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    Transcript 1 - Introduction: What We Eat, Why We Eat

    and the Key Role of Food in Modern Life

    by mvd4last modified 07-25-2011 03:19 PM

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    Professor Brownell gives an overview of the class's agenda. The psychological issues of food

    are introduced, such as who defines food, what promotes health, and how the food industrycontributes to both debates. The biological issues that will be discussed include how people's

    hard-wired preferences interact with a modern food environment. The political issues of theclass will integrate food production, consumption, marketing, and world politics, with

    discussion of potential interventions for changing food preferences and food intake patterns insociety.

    The Psychology, Biology, and Politics of Food: Lecture 1 Transcript

    September 3, 2008

    Chapter 1. Course Overview and Key Topics [00:00:00]

    Professor Kelly Brownell: How are you guys? It's really nice to see you all and I appreciate

    you getting up so early in the morning. I realize that Yale students aren't accustomed to

    doing that. I served as Master of Silliman College for six years and during that time Iwould get up at 5, 5.30 in the morning and start working. Students would see my light on

    in my office and say, "Oh that's great Master Brownell, you stayed up all night just like we

    did working," but of course we were on different schedules. So it would have been nice to

    have this at a later hour but this was the only time that really worked into the schedule, so

    I appreciate you being here. This is a very fun class. We talk about issues that are relevant

    to the world, to politics, to economics, and to all our lives. And we're going to talk about

    food and the psychology of it, the biology, and the politics, and this morning I'd like to run

    through what I mean by those things and what the course is going to be all about. So let

    me start off with is this the first day of shopping or was it yesterday?

    Student: Today.

    Professor Kelly Brownell: So this is the first class, the first moment of shopping that you

    guys are going to! Well it'll be interesting to see if you swing at the first pitch and decide to

    take this class on. We're going to talk about various aspects of food and I'd like to start off

    with a little pop quiz. This is a food, a common food that most people would recognize, and

    I'd just like to see if you could guess what it is from the list of ingredients, so take a

    moment to look at the list of ingredients and then I'll see if you can guess. Anybody who

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    has ideas just shout them out.

    Student: Brownie.

    Professor Kelly Brownell: Brownie.

    Student: Pop tart.

    Professor Kelly Brownell: Pop tart.

    Student: [Inaudible]

    Professor Kelly Brownell: S'mores, what?

    Student: A Ho-Ho.

    Professor Kelly Brownell: S'mores, okay that sounds

    all possibilities. Any other ideas?

    Student: M&M's.

    Professor Kelly Brownell: M&M's. Okay, well the interesting thing is, you guys in a very

    short period of time generated a number of ideas about what this could be. Well the fact is

    it could be hundreds of foods in the American food supply, and what's noteworthy about

    this particular list of ingredients, is that it's fifty-six entries long; fifty-six things in this

    particular food and we defined it as food. Now, whoever guessed it was a pop tart was

    correct, that's what it happened to be so you get extra credit for that. And so it's a very

    interesting question to ask, what is this? I mean is this is it a food? Should we define

    this as a food? Is it a chemical? Because there are a lot more chemical-sounding things inthat list of ingredients then there are things that nature would recognize or we would

    ordinarily recognize as food.

    One even might go so far as to say that it could be a controlled substance. If food has

    addictive properties, and we'll discuss this in the class, then is this the sort of thing that

    should get regulated by government? Now that's pretty far fetched and not many people

    would say that a pop tart should be a controlled substance and regulated by government,

    but there are some very interesting chemical properties associated with foods like this that

    trigger things going on in the brain that affect us in a very big way.

    Now I'm going to give you another little pop quiz here. I'm going to show you slogans fromfood companies and you guys tell me what foods they're affiliated with, what foods they're

    associated with. Okay, 'melts in your mouth not in your hands?'

    Student: M&M's.

    Professor Kelly Brownell: Okay, you guys are a little slow this morning. It's kind of early

    but let's see if you can pick it up. Okay you're right; M&M's. What about, 'obey your

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    thirst?'

    Student: Sprite.

    Professor Kelly Brownell: Okay. 'I'm lovin' it?'

    Student: McDonald's.

    Professor Kelly Brownell: Okay. I've got a pretty smart group of people here.

    Student: Kit-Kat.

    Professor Kelly Brownell: Okay. Kit-Kat bar, you're right and one more.

    Student: Cocoa Puffs.

    Professor Kelly Brownell: Okay. If you guys have had

    many health professionals saythat there's not enough nutrition education out there, that most people don't learn it in the

    schools, people aren't getting it so much from families because families don't know a lot

    about nutrition, but the fact is you've had a lot of nutrition education and you've just

    proven it. But the question is "who is it coming from?" Who has taught you and other

    people in our culture what food is all about? Who has taught you what constitutes food?

    What's acceptable to eat? What's good for us? And there are a lot of interesting things

    that the food industry has trained us to believe that experts say may or may not be true.

    Because a product has the word 'fruit' in its name doesn't necessarily mean it actually has

    fruit in it. Now is that deceptive, is it misleading? Well these are very interesting questions.

    This course, as I said, will emphasize psychology, biology, and politics of food. Let's talkabout each one for just a moment. First of all, what you choose to eat, and what the world

    chooses to eat, which has enormous impact on the public's health, on the vitality of

    countries, and even on world politics. With the recent spike in food prices around the

    world that you've all heard of because of rising energy costs, the corn to ethanol

    conversion in the United States, and other things like that has really changed the world

    landscape in a lot of interesting ways. It's helped some countries and hurt other countries,

    but it certainly has changed the food landscape.

    So those are very important political factors, but let's talk about psychology for a minute.

    You guys have been trained by your culture to define what constitutes a food. And food is

    associated with feelings. Some people eat when they're stressed, some people eat morewhen they're stressed, some people eat less when they're stressed. Some people eat for

    comfort, some people get enormous psychological gratification from food, other people

    couldn't care less they have to be reminded to eat. What's the difference in there? Now

    how many of you let's just get a show of hands, how many of you would say you eat

    more when you're stressed? How many of you would say you eat less? Okay it looks like

    about a fairly even split which is interesting. We've done some research on this in the past

    and found that men and women differ in the response to that question, and of course, the

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    level of stress matters and even the type of stress people are feeling. Is it academic stress,

    social stress and the like, that depend that determines in part how people respond with

    their eating.

    So psychology is a big player here. We like certain foods, we have positive associations

    with them because of our families and all these

    and marketing of course, and all thesefactors come into play in shaping how we feel about food.

    Biology is an obvious player. How many of you would say that food can be addictive? Well

    maybe three-quarters of you, a lot, that's a lot. Now actually, the science on this is pretty

    new and very interesting, and we'll talk about that in the class. But for those of you who

    raised your hand just tell me I mean why do you think what makes you believe food

    can be addictive? Just somebody tell me. Anybody, go ahead.

    Student: If you have withdrawals after eating a certain type of food for a long time.

    Professor Kelly Brownell: Okay, so withdrawal is a possibility. If you eat food for a longtime and then you stop, let's say a high sugar diet or something and withdrawal symptoms

    occur, well that might mean addiction is occurring. Who else has ideas about that?

    Somebody else had their hand up?

    A lot of interesting reasons, we've all heard the topic the word chocoholic, sugar addict,

    we hear the words withdrawal and things and that becomes an interesting part of the

    biology of food. But of course food has this cascade of effects once it enters our body. It

    starts even before it goes in our mouth. We sense food coming in, that sets into gear a

    series of metabolic and biological processes that are very interesting, and then of course

    once the food gets in the body it does lots of interesting things some good things and

    some bad things. So we'll talk about what people are eating, we'll talk about what's goodand what's not good and what the optimal diet might be.

    Here are a few of the topics that we'll be discussing in the class. First, we'll talk about what

    you eat and why, and what the world eats and why. How much is psychology, how much is

    biology, how much of it is world politics? All these things are very important players, so

    we'll talk about this and discuss what sort of things are shaping your diet, but also the

    world's diet and the reasons behind them. We'll talk about whether food can be addictive,

    as I mentioned just a moment ago. We'll talk about whether food can promote health; of

    course it can if done right, and we'll talk about the specific properties of food that promote

    good health and what can be done to increase the opportunity of food to improve the

    public's health in a national and international way.

    We'll also discuss what we perceive food to be and what we perceive is promoting health

    and that may be quite different than what actually promotes health. Are trans fats bad or

    trans fats good? If a food never had trans fat in it but it gets labeled as having no trans fat,

    does that increase your perception of how good that food is for you? So the perception is

    really important here.

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    We'll talk about genetically modified foods. Any of you who have come from Europe will

    care a lot more about this issue, in all likelihood, than the Americans because it's been a

    much hotter topic in Europe. European governments have taken stronger action against

    genetically modified foods than is the case of the American government and there is a very

    interesting political history to this.

    And we'll talk about how modern agriculture affects us. Now most of you probably didn't

    come to Yale thinking you were going to learn about farms, but if you take this class you

    will, and we'll talk about where food comes from because people have become very

    interested and they're becoming ever more interested in the story of their food. They want

    to know where it comes from, who grew it in some cases, how many miles it got

    transported, what was put on the food as it was being produced, what was given to the

    animals or injected into them as the beef was coming out, or the pork, or the chicken, and

    these will be very interesting topics to discuss.

    And we'll talk a lot about the food industry because of course the food industry is a series

    of very important players. They're names that you know, names like Coca-Cola, andMcDonald's, and Pepsi, and Kraft, and companies like this that you've heard of; but there

    are also very powerful and important agribusiness companies whose names you may not

    have ever heard of who have a big influence on international politics and what that does to

    our eating.

    Another little pop quiz here, and these aren't trick questions necessarily, but if you had to

    guess what the bigger problem was in the developing world, so let's not just say outside the

    U.S. but in the developing world, is it hunger and malnutrition, or over nutrition and

    obesity? How many would say over nutrition and obesity? A few; and more hunger and

    malnutrition? Okay. Incorrect. Believe it or not, the health minister of China recently said,

    that over nutrition and obesity and the chronic diseases they cause, is a more significanthealth problem than under-nutrition and the traditional infectious diseases that used to be

    the major killers in that country. We're seeing the same thing in all sorts of other countries

    around the world. So the nutrition landscape and the physical activity landscape is

    changing and is sweeping way across the world. It's interesting to think about what's

    driving that and what it means for our health and for international politics.

    Here's another little quiz. I'll give you four food companies, and tell me which one you

    think is the world's largest. Unilever is one, Kraft is another, Nestle is another, and then

    the final one is Coca-Cola. How many of you would guess that Unilever is the world's

    largest food company? Maybe ten people. How many would say Kraft? Okay, a few more.

    How many would say Nestle? Okay, maybe double the number. How many would sayCoca-Cola? Okay, Coke got the most votes here which is interesting, and in fact Coca-Cola

    is an international giant of a company. The Coca-Cola logo is recognized around the

    world, there are people in many parts of the developing world who don't trust local water

    and hence drink bottled things like Coca-Cola, so they're enormously powerful company,

    but the answer to the question is Nestle. They're the world's largest food company. The

    second largest food company is Unilever, and the third is Kraft, which is America's largest

    food company. And and each of these companies owns thousands and thousands of

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    brands and products, so they're very big and very powerful, but it's interesting that we

    think that the United States food companies are governing the world market. Well they're

    not necessarily, because we only have the number three player in terms of size.

    Let me ask another question, if you give this and we'll talk about this in a later lecture,

    but if you give this diet to laboratory animal

    rats, mice, whatever

    it's very commonfor animals to gain a good bit of weight when given access to this diet. Even if they're given

    healthy food at the same time, they'll tend to ignore the healthy food and eat a diet like

    this. And there are three properties of this diet that help promote overeating and obesity in

    laboratory animals. What would you say those three features are?

    Student: Sugar.

    Professor Kelly Brownell: Okay, sugar is what people usually guess first and that's

    correct, that's one of the three. Yes?

    Student: High fat.

    Professor Kelly Brownell: Okay, fat is number two, so you guys are good so far. Who can

    guess what the third might be?

    Student: Salt.

    Professor Kelly Brownell: Salt is a good guess, but that's not the answer.

    Student: Diversity.

    Professor Kelly Brownell: Okay, very good variety is the right answer. Most peoplewouldn't think this. But why would a laboratory animal, unaffected by never having

    given access to foods like this, not being exposed to marketing or other social influences

    that humans are, why would a lab animal seek out a diet, become very overweight, become

    nutritionally deficient in some things because it's not eating the healthy food and prefer

    these foods to the extent that it becomes unhealthy?

    Well there are interesting evolutionary reasons that we'll talk about in the class for that.

    So the fact is those lab animals have a hard-wired preference for foods that are high in fat

    and high in sugar, primarily because of the energy density that those foods bring to one,

    and then the variety is important because you get a mix of nutrients. If you ate the same

    food day after day after day, you'd have too many of some nutrients and too little ofothers, and you become nutritionally deficient. So this the seeking out fat, sugar, and

    variety is a highly evolved, adaptive evolutionary trait; but in the presence of the modern

    food environment that provides access to these things, and to foods like a pop tart with

    fifty-six different things in it, the body gets thrown off. The animals become sick from it

    and humans become sick from it.

    And so one could say that there is a very unfortunate mismatch between our biology and

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    our evolution and the modern food environment, because biology of course takes

    thousands and thousands, millions of years even to change, but the food environment has

    changed relatively recently. The food environment that you're exposed to today is much

    different than when I was a boy. When I was a boy the eight ounce Coke was the default

    serving, and when I was a child when it was time to have a Coke or a Pepsi you had eight

    ounces and the event was over. You didn't go and have another one, or another one, oranother one, and now the default is a twenty-ounce bottle, so you get a sense of how those

    sorts of things have changed.

    So the environment has changed in a short time but evolution has not and there's a real

    mismatch now, which explains why you probably like Haagen-Dazs better than you like

    cauliflower. Now why would that be? Well the cauliflower has some nutrients that are

    important, but the Haagen-Dazs has immediate value because of the energy it gives you.

    And if your body is biologically programmed to defend itself against famine or starvation

    which is what humans and animals have faced over all the centuries then you're

    going to seek out the energy dense food and that's why those foods taste inherently better.

    There's a reason we like fat. There's a reason we like sugar, and there's a real reason whenwe like the two of them together in something like ice cream. So these biological things are

    very important.

    So there's some very interesting questions we'll address in the class. First of all, what is

    food? Now, that seems like kind of a funny question because food is whatever a society

    eats. But in fact, it varies a lot from culture to culture, and we'll talk about that during the

    class. We'll talk about the story of food. We'll talk about where it comes from, and the

    biological, economic, and political reasons that drive food to be certain things, and we'll

    talk about what it does to us and for us.

    And, probably most important of all is can the food environment change? There areprobably those of you in the class already who are outraged by things like the modern food

    environment, how much energy it takes to transport things from place to place, lack of

    concern with sustainability and issues like this, and you'd like to see social change. Other

    people might have other interests, but we'll talk a lot about social change and what might

    be done ultimately to effect the environment.

    Right before you guys came to campus there was a tournament, a tennis tournament in

    town called The Pilot Pen, which is a lead in tournament to the U.S. Open. And I was out

    there and the only place you could really get water, except for a few drinking fountains,

    were from the Evian booths and it talks on sand o three fifty for a bottle of water, which

    is pretty typical of these places, but what was interesting was the fact that this is shipped infrom France. Well how much sense does it make to ship water to the U.S. from France?

    And my guess is that if we did taste tests with all you guys of all the popular bottled

    waters, very few people could probably pick out Evian from any other water. And if that's

    the case, why in the world would can we justify all that shipping, all the excess energy to

    taste, to ship water in from France, rather then just buying something local or drinking

    water out of the tap?

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    So the food environment can change and can change in productive ways and there are a lot

    of signs of this happening. Those of you who are familiar with what's going on in New

    York City may know that if you're in a New City restaurant now you cannot eat trans fats,

    because trans fats have been banned from the restaurants. There's a very interesting

    political history to that. That's a very positive change in the food environment, so we'll talk

    about those sort of changes. Okay.

    Chapter 2. An Introduction to the Social Construct of Food [00:19:41]

    So again, let's talk about what food used to be and what it is now. So we'll take Flaming

    Hot Cheetos up there, and later in the class I'll play you a very cute clip from NPR about

    kids eating Flaming Hot Cheetos in schools. So the the ingredient label looks like that,

    the ingredient label for this looks like that; and so forty-three ingredients in one and one

    ingredient in another. It's a really very interesting question about whether that thing on

    the left is really food. So if we asked you which of these two things is food, I can imagine

    what you'd say. You have Flaming Hot Cheetos and a cockroach.

    Now I could probably make some of you very sick to your stomach by having you close

    your eyes and imagine eating a cockroach, and if I really walked through what you'd be

    experiencing if you did that, you'd be very upset. Well, why is that? I mean probably those

    of you I mean I can see you people squirming right now when I just at the mention of

    that so I'm not going to go through the process of having you close your eyes and

    imagine eating the cockroach. But why would you feel that that's so disgusting? It's not

    like you've ever eaten one and had a bad experience and think it's a yucky food. You've

    been totally trained by your culture. There are people in the world who do eat

    cockroaches, and they would consider that thing on the left not food. So it's totally a social

    construction.

    If we think about what is food and what isn't food, we have to ask what are the definitions.

    Now one of the books that will be assigned for the class is by Michael Pollan called, In

    Defense of Food, and he spends some time in that book discussing this issue of what is food

    and he has a very interesting take on it. Let's just put together some criteria for what if

    you had to say what defines a food, what makes something a food, what would you say?

    Okay if it's 'something you can eat,' okay well that makes a cockroach food. Okay what

    else defines a food? Yes?

    Student: It has nutrients.

    Professor Kelly Brownell: It has nutrients. Okay, the cockroach meets the criteria again.Yes?

    Student: It's a socially acceptable thing to be eating.

    Professor Kelly Brownell: Okay, 'a socially acceptable thing to be eating,' which of course

    will change from culture to culture even within a country, so that's very true. Other ideas

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    of what might constitute a food?

    Student: Energy.

    Professor Kelly Brownell: Energy pardon me?

    Student: Gives you energy.

    Professor Kelly Brownell: 'Gives you energy,' okay. Yes, so that would be the nutrient part

    of it. Did I see a hand back here?

    Student: I was just going to I don't know if this is one of the things, you can eat it and

    you can metabolize it and trap the energy.

    Professor Kelly Brownell: Okay, so the body has a way of metabolizing and making use of

    the food such that you can get energy or nutrients from it. Okay those are all good

    answers. Well I made up some answers too and let's just use these as hypotheticalexamples. One might have to do with where it's from and how it's made so that might tell

    us a little bit about whether something should be defined as a food. Its effects would be

    next and its social construction would be next, and you guys alluded to all these in your

    answers to my question. So first, you might say, well food is something that's found in

    nature, that humans have evolved to eat foods that are found in nature. They're out there,

    you can gather them, you can hunt them, you can fish them, or you can grow them, you

    can do something but it's out there in nature.

    Well that's one possible definition of food. Another is how much it's processed and how if

    you take things that started out as food like wheat or corn, and then they're processed

    many different ways, and things are added to them or done to them that change theirchemical properties, does that affect whether we would consider them food? Its effects, is it

    recognized by the body? Can the body ingest this particular item and deal with it in a

    reasonable way and not have internal havoc occur? When people are eating foods that are

    too high in fat and sugar and they eat these foods consistently, and have other bad

    nutrients like trans fats, a lot of bad things happen to the body. The body cannot adapt to

    a diet that has certain properties. So if a food belongs to a class of foods that a class of

    items that contributes to that internal metabolic havoc, would that be reason to consider it

    a non-food?

    Then the social construction of course is very important. Do we think something would

    taste good and do we define it as a food as part of a culture? So if we go back to theCheetos and the cockroach and we look at our different criteria, and we ask ourselves, is it

    found in nature? Well we get a check for the cockroach on that one don't we? Flaming Hot

    Cheetos are not found in nature. Is it concocted? Well the cockroach is pretty much its

    natural state and you have all the ingredients in the other food. Recognized by the body?

    My guess is that eating cockroaches probably won't do internal damage, eating too much

    of foods like this certainly will. Is it harmful? Well, I mean a cockroach might be seen as

    being harmful because we consider them dirty, disgusting, revolting insects and we don't

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    define insects as something we eat, at least in our culture.

    Then finally, do we define it as food? Well then we get a check for the Cheetos, does it taste

    good? We get a check for the Cheetos as well, but only because we're trained to believe

    that one tastes good and the other one doesn't, because in different cultures it would be the

    reverse. So you see how these different properties of food affect whether we would evenconsider it a food.

    Chapter 3. Understanding Physical and Psychological Distances to Food [00:25:30]

    Farms are an interesting part of this. There was a time when people were very close to

    their food. They were physically close to it and psychologically close to it. The food was

    raised locally. Excuse me. If you think back to New Haven in the 1950s or 1940s, or 1930s,

    a lot of the food, much more then is the case today, was grown locally and was sold in

    markets and so there might have been one person or one step that resided between you

    and your food. You might even see the farmers sometimes who brought the food into

    market, and that was certainly true in earlier days.

    The distance to food has changed a lot because food has to come in from far greater

    distances than used to be the case, and that's changed our relationship with food a lot, into

    a distant rather than a close relationship. Here's an example that highlighted in the block

    there are the is a farm called Fairview Gardens, that's outside of Los Angeles, in

    suburban Los Angeles, and so that's the bracketed part is the farm in 1954. The next

    slide shows the farm, same farm and its surroundings in 1998, so you can see that a lot has

    happened here. This means that all the area surrounding that Fairview Gardens was

    mainly farmland back in the 1950s, all growing food, probably a fair amount of it being

    eaten locally by people.

    Since that's all been pushed out of the way by development, that means the food has to get

    shipped in from larger distances. And it means the people in Los Angeles who were eating

    their food, a lot of it shipped in from far away have a distant relationship with it. There's

    also a distant psychological relationship with it because we just aren't as concerned as

    people used to be about where it came from. But that's changing, and more and more

    people do want to know the story of its food. And that story is something we'll talk about

    in the class.

    By the way, if we go back to this, another big part of disease chronic disease that's

    related to diet, is the physical activity part of the equation. As we'll discuss in the class, and

    most of you probably know this, your body weight is a function of how many calories youtake in and how many calories you burn off through metabolic processes but also physical

    activity. It used to be a lot easier to be physically active then it is today, and we'll discuss

    this later in the class, but energy saving devices all over the place. You guys use computers,

    I used the typewriter when I started college, so I was burning more calories creating a

    paper than you guys have too. That wouldn't seem like a lot of calories but you add that up

    across electric garage door openers, and electric toothbrushes, and windows on your car

    that you no longer have to crank, and of course you don't have to get up and go across the

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    room to change the channel on the television any longer, these things contribute a lot to a

    calorie deficit that used to be there's a calorie there's a deficit in how many calories

    are burning compared to before and part of that is our environment and the way the

    environment is structured.

    There's a group of people in the United States and elsewhere who studied something calledthe Built Environment how the environment is built affects how much physical activity

    we get. So let's look back at this picture here. Let's just say that you have a child who lives

    up here, say in this cul-de-sac, and is friends with a child who lives over here. Now that's

    probably not a very long distance and it's the kind of distance where a kid could easily ride

    a bike, but of course no parent is going to let a child ride a bike from here to here because

    you've got the super highway in the middle, and the only way to get across it would be to

    go down here on this very busy road, figure out how to navigate over here, even if there is

    a walkway that one could ride a bike, and then maneuver over to here. The introduction to

    the super highway, which divides these communities in two, really affects physical activity

    a lot. You have- and another example of that that would be true, is let's say you have a

    child who lives in this sort of circular area here, who lives here and is friends with a childwho lives here. Then that's not a very long distance, probably easily walkable in a few

    minutes; but that child can't be walking through everybody's yard. How do you get there?

    You go to go here, here and these could be busy roads, and so parents don't want to do it

    because of safety reasons, so you see how when the country used to be laid out in a grid,

    like say New York City still is today, then people walk to get to places. But when you have

    things like this, which is typical of suburban developments, it affects the physical activity a

    lot.

    There have been some interesting surveys about people's relationship with food and the

    Pugh Foundation did a survey that was published in April of 2006 that asked people how

    much

    found out what percentage of people really enjoy eating. And in the

    from 1989to 2006 there was a pretty significant decline, but even in 1989 the numbers weren't very

    high. Now there was probably a time when people enjoyed eating more. They weren't

    eating all the time, their eating was confined to three meals a day, it was more likely to be

    a social event because the family was together, and the food had more you had a better

    personal relationship with food. Why in the world, over that period of time, would people's

    relationships with food get even worse?

    Well it has to do with our distance from food, our psychological and physical distance

    from food, and the fact that we don't appreciate it as much as we do because it's

    everywhere all the time and we've been trained to eat outside of the normal meal times.

    How many of you have seen the Taco Bell series of advertisements for the fourth meal?Okay, common one, people see that now, well what that means is no longer is a three meal

    sufficient; there has to be a fourth. People are eating late at night, they're eating early in

    the morning, and they're basically eating all the time. So this is not a very positive sign and

    people are having a bad relationship with food. And what can be done to turn it around?

    In this same poll, people were asked if they were eating more junk food then they should.

    Men and women both said, in pretty high numbers, that they were eating more junk food

    then they should. Now you'd hope that it would be a small percentage of the population

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    that would be affected by this but it's not. It turns out to be a very high number. We have

    to ask why is this? Why are people eating too much junk food? Well, what would be your

    guesses? What are the factors? Go ahead.

    Student: It's cheap everywhere.

    Professor Kelly Brownell: Okay, so availability and cost become two key issues. Yes, and

    somebody else had their hand up.

    Student: [Inaudible]

    Professor Kelly Brownell: Okay.

    Student: [Inaudible]

    Professor Kelly Brownell: Okay, marketing is a big factor. Yes?

    Student: It tastes good.

    Professor Kelly Brownell: Tastes good, yeah?

    Student: It's easy to get I mean it's easy to make too.

    Professor Kelly Brownell: Okay, so it's not only available, it's sort of out there all over the

    place, but it's easy. You can be it can be secured easily and it can be made easily in a

    microwave or things like that, that's all true. Any other ideas, yes?

    Student: Part of the social scene.

    Professor Kelly Brownell: Okay, it's part of the social system that we're in. Yes?

    Student: Less cleaning, to take care of the dishes and you can just throw it away.

    Professor Kelly Brownell: Okay, right it's easy because there's less cleaning, less

    preparation and things, right?

    Student: Expire [Inaudible]

    Professor Kelly Brownell: Okay, that's a very interesting issue about the

    the responsewas that because the other food might expire quickly and so that's true; if you're eating

    things like fruits and vegetables, they only have a certain amount of life before they go

    bad. A lot of these processed foods have very long shelf lives and therefore can be stored

    for long periods of time. They can be on store shelves for a long period of time, and that

    has to do with the economics of food, especially food available to the poor, which we'll

    discuss later. Okay these you guys are all right, everything that I heard was a correct

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    answer.

    Now the people in this poll were asked the same question and here's what they said, so

    75% said that one reason is that it's more convenient, it's what people like to eat, it's

    heavily advertised, it's more affordable, people may not know which foods are healthy. So

    those are all reasons that you guys mentioned.

    Now what you might do about this, let's say that we that you're the Surgeon General or

    you're the top health official in some country and you agree with this poll, that people are

    eating too much junk food. So what are you going to do about it? Well it kind of depends

    on what you think is driving the problem, and each of these things suggest a different level,

    different types of things you might do. For example, if it's more convenient should you

    change the environment to make the unhealthy food less convenient and make healthy

    foods more convenient? That would make sense.

    But if this is the reason, it's what people like to eat, what would you do about that? Should

    we create a drug that takes away the pleasure from some of these unhealthy foods? Orcould you train people to believe that they're not good for you, etc.? If it's too heavily

    advertised, well that screams out for government regulation to cut back on marketing.

    We'll talk a lot about marketing and what government can and can't do about it.

    If it's more affordable of course you'd want to use an economic intervention. So could you

    use taxes and subsidies, for example, to raise the price of foods that you think people

    should be eating less of, and lower the price of things you would like people eating more

    of? Certainly a possibility. If people don't know which foods are healthy well then it argues

    for education but notice that that was almost the lowest ranked thing that people said.

    So that would suggest that education is probably not going to get the job done, because

    that's not the main driving reason because most people know that they shouldn't eat somuch junk food, but education is what we default to when we think about what to do.

    Chapter 4. Marketing and Its Challenge to Altering Food Intake Patterns [00:35:50]

    So really, all these things are potentially interesting possibilities and the question is what

    makes most sense? Well, we'll sort through all these and discuss what a society might do to

    help change food preferences and food intake patterns in the society. We have to ask

    ourselves which of these is true. If people are eating too much junk food, which of these is

    it? Although most of you would probably say 'well it's all these things are involved, at

    least to some extent,' society defaults to certain assumptions about what's driving food

    intake and there are some people that default to an environmental explanation of this. It'smarketing, it's economics, it's the environment is set up in such a way to make these foods

    very appealing and very attractive to people, and that's why they eat them.

    But other people, in fact probably a larger percentage, default to the top option here: that

    these are personal health issues rather then public health issues; that people are making

    choices about what they eat, if they make bad choices it's their fault. You either need to

    implore them to behave differently, you need to coerce them to behave differently, or you

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    need to educate them to behave differently. You can see these two camps of thoughts

    would generate far different approaches to dealing with dietary crises on an international

    scene. We'll walk through these, but of course they're all players.

    Now I'm going to show you two advertisements. You may have seen these on TV. One's

    from Burger King and one is from KFC, and when I show these to you

    we'll talk a lotabout food marketing in the United States, because if you buy the premise that I laid out a

    few moments ago, that what we consider food and what we consider to taste good is pretty

    much a total social construction. I mean not a complete social construction. For example,

    nowhere in the world would people consider eating a rock, because a rock is non-food

    across all cultures; but aside from that, there's great variability and so social construction

    part of this is very important. That means that somebody has taught us what food is.

    Well our family has taught us, our culture has taught us, but the food industry has taught

    us too what's food and what's not food. Not only that, they've taught us what constitutes

    healthy food and unhealthy food. They've been very influential in teaching us how much of

    things we should eat, and look at that in this commercial that you're about to see, and also,the social context of this. Who is deciding what you should eat? And in here, there's a very

    male-dominated theme that you'll see pretty quickly, and what you'll see in this is that this

    man is being told, and men who watch it, obviously a male-oriented sort of thing that I've

    seen watching sporting events and the like. There's a very interesting theme here and it's

    not too hard to pick up. So let me play this, so we may need to have high volume on this

    because this is pretty this is needs a little more volume (commercial). Now we're not

    getting any volume at all. Okay we'll try to correct this problem. It's possible I've got my

    own I have my sound turned on. Any idea why we're not getting any volume? Let me

    try it again, here we go (commercial).

    All right, so what are some of themes when you pick up when you see something like that?I mean there's obviously the manly thing, but what message is being given to the men who

    see this? Yes?

    Student: Eating healthy is a girl thing to do.

    Professor Kelly Brownell: Okay. That eating healthy is a girl thing to do, correct. What

    else?

    Student: Real men eat meat.

    Professor Kelly Brownell: Real men eat meat, that's correct. Yes?

    Student: Small portions are bad.

    Professor Kelly Brownell: Small portions are bad, that's right. Yes?

    Student: Every single man wants to eat this.

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    Professor Kelly Brownell: Okay. All men want it because there are a variety of men in

    there. Yes?

    Student: It's your own decision to eat [Inaudible]

    Professor Kelly Brownell: Okay. The man is in charge of his dietary destiny. He's makinghis own decision as you said and no woman is going to tell him to eat quiche or tofu and

    that you may have missed it but in the song there we'll show this later in class again

    but in the song they say that 'I won't eat quiche anymore' and 'goodbye to tofu' and

    things like that. Yes?

    Student: A Texas Double Whopper will make you stronger.

    Professor Kelly Brownell: Okay, that's right. I mean it's well it's not said directly but

    that's inferred isn't it, because all these are they're doing all the muscle kind of things

    and they're eating the Texas Double Whopper. They're not showing them keeling over

    from a triple bypass surgery, let's say. Yes?

    Student: You shouldn't waste your money on healthy food.

    Professor Kelly Brownell: Right.

    Student: fancy restaurant

    Professor Kelly Brownell: Right, because you waste your money if you're buying these

    little portions of healthy food. That's exactly right. Yes?

    Student: Longer sit down meals are unnecessary.

    Professor Kelly Brownell: Okay. Longer sit down meals are unnecessary because you can

    just go buy it all of a sudden. Okay, you guys were all right. Isn't it interesting how many

    messages are embedded in that short advertisement. And it's done with song, it's done

    visually, all sorts of things are embedded in there. I'll show you some other advertisements

    later that are oriented to men that make that same argument: that if you're a man, nobody

    is going to tell you what to eat. Burger King might, but nobody else. So that becomes as

    very interesting theme in these advertisements. That's one, and we could show you dozens

    and dozens of these sort of things, and we will over the course of the class; each one of

    them very interesting.

    The next one I'd like to show you is a KFC ad, and this ran fairly recently. I don't know if

    it's still on the air but it ran fairly recently. Look at this and then we'll analyze the themes

    in this (commercial).

    Okay, so what's embedded in this message? KFC is now is healthy, yes?

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    Student: [Inaudible]

    Professor Kelly Brownell: Okay, so there was the family theme here that now that KFC is

    healthy it becomes something the whole family can enjoy. Yes?

    Student: It still tastes good.

    Professor Kelly Brownell: Okay, it still tastes good despite not having trans fats. Yes?

    Student: [Inaudible]

    Professor Kelly Brownell: Okay, you don't have to change things because it's now built

    into the healthierquote, "healthier" version. Yes, all the way in the back.

    Student: [Inaudible]

    Professor Kelly Brownell: Okay, say that again, please?

    Student: It's more exciting then your kids.

    Professor Kelly Brownell: Food's more exciting then your kids. Yeah, it's there, yes?

    Student: Talks about that food is more important then family.

    Professor Kelly Brownell: Food's more important then family, right. What about how fast

    the sort of lack of control and now I can kind of binge on it or eat it, I don't even have to

    wait until the family sits down to eat. Also, it can't be an accident that it's an African

    American family depicted in here, so there are a lot of interesting things going on in thislittle video clip.

    Now there's a political and business history to this because KFC, as large a company as it

    is, is owned by a larger parent company, believe it or not, called Yum Brands. Yum

    Brands owns other food-related chains like Taco Bell. But Yum Brands responded in a

    very interesting way when the call to remove trans fat first came out. They were pretty

    slow off the mark to do something about this, and it was after lawsuits were filed that they

    actually made the change.

    But here they are boasting about the change! Talking presenting the picture to the

    world that, 'well look at this wonderful thing we did, we took out the trans fats and nowyou can eat as much of it as you want.' They don't say it but one could infer that from the

    advertisement.

    And the fact is, food is healthier if it has less trans fat, but it depends on what fat's

    swapped out for it, because if you put a healthier fat in then it's then you get a certain

    amount of improvement. But if you put a less healthy fat in you get some improvement but

    less. But also, switching out the trans fat in another kind of fat doesn't change the calories

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    at all. It still has the same number of calories. And obesity is a huge problem in the United

    States, especially in the African American community and other minority communities. So

    to imply that now you can eat all you want, you have an issue to free ticket if you will,

    some people might consider not the right message.

    When we think about the way food is marketed, we have to ask ourselves how were thesemessages framed, who's being targeted, what the message is, and of course what the

    impact is. You guys over the course of your life have been exposed to an enormous number

    of food messages an enormous number. Far greater than I was when I was a boy. And

    they've come in different forms. When I was a boy there was one form and one form only

    and it was cartoon it was on Saturday morning cartoons and there was advertisements

    for foods on that and it was mainly for sugared cereals. But boy, if you think about your

    advertising landscape? So much different then mine was. How is different? Well tell me

    some of the ways, how is it different now then my boyhood with just the Saturday morning

    cartoons? Do you even realize how much marketing you're exposed to? What forms does it

    come in? Go ahead.

    Student: Athletes endorsing food companies.

    Professor Kelly Brownell: Okay, so you have a variety you have athletes, movie stars,

    music celebrities, and people like that who get associated with foods and that's of course

    very powerful for kids. The list of athletes that have endorsed some of the food companies

    or done marketing for them, so the William sisters, the great tennis players have done fast

    food companies. Michael Jordan did fast food companies, Kobe Bryant, and then you of

    course get all the cartoon characters like Sponge Bob and other things that over the years

    have been associated with a number of these products, so that those attachments are

    very important. Yes?

    Student: But real people, not just cartoons, you can relate to.

    Professor Kelly Brownell: So real people endorsing these sorts of things, that's right.

    Michael Phelps, now that he's won all those gold medals, I hear is on Wheaties and

    somebody said Frosted Flakes, but I don't know if that's true.

    Student: He's passing up Wheaties for Frosted Flakes.

    Professor Kelly Brownell: Okay, so there's lots of then these things get coupled like

    you're saying, so these are very interesting things.

    Think about your marketing landscape and how different it was. So It's on television all

    the time, but television used to be almost 100% of the marketing and its share of the

    overall marketing burden if you call it that has is going down, but other things have

    taken its place. You have billboards; when you guys were in high school, how many of you

    had high schools with soft drink machines in them? Okay, almost everybody. Well you

    know when you walk past those soft drink machines you're being marketed to even if you

    don't buy it because it's that big colorful thing that stands out. That's a form of marketing.

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    What about product placements in television shows and movies? There's hardly a movie

    that goes by now that doesn't have products inserted and that's all bought and paid for. In

    general, if you're watching an action movie and there's a car chase and the trucks and cars

    are crashing all over the place, and let's say a Budweiser truck shows up in the scene

    somehow, well people are very likely paying for that. Every time a product shows up it's

    bought and paid for, for the most part.

    Chapter 5. The Importance of Taking a Global View [00:50:11]

    A lot of people don't recognize this as marketing, but there are many other forms that

    we'll talk about in the class, some of which you probably don't even know about, and it's

    some of which you probably see but don't code it as marketing. Your natural defenses that

    might provide some kind of a buffer between a commercial message and your behavior,

    you have a filter, a screen that helps you interpret these message. The opportunity of

    people to control that is going down and down, and down; and the opportunity for parents

    to control it is being eroded day, after day, after day. The amount of marketing, the total

    marketing burden has gone way up over the years. Of course if you think about what'sbeing marketed, it's not the quiche, it's not the tofu. It's the high calorie, high fat, high

    sugar foods for the most part.

    We'll talk a lot about marketing. It's very important if we're thinking about food to take a

    global view. We have to think about the whole world here. Well why is that important?

    Well of course it's an important value to have in general that in order to be good neighbors

    in the world we need to understand it, we need to if we're going to be good citizens in

    the world we have to know what other people are doing and what's affecting us. But even

    if you're totally nation-centric and even if you were only concerned with the United States,

    you still have to know what's going on around the world. Why is that? Well one is because

    we export a food environment. We export food but we also export norms, we exporteconomics of food, and a number of things that affect the world, and that comes back to

    affect us.

    The most recent example, as I mentioned before, is the huge spike in food prices around

    the world which has created rioting, starvation, major crises in various countries. Some of

    that is being forced by the United States and the corn to ethanol conversion program that

    has pushed up the price of corn a great deal, pushed down the world supply of corn for

    eating, and pushed up world prices. There are other factors involved too like high energy

    prices, but certainly U.S. policy is affecting that, but we're also affected by the rest of the

    world. Agriculture subsidies in the European Union affect the politics of subsidies here

    and that affects the costs of food and what we pay for them at the market. These things areall very important drivers of the diet, so we need to know what's happening globally.

    Also, the world's diet is changing to look like that of America. You see these headlines

    from scientific journals, and this is just a small sample. 'High intake of added sugar among

    Norwegian children and adolescents;' 'Obesity rising at an alarming rate in China;'

    'Refined sugar intake in Australian children.' I mean we could I could show these for

    the next three weeks non-stop because there's so many papers like this. As I said, when the

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    health minister of China says that, over nutrition is a bigger problem then under nutrition,

    we're seeing a changing world, so the global view is extremely interesting as we look

    around the world.

    Here's a slide that shows the projected increase in diabetes in the next twenty-five years.

    Now there are two types of diabetes, as you may know, there's Type I Diabetes which is agenetic abnormality that usually shows up in childhood or adolescents where people are

    dependent on insulin. That's that accounts for relatively small number of the overall

    cases of Type I Diabetes. Type II Diabetes usually has its onset in adulthood that's

    beginning to change and is usually created by lifestyle factors: poor diet, physical

    inactivity, and obesity. Type II Diabetes used to be called Adult Onset Diabetes, but it's

    had to be renamed to Type II Diabetes because kids as young as ten, and nine, and eight

    are developing it. This is more alarming then you could ever imagine. A child eight or nine

    years old with what used to be called Adult Onset Diabetes. And it's being driven by their

    lifestyle, and their diet, and their physical inactivity. Some of those kids will need coronary

    bypass surgery in their twenties; some of them will be blind by the time they're thirty.

    That's how dire the environment has become.

    Let's take a global look at this. In the next twenty-five years the increased the

    anticipated increase in diabetes is supposed to be about 37% in the U.S. This is a pretty

    alarming number because the rates so high already, one can't imagine it going up by

    another third. But in China the numbers look like this, and in India they look this. Now, of

    course, there are denominator issues here because we started with a much higher base rate

    then these other countries, but if you think about the size of the populations there, the

    number of people who are going to become diabetic in the next twenty-five years is really

    very frightening. If you collapse data, as we did in this one paper, across all developed and

    developing countries here's what we're expecting in the next twenty-five years. This is

    going to affect the world; it's going to affect world economies; it's going to affect worldpolitics, the balance of power and things like that, so it's important that we understand it.

    And so scenes like this are becoming more and more common around the world. In the

    country of China the most widely recognized corporate logo, other than from Chinese

    companies, is KFC. The American companies have major reach and major power, and a

    lot of the increase in growth in the fast food industry is happening outside the U.S. There

    was a paper that I wrote with a colleague in globalization and health, and this quote that I

    that I'll show you is from that and I'll read it in case it's a little hard to see. It puts

    together the experience with tobacco and the experience with diet, to talk about how

    countries might see this problem coming and doing something about it.

    "One hopes there is still time for countries to see this coming and take preventive action.

    By this we mean poor diet and physical activity and obesity, but history offers a depressing

    picture. Smoking is a key example, it took America decades to mobilize after the

    catastrophic consequences smoking were clear, but when it did, American tobacco

    companies exploited overseas markets, particularly in the developing world. {So we'll

    discuss whether the same thing is happening with food and the tobacco industry. The

    tobacco history is extremely interesting and relevant here} The tobacco industry in

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    countries like China saw the potential as well, and hence, smoking rates like rates of

    obesity have been skyrocketing in China and in countries such as Indonesia, Botswana,

    and Uruguay. By the year 2025 the number of smokers worldwide is expected to increase

    by 45%. {Think about that. As much as we know about tobacco in the United States and

    the fact that there are only half the number of people smoking than used to be the case, it's

    still expected to rise by 45% worldwide.} By 2030 the deaths attributed to smoking willincrease from four to ten million. The epidemic simply migrates from one part of the

    world to another."

    So are we having an epidemic of poor diet and what can be done about that? If we're going

    to be considerate world citizens what can we do about the area of diet?

    Chapter 6. Political Influence and Conflicts around Food [00:57:21]

    This has to do a lot with politics, so some of the political issues we'll talk about in the class

    will be agriculture subsidies. Again, you probably didn't come expecting to hear about

    farming, but farming is where the food starts and we need to understand that world. We'lltalk about the U.S. Department of Agriculture, which at the same time, is supposed to be

    helping sell as much food as possible to boost American agriculture, but establishes

    nutrition policy. And one can see how those two things might conflict at some point, and

    one typically prevails over the other.

    We'll talk about the amount of money that goes into Washington to lobby on behalf of the

    food industry, and we'll use a few exemplars of that like the National Restaurant

    Association which is the major trade association, as you might guess, of the restaurant

    industry. They've been very important political players now in the trying to get rid of

    trans fats in restaurant movement and also the movement that's happening around the

    country to try to get calories put on menus in restaurants.

    We'll discuss the research on this and also the politics on it.

    It's interesting how our leaders have discussed this. Tony Blair, in 2006, was addressing

    the issue of diet and obesity, and here's some of the things he said. And when he said they

    he's talking about diseases related to poor diet.

    "They're the result of millions of individual decisions at millions of points in time. For

    example, 20% of all children in the UK eat no fruits and vegetables in a week. 65% of

    adults and half of all children do not take the recommended amount of exercise."

    Now who's responsible for this? Is it government's responsibility to correct this or do

    people just need to buck up and change their lives in a way that turns these numbers

    around? What happens when you start thinking about children? Then who are the

    responsible players? Further he says,

    "These individual actions lead to collective costs," said Blair, "It's worth pausing for a

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    moment to consider the consequences that inaction will bring."

    All right, so that means that hidden in there is the idea that these people who are creating

    these statistics are costing us all a lot of money.

    "Government can't be the only one with responsibility; if it's not the only one with thepower. The responsibility must be shared."

    This is actually kind of a moderate position because it talks about government and the

    people sharing power here and taking responsibility for change. Very often this personal

    responsibility and collective or government responsibility become dichotomies and people

    are forced into camps. And that has very important implications for whether government

    responds or doesn't respond to these issues. Okay, that's sort of a broad background about

    the content of the course.

    [end of transcript]

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