Michael Jacobson, Ph.D., is the executive director and co-founder of the Center for Science in the Public Interest, a non-profit watchdog group dedicated to fighting battles against obesity, cardiovascular disease and other health problems. A tireless advocate for nutrition and food safety, Jacobson is also the founder of Food Day, October 24, a national observance that aims to mobilize countless Americans to celebrate healthy eating and push for improved food policy at the state, local and federal levels. Hear from Jacobson, the recipient of APHA’s 2011 David P. Rall Award for Advocacy in Public Health, about the impact food policy has on our nation’s health and learn what the public health community can do to help Americans change the way they eat — and think about food.
Q: How important is the role of advocacy in creating a healthier society?
Public health professionals know better than just about any other health professional that change doesn’t just happen on its own. Even with well-meaning people in top government positions, it takes vigorous advocates on the outside to promote sensible policies and appropriate funding and to fend off special interests that seek to stymy just about every policy change or effort to fund health-promoting programs to reduce pollution, cigarette smoking or junk-food consumption. We’re lucky to have a professional association, the American Public Health Association, whose leadership and membership live and breathe health. APHA does a wonderful job of advocating for strong health policies in Washington, D.C., and encouraging and enabling members to get involved at the local level.
Q: Do you see progress in recent years in the general public recognizing the link between good nutrition and good health? What role can public health professionals play in helping people understand the role of nutrition in preventive care?
I first got involved in advocating for safer, healthier diets 40 years ago. Back in the early 1970s, almost no one — other than some hippies and Adele Davis followers — was interested in eating healthier diets. The official government line –and of most health professionals –was that people should eat everything in moderation, with no distinction between cheeseburgers and broccoli. Yogurt, whole wheat bread and brown rice were difficult or impossible to find in grocery stores. But things have changed enormously, with the big driver being scientific research demonstrating ever more clearly that diets high in sodium, trans and saturated fats, and refined sugars, and low in fruits and vegetables, promote everything from tooth decay and constipation to obesity, heart disease, stroke, cancers and diabetes. The media, advocates, legislators, government officials, grocery stores, some food manufacturers and some restaurants gradually looked at the evidence and joined the march toward healthier diets.
Most public health professionals certainly recognize the primary importance of diet in optimizing health, both preventing and treating chronic diseases. People in public health also recognize that, while public education is important, policy change is key. State and local health officials have an especially important role to play, as they have shown on many issues. In areas on which the Center for Science in the Public Interest has worked — eliminating trans fat, lowering sodium levels, calorie labeling in restaurants — local and state health departments have obtained ordinances or program changes that were contagious all the way up to the largest companies and federal legislation. If it weren’t for the bold actions by New York City, Philadelphia, King County/Seattle, California and other jurisdictions, it is possible that little would have happened at the national level.
Q: Do you agree with many nutrition advocates who say the nation’s obesity epidemic is fuelled largely by unhealthy diets?
Between 1980 and 2000, the heart of the obesity epidemic, per-capita calorie consumption rose from 2,200 to 2,700 calories. And many of those calories came from refined grains (think Subway’s buns, pizza crusts and pasta) and refined sugars (soft drinks, juice drinks and energydrinks), all of which saw per-capita increases of 20 percent or more. High-calorie junk foods are everywhere. Advertisements for high-calorie junk foods are everywhere. And portion sizes, especially of high-calorie soft drinks and fast-food products, ballooned. Meanwhile, levels of physical activity have changed little in recent decades. It is crystal clear that diet has been the main driver for obesity.
But there are signs of a turn-around. Consumption of sugary soft drinks has declined by almost 25 percent since 1998, with commensurate decreases in consumption of sugar and high-fructose corn syrup. Overall calorie consumption has dipped a few percentage points since the highs of 10 years ago. Most importantly, national obesity rates seem to be leveling off. Indeed, childhood obesity in New York City, which has mounted vibrant campaigns to eliminate food deserts, mandate calorie labeling in chain restaurants, discourage sugary-drink consumption, and improve foods in schools and day-care settings, has actually declined by 5 percent over the past five years. With the wind at our backs for the first time in many years, now is a most propitious time for health professionals to be advocating for local and national policy changes and for the investment of billions of dollars’ worth of measures to prevent obesity.
Q: How can we address the problem of “food deserts” in our country’s underserved communities?
In theory, eliminating food deserts should be one of the easiest problems to solve. Doing so would enable people in urban and rural areas who lack access to fresh foods to obtain them from supermarkets, farmers markets and corner stores. Indeed, tackling food deserts has become a cause and an opportunity for several large companies, including Walmart and Walgreens. Cities and states such as Pennsylvania and New York City and health foundations, including the California Endowment and the Illumination Fund, have been leaders in providing loans or grants and using their licensing authority to increase access to healthy foods. The Obama administration sought to create a $400 million grant and loan program, the Healthy Food Financing Initiative, but budget pressures in Congress resulted in little funding. Of course, getting supermarkets into food deserts means not only access to fruits and vegetables, but also access to dirt-cheap soft drinks and other junk. Public education will be crucial to helping people in food deserts make healthy choices.
Q: CSPI launched Food Day in 2011 as a way to bring Americans together around the need for access to healthy, affordable food that is produced sustainably and humanely. How do you feel about the effort as we approach the second annual Food Day this October? How can the public health community support this effort?
The first Food Day, Oct. 24, was a great success with people organizing upwards of 2,000 activities, large and small and in every state. Food Day offers city and state public health officials an opportunity to highlight food issues — be they nutrition, hunger or locally produced foods — in their communities. For instance, last year, the Rhode Island Department of Health announced the formation of a food policy council. The commissioner of the Department of Health and Mental Hygiene in New York City announced a new phase in the city’s anti-soft-drink campaign. King County, Los Angeles County, Boston and other jurisdictions organized activities. We’re hoping that Food Day encourages health officials and others in many more communities to highlight ongoing activities and stretch to advance the public’s health with new activities.