‘What to Eat Now’ And Navigating Healthy Foods

0:06The typical American supermarket carries more than 30 ,000 products. And there are nearly that many opinions about what items you should buy and how to eat them to maintain a healthy diet. So you call these protein power-packed bowls. Let's walk me through what we need to do with it. I love intermittent fasting. It's helped me and a lot of my clients. Vegetable seed oils. They're literally made in a chemical factory. Peanut noodles, mushy berries into fruit leather, pumpkin seeds into a crispy snack, chickpea water into marshmallows. Swap out your salad for a burger. a juicy burger patty with maybe a little bit of cheese on it.

0:43Meanwhile, Health and Human Services Secretary Robert F. Kennedy Jr. says changing how Americans eat is key to our public health. Yet some of his advice has nutritionists scratching their heads. Throw in the influence of a multi-trillion dollar food industry and the grocery aisles can be a very confusing place. That's where Marion Nestle comes in. She's one of our country's foremost nutrition experts, not only on what we should eat, but about the invisible forces that shape our options. Nessel's new book is titled What to Eat Now, The Indispensable Guide to Good Food, How to Find It, and Why It Matters.

1:19She joins us after the break from New York City to discuss all things food. I'm Jen White. You're listening to the 1A Podcast. Stay with us. We'll be back in a moment.

1:32Marion, welcome back to the program. Oh, it's great to be here. Now, Marianne, in 2006, you came out with What to Eat. It's a comprehensive guide for consumers on how to choose nutritious foods, given all the mixed messages they were getting. And now you're back with an update, How to Eat Now. Why did you feel the need to revisit this guide? Well, it started out as a pandemic project. I had the bright idea of keeping myself busy during the pandemic by updating a book that I had viewed as a timeless classic. And here we are. I figured it would take me about six months to do an update of it. And then here we are four years later.

2:15I greatly underestimated how much had changed in the supermarket. And I thought the changes were well worth talking about because people feel like, just as you said, people feel like the supermarket is a minefield. And I think that's really too bad because I'm a foodie through and through. I love to eat. I think food is one of life's most fantastic pleasures. And it's something you get to do for yourself all the time. And I really love everything about food from soup to nuts. and I thought it would be really fun to do, but I had no idea about how much had changed. It's interesting because your book is 700 pages.

3:00Yes. I mean, once you got into the research for this new iteration of how to eat, were you surprised by how much had changed? Or how surprised were you, I suppose is the better question. Yeah, I was floored. I mean, partly because I hadn't been paying that close attention and also because the changes were gradual. You know, the first thing was that every single product that I had talked about in What to Eat in 2006 no longer existed in the supermarket. Because the turnover of products is so rapid that they change all the time. And then the big one that I noticed more than anything else was walking into the supermarkets that I tend to go into.

3:49Instead of seeing wall-high displays of sugar-sweetened beverages, I was seeing wall-high displays of bottled waters of one kind or another, flavored waters. There's been an enormous replacement of full sugar drinks by flavored waters. I thought, wow, that's a healthy trend. This is a good one. I wonder what else is going on. Some of the others are less healthy, but plant-based are new. The whole concept of ultra-processed is new. And then the thing that has totally transformed supermarkets is online ordering. It's changed everything. And so I thought it was worth delving into that. What's going on?

4:35Updating the issues. What do people really care about? What's disappeared as an issue? Trans fat would be one of them because there's no more trans fats in the food supply. And they've been replaced by many other issues that really concern people. And, you know, I'm interested in nutrition and health. I'm interested in nutrition in the environment. I thought this was an opportunity to explore every aspect of that. So what are the biggest... Besides, it would be fun. Yeah. What are the biggest factors that determine what products and ingredients make it onto the shelves of the grocery store today?

5:13Well, as I like to put it, supermarkets are not social service agencies and neither are food companies. They are not public health agencies. They're businesses with stockholders to please. And once you understand that, everything that goes on in a supermarket and everything that goes on in a food company makes perfect sense. They're trying to maximize sales. You know, it seems so obvious. And yet, because we need to eat and we depend on these products, we just don't think of the business aspects. So I went into supermarkets thinking about the business aspects. Your book walks people through the supermarket aisle by aisle and digs into what we'll find there.

5:57So the cereal aisle, for example, it seems to stretch on forever. There are all these bright boxes with claims about whole grains and vitamins. And there are so many grams of sugar in even the quote-unquote healthiest cereals. Well, I love the cereal aisle. And my next book for next year is going to be a book about cereals and using the cereal box as a way to deconstruct food policy in America. But the big changes in the cereal aisle, there are two. One is there are many fewer health claims on cereal boxes because the FDA cracked down on them in the last 20 years. But the other one is the proliferation of options.

6:4220 years ago, there were Cheerios. Now there are 20 kinds of Cheerios. There are blueberry Cheerios, honey Cheerios, chocolate Cheerios, protein Cheerios. That's my current favorite. it. And the reason for this is pretty obvious. The more kinds of Cheerios there are, the more shelf space they take up. And one of the supermarket rules is the more shelf space, the more people see the product, the more people are likely to buy it. And the whole point is to get customers to buy products. Well, let's go to our voicemail. Here's the message we got from one of you? I do not find it difficult to find healthy food.

7:26I find it difficult to afford healthy food in our grocery stores. Thanks for that message. Now, food prices are up 29 % since February 2020. That's according to the Bureau of Labor Statistics. Marian, what are some of the factors that are driving prices higher and keeping them up? Well, first of all, I had a lot of prices in what to eat in 2006, and I can compare them. And prices have doubled since 2006 across the board, where much of that happening just in the last several years. The pandemic messed up supply chains that raised the cost. Consolidation in the food industry means that very few companies control large amounts of food that's in the marketplace and they can control the prices because you don't have any choice.

8:20and the cost of basic food ingredients has gone up. The cost of everything has gone up. I'm just shocked by how much food costs. So to what extent does that put healthy food just simply out of reach for many Americans? Oh, yes. Well, this is a matter of policy. Shall we talk about food policy here? You know, this is a situation in which what gets subsidized by the government are the ingredients of processed foods, corn and soybeans, which are used mainly as food, as feed for animals, or a fuel for automobiles, of all ridiculous things. Half of our corn and soybean supply goes to produce biofuels, which seems absolutely amazing to me.

9:07That raises the cost of food. Everything raises the cost of food. And the government policies and the government programs that are helping people with cost of food are the ones that are under attack by the current administration. And I'm very worried about what happens to people without money in our society. We're already seeing photographs of long lines of cars lined up at food banks. Well, you're talking about food banks, and we can't talk about food affordability in this moment without mentioning SNAP. That's a government nutrition program. It helps feed roughly one in eight Americans, and it's been at the center of a political firestorm during the government shutdown.

9:53As someone who's watched the politics around food for decades, Marion, are you at all surprised to find an anti-hunger problem, a program rather, in the middle of this debate? Well, I think it's just shocking. Why would you want millions of Americans to be hungry? I mean, are we going to turn the United States into something like Great Britain during the English poor laws of the early 1600s, where people were starving on the streets? Is that what we want to see in America? What kind of a society do we want? During the pandemic, when the government provided poor families with income and raised the SNAP benefits, people didn't go hungry.

10:38What a surprise. If people have money for food, they'll buy food. If people don't have money for food, they will struggle to feed their families. And the poor in the United States involve many, many, many millions of children. Well, food is a central part of Health Secretary RFK Jr.'s Make America Healthy Again movement, or MAHA. Here's Kennedy in April in an interview with CBS News. The processed food industry has figured out all these ways to make food addictive without making it nutritious. So we're addicted to the taste, and they have synthesized the taste. But there's no nutrients in the food.

11:23So we're just getting bad food that's loaded with chemicals, a lot of them created in the laboratory that our bodies were not designed to metabolize. Marian, how did you feel about the health secretary's approach to regulating the food industry when he first started talking about this? Oh, my God, he sounds just like me. I couldn't believe it. I was really pretty excited about that. And when President Trump introduced the nomination of RFK Jr. to be Secretary of Health and Human Services, he introduced him by saying we have to do something about the food industrial complex. I thought, wait a minute, what's going on here?

12:06But now we're months later, and unfortunately not very much has happened to try to attach some action to any of that talk. I'm afraid that Kennedy is run up against food lobbying in a way that he really didn't expect it. The first report from the Make America Healthy Again Commission talked a lot about ultra-processed foods. The second report said, oh, we have to define them. So it looks to me like there's been a backtracking and that they're finding that doing things about the food system is going to be a lot more complicated than they thought initially. Jennifer writes,

13:15a week can make a big difference, and it's better for your health as well as the environment. So the first thing I want to ask you about, Marian, is not so much the health, but the accessibility question around food. Well, it's an enormous problem for people who don't have any money. And yes, it's true that rice and beans don't cost very much, but you have to know how to cook them. You have to know how to cook. You have to have pots and pans, a stove and a refrigerator, and lots of people in the United States don't have those things. They really don't. You know, it's very hard for those of us who do to recognize what life is like for millions and millions of people in the United States.

14:01Forty-two million people qualify for food stamps for the SNAP program. Forty-two million people qualify and are on SNAP. There are many, many millions more that qualify but haven't applied for it for one reason or another. And so we have vast amounts of people in the United States who don't have money. And by the way, most of these people are working, but they're working at jobs that don't pay enough for them to feed their families adequately. This is all a question of public policy. You know, I think we need public policies that make sure that people have enough money to buy food so they can feed their families adequately.

14:41And when we talk about accessibility, even beyond the financial piece of it, in your research, what have you found about people being able to access a store where they can buy the fresh produce, where they can buy the beans and the rice and food that isn't, you know, over-processed? Well, many, many people in the United States live in areas that are considered food deserts or, if you prefer, food apartheid. And these are places where supermarkets do not locate because they can't make enough money. Supermarkets, when they decide where they're going to put new stores, are looking for places with large numbers of people, vast segments of the population that make more than$100 ,000 a year in income.

15:34They're not interested in moving into areas where people make much less than that or are on food stamps or are on assistance programs. So that what you have instead is the influx of dollar stores into those areas. And these are stores in which keeping the prices as low as possible is their main goal. I mean, they make a profit even that way because they sell a very high volume. But these are not stores that specialize in gorgeous produce sections. They have to have some produce because if they don't, they're not allowed to take SNAP benefits. So they have some produce there, but they're not places where people have a very wide choice of food.

16:22And if people perceive the cost of fresh fruits and vegetables as being high, it's because they are high. The cost of fresh fruits and vegetables has, the cost of all foods has increased. But the cost of fresh fruits and vegetables has gone up much higher than the cost of ultra-processed foods, for example. So if you could sit across the table from Health Secretary Kennedy and say, hey, from a policy perspective, please do these two things, what would you ask him to do? I would want him, first of all, to change the subsidy system so that we completely reconfigure our agricultural system to focus on food for people instead of feed for animals and fuel for automobiles or airplanes.

17:12We need a rethinking of the way our agricultural system works. It's currently not about food. Fruits and vegetables and beans and things like that are considered specialty foods by the Department of Agriculture. So that would be one thing. And, you know, the other would be to stop marketing junk food, especially to children. I think we need restrictions on the way these kinds of things are marketed. But mostly we need to get money out of politics. Let's take a quick pause here. We'll be back with more of the conversation in just a moment.

17:50Let's bring another voice to the conversation, Dr. Gita Maker-Clark. She's co-director of the Culinary Medicine Program at the University of Chicago's School of Medicine, and she's a physician practicing family and integrative medicine with the North Shore Medical Group. Dr. Maker-Clark, welcome back to the program. Great to be back. Let's get back into the discussion with this message we got from Nancy, who writes, I'm a retired nutritionist. It was thanks to the New York City Housing Authority and food stamps that I was able to get my two degrees from Columbia University, mostly on scholarship.

18:21I always advise the patients, shop the edges of the supermarket, not the middle. Vegetables and fruits, dairy, eggs, fresh meat and fish, not packaged food. I hope to heck your guests are going to say something similar. So Dr. Maker-Clark, again, you're a medical doctor. You specialize in nutrition and the idea that food is key to maintaining our health. How well do your patients understand how and what to eat to maintain a healthy diet? Yeah, that is the question of this time in U.S. history. I would say that you are seeing people making appointments with their doctor to ask, what should I eat, right?

19:04So it's a really interesting time for me to sort of think about how are we in this position historically where people just actually don't know what to eat? Why is it so confusing? And the truth is most people, I think now there's a lot of information available, really understand what it takes to eat a healthy diet, what the components are of a healthy diet. Like your listener described, they understand that it's mostly plant-based and whole foods, but they really are confused by all of the noise. There is so much noise. They're getting information from so many different places. And that's really confusing for folks to be able to say, like, well, how do I, you know, like Marian was saying, how do I eat rice and beans when I'm also told that, like, beans may not be good for some people because that might create gas.

19:50And I have, you know, irritable bowel syndrome. And this may not be the right food for me, according to the podcaster that I was listening to yesterday. So I think people have an understanding, but I think the noise is getting in the way of the simple messages that we can be putting out about how to eat well. Well, we got this recommendation from Frank. There's an app called Yooka, and you can get it on your phone for free and take a picture of any barcode of any food in the grocery store, and it will rate it between 1 and 10, and the reason why it's got that rating about the ingredients in the food.

20:31Marion, how helpful are food labels these days? Well, if you know how to read them, they're terrific, but they're very, very difficult to understand for most people. You know, I study them. I know how to read food labels. I start by looking at the ingredient list, which lists what's in the food from top to bottom, from the one that's there in largest amounts to the smallest. And then I look to see how many calories and what a serving size is and how much sugar there is and that kind of thing. They're very, very helpful if you know what to do with them. But they're enormously confusing because of the daily values, which set an upper limit for some nutrients, but sort of a floor for others.

21:19And it's, you know, I think it's, they're very hard for people. Most people don't read food labels or they look at them, but they don't really know. They look to see how much sugar there is and go on from there. That's why what's on the front of the package is so important and why food companies spend so much time, effort, and research in putting the messages that they want on the front of the package. Well, we got this comment from Bernard who says, it's not difficult or confusing in the least. Merely read the ingredients. If it lists sugar, do not consume it. If it lists seed oils, do not consume it.

21:53If it lists refined flour, do not consume it. If it contains ingredients which can only be found in a laboratory, do not consume it. otherwise follow the so-called Mediterranean or vegan diets easily learned via YouTube videos. Dr. Maker-Clark, what do you make of that advice from Bernard? I love that, Bernard. I love that. What a nice simplification there. I do think that, again, the confusion is really coming from listening to so many sources from people who don't have background in nutrition or science or even in a basic idea of what a good diet for a healthy human requires, but there's so many like celebrity endorsements of supplements and detoxes and people start to think there's some kind of a magical solution that they're missing out on.

22:38And that's not our fault. You know, I think the online world really rewards these kind of sensationalistic claims, but exactly what our listener is describing, I think is very true. If we stay away from these ultra processed foods, we look for minimal ingredients that we recognize the kind of food that our grandmother would recognize, so to speak. You know, we can really guide ourselves back into a direction towards our own personal health. And I will say, as far as the Mediterranean diet is concerned, while I'm very much a believer in all of the health benefits of the Mediterranean diet, and it's backed up by several decades of excellent nutritional science, there are many heritage diets that are very healthy, and we don't all need to be eating in a Mediterranean style.

23:24Well, I just want to hear from you again, Marion, on the accessibility question when it comes to what some, I mean, someone may be reading a label in the aisle of the store they have access to. And it's like, look, this is what I can get. This is what I can reach. So what's your advice to people who may have limited access to food? Well, you know, I mean, dietary advice is so simple that the journalist Michael Pollan can do it in seven words. Eat food, not too much, mostly plants. So by food, he means real foods. That's, you know, fruits, vegetables, grains, beans, meat, dairy, eggs, fish, foods, recognizable.

24:09But in order to use those foods, people have to know how to cook. And I couldn't agree more with Dr. Gita about the variety of ways in which you can eat healthfully. There is no one healthy diet. Eat food not too much, mostly plants. Gives you enormous freedom to choose from the foods that you love eating the most, to put them together in interesting ways. But you have to know how to do that. Victor says,

25:10But we also got this question from, well, statement from Jessica, who says, I would like to point out that not only do people need money, access in the kitchen, outfitted with basic tools, but they also need time. Cooking healthy, delicious meals does take time. Tons of people just don't have that spare time in their lives. Marianne, I'd love your response to that. Well, that was just what I was going to say when we ended up at the end, that most people who are on SNAP and receive SNAP benefits are working. Many of them are working two or three jobs. And then for them to come home and to sit down and have to prepare a meal, even if they're a fabulous cook and can do it very quickly, may be just too exhausting to even think about.

25:57You've got to buy the food. You've got to bring it home. You've got to figure out what to do with it. You have to clean up afterwards. It's more than a lot of people can contemplate. So I don't know what we do about that. We're not teaching cooking skills in schools anymore. I learned how to cook in the eighth grade in a home economics class. I'm everlastingly grateful to it. And to assume that people can just sort of automatically do this and will want to do this seems to me not very realistic. You know, I would love it if everybody knew how to cook, and I would love it if everybody gardened and grew their own food.

26:39But, you know, and would realize how much fun it is to do that. But the, you know, everybody isn't me, and I know that I'm very privileged. Dr. Maker-Clark, how do you advise people who are trying to make food stretch on a budget, perhaps have severe limitations in time or access to, you know, cooking resources? How do you help them figure out what it looks like to maintain a healthy diet? What advice do you give them? Yeah, I think that it's really important, like Marian was suggesting, to understand the situation of most people is that they aren't just dealing with a poverty of money, but also a poverty of time.

27:22And so those things need to be taken into account when you're like asking people to look at recipes, you know, and really taking the time to go buy all these whole food ingredients. So while eating well doesn't have to be expensive, when I'm talking to patients who are on a tight budget, I also remind them about frozen food and canned food and that those are also nutritious foods and sometimes can be even more nutritious. They're picked at peak ripeness, they're preserved quickly. So a can of beans rinsed well, a bag of frozen greens, a few basic spices can actually be a very nourishing meal, not take very much time at all.

27:58It can take as much time as, you know, opening your mail and that you can build around these affordable staples that have been mentioned, the beans or lentils for protein, brown rice, oats, frozen veggies, canned fish, you know, salmon, tuna, sardines for omega-3s, and then use your herbs and spices that come from your culture, that are particular for your taste profile, to bring your life and your culture back into those simple foods. And so, you know, I try to be really realistic with people that you can have a$2 meal that tastes great, that takes 10 minutes, and there's no shame in that. You know, that's a wonderful thing.

28:38Here's a message we got from Cameron in Maryland who writes, As a primary care doctor, I talk to people a lot about a healthy diet. I love the idea of food prescriptions, like health club memberships for exercise. I think healthy food is often more important than meds for good health. I would love to see attacks on highly processed foods to subsidize fresh foods. Dr. Maker-Clark, at a policy level, what do you think would be most useful to the patients you work with and helping them create a more healthy diet? I would love to see food policy that finally treats food as a part of healthcare and not separate from it.