it's the agriculture chemicals we use or the hormones we use in producing beef, the antibiotics we use in beef. These warrant public discussion about how we should produce food.

ROBERTS: But in the meantime, how much choice should consumers have? Dr. Brian Wansink is the director of the Cornell University Food and Brand Lab, as well as the author of "Mindless Eating: Why We Eat More Than We Think." He says we're not even aware of most of the choices we're making about food.

Dr. BRIAN WANSINK: Regardless of how tuned in we think we are to the food decisions we make and how much we eat, we're a nation of mindless eaters. In one study we did, we found the typical person makes over 200 decisions about food every day. Because it's not just whether you want, sort of, soup or salad, but it's, you know, how much salad you're going to eat, whether you're going to finish it, what sort of dressing you're going to be putting on, what do you leave.

And the thing is, most of these decisions, we're not aware of, which is why the environment around us, the little things on the table or next to us, have a huge impact, typically nudging us in the wrong direction to eat worse or eat more than we otherwise would.

ROBERTS: There are a lot of restaurants who are doing things like including calorie counts on their menus. And, you know, McDonald's has reduced the amount of fries that are in their Happy Meals and are including apple slices in addition to the fries. Do you think those sorts of things will actually change the way we eat?

WANSINK: With the restaurant menu labeling, calorie labeling, we're getting a mixed bag. A lot of those studies have been shown that it doesn't seem to have the impact that we kind of want. And in fact, in some studies we've been doing, we find that different people - especially at fast food restaurants - are looking for different things when they go there.

If you're going in with just a couple of bucks in your pocket, you're going to see calories and you're going to say, oh great, what's going to make me most full for two and a half bucks. You're not going to say, how can I minimize calories. In that case, something like calorie labeling can actually lead somebody who maybe should be eating fewer calories into actually ordering the most caloric thing.

With McDonald's, it's a great example. We've done a lot of work with kind of the idea of the Happy Meal, observing things that go on in restaurants. And one of the things we found out that goes on in restaurants is that the Happy Meal is over at one specific time. And that time is when the kid opens the toy. And so, one of the things we found is that with most Happy Meals, the French fries weren't being eaten by the kid. They were being eaten by the parent who's finishing them up.

So the decision to go to smaller French fries, actually around 100 calories' worth of French fries, is a really reasonable decision because it's actually going to keep the kids eating healthy, but it's going to help the parents eat a whole lot healthier.

ROBERTS: You said that we make 200 decisions about our food, and, you know, that can be as simple as whether or not eat. But anyone who's ever stood behind someone at a coffee shop who's been ordering a half-caf, low-foam...

(SOUNDBITE OF LAUGHTER)

ROBERTS: ...skim, two-shot caramel whip, and it takes them 25 minutes to get the order out, you know, is there now an expectation that we get all these choices when we pay for our food in a restaurant? When McDonald's changes what's in a Happy Meal, does that run the risk of making consumers think, hey, I wanted to make that decision.

WANSINK: When I take my girls to McDonald's, they always get the apples, and they get a cheeseburger, and they get nonfat milk. But it's still a Happy Meal, so they love it. Now, those alternatives have always been available to somebody in recent years who wanted to eat at McDonald's and order a Happy Meal, but what they are doing now is, I think, something that's very intelligent. And it's what's Burger King and a lot of the other big players are doing, too, is they are really in your face saying, look, you can have any choice you want: this or this. You choose. Which one?

And I think making it really obvious to people that they have the latitude to come up with the different combinations is good, because in the past, you could do that, but mainly only if you knew that you were able to do that. Now, they're making that very bold and clear to people.

ROBERTS: Brian Wansink is the director of the Cornell University Food and Brand Lab and the author of the book "Mindless Eating: Why We Eat More Than We Think." Thank you so much.

WANSINK: Thank you very much.

ROBERTS: So given adequate information, can we be trusted to make healthy decisions about what we eat and balance the burgers with broccoli? Marion Nestle is professor of nutrition and food studies at the York University, and is the author of three books, including her most recent, "What to Eat." She says there should be a common American interest in making sure all of our food options are healthier.

MARION NESTLE: I don't see that as taking the choice away. People still have the choice. Right now, the default is junk food. How about making the default healthy food? People can always order junk food if they want to. Nobody is stopping them from doing that.

ROBERTS: Is there a way to make healthy food the default and junk food a treat, or should junk food just not be a choice at all?

NESTLE: Oh, I think junk food has a place in American diets.

(SOUNDBITE OF LAUGHTER)

NESTLE: I have my own favorites, and everybody does. Nobody is talking about trying to get rid of these foods. These foods are not cigarettes. With cigarettes, the issue is very simple. You just want people to stop smoking, and if you had the choice, you would put cigarette companies out of business.

With food, it's much more complicated. So what you want is you want healthy foods to be most of what people are eating and junk foods to be occasional treats. Nobody ever thought that fast food would be what people ate every day.

ROBERTS: What's your reaction to things like soda taxes or trans-fat bans? Can those have an effect on the way people eat?

NESTLE: Of course they can, in the same way that those kinds of approaches help people stop smoking. People don't really have a lot of control over what they eat. I know that sounds completely ridiculous, but if you give somebody a large portion of food, or if you put food in front of someone, that person is going to eat it. So the idea of trying to get people to stop smoking and change their behavior around diets is to try and make it easier for people to eat more healthfully.

ROBERTS: Does consumer education, in your opinion, work? Can people be trusted to make the right decisions if they have the right information?

NESTLE: To some extent, people - the education helps a lot. But in addition, I think we have to make things easier for people. It's very, very difficult to eat healthfully if you're surrounded by foods that are going to encourage you to eat more of the wrong kinds of things than you particularly want to, so all of those things have to go on at once.

But I think we need - I think by this time, everybody realizes the food environment is something that has been promoting poor health for a very long time now and that we not only have to educate people but we also have to change the environment at the same time. If we as a society want to have healthy people, we're going to have to have people who eat healthfully. And I think health benefits everybody.

ROBERTS: People make choices all the time that are ultimately not particularly great for their health. You know, they ride a motorcycle, they don't wear their seatbelts. Why do you think food has become such an area of attention?

NESTLE: Food is just like everything else. Yes, people will make choices that are bad for their health, and the government has stepped in, in all of the cases that you mentioned, in order to make it harder for people to make those bad choices. You need to wear a seatbelt, and if you don't, you get into trouble. I don't see why this is any different in that situation.

We do things as a society to try to help people make healthier choices, and that works for food as well as for all those other things.

ROBERTS: That's NYU Nutrition and Food Studies professor Marion Nestle who wrote the book "What to Eat." She's been speaking with us from her office in New York. Thank you so much.

NESTLE: My pleasure. Transcript provided by NPR, Copyright NPR.