Doctor Francis Collins is stepping down as director of the National Institutes of Health after 12 years. He reflects on his legacy and his agency's efforts in the fight against COVID-19.
Soda companies acknowledge that there is an obesity epidemic. Coca-cola and other beverage companies say they are doing their part to help to help solve the problem by funding research on health. But nutrition experts say these industry-funded researchers are erroneously saying exercise, not diet, is the key to maintaining a healthy weight. Health expert Marion Nestle says this industry funding blurs the line between philanthropy and marketing. In a new book, she argues that sugary-beverage companies are using a number of tactics to deflect criticism and mislead consumers.
- Marion Nestle Professor of nutrition, food studies and public health, New York University; author of several books about food and health, including "Eat, Drink, Vote."
A Statement From The American Beverage Association
The American Beverage Association released this statement in response to the release of “Soda Politics,” by Marion Nestle.
The people who make up America’s beverage companies have a long history of engaging in thoughtful discussions and meaningful actions to address the public health issues of overweight and obesity. By bringing stakeholders together and working with leaders like President Clinton and First Lady Michelle Obama, we are delivering real and significant results. To support our voluntary efforts, we work hard to bring consumers the fact-based information and the beverage options they need to make the right choices for themselves and their families. And, we are always interested in new opportunities to make more meaningful changes to improve public health. We welcome discussions with anyone from government, academia or non-profits who are willing to partner and make a difference together.
MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Rising concern about the health effects of sugary beverages has lead to a decline in U.S. soda consumption, but health expert, Marion Nestle, argues people are still drinking too many sugary drinks, putting them at greater risk for obesity and type 2 diabetes. The title of her new book is "Soda Politics: Taking On Big Soda (And Winning)." Marion Nestle joins me in the studio.
MS. DIANE REHMYou are, as always, welcome to be one of our guests. Join us on 800-433-8850. Send us your email to email@example.com. Follow us on Facebook or Twitter. Marion, it's good to see you.
MS. MARION NESTLEGlad to be here.
REHMI'm so glad to have you here. For our listeners, we did invite the American -- no, first we invited Coke and then Pepsi who both declined and they referred us to the American Beverage Association, which also declined to be on the air with you, Marion. The American Beverage Association did bring -- or send us a statement as follows, saying "The people who make up America’s beverage companies have a long history of engaging in thoughtful discussions and meaningful actions to address the public health issues of overweight and obesity.
REHMBy bringing stakeholders together and working with leaders like President Clinton and First Lady Michelle Obama, we are delivering real and significant results. To support our voluntary efforts, we work hard to bring consumers the fact-based information and the beverage options they need to make the right choices for themselves and their families. And, we are always interested in new opportunities to make more meaningful changes to improve public health. We welcome discussions with anyone from government, academia or non-profits who are willing to partner and make a difference together."
REHMWhat's your reaction to that statement?
NESTLEWell, my reaction to the statement is that it's typical of my reaction to the entire industry. If there was one take-home lesson from this book and the research that I did for it, it was that this is a schizophrenic industry. It's Dr. Jekyll and Mr. Hyde all rolled into one. The wonderful Dr. Jekyll is interested in public health, is interested in making products that will reduce the problems that are of obesity and so forth and help things in schools, while the Mr. Hyde is working behind the scenes to lobby against any public health measure that suggests drinking less soda or anything else that's going to improve health.
REHMTell me how clear the science is that sugary sodas contribute to the rise in obesity and type 2 diabetes.
NESTLEWell, it's always circumstantial as with any relationship of any specific food in the diet to health. It's always in the context of everything else that people are eating. But by this time, there is so much circumstantial evidence that links regular, habitual consumption of sugary beverages to obesity, bad diets, type 2 diabetes and so forth and so on, a great deal of correlational evidence. But then, also, there are empirical studies that show if people stop drinking sodas, they lose weight and manage their weight better.
NESTLETheir symptoms of diabetes resolve and so forth. By this time, it's really overwhelming.
REHMAnd how much has drinking of sugary sodas declined in recent years?
NESTLEWell, it's at least 20 percent over the last 10 years, at least.
REHMSo somebody's been doing a good job at informing.
NESTLEAbsolutely. And, you know, taking off from your last interview, sodas are about race and class in America. So the people who are eating more healthfully and drinking less soda tend to be white. They tend to be wealthier. They tend to be better educated. And the people who are still drinking a great deal of sodas are people who are less educated and have less money and are members of minority groups and the soda industry is targeting these groups for special marketing so that they'll consume more, not less.
REHMAnd the soda companies themselves say that diet is not to blame for obesity, not alone anyhow. And Coca-Cola has teamed up with scientists who support this view. You talked with Coca-Cola the other day.
NESTLEI did. I spoke with the president of Coca-Cola North America who came and visited me in my office. He's a very, very nice man and we had a very useful and, I think, highly constructive conversation, very frank on both sides. And so they are reaching out as a result of the revelations in the New York Times about Coca-Cola's funding of the Global Energy Balance Network and the scientists behind it who made the statement that it really doesn't matter what you eat. You can eat anything you want. You just have to be more physically active.
NESTLEOh, it would be wonderful if that were true. It really wonderful. But if you're overeating by the amount of calories in a 20-ounce soft drink, you've got to walk three miles to work that off. That's not going to be easy for a lot of people.
REHMSo these articles in the New York Times suggesting that what the companies are trying to do is shift the responsibility onto the consumer who's not exercising enough, rather than to say these sugary drinks can put weight on you.
NESTLEThat's exactly right. And there's also the marketing of sodas as methods for hydration. You know, if you don't want to drink water, you could have something better. That would be fine if the sodas didn't have so much sugar in them. And the way that I remember it, it's roughly a teaspoon of sugar per ounce so that if you have a 20-ounce soda, it's not going to be 20 teaspoons. It'll be 16, but it's still an awful lot of sugar.
REHMAnd what about sugar-free?
NESTLEWell, the sugar-free sodas are going down, too. They have artificial sweeteners in them and they're kind of off my radar because one of my eating rules is don't eat anything artificial and they don't taste good. I mean, that's actually one of the things that's so interesting about this and in a way, it's Coca-Cola's problem. I went a week ago to Atlanta to the World of Coca-Cola, their big theme park in Atlanta. And they have a tasting room where you taste about -- you have between 50 and 100 of their products up there.
NESTLEAnd I came away from it thinking that Coca-Cola tastes better than any of them.
REHMI'd go to sleep.
NESTLEYou just sip. You just sip them.
NESTLEYeah, yeah. Coca-Cola tastes better than any of them and so all of the efforts that the company is trying to go to to make products with less sugar, to make products that are fruitier, that are healthier, that are sweetened in ways that aren't bitter and don't have bitter aftertaste, so very, very difficult when their core product really tastes better than any of -- all of them.
REHMWell, I must say Coca-Cola has been around for how long?
NESTLEMore than 100 years.
REHMMore than 100 years. So can you share with us the constructive conversation you had with the CEO of Coca-Cola?
NESTLENot really because he asked that it be all off the record. But I can say just from other research that I've done that it was typical of what I've seen, which is that executives of soda companies are genuinely interested in public health. They're not trying to poison the American public. They're the Dr. Jekyll face of a company with a very strong marketing imperative. And yes, they want to do something about public health and yes, they are taking all these actions that the American beverage association talks about in its statement, but at the same time, the company is lobbying against public health initiatives.
NESTLEIt is funding what are called astro turf, supposedly, grass roots organizations to fight soda taxes and soda caps. I live in New York City where Mayor Blumberg had the bright idea of setting a 16-ounce cap on the size of sugar-sweetened beverages that could be sold in New York City. I actually thought it was a good idea, except he should've tried for an 8-ounce cap, not a 16-ounce one. But to watch the soda industry's reaction to that was extraordinary. There were planes flying overhead with banners. There were signs on every Coke and Pepsi delivery truck.
NESTLEThere were young people out on the streets collecting petitions, part of this grass roots, ostensibly grass roots organization, New Yorkers Against Soda Taxes. And one of my -- my research assistant asked them how much they were paid and they told them they were paid $30 an hour by the American Beverage Association to do that.
REHMWow. Marion Nestle, her new book is titled "Soda Politics: Taking on Big Soda (And Winning)." We'll take a short break here. Your calls, your comments are always welcome. I look forward to speaking with you.
REHMAnd if you've just joined us, Marion Nestle is with me. She is professor in the department of nutrition, food studies and public health and professor of sociology at New York University. Her new book is titled, "Soda Politics: Taking on Big Soda (And Winning)." I gather, Marion Nestle, you are very much concerned that Coca-Cola gives grants to medical groups like the American Academy of Pediatrics. What's wrong with that?
NESTLEWell, the American Academy of Pediatrics should be in the position of telling parents not to feed their kids soda, especially young children. You would think that that would be reasonable advice from a pediatrician. And yet, if Coca-Cola is funding their educational programs -- somehow those educational programs are unlikely to have that particular message in them.
REHMWell, can you prove that? How do you...
NESTLEYeah, you can look for the message on the website. It's not there. No, it's what's not there. And one of the things that you do if you donate to health organizations, is you buy silence on that particular issue. And there are many, many examples of that.
REHMSo you're saying that Coke is donating $3 million to the American Academy of Pediatrics to both deflect criticism and confuse the science?
NESTLEWell, the Dr. Jekyll part of the company would say, we're supporting an organization that's doing wonderful work in public health. The Mr. Hyde part would say, if we give money to these organizations, they won't criticize us.
NESTLEThey don't. I mean there are classic examples -- I suppose the most classic is the donation of Coca-Cola to the city -- to the Children's Hospital of Philadelphia, when the Philadelphia City Council was planning on imposing a soda tax. Coca-Cola came in and offered $10 million to the hospital. And somehow the soda tax initiative disappeared.
REHMAre there Coke machines within that hospital?
NESTLEWell, I haven't been there to see them but I wouldn't be surprised.
REHMYou're also concerned about soda company marketing and advertising to children.
NESTLETo children, yes. And the soda companies, the Dr. Jekyll part say, we don't advertise on certain television programs -- on kids' television programs, to anybody under the age of 12. But if you go to Coca-Cola World, it's filled with toys. And there are many, many other ways in which soda companies market to children: through sports celebrities, music celebrities, and so forth.
NESTLEBeyonce, who has a $50 million deal with PepsiCo to advertise -- and her face is on the PepsiCo can...
NESTLE...and this does two things. It attracts kids who are interested in music and it attracts African-American kids who are interested in music.
REHMBut doesn't she also serve with Mrs. Obama?
NESTLEOh, yes. As part of the Let's Move! Initiative, of Let's Move!, partnered with a large number of soda companies. And I thought this introduced certain conflicts of interest. But that's how the game is played.
NESTLETo market -- to advertise Coca-Cola -- to advertise Pepsi-Cola, sorry.
REHMAnd now, explain how many, many soda companies have what are called pouring rights contracts at colleges and universities.
NESTLEWell, actually, they have pouring rights contracts with high schools as well. They used to have pouring rights contracts with junior high schools and grammar schools. Those are mostly gone, as public health advocates have gotten angrier and angrier about them and there was more negative publicity. The soda companies have withdrawn those and it's mostly high schools and colleges. But one of the incidents that I talk about in the book is a $24 million deal with the City University of New York to put Pepsi as the exclusive soda sold in those campuses. I work at New York University, which is a Coca-Cola campus.
REHMAnd that means?
NESTLEAnd that means only Coca-Cola products are sold on the campus.
REHMGosh. And you're belief is that consumption -- greater consumption of these beverages is becoming a health risk for Americans.
NESTLEWell, I wouldn't call it a belief. I think there's an enormous amount of evidence that demonstrates that. And the only counterevidence comes from studies that are funded by Coca-Cola and the American Beverage Association. What a coincidence.
REHMSo who's doing all the studies? You're talking about where are being done. What are they finding?
NESTLEWell, it depends on whose studies they are. If the studies are funded independently, they generally find strong correlations between soda consumption and poor health.
REHMWhen you say funded independently...
NESTLEI mean, by government and foundations...
NESTLE...by independent foundations.
NESTLEIf they're funded by the American Beverage Association or Coca-Cola, they almost invariably come out with results that favor the soda industries' interests. So that the investigators who were behind the Global Energy Balance Network, for example, have published papers demonstrating that sodas have nothing to do with diabetes and nothing to do with childhood obesity.
NESTLEAnd then, even more insidious, soda-industry funded researchers have mounted a concerted attack on the quality of information that comes from the government's National Health and Nutrition Examination Survey, which is the nutrition-monitoring survey that provides almost everything that we know about diet and health in American and the relationship between diet and health. And this is the study that has shown the strongest correlations between regular soda consumption and poor health outcomes. And so the soda industry has all these investigators that are looking at the survey and saying, well people -- the quality of the information is so poor that you should ignore it.
REHMHow do you make the correlation between consumption of these beverages and type 2 diabetes?
NESTLEWell, there are lots of different ways of doing it. You can look in a country at the average consumption of sugar-sweetened beverages and the average percentage of type 2 diabetes and show a correlation that way.
REHMAnd what is the mechanism within the body by which this happens?
NESTLEAh. Yeah, the -- I mean, let me make it clear that sodas in small amounts are really not a problem. But if you start thinking about sodas as liquid candy, as Center for Science in the Public Interest dubbed them years ago, you know, you would never let your child eat candy all day long, or most people wouldn't. But somehow it has become socially acceptable to allow children to drink sodas all day long. And yet the effect is the same. And part of it, I just need to say, is that there's so much sugar. You don't realize how much sugar there is.
NESTLEAnd when it comes into the body in liquid form, it's absorbed very rapidly. And if your caloric intake is adequate and you don't need those extra calories, those sugars are going to go to your liver and form fat in the body. And instead of being burned for energy, they're going to be stored as fat.
REHMHere's an email from Cass, who says: There was a powerful ad campaign that showed a can of soda. Next to it was a pile of white sugar. The caption read something like, quote, "You wouldn't eat all of this at once? Why would you drink it?" The ad was short-lived. I always wondered if soda companies somehow blocked the ad.
NESTLEOh, I think television stations are very reluctant to take anti-soda advertising. Magazines are very reluctant. I've been told that magazines are not going to want to review my book because it will interfere with their advertising.
REHMSo instead, you're going to talk about your book.
NESTLEWell, I'm doing -- I'm doing what I can.
REHMYes. Indeed. But isn't that interesting? Do we know how much revenue these ads bring to, say, magazines?
NESTLEOh, I don't offhand. I don't. I do know that, you know, the price of some ads -- a full-page advertisement in The New York Times is $80,000 to $100,000, depending on when it is. They cost a lot of money.
REHMMarion, what about efforts to limit portion size?
NESTLEWell, I think that's actually a good idea. And one place in which I think soda companies are doing the right thing is in promoting their small sizes.
REHMI've seen those small cans.
NESTLESo, and in fact, Coca-Cola says that it's profits for last year -- and it continued to do quite well last year -- that it's profits are from the amount of marketing that it put into promoting the 7.5 ounce cans, and that they can charge a higher price for those cans. You're required to buy them in packs of six or eight. And they cost all most as much as much larger portions of soda. But people are willing to buy them. And so that's how the soda companies are making money. Well, more power to them.
REHMAll right. We've got lots of callers who want to join the conversation. Let's go to Laura in Pittsburgh, Pa. You're on the air.
LAURAHi. Thanks for taking my call.
LAURAI was just calling because I feel like soda has been in the news a lot lately. And I'm wondering why we're not really focusing on physical activity, you know, portion size, affordability of healthy food. Aren't these much more important issues?
NESTLEOh, I think that's really a good question -- really, really good. And I actually wrote this book as a -- as the part standing for the whole. I make it very clear that what I'm trying to do here is write a book about how you advocate for important issues in the food system using sodas as an example because health advocates have been successful in bringing down sales of soda. And so this is a book about how to advocate for a healthier food system in every possible way. But you have to start someplace. And this is, in public health terms, low-hanging fruit. It's the easy target because sodas are sugars and water and nothing else. The kinds of things that you're concerned are going to be much harder to do. You have to start somewhere. Why not start here?
REHMAnd to Ed in Kalamazoo, Mich. Hi, you're on the air.
EDHello. I have two quick questions. One is, would you way that the country has a obesity/diabetes epidemic that should be a main focus of the government or, you know, it's at a level where it's just -- it's costing so much in health care costs. And two, what do you think about labeling -- a warning label on high-sugar sodas?
NESTLEWell, let me answer the first one. I don't think there's any question that obesity is a massive problem in this country. I've seen estimates of its cost in health care and lost productivity that range from $200 to $800 billion a year. That's a big range. And I have no idea which of those figures is correct, but it's a lot of money. And it's not only -- the health care costs are not only a problem for individuals, but they're a problem for society. There have been proposals for warning labels. None of them have gone through yet. Whether they're politically possible or not, I don't know. But I think it would be an amusing exercise to try it. I'd like to see it tried.
REHMWhat kind of warning label would you like to see?
NESTLEWell, I think just making the amount of sugar that's in these drinks more prominent would really take care of it. And of course the FDA has proposed to put added sugars on labels. That's being strongly fought by many, many food companies and it's not clear that they're going to be able to do it. I hope they will.
REHMAnd you're listening to "The Diane Rehm Show." If you're just joining us, I do want to let you know, Marion Nestle is going to stay on after our show to answer your questions on sodas and health in a Facebook Q & A. You can post questions at Facebook.com/thedianerehmshow. We'll get started at noon Eastern Time. And let's go to Melissa in Ranson, WV. Hi, there. You're on the air.
MELISSAHi. Thank you so much for bringing up this subject. I really appreciate it. I just want to let you know I'm a 46-year-old woman and I just started exercising a year and a half ago, I started horseback riding. Initially, it was once a week, then it twice a week, no weight loss whatsoever. And then my husband and I watched the documentary, "Fed Up," and learned about diet soda being just as bad as regular soda, juice being just as bad because there's no fiber in it. And so I actually stopped drinking soda about three and a half weeks ago and I've lost eight pounds already.
REHMOh, my goodness.
NESTLEI hear this...
NESTLEI hear this all the time.
NESTLEAll the time. And this is where the empirical studies come in. You take -- you tell people not to drink soda. They take those sugars and calories out of their diet and the weight falls off. Good for you.
REHMHow do you feel, Melissa?
MELISSAThank you. I feel -- I have so much more energy and I just feel so much better.
REHMI'm so glad.
MELISSASo sometimes I slip. But I'm just trying to be aware of those decisions I'm making when I'm choosing a drink or a snack.
REHMAbsolutely. Thanks for sharing with us. Let's go now to Jim in Alexandria, Va. You're on the air.
JIMHi, Diane. I'm a big fan of yours. You spoke at our church recently about your relationship with Bishop (word?) Dixon and I just wanted to say thank you for that.
JIMIt was wonderful.
JIMYes. I just had a question for Ms. Nestle. It seems like when you talk about science that you're sort of relying on science the same way that you're accusing others of doing, which is being kind of selective in what you want to look at. And I saw a quote online where you talked about the studies that look at personal behavior and responsibility are really just offering cover to the industry. And I'm just -- I'm curious that, in saying that, aren't you sort of, kind of getting at a conclusion before one kind of looks at all of the facts?
NESTLEWell, I think nutrition research is very difficult because you can't take people and lock them in cages and -- for 20 or 30 years and feed them different kinds of diet. So you're always going to have a complication of complicated diets and lifestyle patterns and it's very hard to parse out one particular product form everything else that everyone is eating. I think, if you take a look at my book, you'll see that it's got something like 100 pages of references. I did the best job I possibly could to be fair in my evaluation of the research. And I think you'll just have to judge for yourself on that.
REHMMarion Nestle. The book is titled, "Soda Politics: Taking on Big Soda (And Winning)." Short break here. We'll be right back.
REHMAnd welcome back. Marion Nestle is my guest. She is a professor at New York University in food studies, nutrition and public health. Her new book is titled "Soda Politics: Taking On Big Soda (And Winning)." I have a very emphatic email from Vicky who says, "This argument is ludicrous. Should we now put warnings on all sugary products, like brownies, cookies, cereals, candy bars, sodas, warning the public that the products are made from sugar and could cause weight gain? I'm sick of people not taking responsibility for their own actions and pawning it off to somebody, something else. If people want to become healthier and lose weight, then stop drinking the stuff. Quit blaming everyone but yourself for being overweight."
NESTLEYeah, that's the standard argument about that, and of course it has a great deal of merit in it. People do make their own decisions, but they don't make their decisions in a vacuum. We live in a world in which soda companies and food companies, in general, are spending billions of dollars a year in marketing products. And the thing about marketing that's so interesting to me is you're not supposed to notice it. You're certainly not supposed to notice it to the extent where you think that it has any influence on what you do. And that's the whole point of advertising. Advertising is directed towards your emotions. It's directed towards something else.
NESTLEAnd soda advertising is so much part of the landscape that we live in, we don't even see it. And we certainly don't think it has any effect on us, but the studies that have looked at whether it does, say that it does.
REHMBut you're talking about the sugar consumption in these soft drinks. What about her concerns over other sugar filled foods?
NESTLEWell, the reason that sodas are a good target, and they're low hanging fruit, and they're an excellent target because they're really simple. The contain sugars and water and have no redeeming nutritional value at all. The minute you get into anything else, you start having nutritional value there. Maybe too many calories, maybe the wrong kind of calories, but it still has some nutritional value and it makes it much more difficult. So that's why this product is singled out. The soda companies say, this isn't fair, there are lots of other products that cause weight gain, and of course they're absolutely right.
NESTLEBut this particular product has been advertised as a substitute for water for years now, and to the extent that the companies have succeeded in selling it in large quantities as something that people could drink all day long with impunity, that can't. And so that has to stop.
REHMAfrican-Americans and Hispanics apparently drink more soda and have higher rates of obesity and diabetes.
NESTLEType 2 diabetes, yes, they do. And the relationship of soda companies to the African-American and Hispanic communities has a very long history, and a very complicated one. Because in the '50s and '60s those communities did sit-ins, and had protests and had boycotts to try to get soda companies to advertise to them in their own publications. Martin Luther King, on the night before he died, gave a speech in which he extorted his followers to boycott Coca-Cola because they weren't hiring African-Americans. So this is not simple.
NESTLEWhen obesity became a problem and it became an especially difficult problem in the African-American and Hispanic communities, the game had to change, and it's taken a long time to realize how this marketing has been so insidious and has had such a bad effect on this community.
REHMAll right. To Miami, Fla. Hi, Ali, you're on the air.
ALIHi, Diane. I just want to start by saying that I'm honored to be on your show. My sisters, two of them are pharmacists. I'm a med student. They're pressuring me to get married right now, and I tell them, find me a girl like Diane Rehm.
NESTLEYou should be so lucky.
ALII would, I would. I would just want to thank the guest for her very thoughtful discussion about what's going on with the beverage industry. And I wanted to say that when you guys made the point that Coca-Cola's been around for more than 100 years, when a group has been around that long with such a drink that people find delicious, it's hard to get them to switch from a sugary beverage like that. And then you hear things like the soda industry are also partnered with The First Ladies Get Fit Program.
ALISo on a personal level, maybe on the level of the consumer, how do you -- (a) what would be a good starting point to get a patient or a person to switch from a drink that's potentially harming them? I know you said you don't like the use of, for example, diet beverages with artificial sweeteners, but they are zero calories, so for me, when I encourage my friends to -- for easy ways to cut calories, that's kind of a starting point. And, B, how do you get the consumer involved on this level of knowledge where they get these big picture concepts about what's going on with the massive amount of funds that are being appropriated towards these advertising campaigns, getting people to...
REHMAll right, Ali. I first of all want to thank you for your very flattering...
NESTLEOffer of marriage.
REHM...comments. And second, I want to say that from the moment I get up in the morning, I have a big glass of water. And then I have two cups of coffee. And then I drink water for the rest of the day. Now, obviously that does not have the sugary taste, but I am not addicted to sugary drinks. You've got to break that addiction somehow, don't you?
NESTLEYeah, I think so. And I don't think that diet drinks are the way to do it because there's no evidence that diet drinks help people maintain or lose weight, that people make up for the calories that they're saving. They're still having the sugary taste. I don't know. It depends on who your patients are, and you need to know your patients to know what the best approach is. Some work very well by understanding how they're marketed to. Some can start just with smaller portions. Some can start with just weighing themselves. But if they stop drinking as much soda and start losing weight, that's big reinforcement.
REHMThat sure is, and would be a big enticement. Let's go to Tulsa, Okla. Hi there, Dale, you're on the air.
DALEHello, Diane. I'm interested in listening to you talk about addictions. I'm a fourth year medical student. And doing my rounds in the hospitals I see how much damage the obesity does to people. I mean, it's life changing for so many people. But I'm particularly interested in addiction issues, so when I deal with a patient who's having a problem with addictions in some sort of drug or something, I say, look, there's a drug we're all using, that we're heavily addicted to, and that is sugar. There is no difference, from what I understand, in the brain to a -- how the brain reacts to sugar than it reacts to cocaine or meth.
DALESo when I talk to a patient, I talk to them about this addiction. They're falling in love with sugar. You can only have one addiction in your life. You can only fall in love with one thing.
REHMI'm not sure I would agree with that. What do you think, Marion?
NESTLEOh, I'm uncomfortable using the word addiction when it comes to sodas or sugar. I mean, we need sugar. Does that make it an addiction? We have to have sugar as a fuel for our brain. The brain runs on glucose. The addiction researchers talk about this very, very carefully, and say that sugar stimulates the same receptors in the brain that cocaine does, but the level of addiction isn't the same. The level of dependence isn't and many of the symptoms aren't. Although there are many people who feel that they're addicted to sugar. I think it's one of these things that people are still trying to sort out. But it's delicious. It makes food taste wonderful. I like sugar, but, you know, you have to figure out a way to manage it and keep it...
REHMThanks for calling, Dale. And let's go to Kenneth in Richmond, Va. You're on the air.
KENNETHHi, Diane. Thanks for taking my call.
KENNETHI just wanted to ask what Marion thinks a good initiative would be as far as paying attention to eating disorders which aren't usually addressed when we talk about soda. Unfortunately being a young woman growing up, I noticed a lot of my friends in middle and high school would replace meals at lunch for soda. Knowing how high calorie they are and that they're not very good for you, they would just swap out, say, a chicken sandwich for a large Coke. And now I'm 23, so I see quite a few young women out at college who replace a significant portion of maybe their dinner or an appetizer to have a sugary soda cocktail.
NESTLEYeah, I mean, this is not something that I know a great deal about, and I think I'm just going to say I think that's unfortunate, and sodas shouldn't be a substitute for food. What you really want is to substitute food for sodas. Even jellybeans are absorbed more slowly than the sugars in sodas.
REHMHere's an email from Betsy in Cleveland Heights, Ohio. And we've had several questions like this. She says, "I'm always dismayed by kids sports teams...
REHM...being supplied with Gatorade at practices and events. Thereby negating the healthy benefits of their sports. And even worse than sugar, they're laden with high fructose corn syrup. Can you address this?"
NESTLEYeah, sports drinks don't usually have as much sugar as the full sugar sodas, but they still have plenty of sugar. And I do have to say something about high fructose corn syrup. It's sugar. It's made up of glucose and fructose and so is table sugar. Really the body cannot tell them apart. And they both -- everybody would be healthier eating less of all of them. Sodas have had high fructose corn syrup since the 1980s because it's cheaper, or it was cheaper at the time. Now that we're growing so much corn for -- subsidized corn for ethanol, the price differential is getting smaller. And the soda companies are putting table sugar back, but it's the same.
REHMAnd a number of people are asking about Stevia...
REHM...to sweeten soft drinks.
NESTLEYes. It's an artificial sweetener approved by the FDA. It's originally extracted from leaves of the Stevia plant. But in large amounts it's synthesized in a laboratory. It's an artificial sweetener, and the companies are using it because they can advertise it as natural, and people like that. Whether it tastes good, you have to decide for yourself.
REHMYou're listening to "The Diane Rehm Show." I gather at this point most of Coca-Cola sales are outside the U.S., and you're concerned about that.
NESTLEWell, I'm not sure what the exact proportion is. They're still selling very well here, and their products in general are. But moving the marketing overseas into developing countries seems to me is exporting our obesity and Type II epidemics, So that both Coca-Cola and PepsiCo have said that they are going to put on the order of $5 billion each into Africa, Asia and Latin America over the next five years. So expect to see soda sales increasing. And, you know, they're in every country in the world. I was in Cuba over the summer, and you can get Coca-Cola in Cuba, even though we have a blockade, and that still exists. It gets brought in from Mexico, but there it is. It's everywhere.
REHMBut hasn't there been some success in posing restrictions, for example, in Mexico, Russia and elsewhere?
NESTLEWell, in Mexico they've passed a soda tax. And this was another one of those great advocacy victories. There's a coalition of advocacy organizations in Mexico who did an absolutely phenomenal job.
REHMSo that's one of the ways in which we are winning?
NESTLEOh, absolutely. I think we're winning on the education front. I think we're winning on some of the legislative fronts. And this is an example of how advocacy when done right can really make progress.
REHMBut to what extent are members of Congress, for example, being lobbied by the soft drink companies?
NESTLEWell, if anyone looked at the hearings yesterday, you can see that any attempt to tax sodas is something Congress is not going to approve.
REHMSo it's only in the protection from taxes. How much money would you say these soft drink companies are handing out to our politicians?
NESTLEI think you can get those figures online. I don't know what they are offhand, but certainly in the election campaigns that lost in California, they spent $2 million in Richmond, Calif., which is a very small town with a large minority population.
REHMWhich wanted to tax.
NESTLEWhich wanted to tax sodas. And in Berkeley and San Francisco, it was about $11 or $12 million. I would give anything to know how much money they spent to defeat Bloomberg's soda cap initiative in New York City, but that wasn't an election, so they don't have to reveal it. And we know from the exposé in The New York Times that they spend millions of dollars on alliances with organizations and with researchers.
REHMMarion Nestle. She is a professor in the Department of Nutrition, Food Studies and Public Health, and professor of sociology at New York University. Her new book is called "Soda Politics: Taking On Big Soda (And Winning)." And she has agreed to stay on after our show and to answer your questions on soda and health in a Facebook Q and A. You can post those questions now at Facebook.com/TheDianeRehmShow. Marion Nestle, thank you so much...
REHM...and good luck in your efforts. Thanks for listening all. I'm Diane Rehm.
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