During Reunions Weekend this past spring, the annual Duke Magazine Forum served up a conversation, led by editor Robert J. Bliwise, among Duke experts about how we can be more adventurous, more intelligent, and more environmentally conscious eaters. What follows is an edited version of that discussion. First meet the experts:
KELLY BROWNELL is dean of the Sanford School of Public Policy and former director of the Rudd Center for Food Policy and Obesity at Yale University; the author of fifteen books and more than 350 scientific articles and chapters, he was named by Time magazine as a leading “warrior” in the area of nutrition and public policy.
EMILY MCGINTY ’13 is the current Duke Campus Farm Fellow, a role that includes supporting the farm’s production operations and educational programming; the farm itself sprouted from a class at Duke’s Nicholas School of the Environment.
NORMAN WIRZBA is a professor of theology and ecology at Duke’s divinity school; with research and teaching interests at the intersections of theology, philosophy, ecology, and agrarian and environmental studies, he is the author most recently of Food and Faith: A Theology of Eating.
RUTH WOLEVER, a clinical health psychologist and director of research at Duke Integrative Medicine and associate professor in the department of psychiatry and behavioral sciences, is coauthor of The Mindful Diet: How to Transform Your Relationship With Food for Lasting Weight Loss and Vibrant Health.
Q: What’s the most important thing you think about in your food choices?
BROWNELL: More and more people are caring about the story of their food. They want to know who grew it, where it came from, how far it got transported, whether it was genetically modified. This interest in the broader story of food is really transforming the way we look at food and the systems that create it.
MCGINTY: I try to think about food at a really simple level: whether I actually know what it is I’m eating, whether I can break down the food into its component parts, which is easy when it comes to whole, raw food. But, as someone who grows food, it’s still a complex thing—knowing about seed structures, for instance, and how different crops are harvested.
WIRZBA: When I think about food, I think about two primary things: One is health—the health of the economies, the health of the farms that grow this food—because eating is such a deep act that takes us beyond our own bodies to the bodies of all the things of this world, ranging from soil microorganisms and water, to food plants and animals, and then to human eaters. The other thing I think about is celebration: Eating ought to be a celebration of the fact that when you pick something fresh from the vine and you get this flavor explosion, it’s just amazing.
WOLEVER: I’m interested in how we make the decisions we make, why I’m eating what I’m eating, how I decide to start eating, how I decide to stop eating.
Q: Kelly, you’ve put a focus on sodas, energy drinks, fruit drinks, flavored waters, sports drinks. What makes those drinks particularly worrisome?
BROWNELL: When you’re thinking about preventing obesity, which is a major problem not only in the U.S. but around the world—the health minister of China recently declared that obesity is now a more significant problem than hunger in that country—you have to think about the major contributors. Sugared beverages are devoid of nutrition. Even a Twinkie has at least a little nutrition, but soda really has none at all. Also, the body doesn’t seem to recognize calories very well when they get delivered in liquids. So you just don’t feel as full, and you’re likely to keep eating beyond the calories that you’ve consumed with the sugared beverages. There is pretty good evidence that sugar acts on the brain very much like traditional substances of abuse—there’s withdrawal, craving, possibly tolerance.
Q: Emily, it seems that Duke students are not immune to the fast-food culture. There’s a pretty popular McDonald’s right in the Bryan Center. How might we change eating habits on campus?
MCGINTY: We’ve lost a lot of the basic toolkit to understand what food is; we lack food literacy. Food literacy can mean a lot of things. It can mean knowing what grows when and where, what things actually are in season. You’d be surprised by the number of e-mails I get asking whether the Campus Farm has tomatoes in January, or whether we grow limes or lemons. But there’s also a kind of relational deficit in how college students experience food. Even if students are buying a lot of grab-and-go food, even if they need to be thinking about cost and convenience, can we make their engagement a little bit deeper? On one campus I just visited, they’re using touchpad technology at the point of purchase to share the story of where the food was grown.
Q: Norman, you write, “Eating together should be an occasion in which people learn to become more attentive and more present to the world and each other.” Tell me more.
WIRZBA: The desire to have food cheaply and conveniently on our terms means that we’re destroying the world, we’re destroying agricultural communities, we’re abusing animals and agricultural workers, and we’re doing a lot of injury to our own health. Part of the problem is that we’ve stopped asking questions about the meaning and significance of the things that we’re doing.
What is food? The immediate response from a lot of people will be, “Well, it’s fuel,” or, “It’s a commodity.” If you think about food strictly as a commodity, the primary things that matter are cost and availability. But what if food is something much more than that? What if we were to say that food is in fact something like the expression of love? If you have the joy of being able to cook for people, you shouldn’t expect them to wolf down what you cook. And what are the stories behind a tomato or behind a hamburger? For us to eat, others have to die, right? This is serious, this is profound, this is something that ought to make us realize that we’re all in a world of gifts. We need to learn to see these gifts.
Eating together, talking with other people as we’re eating and cooking together, sharing the deep stories of food can be a way to contribute to the healing of our agricultural communities, the healing of our lands, the better treatment of our animals and our plants. The beautiful thing is that when we learn to take care of each other we actually get better food, healthier communities, healthier ecosystems, and healthier eaters.
Q: Ruth, the assumption is that the solution to out-of-control eating is simply to clamp down on it with hyper-controlled eating. Why doesn’t that work?
WOLEVER: Diets don’t work because they’re basically this external set of rules that leave out of the picture what the individual might really be needing, what the individual might be feeling, what signals the body is sending to tell the person when they’re actually hungry. That’s basically telling the person to ignore his or her own innate wisdom and follow some external signal instead.
Because of the way our brains are structured, we’ve learned over time to pair eating with comfort, eating with managing anxiety, eating with some behavior pattern that over time we did to calm ourselves in some way. We’re often doing things automatically without really recognizing what the driver is for our eating. So we may be lonely, but what we’re doing is reaching for food. Or we may be bored, and what we’re doing is reaching for food instead of actually creating a community or a relationship, or tending to what our real needs are.
Q: I keep reading different expressions of expert opinion. One day a low-carb, high-protein diet is in; the next day, a low-carb, high-protein diet is out. Do we know whose food recommendations we’re supposed to trust?
BROWNELL: There’s a broader question, and that is related to what food really is. When I do talks, sometimes I’ll show a slide that’s an ingredient label and ask people to guess what that food is from its ingredients. This particular food item has fifty-six things on the ingredient label; sugar is about nine of the fifty- six things. Why would there be nine forms of sugar in there? So sugar doesn’t have to be listed as the first ingredient on the label: It’s complete trickery by the companies. It happened to be a chocolate Pop-Tart.
If you look at those fifty-six different things, do we know what those are doing to the body? We don’t know what they do to the brain. And so what is that chocolate Pop-Tart? Should it be regulated by the Food and Drug Administration, the Environmental Protection Agency? Should it be considered an addictive substance? If you consider food anything you consume, a chocolate Pop-Tart qualifies. If you consider food something that nurtures body, soul, and health, then it doesn’t qualify.
On the question of seemingly ever-changing nutrition advice: You hope that would occur, because science advances, and we learn new things, and so some of the contradictory information is the result of the fact that science marches ahead. But there’s a lot more going on than just that; it’s the way the press handles information on nutrition. The press wants new news, and if there is news that comes along that’s consistent with previous advice, it’s unlikely to get reported or covered. If it’s contrary to that, it is likely to get reported, even if it’s one study, even if it’s not even a particularly well-done study. Anything that gets people’s attention gets reported, and it’s highly confusing to consumers. So omega-3 fatty acids are good, and then they’re bad. Butter is good, and then it’s bad. Eggs are good, and then they’re bad.
One thing I think would be tremendously helpfulis if there were some sources that people could count on and go to: If they have questions about any of these foods, they could go and get the most recent scientific information. Sometimes scientists are paid by the industries whose products they’re studying, and you know what you get from that.
Q: In the past, we know that it was primarily the rich who were fat; now obesity affects the poor disproportionately. We also know the cost differential continues to rise between healthy and unhealthy eating, which means it’s a heck of a lot cheaper to eat in an unhealthy way. Can we solve an obesity crisis without solving a crisis around social inequities?
WIRZBA: We have to acknowledge that the obesity problem in our culture doesn’t just happen, that there is a kind of planning that makes this inevitable for a lot of people. Taxpayer dollars are going to subsidize these foods that are relatively inexpensive for the consumer on the front end but are very expensive on the health end, very expensive on the ecological end, because to produce all of these cheap foods, we have to have an agriculture that is really degrading. Let’s think about how we could have different kinds of policies that subsidize better food. There are some things happening to make that possible—SNAP [Supplemental Nutrition Assistance Program, formerly the federal Food Stamp Program] benefits that can be used in farmers’ markets.
Another step is to invigorate local, smallscale agriculture where the production of fruits and vegetables, healthy meats, humanely raised meats becomes much more available to people, especially in inner cities. We know that the presence of food deserts is a major problem for the poor, so the options to buy groceries are the 7-Eleven, the liquor store, gas stations—you’re not going to find healthy food in these places. How do you figure out ways to create farmers’ markets? How do you get community gardens going? How do you get grocery stores back into these neighborhoods? When we say we’re spending less on food than ever, we have to ask, is that a good thing or a bad thing? A lot of this food is bad for us, and the population that has to deal with the health effects of this cheap food are on the poor side of the economic spectrum.
Q: Talk about the triggers that fuel our eating behavior—ads, snacks in the workplace, snacks everywhere else, the association that we tend to make between watching TV and eating.
WOLEVER: Something that we might experience as a single event is actually made up of body sensation, of emotion, of thought, and behavioral urges. It all gets kind of stored together, and some kind of cue can trigger a sequence. You can train the mind to observe, through a very consistent training process, what seems to be a single event and begin to see that it has all of these tiny pieces to it. You begin to see that there are lots of different choice points. So one way of working with triggers is to build in a “pause” button, to become a more astute observer and to experience your life, in a sense, in a different way.
Q: We know that food companies create flavors and textures that make foods stuffed with carbohydrates, fat, salt, other bad things nearly impossible to stop eating. How do we regulate that?
BROWNELL: The food companies are very interesting players. We obviously can’t get by without them, so they’re not like the tobacco companies, where you can just wish them away. Their bottom line is they need to sell as much food as they can. They may offer healthy and unhealthy versions. But people don’t overeat healthy versions of things; they do overeat unhealthy versions of things. If you give children cereals like regular cornflakes versus sugar-frosted flakes, it’s completely different how much they eat, in the direction you might imagine. So the companies have an interest in formulating foods in ways that thwart our natural satiety mechanisms and the natural wisdom of the body. And that means things like sugar, fat, and salt; it means texture changes; it means chemical additives that give things aromas to make us want more. And it means putting in things that fool the brain into thinking you haven’t eaten as much as you really have.
If you were a company CEO, you would want to do those things, because you owe it to your shareholders to maximize sales of your products. So I don’t think it can only be done by hoping that their social conscience wins out over their need to make money. You could require the companies to gradually reduce the amount of salt in things like soups in ways that adjust consumer preferences so people aren’t accustomed to as much salt. If you wait for one company to do it, and they do it and they lose market share, it’s a disincentive for any of the others to do it, and it certainly is a disincentive for that company. But if you make them all do it at the same time, we’ll all get accustomed to our soup without heaps of salt, much as we’ve become accustomed to milk that isn’t whole-fat milk. There is just no question that we can’t get to the goal line without government intervention.
Q: Former New York Mayor Michael Bloomberg famously and virtuously sought to limit the size of these sugar-sweetened beverages sold in movie theaters and restaurants, by street vendors, and so forth. He got huge pushback; the initiative fizzled. How would you have advised him?
BROWNELL: For those of us that care about government’s involvement in this space, Bloomberg is a complete hero—getting rid of trans fats in restaurant foods, requiring restaurants to put calorie labels on their foods. The place where he wasn’t successful was in restricting portion sizes of sodas. There is a very good public-health rationale for doing that: Sodas are a bad actor in the whole nutrition scheme, and there is very clear evidence showing that as you increase portion sizes, people consume more without realizing it. But the city got sued by the soda industry. It then went to the highest court in the state of New York, and they ruled that because the city has just limited jurisdiction—movie theaters and food carts, for example—it was arbitrary. But I suspect some other city will pass this, and then it can be tested in a different legal context.
Q: So Emily, I’m awarding you the prerogative to direct the nutrition program for all public schools. What’s your nutrition program going to be, and how are you going to persuade these kids to become healthy eaters?
MCGINTY: We don’t always give kids enough credit for being excited about making food choices. I also think we need to consider everything from the infrastructure of actual school buildings, to how well our schools are set up to prepare and store healthy foods, to the kind of training we’re giving food-service workers. I run into that issue even here on campus. In the earliest days of the Duke Farm, we were constrained in what we could sell to the university dining halls based on what the line staff was trained to handle. Some raw, oddly shaped vegetables were unfamiliar. Not every line cook is hired and told, “Tell me ten ways to use kohlrabi. Tell me twelve ways to use rutabaga for X thousands of meals a day.” And so the conversation too often cycles back to, “Well, it’s a lot easier to heat up corn dogs.”
WIRZBA: So much of the food we now have in the system has no flavor. I mean, you all have had the experience of picking up a piece of cantaloupe and saying, “There is no flavor here at all,” which is a shame, because if you eat a vine-ripened cantaloupe fresh from a patch, it’s incredible what you will experience. One of the reasons people don’t want to eat so many of these fruits and vegetables is that the food is picked and shipped from great distances, it’s picked weeks before it should be picked, and so the food has nothing of nutritional or taste quality that would compel a child to eat it. Changing the system by which we produce and distribute food, how long it sits in a truck or on a boat, will add a lot to persuading kids that fruits and vegetables taste good.
Q: Norman, you refer in your book to that first human transgression as an eating-related transgression: Adam and Eve were exiled from the Garden of Eden because they ate the forbidden fruit. I know you see in that story some kind of message about eating smartly, eating with discipline, versus eating with abandon.
WIRZBA: The Adam and Eve story is really rich with lots of different elements. But it’s centered on the question of human desire.
One of the key things going on is that Adam and Eve are creatures, and by creatures we mean they’re dependent, they must receive life as a gift, and they must learn to accept responsibility for the gift by learning to take care of the gift. So these people are put in a garden and told, “You have to take care of the garden now.” And so desire is sort of enfolded within responsibility.
If you think about traditional cultures, traditional farming communities, for instance, it makes perfect sense for people to tune their expectations to the expectations of their animals, and that their desire only be appropriate insofar as it aligns with the desires of their animals or land. It’s through the work of taking care of plants and animals and soil and other people that we learn a basic lesson: the need to restrain our desire so that we can accept responsibility.
So this first eating act, which is a violation, I think, is important because it shows how through our eating, our desires can go really crazy. We have all kinds of hungers as people—not just hunger for food but hunger for power, hunger for recognition. And eating is just the most visible expression of these kinds of hungers. Getting our desire about food right has been a big part of not just Christian and Jewish traditions, but all of the world’s religious traditions. We have to learn to eat properly because that’s the most immediate, the most visible, the most practical way in which we attend to this very basic human issue, which is how the desires we have can be appropriate or inappropriate.