Can You Have a ‘Healthy’ Thanksgiving? How the Food Industry Conspires Against Us

Mark Masselli (00:04)
The holidays are here. It's a joyous time. But what about all those traditional meals we're about to enjoy? Our
guest has important insights regarding food and its effect on our health and pocketbook as we celebrate the
holiday season.

Marion Nestle (00:18)
If the food supply provides twice the calories we need, Thanksgiving provides five times the calories we need.
It's a time for getting together, for celebrating. I think it's a week in which you just have to do the best you can.

Margaret Flinter (00:35)
Marian Nestle has a PhD in molecular biology. She is a renowned nutritionist who writes about how food
choices are shaped by health, marketing, politics, and culture.

Marion (00:47)
Certainly these things are related and are resulting in food companies responding by producing products that
they think will appeal to GLP1 users. And these are products that are higher in protein, higher in vitamins and
minerals, higher in fiber, and lower in sugar.

Margaret (01:07)
This is Conversations on Healthcare.

Mark (01:20)
Well, Dr. Marion Nestle, welcome back to Conversations on Healthcare.

Marion (01:25)
Glad to be here again.

Mark (01:26)
Well, that's great. And you know, we're posting this interview during Thanksgiving week, and I can't think of
the holiday that revolves around food more than Thanksgiving. Margaret…

Margaret (01:36)
My favorite.

Mark (01:37)
My stomach's getting just bigger thinking about it. And you explained that America's food system delivers twice
the calories we need while wasting. This is just a terrible stat, wasting 40% of what's prepared. Tell us what
your advice for having a healthy holiday without waste entails.

Marion (01:56)
You know, do the best you can with it. If the food supply provides twice the calories we need, Thanksgiving
provides five times the calories we need. It's a time for getting together, for celebrating. I think it's a week in
which you just have to do the best you can.

Margaret (02:17)
Well, that is a very great, that's good advice and pragmatic answer. And, I think this year also big doses of,
Thanksgiving for what we have and compassion for people who are struggling with food scarcity is going to be
on the table, for everybody around the country. But, Marian, we are excited about the, release of your new book.
Congratulations. “What to Eat Now: The Indispensable Guide to Good Food, How to Find It and Why It
Matters” was just published by North Point Press. And it's an updated version of your book that was first
published almost 20 years ago. So what new is in the book?

Marion (02:55)
Oh, this was going to be a very quick pandemic project where I, I read the book. I thought, oh, this is a timeless
classic, all it'll take me six months to just kind of polish up the details. Four years later, we are sitting here
looking at the release of this book because so much has changed and I hadn't been paying close enough
attention. I didn't realize it. I mean, there are some things that are just obvious for one thing, online ordering. it
was barely started 20 years ago, and now it's taken over a huge fraction of supermarket sales. And lots of people
have had to do lots of things to accommodate to that. ultra processed news, ultra processed foods, that's a new
concept in nutrition. And one that's very important for health advising. The replacement of full sugar sodas with

bottled waters of a million different types. That's new plant-based. There used to be soy milk and now there's a
dozen different kinds. and I think a lot of interesting things like the introduction of international foods
throughout the supermarket instead of in special little sections makes a big difference. And then on top of that,
all the same old issues that were there is still here, only more so.

Mark (04:24)
You know, Margaret, you go into Whole Foods and half the half the people in the, in Whole Foods are shopping
for somebody else for the online delivery. So, dramatic, dramatic change happening across the wayside. I think
anybody who knows Maryanne knows you are a very positive, person looking for the best in, in every
engagement in every person. And when we last talked to you, you had some positive thoughts about the Trump
administrations make America healthy again, plans. So I'm wondering what the grade is now.

Marion (04:57)
Oh dear. C minus maybe D plus. very, very disappointing that the talk at the beginning, which was so exciting
about we're gonna end chronic disease in America. We're gonna prevent obesity, we're gonna make kids healthy,
we're gonna do all these things, has boiled down to getting companies to voluntarily remove color additives,
from their food products. Yes. That's terrific. it's gotten the FDA to say that it's going to take a closer look at,
additives and chemicals in the food supply. That's good. but then it's done some sort of funny things like, we're
celebrating that Coca-Cola is now using cane sugar instead of high fructose corn syrups. I can't talk about that
one without laughing. I'm sorry. Because they're basically identical biochemically. and then there's the weird
thing about seed oils, and then you can't talk about what they're doing without talking about how they have
destroyed the public health apparatus in this country. Destroyed the CDC made the FDA dysfunctional and
destroyed the research enterprise in, in NIH. somehow getting rid of color additives just doesn't make up for
that.

Margaret (06:18)
Well, thank you for taking that broad look at it. Marian and, and certainly in this first year, we've seen, the
administration make, big cuts to, food and drug administration, agriculture, department EPA in addition, to
some of the others that you mentioned. I guess if you, if you had an audience of 30 minutes, with some of the
leaders in the administration, what would you prioritize in terms of restoring funding for that you think has
potentially made the biggest negative impact by removing it . Or needed the most investment to move us
forward?

Marion (06:53)
Well, if you're going to make America healthy again, and I'm of course interested in the food aspects of that,
you wanna make healthy food cheaper and more available for everybody. and you wanna stop the marketing of
that, of junk food, ultra processed junk food, especially children. you want healthier food in schools. You want
universal school meals. You want school meals funded better so that the food can be better. you want universal
healthcare, you want, you know, a lot of other things that support that. maybe warning labels on ultra processed
foods. I mean, kinds of things like that. And there was talk about those kinds of things at the beginning, but,
they seem to have backed off on all that. . so I think there's plenty we could do. And there's plenty that a
government could do to make it easier and less expensive for people to eat healthfully. But I don't see any signs
of that being done.

Margaret (07:56)
No proposals on the table, no legislation in the Big Beautiful Bill

Marion (08:00)
If there is, I'm not hearing about it. You know, the two MAHA reports that have been published, the first one
was aspirational and had an enormous agenda of kinds of things that they wanted to work on. The second one,
cut back on all of that. didn't mention the word regulation. We're not gonna regulate. We're gonna ask
companies to do these things voluntarily. Good luck with that. Okay. It's working with, with color additives, but
color additives are easy, in comparison to some of the other things. The regulation? No, we're not gonna
regulate. We're not gonna do anything about ultra processed foods. We're just going to try to define them. we're
not gonna say anything about marketing to children. We're going to investigate. We're going to look into, we're
going to study, we're going to research. We're going to think about, we're going to consider hard to know what
they're gonna do. I wanna know what they're going to do. And we don't have the dietary guidelines yet. The
dietary guidelines will tell us a great deal about this administration's agenda. They're expected by the end of
December. by law, they're supposed to be out by then. And they were promised for September, then October.
My suspicion is that they've discovered that they're not quite as simple to deal with as they thought they were.

And that the promises that this would be a five-page document may have turned. And in simple language,
promoting consumption of, relatively unprocessed foods is turning out to be a little bit more complicated than
they thought. But I don't really know. Everything is speculation at this point.

Mark (09:42)
You know, Margaret, New York City had a big election, A lot of conversations about bodegas, and these small
restaurants and the conditions that people are in. And Marian, you really make the case for paid sick leave or
anyone who works in a bodega grocery store or a restaurant, who handles food. And of course, these sectors
oppose such mandates. I'm wondering if you could just explain to our listeners why you're so strongly
supportive of paid sick leave for these workers.

Marion (10:11)
Well, because if people are working when they're sick, because they can't afford not to, they're going to
contaminate the food that they're, that they're working with, and you're likely to pick it up from them. you know,
contagious diseases are contagious. That's what they talk about. And they, they're transmitted by hand to mouth
contamination. They're transmitted by breathing. and you want sick people to stay home and take care of
themselves, not least, so they won't make other people sick.

Margaret (10:48)
Well, Marian, this is probably well known to most people at this point, that food companies are paying our
grocery stores for the placement on the shelves and paying a premium for the best placement. So, you explain
how branding works, in your book and how the industry uses loyalty data to influence consumer choices. You,
you wonder sometimes what decisions are we making on our own, but what, what tips can you give us for
overcoming, the influence that the, companies really wield over what placement we have or what we see when
we go into the grocery store?

Marion (11:25)
Well, you know, if I wrote this book for one reason, it was to get people thinking about how difficult it is to
make healthy food decisions in the face of a food system that is absolutely set up to sell you too much of the
wrong kind of food all the time, because it's more profitable to do so. So you have to understand right from the
beginning that you're fighting an entire food system on your own. That's a lot to ask of an individual. They're
bigger than you're, and with a lot more firepower to try to get you to buy what they want. And when you're,
when you sign up for one of these plans with a grocery store, and you're giving them all this personal
information about who you are and where you live and how many children you have, and whether you drive a
car or not, and all of these kinds of things that they're asking their AI algorithms go to work to sell you the
products that are going to be the most profitable that they think you're gonna buy, that you're most likely to buy,
they're really good at that. And so to resist that kind of thing, you have to not use those services, make your own
food choices, grow your own food if you can. but I think it's very difficult. I think anybody who wants to eat
healthfully in today's food environment has a big job to do. I have a lot of sympathy and wrote what to eat now
to try to empower people to make those kinds of decisions, or at least understand why. Right? Sure. They leave
a supermarket with a shopping basket full of impulse pies. we're human. And they know how to get us to do
that.

Mark (13:16)
You know, I'm thinking to an earlier question about what's, what's changed. You were, you were reflecting on
what is different from 20 years ago, and certainly Margaret, social influencers, who aren't the big media
company, but they are using the social influencers. So it looks like your neighbor's giving you this advice. So
that, that's been a dramatic change, that's happened over the 20-year period about, how, how we're receiving that
information. And it, and it, I won't say it's deceptive ad advertisement, but it's certainly, it's, it's, it's engaging, a
different way of, of impacting. And probably another thing that wasn't something you were talking about 20
years ago, was the, GLP1s, and how they've cut into grocery store sales. and you know, I was looking at some
interesting statistics in this calendar year from January to March, there were 1 billion fewer, restaurant meals,
again, sort of getting back than there were a year before. 1 billion fewer. And so more people are eating at home.
And that's kind of interesting of how that's going on. But I really wanna focus in on the GLP’s and their, their
influence, the industries really trying to also respond with GLP1-friendly foods and more items, focused in on
protein. I'm wondering if these are hopeful trends. I'm, I'm not sure what a GLP1-friendly food is.

Marion (14:51)
Well, I can tell you what they are. I mean, I'm completely fascinated by these drugs, because they not only help
people lose weight, but it's the way they help people lose weight that is con, I mean, what they do is they stop
the food noise. People who are taking the drugs tell me that they just don't hear the food noise anymore. What is
food noise? That was a new concept to me. I never heard it before.

Margaret (15:18)
Right, Right. But we immediately have a sense of what it is.

Marion (15:21)
But I love the term. I just absolutely love it. And it's, you've got food in the house. If it's in the house, you have
to eat it. It's that simple. And it's being obsessed with food. It's thinking about it all the time. It's thinking about
the next meal when you're in the middle of the previous one. It's just being obsessed with food and that stops
with these drugs. That's fascinating. That is absolutely fascinating. And the result of it is not that people don't
want to eat. They still want to eat. They still like the foods they liked. They just don't want to eat as much of
them. And that in itself is completely fascinating. And what's happened as a result is that sales of, food by
purchases of food, by people who are taking GLP1 drugs are down by somewhere between five and 10%.
Supermarkets are seeing this. They're absolutely seeing it. Restaurants are seeing it. It's very hard to sort out
how much of the decline is due to the GLP1 drugs and how much is to do with the shocking increase in prices of
food. Another thing that I noticed in writing this book is, is food prices have doubled since 20 in, in the last 20
years. Doubled. That's a lot in the last 20 years. I certainly, I live in New York City where prices are ridiculous,
but I certainly notice the difference in going to a grocery store that what used to cost $10 is 20. what used to cost
20 is 40. What used to cost a hundred is 200. I mean, it's just amazing. Yeah. And, and so it's very hard to, to
sort out what, what is going on there. But certainly these things are related and are resulting in food companies
responding by producing products that they think will appeal to GLP1 users. And these are products that are
higher in protein, higher in vitamins and minerals, higher in fiber, and lower in sugar. . You know, that take, that
takes care of it.

Margaret (17:38)
Yeah. Mary, can I just ask you a follow up, question on that, though, again, this moment in time, that we're
living in where, the, economics are so difficult for people, including the potential for further reduction in food
stamps, as we've been, preparing for, recently. So the challenge is the more expensive the food, the more people
are drawn towards the poor choices, which have higher volume, maybe higher satiety, more of the empty
calories, the bad foods. Right. What's, what's your advice to the person who has the very limited income in
terms of the focus in the grocery store? What's the maximum value for people to get nutrition for their family
and, and stay at the lowest end of the scale they can. Is it possible?

Marion (18:27)
Beans.

Mark (18:28)
Beans.

Margaret (18:29)
Beans.

Mark (18:30)
Beans in rice, brown rice.

Marion (18:31)
Beans are the, you know, are, if there is anything that's a super food, it's a bean, because they're quite high in
protein and they have a lot of vitamins and minerals as well. You have to be able to cook if you're going to eat,
or you can buy them canned, I suppose. But the, yeah, a cooking is a, if you wanna save money on food, you
gotta cook. And of course, that means you have to have equipment, you have to have knowledge, you have to
have a, a refrigerator is useful. Yeah. A stove is useful, pots are useful. And you have to have the time to do it. If
you're really good and you know how to cook, you can put a meal together very quickly. using real foods and
throwing them together in various ways. I mean, one of the things about diets that is really interesting, but
makes them complicated is there are thousands of ways of putting foods together in combinations that taste good
and are healthy. I mean, there are whole civilizations that are based on healthy foods, cooked in delicious ways.
You know, classic Chinese cooking, classic Japanese, classic Mediterranean, classic whatever. I mean, these

were all very, very healthy diets. All which have in common that they were based largely, but not exclusively on
plants. and required cooking and seasoning in various ways. The fats differ, the amount of fat and carbohydrates
differ enormously, but they were all healthy. So that tells you that there are lots and lots of ways that you can eat
that are good for you, and you ought to be able to find ones you like among those possibilities.

Mark (20:20)
You know, I wanna go back. You were talking about food noise, and I'm wondering if, if there's sort of an
addiction element here. We had Marian, the head of the National Institute of Drug Abuse online, who was really
talking about “can GLP drugs be sort of tested around addiction”, right? It's 'cause it seems to be, what we're
hearing anecdotally is it's stopping craving for alcohol, stopping craving for cigarettes, stopping craving, maybe
for food. Yeah. I'm, I'm not sure, but we're certainly talking about this is an area that really should need some
robust research.

Marion (21:00)
Well, there's plenty of it. And there certainly are people who believe that GLP1 stop food addiction. you know,
whether food is different, you have to eat to live. You don't need alcohol, you don't need cigarettes, but you
don't need fentanyl or opioid drugs, but you do need food. You can't live without it. So it puts food in a
somewhat different category. But certainly there are people who report relationships with food that sound very,
very much like, addiction. they think about it all the time, food, noise. They think about it all the time. They hear
the food noise all the time. They're uncomfortable if they're not eating, they wanna eat all the time. it's for
people like this, these drugs are great blessing. and I've asked, I've talked to lots and lots of people who are
taking these drugs about whether they can handle the side effects and the ones who are still on the drugs can, the
cost of the drugs is prohibitive for many, many people, but I think that cost will go down. Right. And the
injections will turn, will get translated into pills. I mean, they'll figure out a lot of these things with time. We
still don't know what the long-term effects are because they haven't been around that long. But we'll find g
there's lots of research going on.

Margaret (22:24)
Absolutely. Well, Marian, you've posted information on your blog about California Governor Gavin Newsom,
signing a bill that restricts ultra processed foods in school meals. tell us about the law. I'm not sure what its
status is right now, but, are there deadlines for it to happen? And do you see this as a hopeful way to get to the
next generation as they're coming up and get them starting with good food choices?

Marion (22:52)
Well, I'm laughing at the question because it doesn't get implemented for 10 years.

Margaret (22:57)
Is that right?

Marion (22:58)
By That time, there will be many generations of school children who will go through, I don't really know how
it's going to work. I'm sure it will be challenged in court. I have no doubt because everything is challenged in
court these days, and that will be too. I think the idea of it is good. What it doesn't say is what schools will use
as alternatives. because if you want schools to be giving real food to kids, that food has to be cooked or prepared
in some way. Not all schools can do that. Not all schools have kitchens. I've been to a lot of school meal
programs, and I'm very impressed by how individual they are. Yeah. but even though they all followed the same
Department of Agriculture rules about what they can serve the kids and the nutritional value of the foods, how
that gets implemented is so dependent on who's in the school and whether the school has facilities and how well
the school food service staff knows the names of the kids and cares about it. And that, and what the principal's
like. I mean, it's, they're, they're very, very different. And, and there are two issues related to school food. One is
whether the food is edible, and the other is whether the kids are going to eat it. And I've been in all, I've seen
schools with all four combinations. Schools, that was schools where the food was pretty awful and the kids
weren't eating it. Schools where the food was pretty awful, but the kids were eating it. Schools where the food
was restaurant quality and the kids weren't touching it. Schools where the food was restaurant quality and the
kids were adoring it. All four combinations. That's correct. Depending completely on who the people were, who
were there and what they cared about. So…

Mark (24:52)

You know, you write in, to keep it simple in beverages and that water, which we agree should be the default.
wondering if you could share a bit more about your advice on so-called health drinks and what about mocktails,
which I think is a favorite . which are gaining in popularity.

Marion (25:10)
Well, first of all, I'm in favor of tap water. I, most cities in the United States, not all, but most cities in the
United States, have very well-treated tap water. where I, I actually visited a treatment plant in upstate New York
and was…

Mark (25:30)
New York City has great water. Yeah.

Marion (25:32)
New York City has great water. I visited the treatment plant in Ithaca, New York, a small town upstate. but I
was so impressed with the dedication of the people who worked there and how hard they were working to make
sure that that water was of outstanding quality and safety.

Mark (25:54)
My father was a water chemist, so I absolutely…

Marion (25:58)
You know about this. You know about this and really worried about too much sodium in the, in the, in the
winter because of all the salt that got put on the roads and too much magnesium in the summer because of what
leached in from glacial leaching and making sure there were no PFAs, you know, these forever chemicals in the
water, really doing an outstanding job. And the problem is that the bottled water industry has worked very hard
to convince people that bottled water is better than tap water. It isn't necessarily, and it actually, most, most
bottled water comes from tap water. That's right. and, and the, and I worry that if people drink tap water, they
drink bottled water all the time, that they're not going to politically support their water treatment plants to the
extent, that extent that they should. and I'm, you know, I'm just astounded. One of the huge changes in
supermarkets in the last 20 years, as I said, is the substitution of water of one kind of another for, sugar
sweetened beverages. That's a plus. Yep. for health. But a lot of it is, you know, I it's still sweetened. It's
flavored. It's…

Margaret (27:24)
And we still have to get rid of the plastic bottle that it comes in.

Marion (27:27)
And we still have, have to get rid of the plastic bottles. That's a problem. That's a Huge, huge problem. Too
much plastic in our environment.

Margaret (27:35)
Totally Agree. Marion, you're known, not only for being a nutritionist, but I think you're a self-described foodie,
if that is correct. so of course we do have to ask you, what will be on your Thanksgiving table this year? Is
pumpkin pie going to be on? And what other, what would you, say constitutes a great Thanksgiving dinner for
you and your family?

Marion (27:58)
Well, I'm going to have to confess that I'm skipping Thanksgiving this year. I'm going to Brazil, on a, on a
speaking tour. I'm going to three cities in Brazil over Thanksgiving week, so I'm going to miss it this year. But
other than that, I'm a Thanksgiving traditionalist. I like a really good turkey, preferably from a local producer,
squash from my garden, the usual.

Margaret (28:27)
Wonderful. Well, we wish you the very best on Thanksgiving.

Marion
Fruit pies, fruit pies.

Margaret (28:31)
Fruit pies. There you go. A little indulgence.

Marion (28:33)
But, But no Thanksgiving this year for me. Sorry.

Margaret (28:37)
Thank you, Marian, for joining us. And thank you to our audience for being here. Just a reminder, be sure to
subscribe to our videos on YouTube, find us on Facebook and x and please share your thoughts and your
comments about this program. Take care, be well.

(28:56)
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