Podcast appearances and mentions of kelly brownell

Professors—and ultraprocessed food experts—Ashley Gearhardt and Kelly Brownell join Mark and Kate to talk about why the robust new science about food and addiction is going to be hard to ignore, how junk food could take the path of cigarettes and opioids with regards to litigation (and how tobacco paved the way), and why marketing these foods to kids is so successful (and the many reasons why kids are so important to focus on).Subscribe to Food with Mark Bittman on Apple Podcasts, Spotify, or wherever you like to listen, and please help us grow by leaving us a 5 star review on Apple Podcasts.Follow Mark on Twitter at @bittman, and on Facebook and Instagram at @markbittman. Want more food content? Subscribe to The Bittman Project at www.bittmanproject.com. Hosted on Acast. See acast.com/privacy for more information.

The first nutrition labels mandated by the Food and Drug Administration appeared on food packages in 1994. A key update occurred in 2016, informed by new science on the link between diet and chronic disease. Along the way, things like trans fats and added sugars were required, but all along, the labels have been laden with numbers and appear on the back or side of packages. There has long been interest in more succinct and consumer-friendly labeling systems that might appear on the front of packages. Such systems exist outside the US, but for political reasons and lobbying by the food industry, have been blocked in the United States. There's new hope, however, described in a recent opinion piece by Christina Roberto, Alyssa Moran, and Kelly Brownell in the Washington Post. Today, we welcome Dr. Christina Roberto, lead author of that piece. She is the Mitchell J. Blutt and Margot Krody Blutt Presidential Associate Professor of Health Policy in the School of Medicine at the University of Pennsylvania. Interview Summary This is a really important topic, and if the nation gets this right, it really could make a difference in the way people make product decisions as they're in the supermarket. So, let's talk first about the importance of labeling on the front of the package. Why is that important when all the information is somewhere else, namely on the side or the back? I think there's a couple of key reasons why it's good to do front of packaging food labeling specifically. So, as you mentioned, it was a huge deal in 1994 to get this information mandated to be on food packaging to begin with, right? All of a sudden, there was much more transparency about what's in our food supply, but that being said, when you think about the nutrition facts label, it's pretty dense. There's a lot of percentages, there's a lot of numbers, there's a lot of information to process. And when people are actually in the supermarket shopping, they're making these split-second decisions, right? So, it's not to say that some consumers are turning it around and inspecting that packaging, but the reality is, for most people, it's a very habitual behavior. And so, we want to be in a place where that information is prominent, it's easily accessible, and it's easy to understand so that when you're making those snap judgements, they can be informed judgments. So, you're not talking about taking what's on the back and just moving it to the front. You're talking about a different set of information and symbols that might be available? That's right. Yeah. What front of package labeling is designed to do is just take some of the key bits of information that we know from science is going to be most important for consumers to base their nutritional decisions on. That's things like saturated fat, sodium, added sugars, right? And moving that to the front of the package and communicating about it in a very simple, clear way. So, no numbers, no percentages, just very straightforward language. And ideally some sort of icon, like an exclamation point, that would draw attention to that symbol and just quickly let consumers know that this product is high in those nutrients that you need to be concerned about and you need to try to limit. Why is it an important time to be thinking about this issue in the US? It's an important and it's an exciting time because the FDA right now is highly interested in actually moving forward on a policy that would require these types of front of package labels. And that hasn't been true, as you noted, for about a decade. But last year, the White House convened a very significant conference that hadn't happened in 50 years about nutrition, health, and hunger. And front of package labeling actually made it into their report in that conference as a key objective for this country in terms of a food policy that, under the Biden administration, they want to achieve. What we're seeing the FDA do now is actually undertake a series of research studies to try to understand what should this label look like, and how should it be designed to be consumer friendly. With the hope that actually we'll get a proposed rule on this potentially by June, and even if not by June. There's clear momentum that it looks like this is going to be happening in the near future. In a few minutes, I'd like to ask you about what's taken place in other countries, but what's been the history of this in the US? Front of package labeling really came to a head back in 2009. And it's actually quite a delight to share this with you, Kelly, because you and I were doing some research around it at the time. So, what played out then is a labeling system was introduced called Smart Choices. At its face, it seemed to make sense, right? It was going to be a check mark that was going to be put on products that were deemed to be healthy as a smart choice. So, a consumer could look at that and select something they wanted to eat that was relatively healthy. The reality is when that labeling system came out, it was on Fudgesicles and it was on Cookie Crisp cereal, and there was a lot of kind of concern about whether this type of labeling system was systematically problematic and was going to mislead consumers. And at that time, Kelly, I was a grad student at the Rudd Center and you really taught me quite a bit about how to make things happen and how to have a public health impact. Because we were quite concerned about that system, we actually did a study where we randomly sampled 100 products from Smart Choices and we applied an objective nutrition standard - an algorithm to score those products. What we found is that 64% of those Smart Choices products would not meet healthy by this objective nutrition standard. And so, you had the vision to reach out to the New York Times and alert the media to this. And we started to see a lot of kind of concerning reports in the media, like Smart Choices, what's going on? This doesn't seem very smart. We had done this little bit of science, and then at the Rudd Center, you had reached out to the attorney general of Connecticut at the time, Dick Blumenthal, who was quite interested in consumer protection issues and worked a lot on tobacco. And he took this up as a real public health champion to say this is concerning, we have some of this science, and he came out and threatened legal investigation into that program. What was so remarkable to see in that story, particularly for me as a grad student, was wow you can get these different actors coming together, right? Some of that media attention, science playing the role it needs to play, a public health champion who can really make a difference in the attorney general, and all of that can come together and this program literally halted, they stopped it. And I should say, that was a great public health victory. But immediately after that, the Institute of Medicine, so now the National Academy of Medicine, was charged with writing two reports on front of package labeling. And they came out with one that was focused on the nutrition criteria that should underlie a system like that, and one about the design of the label. And they had some great recommendations, very consistent with what you and I have seen in the science, right? It needs to be accessible, simple, easy to understand. Well, what ended up happening is not much. The industry at that point then released their voluntary labeling system that they call Facts Up Front, which is what we have to this day. And as you might imagine, it has percentages and it has grams and milligrams and it's confusing, and they can also highlight positive nutrients on there. So you can have a Cookie Crisp cereal that's also touting the amount of fiber, the amount of protein. And so that's really what we've been stuck with. It's now only over a decade later that we are at this moment where we're finally seeing this progress, and we're at a place where we might get a labeling system that does a really good job of communicating this information to the consumer. I guess one sort of ironic form of evidence that such a system is likely to really help consumers make decisions is how hard the industry has fought against having such a system. And not to mention the science that exists suggesting that these things might be helpful. A lot of activity has occurred outside the US. Can you describe some of that? Over 40 countries have front of package labeling systems. Now, some are mandatory, some are voluntary. The mandatory ones, as you might imagine, produce better effects. They range. And many of them are designed really well. So, let's take some of the best examples. Chile, for example, has warning labels that alert consumers to whether products are high in saturated fat, sugars, sodium, and calories, and those symbols are designed in a very intuitive way. They're stop sign shaped, so they really leverage the automatic associations consumers have. They're prominent, they're black, they stand out from the packaging. And these well-designed labels, we now have evidence from scientific evaluations that they're producing effects, right? They're leading consumers to purchase less of these unhealthy nutrients. They're also leading to some reformulation. And by that, I mean the industry is trying to figure out, 'well, can we lower the sodium, so we don't get one of those labels?' The other thing that I think is often overlooked with labeling but is so important is once you decide to label the food supply and you have an agreed upon system, that can support other policies. And that's what we see in Chile as well. Now all of a sudden, you can't market foods with these warning labels to kids, right? And you can't sell those foods with these warning labels to kids in schools. So, it really has even a broader impact than just the behavior change you see from the labeling, and so many other countries have followed suit. Mexico has a very similar labeling system. One thing that they've learned from Chile is, and this is a concern, that as the industry brings down the levels of sugar, for example, in foods in response to labeling, they're increasing the levels of non-sugar sweeteners, right? Things like Sucralose or Stevia or monk fruit, and so that's a worry. Mexico has, in addition, also labeled those non-sugar sweeteners on the food packaging. And then you see other examples. France has a really nice system. It's called Nutri-Score. Very intuitive. There are letter grades. I myself had the chance to go to France. I was trying to buy some turkey for my son. I don't speak a bit of French, and I'm standing in the supermarket and I just see the letter grade A and I think, oh, okay, I'll pick that one.   Great, great example. Yes, very intuitive systems around the world. So, are there studies showing which of these systems work and what sort of effects they have? And I know you've done additional work beyond what you mentioned earlier. Absolutely, and there are a whole range of studies, whether they're randomized controlled trials, lab studies, or online experiments. And then the more compelling, convincing evidence, which comes from natural experiments that are done around the globe, or even research we have from stores that have voluntary implemented these labels and we can look at changes in sales data. And what all that boils down to is labeling will produce behavioral effects. They will get people to purchase healthier foods, they will get people to purchase less of the unhealthy foods. Labels inform consumers, which I think is kind of the first order goal, right? Like let's just make sure people understand what's in the food supply, and then we see this reformulation. And that's been true, even if you look back to trans fat labeling, like requiring trans fat on the labels was also associated with trans fat coming out of the food supply. So, I think we can feel really good and solid that labeling can help people make healthier choices. And as anyone who's worked on issues related to chronic diseases, we're going to need a suite of policies, right? Labels are never going to be the silver bullet. They're not designed to be, but it's a policy that makes a lot of sense. It's a very cost effective policy. It's not very expensive to do labeling, and it can help support many other policies that might produce bigger effects. So, given the different options, the different kind of systems that have been proposed or are out there in use, do you have a sense of what ultimately might be the best system? I think the FDA has some good options in front of them. Now, if I were to wave a magic wand, I would do warning labels. I would make them more similar to what's done in Chile, just because we have good evidence that warnings in particular, and these kinds of symbols like a stop sign, are probably going to be more effective at educating consumers and shaping behavior. Now, that being said, we have some unique legal challenges in the US for getting a system like that. The FDA is proposing, I think, a totally reasonable, science-based label that essentially would have what it's high in and then indicate whether it's high in added sugar or saturated fat or sodium. I would love to see that label also have some sort of icons, some eye-catching exclamation point or something like that, but that label is great, it's a great option. Let's compare it now to what the industry is pushing for, which is basically what we have now, facts upfront. And as I said earlier, this is a label that has percent daily values, that has grams, that has milligrams, that can highlight positive nutrients that are going to appear on unhealthy foods. I think when you look at those two options, it's just a no-brainer to go with this very simple, very straightforward, high-end label that lists the nutrients and let's put some sort of icon on it. So are you optimistic about where things might go? Well, I'm a glass half full kind of person. I would say yes, I try to be very optimistic, but I think there's reason to be. I think we have some good options on the table, FDA is moving forward, research is being done, scientists and others are highly engaged in this process and giving feedback to FDA. And so many other countries have done this. So yes, I am feeling optimistic. So at the end of the day, a lot of this will come down to how much the FDA can resist pressure from the food industry. Right, so many things in food policy do come down to that. That's really true. So true. It's interesting, one of the things that you highlighted, but I'd like to even bring a little more attention to is the issue of the industry reformulating its products so that they don't have to show these negative labels. That's such a potentially powerful public health consequence of this, that it needs to be focused on even more. I'm hoping the valuations are being done of the impact of that on public health. Because you can make an argument, couldn't you, that if these labels don't affect the purchasing behavior of a single individual, they still could have enormous public health benefit just because of the reformulation, do you agree? Oh, 100%. Yes, absolutely. I would even argue that we have very few mechanisms to hold industry accountable, and to me is just a fundamental right of consumers. Like they have the right to know, there needs to be transparency, and great that they are likely to produce behavior change and great that they are likely to make the industry reformulate, but I just feel like that there's so many reasons to do labeling that it just feels like an obvious policy to pursue. Hopefully, any system that comes into place can be nimble as much as they can be in these government regulations to take into account new science that occurs. Like at some point, maybe a symbol that notes whether a product is ultra processed would be in order, or as you said, in France, I think it was, where they've labeled the addition of the artificial sweeteners. Was it France or was it another place? Mexico. Yes. That's right. Okay. Yeah, thanks for clearing that up. Something like that might enter the system, so having a system that can adjust to the science as it goes forward would be really important too. Kelly, it's such an important point. I think part of any labeling strategy needs to be monitoring and evaluation, and particularly with the non-sugar substitutes. Like right now, we don't know, it's a very hard thing to track. It's only on the ingredient list. We can't quantify how much is in the food supply. And so I would love to see coupled with labeling some way that that gets disclosed so we can really monitor and ensure how that might be changing in the food supply over time and evaluate, to your point, what's happening in terms of reformulation. As an aside, we've done a cluster of podcasts on the influence of these artificial sweeteners and the sugar substitutes and the available science on this, on what goes on in the brain, what happens to the microbiome, the impact of health overall is really concerning, so I totally agree with you that having that information disclosed could be really helpful. Yes, 100%.     BIO Christina A. Roberto, PhD is the Mitchell J. Blutt and Margo Krody Blutt Presidential Associate Professor of Health Policy at the Perelman School of Medicine at the University of Pennsylvania. She is also an Associate Director of the Center for Health Incentives and Behavioral Economics (CHIBE) at Penn. Dr. Roberto is a psychologist and epidemiologist who studies policies and interventions to promote healthy eating habits and help create a more equitable and just food system. In her work, she draws upon the fields of psychology, behavioral economics, epidemiology, and public health to answer research questions that provide policymakers and institutions with science-based guidance. Dr. Roberto earned a joint-PhD at Yale University in Clinical psychology and Chronic Disease Epidemiology. Dr. Roberto completed her clinical internship at the Yale School of Medicine and was a Robert Wood Johnson Foundation Health and Society Scholar at the Harvard T.H. Chan School of Public Health.

 In this engaging episode of SBM's BUZZ in Behavioral Medicine, we sit down with Dr. Kelly Brownell, a trailblazer in the fight against obesity and a staunch advocate for public health policy. Dr. Brownell discusses the importance of "Strategic Research" in addressing global health challenges, advocating for a multidisciplinary approach to behavioral medicine. Dive into the conversation as we explore how community engagement and strategic partnerships can catalyze change in public health, inspired by principles outlined in his influential work in The Lancet (Read more). Discover how SBM fosters a community of professionals dedicated to improving health and well-being through behavior change, promoting initiatives like the Community Engagement Studios to bridge research and real-world application (Learn about SBM, Community Engagement Studios, Communities in Partnership). Join us in this insightful dialogue that not only highlights Dr. Brownell's contributions to behavioral medicine but also encourages us to think broadly about the role of community and interdisciplinary collaboration in advancing health. Key Takeaways for Early Career Professionals/Undergrads: Insights into blending public health policy with behavioral science for societal impact.Strategies for engaging with communities and leveraging interdisciplinary teams.Guidance on carving out unique career paths within the behavioral medicine landscape.Don't miss this enlightening conversation with Dr. Kelly Brownell, especially if you're navigating the early stages of your career in behavioral medicine. Subscribe to SBM's BUZZ in Behavioral Medicine, hit 'Like', and turn on notifications to gain access to this and other episodes filled with expert advice and career development strategies tailored for the aspiring behavioral medicine professional. Connect and Grow: Subscribe to SBM's BUZZ in Behavioral Medicine to unlock the secrets to a fulfilling career in behavioral medicine. Engage with each episode to learn from the best in the field and stay ahead in your professional journey. Hit 'Like', subscribe, and turn on notifications to never miss an episode dedicated to your career development in behavioral medicine. Interested in becoming a member of SBM? Check us out at https://www.sbm.org/membership Special Thanks to our production team and Jay Conner of Jaybird Media for his skillful work in compiling and editing the audio and video for the Buzz in Behavioral Medicine: Season 2 podcast series.

This February and March, delve into the future of behavioral health with SBM's BUZZ in Behavioral Medicine, hosted by Dr. Bernard Fuemmeler, the esteemed 2023 president of the Society of Behavioral Medicine (SBM). Under the theme "Moving Behavioral Science Upstream," this podcast series is a curated journey designed for early career professionals and trainees in behavioral medicine, offering a wealth of career development insights, guidance, and inspiration from leading experts in the field. This podcast series is more than a collection of interviews; it's a beacon for early career trainees in behavioral medicine, illuminating the path to professional growth, community impact, and interdisciplinary success. Our esteemed guests are not only leaders in their respective fields but also advocates for community engagement, diversity in team-building, and innovative research paths that challenge traditional career trajectories. Season Schedule & Insights:February 8 @ 5:00 am ET - Set the stage for a season dedicated to "early career guidance in behavioral medicine," offering a preview of the invaluable insights to come.Episode 1 - Dr. Kelly Brownell: February 15 @ 5:00 am ET - In this engaging episode of SBM's BUZZ in Behavioral Medicine, we sit down with Dr. Kelly Brownell, a trailblazer in the fight against obesity and a staunch advocate for public health policyEpisode 2 - Dr. Sherry Pagoto: February 22 @ 5:00 am ET - Gain insights on innovative career trajectories in digital health and community engagement from Dr. Sherry Pagoto, a testament to the diverse opportunities in "professional development in behavioral medicine."Episode 3 - Dr. Karen Emmons: February 29 @ 5:00 am ET - Dr. Karen Emmons shares her journey in community-driven research, highlighting interdisciplinary collaborations essential for early career scientists in behavioral medicine.Episode 4 - Dr. Abby King: March 7 @ 5:00 am ET - Discover the intersections of technology, active living, and health with Dr. Abby King, offering a roadmap for integrating innovative solutions in your behavioral medicine career.Episode 5 - Dr. Monica Baskin: March 14 @ 5:00 am ET - Learn from Dr. Monica Baskin about advancing health equity and culturally relevant interventions, crucial areas for developing a purpose-driven career in behavioral medicine. Connect and Grow: Subscribe to SBM's BUZZ in Behavioral Medicine to unlock the secrets to a fulfilling career in behavioral medicine. Engage with each episode to learn from the best in the field and stay ahead in your professional journey. Hit 'Like', subscribe, and turn on notifications to never miss an episode dedicated to your career development in behavioral medicine. Interested in becoming a member of SBM? Check us out at https://www.sbm.org/membership Special Thanks to our production team and Jay Conner of Jaybird Media for his skillful work in compiling and editing the audio and video for the Buzz in Behavioral Medicine: Season 2 podcast series.

A diversity of bacteria and microorganisms making up the gut microbiome supports both our physical and our mental health. Research has shown that stress and trauma can negatively impact the microbiome. But a recent study took that finding to a new level. This was a study published in the Proceedings of the National Academy of Sciences. Scientists now see inflammation-related microbiomes in babies born to women who experienced mistreatment or adversity during their own childhood. These microbiomes predispose children to physical and mental health problems. We'll talk today with the co-author of that paper, Fran Querdasi, from the University of California, Los Angeles. Interview hosted by Kelly Brownell. Interview Summary This topic is so important, and you just hear time and time again from experts all around the world how profoundly the microbiome was influencing our health and how many factors affect the microbiome. But now to think about this generational matter that you addressed in your research is interesting and scary, in a way. Let's first start off with this question about how you studied these mothers and the children. What were you looking for? The goal of the study was to see how experiences of adversity or hardship across two generations might be related to the composition of the children's gut microbiome, or in other words, which microbes were living in their guts. So, for this paper, I worked with colleagues at the University of California-Los Angeles, as well as a team of scientists in Singapore who are currently conducting a big birth cohort study called Growing Up in Singapore Towards healthy Outcomes, or GUSTO for short. That study has thousands of mothers and families enrolled but, in this paper, we focused on around 450 families who had data on what we were interested in - the mother generation, as well as her child generation. We specifically wanted to study the children when they were around two years old because the gut microbiome develops really rapidly during that period from birth until around two years of age.  In this study, we asked mothers to tell us about three different kinds of adversity. First, their history of maltreatment. That would be things like abuse and neglect in their own childhood and then kind of moving forward in time, any symptoms of anxiety during their pregnancies. Then moving forward again into the children's generation, their children's exposure to stressful life events. So, things like their parents' divorce or the death of a family member from birth till two years of age. At two years of age, we collected poop samples to analyze the children's microbiomes. Then we also asked families to report on their children's social emotional problems. So, things like aggression, sadness, issues with attention on when they were two years old and then again at age four because we really wanted to see also how their microbiomes were related to their early childhood health. I'm eager to hear what you found but first, let me say I'm impressed that you even bothered to ask this question because one wouldn't think that traumatic experiences decades ago in the life of a mother would affect the microbiome of a child today. So, tell us, please, what did you find? We found that each of the adversity experiences that we asked about - so abuse or neglect that the mother experienced in her own childhood, the mothers' symptoms of anxiety during pregnancy, as well as children's experiences of stressful events in their early life - all of those seem to have an impact on the children's gut microbiomes. Specifically, we found something interesting, which was that some of the microbes that seem to be related to adversity we think that they might perform similar functions to those that we found were related to the children's social emotional health, both at two years and then at four years of age. We think that those microbes probably play a role in regulating the immune system and inflammation. Our findings kind of hint that maybe disruption to some immune-related functions within the gut could help explain how some children go on to develop mental health struggles after they experience adversity. And how that intergenerational experience of adversity shows up in subsequent generations. Like I said, it's hard to imagine that things so distinct in timing can have such a big impact. How is it possible that adversity experienced by a mom in her own childhood could affect her child now in terms of the microbiome? That is pretty surprising. You think that it's so far in the past, but it's really striking that it does still appear to have an impact. This study was the first one to find evidence for that in humans. There have been studies in animal models, researchers that work with rats and mice, and there was evidence the mom's experiences during childhood affect their children's gut microbiome. There is other research that studies this phenomenon, called intergenerational transmission of adversity, and that's when trauma, chronic stress, adversity, those kinds of experiences experienced in one generation have impacts on the following generations. Even in those who have never directly experienced the event. Research has brought up many possible explanations for why that might happen, from changes to gene expression after adversity to changes to the parent's health and behaviors. In terms of the microbiome specifically, it's possible that the mother's health or underlying biology and physiological response to stress was affected by that adversity that she experienced in some way. And that shaped her child's development in terms of brain or stress response systems during her pregnancy. Then, because the microbiome is really connected to other biological systems that had an impact on the microbiome, the mother's microbiome plays a big role in shaping the child's initial microbiome during birth, and then after birth in terms of contact with the child and breastfeeding, things like that. The bottom line is that the mother's microbiome was affected by her adversity and then directly shaped the child's microbiome. A fascinating set of possibilities you're talking about. Let me ask you a down in the weeds question. How can you isolate the impact of the adverse childhood experiences in the mother in terms of its impact in the microbiome from other things that just might co-occur with the adverse childhood experiences, social disparities, economic disparities, health disparities in general and things like that? That is definitely really challenging to do, and we did that to some degree in our study. There's definitely a lot of future research that needs to be done to tease apart the different factors that might play into that relationship between the mother's adversity in childhood and her child's microbiome. But we did account for the mother's socioeconomic status in terms of the family's income, and we also accounted for the birth mode of the child, so whether the child was born by C-section or vaginal birth. So, in that sense, we tried to isolate the impact of the mother's adversity. That makes sense. It sounds like you took care to address that issue. Now let me ask a question about what can be done given this relationship you found. Is there anything that can be done to disrupt this connection? One might think perhaps if the mother had eaten a diet that was specifically designed to optimize the microbiome, would that help, for example? That's a really important point. There are many things that impact the gut microbiome in addition to adversity experiences. Diet, other things in the environment like exposure to nature and other people, the urbanity of your living environment and overall stress levels as well. That also highlights that many things can be done, both on an individual and societal level to promote a healthy gut microbiome and possibly counteract or mitigate impacts based on adversity. We're very far away from knowing exactly what the perfect way is to address this because there's just so much more that we need to know about the gut microbiome. But there are some general things. We know that eating a variety of foods that have a lot of fibers like fruits and vegetables, that's good for your gut microbiome. So, policies that make those foods more widely accessible and affordable. And then things that can help you manage stress in a healthy way. So, meditation, exercise, really strong supportive social relationships, as well as policy supports for families that reduce financial stress and precarity. Then, in terms of focusing on specifically early life policies that allow parents the time to form positive relationships with their kids, like parental leave and things that help maximize the mother's health broadly. So, affordable perinatal care can set the child up for the best possible start to life. Those are changes that would promote microbiome health broadly in addition to overall health. Those things all make sense. And the good news is that every one of those things you mentioned would have health and mental health benefits way beyond the microbiome. So, good reason to focus on those things. Now let me ask you one final question. Are you working on follow-up studies to this? Yes, we are. So, in that study, as I mentioned, we were looking at microbiome composition, which means which microbes live in the gut. We found evidence suggesting that immune functioning was really important, but the methods that we used were not able to test the function of the microbes directly. So, we're following up on this work by looking at the same questions of how adversity experiences impact the microbiome but looking at function of the microbes directly. So, in this group of families that we studied, as well as others, I'm also interested in looking at how adversity might impact communication between the immune system and the gut microbiome. The gut microbiome is really intimately connected to other systems. For example, there's many connections between the gut microbiome and the brain and the brain and gut microbiome influence each other. I'm looking at communication between the gut microbiome and brain as well. So, trying to get a more complete and whole-body picture of the processes that are affected by adversity and if those changes relate to mental and physical health and kind of the specifics of how that works and I really hope that that work will open up new ways to treat and prevent health problems in families exposed to adversity. Bio Francesca Querdasi, M.A. is a PhD student in developmental psychology at the University of California, Los Angeles, with minors in health and quantitative psychology. Her research focuses on understanding how experiences of adversity or hardship predispose individuals to develop physical and mental health problems, with a particular focus on depression, anxiety and chronic pain disorders. Her prior work has examined the intergenerational transmission of adversity by way of the gut microbiome, and how adversity is related to communication between the brain and gut microbiome in early childhood. In the future, Fran plans to examine the role of the immune system and immune-gut microbiome communication in the development of mental health problems during the teenage years. The ultimate goal of Fran's work is to inform new prevention and treatment strategies that promote health and well-being for children and families impacted by adversity.

What does it mean to live a process-based life? What processes can you engage in that will serve as protective factors for your mental health? And how can you find space even when faced with difficult thoughts, emotions, and sensations? In the launch episode of Season 2 of “Your Life in Process," Diana explores these questions with Dr. Steven Hayes, the co-founder of ACT. About Dr. Steven HayesDr. Steven Hayes is a professor of psychology at the University of Nevada at Reno. He has revolutionized the field of Clinical Psychology and has been listed as the 30th highest impact psychologist in the world. Dr. Hayes has authored 47 books and nearly 670 scientific articles. He has dedicated his career to the understanding and alleviation of human suffering–leading studies on everything from peak performance in sport to how to promote mental health in refugees and trauma survivors.  Key TakeawaysPromote your mental health by personalizing the science of the processes of psychological flexibility to fit your individual needs.  Pay attention to which processes contribute to your own thriving by noticing what you do are at your best.  Learning to observe your thoughts and the silence between your thoughts provides good information and can increase your flexible attention. Relevant Resources Mentionedhttps://drdianahill.com/extras/ (Download Your Daily Practice for Episode 18 Here) https://stevenchayes.com/about/ (Learn More About Dr. Steven Hayes) Read Dr. Hayes's books: https://stevenchayes.com/a-liberated-mind/ (The Liberated Mind); https://www.newharbinger.com/blog/professional/process-based-cbt-a-step-toward-psychological-processes-and-away-from-medical-diagnoses/ (Process-Based CBT); https://www.newharbinger.com/9781572244252/get-out-of-your-mind-and-into-your-life/ (Get Out of Your Mind and Into Your Life) Download the World Health Organization “https://www.who.int/publications-detail-redirect/9789240003927 (Do What Matters In Times of Stress)” Workbook Learn More about http://insightla.org/drdianahill (InsightLA) Read more of https://scholar.google.com/citations?hl=en&user=_QUS_ZoAAAAJ (Dr. Steven Hayes' Research) Learn More about https://sanford.duke.edu/profile/kelly-d-brownell (Kelly Brownell and Policy Food Science) Listen to https://podd.app/podcast/psychologists-off-the-clock/56-act-and-process-based-cbt-with-steven-hayes (Diana's Episode with Steven Hayes on his 70th Birthday) https://drdianahill.com/events/ (Diana's upcoming events) Thank you for listening to Your Life in Process! If you have any questions or feedback you can contact me by email at podcast@yourlifeinprocess.com, leave me an audio message at (805) 457-2776, or message me on Instagram @drdianahill and remember when you become psychologically flexible, you become free. Episode Segments[00:04] Introduction [00:30] About Dr. Steven Hayes [01:43] What Do We Mean By Processes? [06:57] Sponsor: Lightfully Behavioral Health [08:06] Reflecting Back [15:09] Dr. Hayes's Personal Story About Process [19:40] A Psychological Vaccine [24:42] A Process-based Approach To Insomnia And Worry [29:56] The Silence Between Thoughts [32:57] Learning How To Do Nothing [38:58] ACT And Psychedelic Therapy [42:09] An Individualized Psychology [45:34] Why Dr. Steven Hayes Is Eating Walnuts [50:15] Episode Summary [51:54] Your Daily Practice [53:25] Connect With The Podcast Stay tuned for my next episode on YLIP when we discuss Strategies to Get Grounded with Brad Stulberg. Thank you to my team Craig Schneider, Angela Stubbs, Ashley Hiatt, Abby Diehl and to our sponsor Lightfully for making this podcast possible. Thank you to Benjamin Gould of Bell & Branch for your beautiful music.

When the food industry promises to police itself and pledges to improve nutrition in public health, can it be trusted to make meaningful change or must government mandate those changes? Our two guests today have done groundbreaking work to help address this very question. Dr. Jessica Fanzo, Professor of Global Food and Agricultural Policy and Ethics at Johns Hopkins University, and Dr. Jennifer Harris is Senior Research Advisor for Marketing Initiatives at the Rudd Center for Food Policy and Obesity at the University of Connecticut. Interview Summary So Jess, let's begin with you. You coauthored what I thought was a very important and novel report released by the Global Alliance for Improved Nutrition on product reformulation by the food industry. Would you might explain what's meant by reformulation? When we think about reformulation, it's really defined as the process of all-terrain a food or a beverage product. You can alter that by improving the products' health profile or reducing the content of harmful nutrients or ingredients. So it's a process of either removing those negative ingredients or nutrients or adding back positive ones into foods. Why is that done? Because people consume a lot of processed foods. Almost every food that we consume has gone through some form of processing, but there's a whole range of that processing from very minimal to very highly processed, what's often called ultra-processed or junk food that doesn't have a lot of nutritional value. In the report, we were looking at what are the challenges with reformulating food? What are some of the opportunities to reformulate food? And in the realm of reformulation, has it had a positive impact on public health? So we were looking at those aspects of the reformulation of processed foods. So I'm assuming there could be enormous advances to public health if reformulation were done on a broad scale and or if it were done in a meaningful way. So what were your main findings then? Have there been examples of industry being successful with voluntary reformulation? Somewhat. And absolutely it could have potentially really important positive impacts for public health, but it's also not a panacea for improving diets and nutrition. And while there are some examples where voluntary reformulation has had some impact, the UK with salt and some other examples, overall we found that it's important for governments to mandate reformulation through different tools, whether it's labeling, taxes, et cetera. For foods that are not reformulated, we felt that it was really important for governments to mandate with clear, transparent and direct targets, particularly removing the unhealthy ingredients like added sugars, salts, unhealthy fats like trans fats. The food industry should be involved in implementing reformulation policies but not in their design. And governments need to really step in and step up. But that said, that doesn't mean that reformulation is going to solve all the problems. Governments also need to invest in many other tools to protect consumers and to invest in other ways to improve diets for nutrition. So reformulation shouldn't be the only answer. So I'm assuming the reason that food industry won't go far enough on their own is that these things that make the food less healthy also tend to make them pretty palatable, or give them long shelf life or properties that make people enjoy them a lot. And that why in the world would they do something that would make their products less desirable? Does that pretty much the case or do you see other reasons why? That's definitely true. I mean, these highly processed foods are cheap in their ingredients to make, they are very palatable, there's a high demand for them. We're seeing this shift now into low-income countries like with tobacco when consumers catch on that these foods are not so healthy, they go to populations where there's a bit of a lag in that knowledge. But also reformulating foods from the industry's perspective is not so easy. It's quite expensive to do it. It's difficult to reduce salt and sugar, which are vital not only for the taste of foods, but for their composition and shelf-life and texture. So it has a lot of ramifications to remove those ingredients. So meeting government mandates around reformulation can be really challenging and sometimes impossible for companies. So they often will deal with getting a warning label, for the example in Chile, they'll just take the warning label because they can't reformulate some foods. But there's a change in consumer demand and tastes. Consumers like their brands, but the more and more consumers are caring about clean labels, environmental sustainability, their health, people are concerned about the amount of sugar in foods so they're going to have to answer to that, that changing demand as consumers demand better foods whether it's from a health or sustainability or transparency perspective. Let me ask one more question related to this. Is it also the case that it's pretty difficult for some company to be the first out of the gate if they were inclined to do this voluntarily because then their products would become less desirable and their competitors would be kinda stuck in the old ways? So isn't that another argument for government intervening that everybody is on the same playing field? Absolutely, yes. I mean, why not hold every player accountable and to the same standards and mandates? It pushes them all to take action. So when we were interviewing some of the industry players, they really struggle because when they did try to reformulate some of the foods, consumers no longer bought them because they're very wedded to their brands, they're wedded to certain tastes, it's a real challenge for them to keep their consumer base. But at the same time, try to adhere to government mandate. And some companies care more about health and sustainability than others. We definitely learn that some companies have no interest in that, because they know they'll always be a big consumer base for these quote less healthy foods. So there's a real issue from company to company of who's willing to take more action to reformulate and who doesn't really care to reformulate at all and they're willing to live with warning stickers and taxes. So Jennifer, let's turn to you. So you've done really pioneering work on the impact of food marketing on children that began when we were colleagues together at the Rudd Center when it was at Yale University. And there I was witness to the fact that you created a very impressive methodology for studying what's a pretty complicated issue. And you paid a lot of attention to industry promises for self-policing of children's food marketing. Do you mind giving us a quick sense of what's being marketed to who and how, and how much marketing children are exposed to? Annually, companies spend over $13 billion in advertising food to all consumers. And just to put that number in perspective, the whole chronic disease prevention budget at the CDC is 1 billion. So the companies are really controlling the messages about what people should eat. And most of that money is spent to advertise very unhealthy products. The products that are contributing to poor diet and disease in this country. The biggest ones are fast food, sugary drinks, sweet and salty snacks and candy. Those categories represent about 80% of all foods that are advertised. Healthier categories of foods, if you look at all of juice, water, fruits, and vegetables and nuts combined, it's less than 3% of the total. So they're really pushing these very high fat, high sugar, high salt products extensively. Companies spend most of their advertising dollars on television ads. On an annual basis, kids see about 4,000 of those ads per year. So almost 4,000 ads, that's over 10 a day for unhealthy food. Kids of color, so black kids see twice as many of those ads. A lot of the worst products, their advertising is targeted to Black and Hispanic communities and especially adolescents. But TV isn't the only way companies advertise. And in the last few years, the ways that companies market just increased exponentially. Now with smartphones and tablets, they can reach kids any place and any time through things like ads on YouTube videos, social media, smartphone apps, with games and ordering programs, even educational websites teachers are using in grade school have ads on them. This kind of marketing is personalized. So what you see depends on what you do online. They know who you are and they can reach you. And unfortunately, this kind of marketing also is the kind of thing that parents can't monitor as easily as what your child is watching on TV. So the companies basically try to be wherever the consumer is to reach them with their advertising. Well those are really stunning numbers. I know one of the arguments the industry has made for years, and one of the things that you've addressed directly in your research is their claim that this food advertising doesn't really make kids or adults eat an unhealthy diet, it just shifts their preference from brand to brand. So if Coke is advertising a lot, they might say, "Well we just wanna take market share from Pepsi, "but we're not encouraging sugar beverage consumption." What would you say to that? That is something they've argued for a long time. And one thing that we showed is that just watching a television program with food advertising makes kids and adults eat a lot more both while they're watching and afterwards. And another of our colleagues, Ashley Gearhardt has done some really interesting research showing how the food advertising actually activates the reward regions of the brain and leads to increased consumption. So that's one way that food marketing affects more than brand preferences. There's also been a lot of research showing that if you advertise Coke, it increases consumption and purchases of all sugary drinks. They also affect sales of the categories, not just the specific brands. So with you and others doing so much work showing how much of the marketing there is and how disastrous the impact is, you can imagine the industry feels vulnerable to the possibility of outside regulation or perhaps even litigation. And so one of the things the industry has done and this links back to what Jessica was talking about in the context of reformulation, is to say that they can police themselves. So can you explain how they've gone about doing that? Well in the US there's a program called the Children's Food and Beverage Advertising Initiative, which is the food industry self-regulatory program to address food advertising to kids. And there are similar programs in countries around the world. But basically what the industry has promised is that they will only advertise products that meet nutrition standards in child directed media. That sounds really great. They implemented the program in 2007, but you said Kelly, we've done a lot of research showing how many limitations and loopholes there are in this program. One is that they only define children as 11 years and younger. So they only have promised to reduce unhealthy advertising to young children. And more and more of the research is showing that adolescents are just as affected and maybe even more effected by the advertising. Since their program was implemented, they've increased their advertising to the slightly older group that isn't covered by the CFBAI. Another limitation is their definition of what is child directed is advertising in media where children are the primary audience. So on television that would basically be children's TV. So Nickelodeon, Cartoon Network, those kinds of programs. But children watch a lot more television than just children's television. And so they can still advertise anything they want on programs that are also watched by adults and older children. And then the third major limitation is that they've set their own nutrition standards. So they have defined what is healthy. And maybe not surprisingly, a lot of the products that they say are healthier choices that can be advertised to kids are things like sugary cereals, fruit drinks that maybe have less sugar but they also have artificial sweeteners in them. Things like goldfish crackers, fast-food kids' meals, all of those can still be advertised to children under their nutrition standards. What we found is since the program was implemented in 2007, food advertising on children's television has gone down quite a bit, 45%. But at the same time, advertising on other types of television that children watch has gone up about 30%. So now kids see almost as much food advertising as they used to, but most of it is not on children's television, it's on the other kinds of television that they're watching. And a lot of the harder things to monitor, things like apps and social media and websites do not qualify as child directed media under this program. Now the reason I asked both of you to be on this podcast at the same time as I figured there would be interesting similarities, even though you're working on somewhat different topics, and boy does it turn out to be they're real themes weave through this. So let's talk next about what might be done then. So Jessica, with your work on industry reformulation, what have you concluded can be done voluntarily? Kelly, I think government needs to be much more involved than they are. The challenges that we see with voluntary regulation, whether it's in reformulation or marketing of unhealthy foods to children, we know that voluntary reformulation, industry sets its own agenda, they set their own targets, they have no accountability to meet those targets, they may pledge to reduce harmful ingredients but if the product has a very high level of these unhealthy ingredients, the reformulation may not make much of a difference from a public health point of view. So I think we need much more regulation. Governments need to hold industry accountable and ensure that they are meeting national standards for public health. I think government has been too laissez-faire about industry and the power that they hold. And I think now we're seeing the consequences of that not only in the United States, but everywhere in the world with rising levels of obesity and NCDs and unhealthy diets being a big risk factor with these processed foods playing a huge role in that. So we really need to see government step up in a much more profound way and hold industry having public health goals. It's a little bit of enough is enough. So Jess, just out of curiosity, let's say you were the government official in charge of taking such action and you have the authority to do it, where would you start? Would you start with particular nutrients across the food chain or would you start with certain categories of food and would you worry first about sugar, salt, fat? That's a good question. In the paper we outline four types of processed foods. To me I would probably look across the entire food supply chain at those highly, highly processed foods. And it would be good to start with at least the three categories of sugars, salt, and trans fats to even start with and setting key targets for those and marking those ultra-processed foods that go beyond that target. Chile had the great food law that's been enacted that's put warning labels on the front of packages and has regulated I think some of the advertising of those foods. Jennifer you probably know about this. And I think that's been an important case study for the rest of the world to look at of how Chile has done that because sales of those foods that have the warning label have gone down somewhere in the ballpark of I think between 23 and 28%, depending on the population. But I think there's lessons to be learned of how Chile has done that that other governments could learn from. Now I'm happy that you pointed out the advances in Chile because there have been some very impressive impacts reported from the studies that have been done so far. So I agree that that is really a model to look to. So Jennifer, let's just get your opinion on this. Where do you come down on this issue of voluntary versus mandated? So we've given the industry 12 years now to show that they can market healthier products to kids. And basically what they've done is they're marketing slightly healthier products to kids but the products they're marketing are not nutritious products that children should be consuming a lot of like sugared cereals. So it's pretty clear that they can't do it on their own and that regulation is required. In the US, we have a little bit of an issue that not all countries have because of the First Amendment. And advertising is protected speech according to the Supreme Court. So we can't just say companies cannot advertise anything. So we have to be more strategic about the kinds of regulations that we can implement here. If we could do anything we wanted, Chile is a great example. In the next year, they won't be able to advertise any products that are high in fat, sugar and salt before 9:00 p.m. So it's not just children's programming, they won't be able to advertise it. They had to take all their characters off their packages. And so Tony the Tiger can't be on the package of frosted flakes anymore because it's high in sugar. They've done a lot of great things in Chile and sure we can adapt some of what they've done. In other countries also, for example the UK has very strong laws about marketing foods in digital media. So that would be another thing that we could import from other countries.   Bios   Jessica Fanzo, Ph.D., is the Bloomberg Distinguished Professor of Global Food Policy and Ethics at the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the Nitze School of Advanced International Studies (SAIS) at the Johns Hopkins University in the USA. She also serves as the Director of Hopkins' Global Food Policy and Ethics Program, and as Director of Food & Nutrition Security at the JHU Alliance for a Healthier World.  From 2017 to 2019, Jessica served as the Co-Chair of the Global Nutrition Report and the UN High Level Panel of Experts on Food Systems and Nutrition. Before coming to Hopkins, she has also held positions at Columbia University, the Earth Institute, Food and Agriculture Organization of the United Nations, the World Food Programme, Bioversity International, and the Millennium Development Goal Centre at the World Agroforestry Center in Kenya. She was the first laureate of the Carasso Foundation's Sustainable Diets Prize in 2012 for her research on sustainable food and diets for long-term human health. Jennifer Harris, Ph.D., is a Senior Research Advisor, Marketing Initiatives at the Rudd Center. Previously, Dr. Harris worked as Director of Marketing Initiatives and was an Associate Professor in Allied Health Sciences at the University of Connecticut. Harris received her B.A. from Northwestern University and M.B.A. in Marketing from The Wharton School. Before returning to graduate school, she was a marketing executive for eighteen years, including at American Express as a Vice President in consumer marketing and as principal in a marketing strategy consulting firm. Harris completed her PhD in Social Psychology at Yale University with John Bargh and Kelly Brownell.

. There's a great deal to learn from the deep connections between regenerative agriculture and the farming traditions of First Nations people. My guest today is James Skeet, a member of the Navajo Nation and the founder of Spirit Farm in New Mexico, a demonstration farm that draws both Native Americans and others to learn more about issues like composting and regenerative farming techniques. So James, welcome. I'm really happy to have you with us today. I'm very happy to be here with you. How would you say that farming and conservation and preservation are a part of your cultural heritage? As I look back historically and through our traditional perspectives, who we are as a people, indigenous worldview is something that is very important to the earth and to the relationship to the environment, especially here in the Southwest. The climate, it can be harsh as well as very sustainable. A very delicate process. It's not something that can be done quickly. You have to look at seasons rather than what you're producing. James, as people think about the term regenerative agriculture, one might conclude that it's new on the scene? But you're making the point that it's not new on the scene at all, that there are hundreds of generations of people who have been working on doing just this. Indigenous people have always had this organic mindset that all things are sacred. Nature is to be respected and copied. Time is not linear but secular. There's always been sort of a bartering regenerative economy there, dealing with our relationship with different tribes. And then, food is considered as medicine. Because the plants were here first, they're our grandfathers and grandmothers. So they're teaching us things about that relationship with the environment. And it goes into some deep religious activities, ceremonies to have that relationship. It's really biology based. We were looking at minimal disturbance, especially when the Navajos went into a sheep economy, which was after the introduction of Churro sheep from the Spaniards. We had some of the tallest grasses in the so-called New World because they were using herding techniques that went from summer camps to winter camps. That relationship with the sheep and the biology and the soil, the grasses, to maximize productivity in the grasses. My guess is that many people would look at the landscape where you do your farming and think that it just wouldn't be possible to grow enough food to survive there. How would you respond to that? I would totally agree with that. The way we've understood farming has been based on annual crops, monocropping, productivity. But indigenous people have looked outside of that box to where hunters and gatherers were a type of farming that was taking place with the relationship with their herding animals, as well picking plants as they go along. And what we're trying to do is really a subtle edge, and that's where the complexity of our religions come from. Delicate relationships with Mother Earth and Father Sky. A lot of these ruins dictate to us, now looking back, their dependency on annual crops, corn, beans, squash. A lot of indigenous people all understood the relationship between plants that were outside of that category, the annual crops. They would focus on what we call weeds today. If you study the nutrient density of those plants, their medicinal nutrient values are very high. My mom was an herbalist. That understanding of our environment has really been misunderstood or overlooked. I really feel like what would we call food deserts aren't really food deserts. It's in our minds that we think that it's a desert, but in reality what nature, like I said before, grandfathers and grandmothers, are reaching out today and saying, I can heal you if you reestablish that relationship. And that cosmology is really another way of interpreting the goodness of Mother Nature. The idea of sustainability. Could you tell us a bit more about Spirit Farm, and what inspired you to do this work? And, how do you do things differently than what conventional farmers might do? Yeah, it really has to do with epistemology, how we view the world, view nature. Do we look at reductionists rather than systems? My wife and I, we were working for a managed care organization for a number of years. But in the back of our minds we felt like, why are indigenous people getting sicker? Why are they unhealthy? And the more we looked into that, we realized that it was the relationship they had with the kinds of foods. They had plenty of food, but it wasn't the right kind of nutrient dense foods. So, we had to really look at what can we do instead of complaining about the colonization, how we've been overtaken by the European Western world view, what can we do? We decided to just farm, to get back to nature, step off this corporate machinery. And we had some land there that my folks had that my grandfather in the past had plowed the heck out of it. And now, 50, 60 years later, the soil is so bad. Most of the top soil is blown off. We have invasive species that take up a lot of the water underneath the soil. You couldn't really grow anything. Right at that time we ran across Elaine Ingham, a soil scientist. And then also up here in Gallup, Ann Malloy. They were the ones that tracked us on the biological amendment, doing the thermal compost, putting organic material back into the soil, that the soil is alive. So when I started doing that study of that relationship with, what I call [inaudible 00:06:09], the unseen bugs, we started sharing a lot of the information with our elders. I remember one grandmother said, "They finally figured us out." And I was asking her, what do you mean by that? And she said, "They finally figured out what we used to do in our planting and what those dances mean, what the clans mean, what their purpose is, what their relationship was." We found this whole perspective of re-indigenizing, meaning that there were some things that were local, ideas, knowledge, seeds, information on plants, information on relationships. We just stumbled into a whole new arena. And so what happened to our farm was we just decided to provide for ourselves, see if we can grow things for ourselves. But what we came across was conventional farming had taken root, the use of the tractor, the deep plowing, which further messed up the system. And in looking at the microbial activity, what I realized was we were talking about kinship and relationship. So what we tried to do was give sacredness to the soil and to the bugs that were in the soil that do the job for regenerative farming. And when we did that, we began to hear things, not just from people, not just from our indigenous worldview, but from other farmers and even the plants themselves were communicating things to us. We coined the term indigenous regenerative intelligence as our mission. What sort of things do you grow on the farm? We've been able to grow just about everything. We don't have a well here on our farm. Everything is captured. And that's our first principle, is looking at water as sacred. We've been able to grow, of course the three sisters, corns, beans and squash, and we found as we studied that, that relationship was symbiotic. The corn was the windbreaker. The squash was the cover crop that lowered the temperature, and the beans was the nitrogen fixer to the corn because it took a lot of nitrogen out of the soil. But there's one grandma that still grows corn down from us a couple of miles, but they do a lot of dry farming. So she went and plowed the field and grew the corn. Whereas we heavily mulch and we amended it with compost, and we put a lot of the aeration back into the soil. We did a lot of cover crops so that the roots itself can release exudates that draws the microbes in there. So I said, you take 10 seeds, I'll take 10 seeds. Put mine in, and she put hers in. And at the end of the season she came by and she said, How's your corn? Where did you plant it? What did you do?" She was asking me a lot of questions. She said her corn reached up to about three to four feet, and she was standing in front of the corn that I grew and it was eight feet tall. We've been able to grow lots of different kinds of tomatoes. Broccoli did very well. We've got a whole herb bed of perennials that come up. I don't even have to mess with that. Some of the soil is getting to the point where we really don't have to amend it. It's deep and lush and it smells really good. We've been able to grow sunn hemp for biomass. We've been able to grow 18 different species of cover crops for our sheep to come in and feed on, and do the disturbance teas, a lot of different types of berries. Saskatoon seems to do very well. So, in looking at all the [inaudible 00:09:32], the unseen bugs, through the microscope and also looking at indigenous cosmology, because to them that's sort of their microscope, we've been able to grow just about everything and anything. I love hearing your thoughts on these things and what's so impressive are the personal stories, like with the grandmother and your comparison of the corn planted on her land and yours. And then, just your discussion of how you go about the farming. The practice of the farming is really instructive. But I think what comes through so loud and clear, and you discussing this, is the spiritual meaning of all this, and how everything is there for a reason, and how it can be nurtured and cared for in a way that protects the land and protects the creatures that are in it. These things are messages that just not enough people get to hear. Now, I know you go all over and speak about these things. Are audiences receptive, do you think? I definitely think that what is happening, just to put it simply, is Mother Nature is mad. The reason why it's mad and angry is because the way we've used science and reductionist thinking, industrial conventional farming mindset. It's based on a currency based economy. Food as a commodity. The use of synthetic fertilizers rather than the biology base. It's very production heavy. Monocropping, you have to have big tractors. It's a very dense disturbance rather than looking at the minimal disturbance. So, that's spirituality. If we think about it, that's created the fragmentation. That type of thinking has created the systemic racism, ethnic disturbance in countries where people are fighting over state, nation lines without really considering tribal people groups. Science disembodies itself from the spirit and the soul. That's what's happening to this country and all around the world, is that the haves and have not, winners take all, is taking place. There's a mindset that's shifting into more the organic indigenous perspective, and those are people that are being drawn to the idea of Spirit Farm. Having concrete, very practical examples of that relationship with what we grow, the biology, the biome that's in our gut as well as the biology that's in the soil, what we feed our animals, all that is a cycle of the use of compost. It's creating a closed system. I've done a lot of work internationally and one of the things that we've looked at is transformative adaptation. Indigenous people has adapted to European style of urbanization. But now I think what's happening because of all the climate change and the pandemics, we have to look at a transformative adaptation. Transformative challenges the systems of resilience and sustainability. It looks at incremental steps away from why we've gotten to this place is that we have a marginal perspective that we're outside of that system. The reductionist mechanical mindset cannot interpret change unless it looks from outside, and because of these marginal perspectives, feminists, Native Americans, tribal people groups, people of color, have been looking at this dominant systems. That has to change. We have to look at a different model through a different lens. In indigenous people, our philosophy is rooted into a story about a coyote, our relationship with the land and the earth. It's not about just spending abstract ideas up in the air. As my wonderful professor used to say, Alphonse Ortiz, all we're saying is that at least get the pendulum moving towards this organic indigenous mindset. You have to become attached to the land. I think you've partly answered the question I'm about to ask, but so are you optimistic? Do you believe that people are listening to these messages more? Are practices beginning to change? Are you hopeful? A lot of these regenerative farmers are swimming up against the current? The mine has to shift into more a secular pattern rather than a linear pattern to realize that it's about the people. Transformative adaptation is really positive because you're not only adapting to the changes, but you're actually transforming the system. We're going to come out in a whole new world from the things that are happening in the environment, and the system is not going to be the same, and that we will have to be willing to change. And it's positive because it gives us challenges. And to tell you the truth, I'm really sick and tired of trying to sustain stuff that doesn't work. The industrial conventional mindset of farming has really caused some major scars. We plowed up the microbial activity that's under the soil. So yeah, I think it's very positive. We can change, and we've always changed. As indigenous people we've always adapted. There's an area that didn't provide a lot of buffalo, or an area that didn't quite provide a lot of fish, or the climate was changed. We moved on. What's positive is it's rooting people back to the earth. It's rooting people back to these marginal perspectives. People are really struggling and they're looking at regenerative intelligence as the way to move. I've been telling all my farmers, keep doing what you're doing. Keep growing things. Keep that relationship because that's what's going to help transition you, and you'll be able to adapt these changes. Well, thank you so much James. Boy, there's an awful lot to think about in what you've just said, and so much wisdom. And I admire the work you're doing, and I really appreciate you joining us today. So thank you so much. Thank you. Thank you. And I am very positive about what's going to happen. So our guest today has been Navajo farmer, James Skeet, founder of Spirit Farm in New Mexico. And thank you for listening. If you'd like to subscribe to the Leading Voices in Food podcast series, you can do so through Apple Podcast, Google Play, or your favorite podcast app. The podcasts and transcripts are also available on our website at the Duke World Food Policy Center. This is Kelly Brownell.  

Being obese puts people at risk for chronic disease like diabetes and is the leading cause of preventable death in the U.S. In this episode we explore a policy approach to deal with this epidemic – a tax on sugary drinks. Kelly Brownell, director of the World Food Policy Center at the Sanford School of Public Policy at Duke University breaks down the research and policy behind the approach. Subscribe to the Leading Voices in Food podcast Read the episode transcript Music: Donnalee by Blue Dot Sessions / Licensed under Creative Commons Attribution  

Imagine you would like to address food and food insecurity in particular and could start with a blank slate, what kind of programs and practices would make sense given the incredible array of possibilities? Our guest today, Curt Ellis and Karrie Denniston have addressed this issue in their own work. Welcome to The Leading Voices in Food. I'm Kelly Brownell, director of the world Food Policy Center at Duke University and professor of public policy at Duke.  I'll begin by introducing Curt Ellis, who was co-founder and CEO of FoodCorps, a national organization affiliated with AmeriCorps. He has received numerous awards for his work and is in my mind one of the most creative people anywhere working on food issues. Curt, it's really nice to have you here. Thanks so much for having me, Kelly. The work of FoodCorps is something that I know personally because my daughter worked in Arkansas as part of the AmeriCorps and FoodCorps program, and I saw the transformative experience it had on her, but also the impact that the FoodCorps volunteers can have on the community. And I assume some of our listeners will know a lot about the organization and others less so. So could you please tell us what FoodCorps is all about? Of course, our work at FoodCorps is an effort attempting to address the challenges of healthy food education and healthy food access for kids at real scale. And we currently support the daily work of 250 AmeriCorps food educators who are working in high poverty schools across 18 states to build school gardens, to introduce kids to new foods on the lunch line and to work with their school communities to build a school-wide culture of health. In addition to that direct impact work that's focused on healthy food education, FoodCorps is doing a new body of systemic work called reWorking Lunch, which seeks to improve the quality of school food at scale and unlock some of the ways in which the way school systems approach healthy food education and access have been stuck in old patterns for far too long. And in addition to those two efforts, we advocate for policies that are rooted in the evidence and that you can see in real life form when you come out to FoodCorps schools around the country, policies that have a potential to drive greater progress faster, in improving what kids eat in school, and what they learn about food there. Our next guest, Karrie Denniston serves as Senior Director of sustainability with the Walmart Foundation, and in this role manages the strategy and grant making for the foundation's efforts to help create environmentally and socially sustainable supply chains globally. Prior to joining Walmart, Karrie served as a vice president of national programs at Feeding America and also worked as a policy analyst with USDA. Karrie, thank you so much for joining us. Thank you so much for having me. It's great to be here. Why did the Walmart Foundation make food insecurity an important priority? Thanks, Kelly. That's a great question. At Walmart and the Walmart Foundation, first think about where we can make the biggest difference. And if you go back in history, Walmart was founded on the idea of helping to democratize access to things that people need in their everyday lives. That was the whole idea of Sam Walton opening a store in rural areas so that people could have affordable access and have that same access that living in a city would afford. So today as the nation's largest grocer, we're continuing that legacy and providing access to safe and affordable food is one important way that we do that. So that's an important backdrop. But also, we fundamentally believe in the importance of addressing hunger, food insecurity, and nutrition and its importance to society. This is a place where we have a lot of assets that we can contribute, even just going beyond philanthropy. So if we think about the business side, what might that look like? Having low food prices. That looks like thinking about how do we reformulate product to make it healthier so that people can access that. It looks like us donating any excess food that's coming through that may not be sellable but is still quality and could still be utilized. And it also means that engaging our suppliers and customers to helping them understand issues of food insecurity and how they can help. We utilize our philanthropy to try to help increase the capacity of the food banking system, the charitable system, access to federal benefit programs. How do we make that system help people get food when and where they need it? So we support initiatives to increase things like access to emergency food programs, or things like benefits, like the SNAP program, the WIC program, children's meal programs in schools, which Curt has a lot of experience with. And we also help to think about how can we advance nutrition literacy and skills. Curt, if you think back to when you founded FoodCorps back in 2010, there were lots of things one could have done. Why did you choose to focus on children and then schools in particular? One in six kids today is growing up in a food insecure household where they don't reliably have enough healthy food at home. And one in three kids across our country is already showing early signs of diet related disease and we know that these diseases discriminate and we know that one in two of our kids of color are expected to develop type 2 diabetes during their lifetimes. And for FoodCorps and the five folks who I co-founded this organization with back in 2010, it was clear to us that our nation's school system represents the best chance we have as a country to reach kids when they are setting their lifelong eating habits in place and school systems represent one of the most powerful leverage points for unlocking larger change in our food system as a whole. There are seven times as many school cafeterias in this country as there are McDonald's franchises. And if we could only turn those school cafeterias into places where every child is getting great high quality food every day and where the supply chain that serves those school meals protects the lands and waters that we depend on, that could be a powerful transformation. For a company as large as Walmart, is this caring for example about the welfare of the farmers and caring about sustainable practices and things like this just considered a good business? Is it part of the ethical nature of the company? Is it because customers care about it? Why be doing these things? Yes to all of that. I think the principle of shared value first is that if we don't actually do those things, very hard for us to run business in the longterm. If we aren't thinking about the sustainability of supply chains and the practices that are in place, and we aren't thinking about how we can have that, we are not going to have a supply in the future, right? So that's important. So it is good business and it is important to business. That is coupled with it is also a place where we can have a leadership position and help advance those issues forward. And customers do care and they should care. Well, given the enormous scope of the Walmart customer base and the stores all over the world, why did you decide to partner with FoodCorps? Well, one objective of our philanthropy is to help improve people's confidence in their ability to consistently consume healthier foods. So we decided to support FoodCorps for a couple of reasons. First was the approach. Nutrition education itself, it's an incredibly valuable tool and it has an importance in trying to help advance people's ability to understand what's healthy and how to make choices. But FoodCorps also developed their program with the belief that nutrition education had to be delivered in context. So if the food quality in the cafeteria and the overall school environment was sending a different signal to the kids after they just had this great nutrition education lesson, that was going to be really hard to maintain those healthier choices. We were also really impressed because FoodCorps thought about, and I'd be curious for Curt to comment on this, they thought about learning from day one. I really feel like FoodCorps wants to know if their efforts are making a difference. They're willing to be creative and they're willing to take some risks in figuring out some paths forward. For us, because we were also trying to figure out this balance, this important question of what can you do at scale in a really structured and thoughtful way, and what has to be built at the local community and really contextualize to a particular location, FoodCorps was really thinking about that and wrestling with those same questions. So we were really excited to be a part of that journey with them. So Curt, can you explain how the partnership with Walmart is working? What's actually occurring on the ground because of it? Yeah. Over the five years that FoodCorps has been able to partner with the Walmart Foundation, so far we have scaled up our quite significantly. So a big piece of what we've been able to do has just been to reach more kids and more schools with the kind of hands-on food education that we know make a really powerful difference in what children eat. This year, FoodCorps is reaching 170,000 students in 350 high poverty schools, thanks in really significant part to the partnership we have with Walmart. The relationship we have with the foundation has also enabled us to bring a strong equity lens to the AmeriCorps service members who we are recruiting and supporting in their work in the field. The Walmart Foundation has made it possible for us to increase what we pay our core members well above what AmeriCorps requires of us. That means we're able to attract core members who come from limited resource backgrounds themselves or members who themselves grew up struggling with hunger and food insecurity, grew up struggling with the realities of a food system that did not serve them healthy food every day. It makes a huge difference in how effective our core members are and how much authenticity we can show up with in the communities where we serve. And the Walmart Foundation has made it possible for FoodCorps to bring our work to places that don't have the kind of philanthropic supporter base that a New York city or a Bay area has. At least a third of our service members are in rural communities and small town settings that don't typically get reached by a national organization. But for FoodCorps, serving native and indigenous communities thoughtfully and well, serving communities like Flint, Michigan, serving communities like the Arkansas Delta and the Mississippi Delta and rural areas in North Carolina, these are huge priorities for us as an organization and they're the kind of priorities that are very hard to achieve without the kind of high trust partnership that we have with the Walmart Foundation. Curt, your mission is so noble and important and I also admire you and your colleagues being willing to have an objective evaluation done to learn and then to move on to other paths that may be more productive than what was going on in the past. Can you give an example of somewhere along the way where you learned something from evaluation that surprised you and changes the way you did things? Yeah, absolutely. So we did a big external evaluation project with Columbia University Teacher's College and the Tisch center on food education and policy there. And one of the findings of that evaluation work was that the real magic happens in food and nutrition education when that approach is hands on. There's a really powerful shift that happens in what kids learn about food and more importantly, what their behaviors are towards healthy food, fruit and vegetables in particular when they engage directly in a school garden and taste a beat pulled raw out of the ground with the dirt still on it, or when they cook in their classroom and learn the skills and build the agency to make a salad dressing themselves, and a cook our recipe for their family at home. We know that kind of thing works because supermarket in Oregon told us they ran out of rutabagas the week FoodCorps taught the rutabaga lesson. That kind of hands-on approach to learning about food is a dramatic shift from what I certainly got in my nutrition education as a kid, which was an authority figure pointing at a government poster on the wall. And I think that old model is one that we've kind of kept going in far too many schools. But because of this finding coming out of the research we did with Columbia University, which showed that when kids get more of that hands-on food education, they triple the fruits and vegetables in their school meals. FoodCorps has oriented much of our policy agenda that we're currently working on in the upcoming child nutrition reauthorization towards trying to stand up programming that would put food educators into school meal programs around the country, because we recognized if we can give more kids that kind of hands-on food education, we'll suddenly be able to take different advantage of the $18 billion our country already invests in putting food on lunch trays for our nation's kids and we can get that healthy food we're putting on lunch trays and the fruits and vegetables in particular eaten by more and more kids if they just get the right introduction to it. So Karrie, from your perspective, what do you see is the value of your work with FoodCorps and what sort of outcomes are you seeing? It's really, it's interesting, Curt listening to you talk about what you sort of see as some of the value and the outcomes. My list would be similar. I think of it in a couple of areas. One has been the learnings on the direct programmatic work. We are seeing that there are practices that are working and some that aren't, that we shouldn't be doing anymore. And in that kind of learning about what are the outcomes that are being driven and what are the different techniques and experiences that can be created more at scale to try and support that. And I think Curt, what as you were sort of talking about, then how do we take that to a more structural level, whether that's through policy or other kinds of mechanisms or embedding that kind of learning across multiple programs. These are really valuable insights that go beyond one organization and one donor, but really start to have implications across the entirety of the field. The other that Curt touched on that I do want to highlight that has really advanced our thinking is how intentional FoodCorps has been about things like hiring, and about diversity, equity and inclusion. Their approach of thinking about recruiting talent, training talent and having that be of the community is incredibly thoughtful and they've been very honest about what does that take. What does that take in terms of stipends? What does that take in terms of support for core members over time? But I think the organization has also not just stopped with frontline. They've also internalized training across their staff in the organization. I would say as a sector, and whether that's food, security support organizations, nutrition education organizations, or really as a nonprofit sector, struggling with issues about how we think about diversity, equity and inclusion in our own organizations and our programmatic work and in the services being provided is something that is very difficult and that the FoodCorps has really been leading the way in starting to put some ideas on the table, learning from those. So that's informed us. It's informed the field. That's really changed the way we thought about the work as well. What sort of training skills do you think are important for the next generation to help tap with food and nutrition and food insecurity issues? Kelly, I love this question because we speak a lot with organizations about how are they thinking about preparing for the future. So the first is that I think we recognize that the needs of families who are experiencing food insecure, they're not static. They're not static in any way. This is a really simple example, but think about when food banks used to hand out information about where pantries were and what their hours were, they handed out paper lists. Today, what's the first thing you would do? You'd go online and you'd do a search. Where is my local place to get help, right? That's an example of how the changing nature and expectation around how people would find information and resources. Now take that to a bigger scale. That means the choices, like do we build a physical location to provide services? Do we offer mobile services? Do we need to explore more on demand kinds of services? Same with nutrition education. Is that hands-on experience the thing that matters? How much can digital play a role? This all has implications for how our responses need to be built for these kinds of issues. So I think our future leaders are going to have to understand and think about how to apply a more human-centered design approach to figuring out how our organizations need to be structured in the future. We need to start with the individuals who are experiencing the situations and build from them as opposed to starting from the structures that we have in place. The second area that I think about is about how technology can be applied to the problems of response. How do we use data? How do we better understand who's in need? How do we better target responses? How do we support shared learning about outcomes? I think about future skills for this sector, applying things like machine learning. How is that going to help us be faster and more targeted in the approach? And then probably the third thing I would offer is not to underestimate personal competencies that we need in the leaders of the future. This is incredibly hard work. It's complex, it's important. It really, really matters. I really think about the kinds of creativity and the passion that's going to be needed from future leaders but also a strong ability to be self-reflected. And as we talk about self reflection, I think Curt talked about this willingness to pivot away from things that aren't working. If it's not working as well as it could, we have to be brave, and that bravery is really important. Thanks for that description. Curt, I was going to ask you the same question. But as Karrie was speaking just now, it made me think of another question that I'd like to ask you instead. Communities often are quite distressful about outside organizations and people coming in to help them, and for a good reason. There's been a long history of this happening without much benefit and the communities are worried about the motives of the people coming in. They just want to get their research done or they want to do their philanthropy and feel good about it. There are a lot of reasons communities have this distrust. How do you address this? Because you're in so many communities of need and I'm sure trust must be a big issue. Trust is the foundation on which all of this work rests and for anyone who's spent meaningful time in your own kid's school or another school setting, you know how relational those environments really are at the end of the day. And it makes me feel like Karrie was spot on in saying a big piece of what is needed in this next wave of work given the ecosystem we all find ourselves in is the ability to be nimble and adaptive and responsive to local context. And so for FoodCorps, that begins with a very strong priority on recruiting folks who work for us, whether it's in our AmeriCorps program as frontline food educators, or the folks who are in our field offices leading the kind of district and principal level relationships and working with other organizations and allies and policy makers around the state, begins with recruiting local talent who come in with expertise and relationships and informal knowledge as well as formal knowledge about the ecosystem in which they are operating. But at an organizational level, it requires us to be placed-based. And it's a tricky thing for a national nonprofit like FoodCorps to strike the right balance between enough consistency from place to place that we get all the benefits of replicability and scalability and measurability and we can tell a powerful story to policy makers, to our partners, and have what is most important, which is adaptive responses to local context, the fact that climate and culture and food culture play out so differently in the Navajo nation from how they play out in rural Maine, from how they play out in New York City. That adaptability is what gives you relevance and it's what actually makes your work make a difference. We work really hard to lean in on the place-based side of that and the culturally relevant side of that. I do think our nation school meal programs in large part are still trying to solve the problems of the last century. The modern school meal program has its origins at a time when we were trying to get the surplus commodities, we were growing on our nation's farms used up by our school system and try to make sure that folks going off to the battlefield in our country were not malnourished and we have a different food landscape today, one that needs to put public health at its center and needs to recognize the fact that in today's incredibly diverse America, food is one of the best tools we have to connect across lines of cultural difference and come together around a shared table to affirm our values. I do believe there's a way we can have school food be an engine, not just for kids being well nourished, but kids feeling really, truly cared for and valued and affirmed in who they are and where they come from. I also would say that there's been a sea change in what young adults are interested in around food. And now everywhere I go there's more and more young people raising their hands saying, "How do I get involved in FoodCorps? How do I donate a year or two of my life to this cause of building a more just and healthful and sustainable food system?" And that is totally thrilling to see. Karrie, do you share Curt's optimism? I do share that optimism. There is an incredible amount of passion. I'm seeing a lot of ignition around what it means to have positive food experiences and how people are relating to food and valuing food within their communities. Food is the most personal thing we do. It's a decision that we make multiple times a day. It's cultural, it's our families, it's we gather around food. We celebrate with food, and we celebrate our communities, our heritage, all around this core convening factor. I am seeing where the value of doing that and putting that in the center is starting to become more and more important, and that is really encouraging for the structures and the processes and the systems and addressing some of these issues. I think that gives me a lot of hope that we have this very personal base in which to build. Given that food insecurity is a major problem in the US and around the world, despite years of efforts to try to help address it, what do you think are the most important things that need to be done? I think first starting with most people just simply don't realize how pervasive food insecurity really is. I often will give people the fact that we look at data and food insecurity exists in every county in America. This is neighbors, friends, family, and that means that we have to think about solutions at a community level and at scale. And it's really complex. At the core, I think food security and food insecurity is about instability. So that might mean housing. That might mean employment. That might mean health. That might mean a very personal family situation. And it also isn't about a static aspect, right? A person isn't food insecure forever. They're insecure often for a moment in time or a few months or some years. For some people, it's more of pervasive over a lifetime. But people are cycling in and out of need. And I think those are all dynamics and aspects that are important to understand. And I think that leads us to two reasons that it continues to be such a pervasive issue. So first, there's still an incredible stigma associated with people who are struggling to have access to healthy food. And it's difficult to ask for help when needed because of that. And second, because it can be so cyclical, it also means that our systems have to make it seamless for people to be able to ask for help when they need it. So it's not easy to navigate a benefit application. It is not easy to figure out, "Where do I go? What's going to be the best place for me," especially when a family is struggling with other stressors in life. So setting aside more of the structural questions around things like housing and healthcare. I think there's some practical short term things that we can really do. We can prioritize helping to reduce stigma, to demystify what food security really is, and to assess where these systems that we have in place may be putting up barriers for people that don't need to be there, that they could be accessing food easier. You know, in our part, well, we think about our own work. We're still going to address these issues at scale. And for context over the last five years, we've helped to provide about 4 billion meals to people in need, right? So scale matters for sure. That is something that needs to happen. But As we think about those lessons and the learnings and some things we can immediately do, we're also thinking differently about how do we prioritize investing in programs in the geographies and for communities that are disproportionately impacted by these issues. You know, Curt shared some of the stats in the beginning for communities of color, for rural geographies. There are areas where we need to have a more targeted approach to develop better tools to address stigma and better tools to reduce some of those system barriers so that people can get access to their needs met in the communities where they're at. So thank you, Karrie. Curt, what are your thoughts on that? At FoodCorps, we're really focused on how do we leverage the scale and reach of our nation's school system to make sure that the 30 million kids a day who are spending half their waking hours and eating often half their daily calories in school learn what healthy food is in a reliably effective way and eat healthy food every day in the meals their schools provide. And our sense is that systemic change that we could catalyze across the school system will have huge longterm impacts on the trajectories of kids who have the chance to fulfill their potential and fulfill their dreams in school and in life and also have a huge impact on how our food system as a whole works there. But I would say if we want to change our school system to better address the needs of the kids who are walking through their school doors food insecure, the kids who on snow days don't get enough food to eat, we have to change some of the stuck mindsets and mental models that have kind of been holding our schools in the place where they've been around food for so long. And really I think we have a school system that very often sees food as a cost center to be minimized instead of an impact center waiting to be unlocked. And when we treat it as a cost center to be minimized, we minimize the amount of time kids have to learn about healthy food. We minimize the amount of time kids have to eat healthy food in their lunch rooms, and we minimize the investment we make in the quality of food we're serving to kids in school, and we minimize the attention we pay to the lunch ladies and gents and the district level school food leadership who are on the front lines of actually getting healthy food to our kids. The result of that is a food system that devalues food in school and leaves a whole lot of kids feeling unsatisfied and unfulfilled and being unnourished by that system and I believe there's another way to approach it, which is to treat it as an impact center and a value center and show what happens when we use the power of food to make sure every child gets the nourishment they need to thrive and every child gets that feeling that only food can give you of knowing you are valued and cared for by the adults around you. Thank you. Well Curt and Karrie, there couldn't be any two more capable, insightful, and passionate people working on this problem. And thank the heavens you're doing this work. And congratulations for what you've accomplished. I know it's only begun. And thank you for being leading voices in food and of course for joining us today. Thanks so much. Our guests today have been Curt Ellis co-founder and CEO of FoodCorps and Karrie Denniston, Senior Director of Sustainability with the Walmart Foundation. And thank you for listening. If you would like to subscribe to the Leading Voices and Food Podcast series, you may do so at Google Play, Stitcher, RadioPublic or Apple Podcasts, or by visiting our website at the Duke World Food Policy Center. This is Kelly Brownell.  

Today's guest, Dr. Hunt Allcott, had two recent papers with colleagues Benjamin Lockwood and Dmitry Taubinsky, on whether soda taxes are effective, and how an optimal soda tax might be established. They were published by the National Bureau of Economic Research. These are important papers and an important time, given all the activity around the world on soda taxes. I'm Kelly Brownell, director of the World Food Policy Center at Duke University, and professor of public policy at Duke. Welcome to The Leading Voices in Food. Hunt Allcott is a principal researcher at Microsoft Research, an associate professor of economics at New York University, a research associate at the National Bureau of Economic Research, and a co-editor of the Journal of Public Economics. Hunt, I'm so pleased to have you join us, and would like to begin with a key question based on your work. What are the key ingredients for calculating the economically optimal soda tax? That's a great question, and thank you so much for having me on the program. I'm a big fan of the program and I'm a big fan of the work that you're doing. The key ingredients for calculating the economically optimal soda tax, I would say, are actually the key ingredients for thinking about the optimal policy in any number of domains. And so, there's a subfield called public economics that has a framework for thinking about this, and it is a utilitarian framework. It starts with the idea that everybody is maximizing their happiness, possibly making mistakes in doing so, but they're trying to maximize their happiness or utility, and there is a benevolent policy maker or a government that's trying to do well by its citizens, but it's trying to maximize this sum of happiness across all people [inaudible 00:01:56], and you might call that social welfare. So the way that we think about lots of economic policy problems, setting optimal taxes on sugary drinks, but also tobacco taxes or income taxes or disability insurance, is from this perspective of a benevolent policy maker that's trying to maximize social welfare. And so, what does that framework specifically then say, or what are the key ingredients for an optimal soda tax? I think that the two key ingredients are, really, a share of health costs that are caused by soda consumption, which are those costs that are born by other people, and then, what you might call internality, is are we making some mistake? Are we failing to maximize our own happiness by drinking too much soda, possibly because we don't know how bad the stuff is for us, or because we have self-control problems? Building on those two key ingredients, you, in general, want impose a corrective tax on tobacco or sugary drinks or carbon pollution or anything else, if and only if the consumption generates externalities or internalities. We, in our paper, calculate what we think is the economically optimal tax rate, and for a nationwide tax, our calculation is that somewhere between one and two cents per ounce actually it would be the optimal nationwide tax rate. And so, there's a sense in which the cities are actually pretty close to the optimal tax that we would set nationwide. And these calculations are speculative. There's a whole industry of economists and public health folks that are thinking about what would be the optimal tax on carbon pollution or the optimal tax on tobacco, and this is an early attempt at setting that optimal tax in the context of soda. And so we've done our best, and I think there's more work to be done there to try to figure out what the optimal amount is. You may have noticed that I was a little bit careful in distinguishing between the optimal nationwide tax versus the taxes that are being set in different cities, and that's actually a key distinction. Most of the taxes, in fact, all of the explicit soda taxes that we have are at the city or sometimes the county level in the US, and when that's been done, there are some papers that document what economists call leakage, in other words, that when you tax soda in Philadelphia, people, when they're shopping outside of town, start buying more soda outside of town. Similar things tend to be happening in Berkeley and I imagine they're happening in other cities that have soda taxes. This leakage reduces the effectiveness of the tax. You know, it's basically, you're taxing one good, which is soda in Philadelphia, and demand for another harmful good, soda outside of Philadelphia, rises. And that means that the optimal level of the taxes lower, and the effectiveness of a tax, at any given rate, is lower. And so, it does mean that the optimal city level tax, taking into account leakage, is certainly lower than the optimal nationwide tax that you would set. And what are the ways in which soda tax design can be improved? The most common structure of soda taxes in the US is that you would tax it one cent or two cents per ounce of sugary drinks. Now of course, sugar drinks vary in the amount of sugar that they contain. Soda pop has more sugar per ounce than some other types of SSBs. Sometimes ice tea, for example, have less sugar per ounce, but it really is that sugar that's causing the harm to our health. And so, we would advocate, and some countries have started to do this, that you would set a soda tax that scales with the amount of sugar in the drink, not the amount of liquid that comes with the sugar. And in fact, our team is working on a paper to sort of quantify that point, and other people have made that point as well. So that's one example, and there are others. And given this work, do you think soda taxes are effective public health policy? Yes, absolutely. Absolutely. So one is that it would be cause consumers to, even if they like some kind of sugary drink, it causes consumers to substitute the less sugary drink, so that's good for their health. And the other benefit is, as you stay on the production side, it will induce faster changes in the product. But it certainly seems like the benefits of a tax are not just that price goes up so demand goes down, but indeed what people infer, what information people start to sense that they're getting from their government about the types of things that are being packed. And as an example of this, you may know that there's a paper by Alex Rees-Jones and Kyle Rozema that is circulating recently, that looks at cigarette taxes, and they look at cities that debated, but in the end, did not pass cigarette taxes. So there was no impact in these places on cigarette prices, yet there was a lot of coverage about the health harms from cigarettes, and there seems to be some evidence that people's cigarette consumption in these areas actually went down in response to these debates. And so I think that's clear evidence that the benefits of taxation are not just through the price channel, but they're also through the sort of public debate and information channel. You also have another line of work on food deserts, and have published impressive work on that topic. How much effort do you believe we should put into combating food deserts by subsidizing grocery stores in underserved neighborhoods? It's a great question, and yes it is a something that we've been interested in. We've just had a paper accepted at the Quarterly Journal of Economics that touches on this issue. And we got interested in this because we've been reading about food deserts and reading about nutritional inequality, just the idea that low income folks aren't able to eat as healthfully as high income folk, and then also the fact that low income neighborhoods often have more convenience stores and fewer healthy grocery stores with fresh produce. This sort of correlation, this connection between lack of healthy supply and lack of demand for healthy groceries might've been sort of a causal thing, where the food desert is causing the lack of demand for healthy groceries. And so, we were interested to try to find out if that was actually true. When new grocery stores open up, does that actually impact, does that actually cause people nearby to buy healthier groceries? And so, we looked at this, we gathered Nielsen Homescan data, and we combined that with data on all the grocery stores that have entered in the United States over the last 15 years or so, and it turns out that when grocery stores enter in the food deserts, they don't cause people to eat healthier food. So what does happen is that people shift their shopping towards the new supermarket, but they don't buy healthier foods. And this is, I think, an important fact, and when we think about why we'd want to subsidize grocery stores in underserved areas, I think that this is an important fact to take into account. It doesn't seem to have much of an impact on healthy eating.

Regenerative agriculture is a highly visible, interesting and promising approach to raising animals. The person credited for conceiving this approach, testing it and helping it spread around the world is our guest today, Allan Savory. I'm Kelly Brownell, Director of the World Food Policy Center at Duke University and professor of public policy at Duke. Welcome to the Leading Voices in Food. Allan Savory is from Zimbabwe and is a livestock farmer, author and ecologist, and is president and co-founder of the Savory Institute. He is credited with creating the holistic approach to agriculture management that is now being used so widely around the world. And as an example of the reach of his ideas, Allan has a Ted Talk that has been viewed more than 6 million times. Allan, I'd like to begin by thanking you and by asking if you could explain the concept of regenerative agriculture. We need an entirely new agriculture and regenerative is what it is being called. I always credit Robert Rodale with this. A regenerative agriculture would truly regenerate economies, small towns, rural communities, whole communities. So now, let me explain why it's so important and the ways in which it will be different, and it has to be. We have to do this. First, let me define agriculture. Agriculture is not crop production. It is the production of food and fiber from the world's land and waters. So almost the entire planet now is involved in agriculture. And only 6% of the planets area is actually crop production, 20% on the land. So it's a vast area that is involved. Now, without agriculture, we couldn't have this podcast. You couldn't have your university. We couldn't have an orchestra. We can't have an army, we can't have a government, a political party or any business. Agriculture is what civilization and all business is built on. Having said that, the problem that Robert and I were seeing in those days was that mainstream agriculture had become based on chemistry and marketing of technology. Now, even a child knows that agriculture needs to be based on the biological sciences. And mainstream agriculture today is the most destructive industry ever in the history of mankind. More destructive than coal or oil or anything we've ever had. And you only need to look at one figure to understand that. If you just take the published figures on dead eroding soil from agriculture, which are very conservative figures. Every year, that equals more than 20 times the weight of amount of food we need for every human alive today. So nothing else is causing that much destruction. It's leading to desertification, to climate change, et cetera. All right? So clearly, we have to change modern agriculture if we're serious about climate change or any business in the world. If they are serious. Now, when Robert and I were talking about this, the problem was we couldn't just swing to organic, sustainable, permaculture, biodynamic; any of the agricultural forms that people think are regenerative. Because if you look at history, the reason farmers and pastoralists have had to abandon civilizations throughout history, was because none of those could sustain a civilization. We knew that prior to the development of chemicals, machinery, and oil, that the forms of agriculture we had were not adequate to sustain a civilization. There was the dilemma of why I produced a Ted talk video saying the problem is sustainable civilization, and Robert Rodale came up with this idea. What we need is a regenerative agriculture. Okay, so now let me answer how regenerative agriculture can be brought about. I'm terribly excited about this because now it is actually possible to do it. But it's going to involve no particular practice. What it's going to involve is, first, an agriculture in which all of us at the management level--whether we're fisherman or foresters or wildlifers, or growing crops, or ranchers, whatever we are--are managing in a way that addresses the cause of global desertification and climate change, and of past failures. Unless you address the cause of a problem, you're not going to solve it. So we have to address that cause. Now, that cause we know was not what climatologists and scientists are blaming. They're blaming livestock, coal, and oil. But if we just use common sense again, we know that livestock, coal and oil are resources. And we'll need them for centuries to come. And there's no way in the world that a resource can cause a problem. The only thing that can cause a problem is the management. The management of that livestock that caused deserts to spread around the world at the level they did and continue to do. Or, it was management that caused coal and oil that are our fossil resources; called them fossil fuels to be burned at a rapid, rapid rate. We have to change management. And that means at the policy level. And at that ground level where people are actually on the land doing it now. When we change management, that management has to change to holistic management where we do take into account the web of complexity. Our present management is reductionist is because we always take out the web of social, cultural, environmental and economic complexity that is inherent in all agriculture. We take that and we reduce it for our management actions to meeting a need for more food or a desire for a different type of crop, or whatever it is. Or in the case of agriculture policy, we reduce it to a problem that has to be addressed, whether it's noxious weeds or whatever it is. Allan, I know from hearing you speak and meeting with you that some profound experiences in your native country of Zimbabwe many years ago, led you to develop the concept of holistic management. Would you mind explaining? Yes. I was just a biologist, ecologist, and I joined the game department. And we were setting aside areas to be future national parks and they were wonderful. The incredible amount of biodiversity, et cetera. We were picking them because of their sheer beauty and magnificence. But I noticed that very, very quickly, they began to deteriorate and desertify.  And that defied logic. Now, I realized that almost everything I had learned as an ecologist in university was not matching what I was seeing on the ground. So I really began my education all over again, just desperate to try to find a solution to that. And that led me to developing the idea and coining the words "game ranching", where we would utilize wild populations in situ. Like harvesting fish in the sea, and we could get rid of livestock, and we would save the ground. But again, we were wrong. All that land continued to deteriorate as our national parks today in the seasonal rainfall environments. And desperate for solutions, almost by accident, I discovered that livestock could do what I had seen almost intact wildlife populations do. In other words, the healthiest land I'd ever seen was where the wildlife populations were most intact. Lots of predators, very big herds, thousands of Buffalo, et cetera. And suddenly I saw on the ground that livestock could do that same thing and I discovered that where livestock had crowded into a corner on a ranch. So then I began looking seriously at livestock and realized how terribly wrong I'd been in developing the idea of game ranching. And also believing that the destruction in the national parks was due to too many elephants. I learned from that terrible mistake, and as I say, looked seriously at livestock. Then I followed the work of a French pastoralist who had discovered that overgrazing is not as scientists believed--a function of animal numbers. It's a function of time on the land, exposure of the plants to the animals, and time of re-exposure. Following that up, I developed a planning process from military planning that could cater for the complexity of livestock, wildlife crops, no matter how complicated any farm was or ranch. That planning process could handle it very well, and that worked immediately. And we began for the first time ever to see desertification reversing. So we were all terribly excited. It began to spread. It spread to five countries around Zimbabwe where I was working, and I was flying into ranchers, and helping them. Then I was obliged to go into exile. We had a long civil war, and it was four years until I could get back. Now during that time, all of the projects I had got going, the ranchers I had got going who were doing so well they all without exception slid back. And two advanced projects that were extremely successful--where we were pushing the envelope and trying to cause failure, and we could not cause them to fail--those had failed in a four year period when I was away. So we then looked into that and what we found was, again, I'd been wrong. I had not controlled for the social, cultural components, and the economic components. So literally, we were back to the drawing board again realizing that we've got a big step forward, but we hadn't solved the problem yet. And in that four years when I was over here in America, the US government engaged me to put 2000 people through training. They came from all the main government agencies, land management agencies, the land ground to agricultural universities, faculty members, and from world bank, USAID, et cetera. Now we learned a tremendous lot during that to a period of training those people. And were able to break through and develop the holistic framework, and the concept of avoiding, reducing the complexity to need or desire or problem. Avoid that by always developing policy or management in what we call a holistic context where you tie how people want their lives to be based on their culture, their beliefs, their spiritual, whatever they are. And you tie that to their life supporting environment and what that environmental would have to be, say 500 years into the future to sustain people with lives like that, and now that becomes the context or reason for the management. And that worked and we haven't had that fail. Well, with the very public discussion going on about the environmental impact of animal agriculture, is there research showing the overall impact of regenerative practices and can this help us set either partially or totally the environmental impact of the animals? There's lots of research of components of it and I was very pleased to see sort of publication out of Davis, California acknowledging that trees don't sequester too much carbon. So that sort of research is coming out that grasslands are where we will sequester the most water and carbon. So that sort of research is what the Savory Institute is gathering. An awful lot of whatever research is available that supports different components of practices that are being verified on the outcomes. No matter what the person is doing, we're not worried so much about what they're doing but what is the outcome? Does the environment improve? And so data is being gathered, a lot of it. That's the sort of data that is needed so that public opinion will shift and then our institutions can change to developing policies holistically. So we don't need research to prove that holistic management works. It works by definition. What we need is masses more research, establishing the, documenting the results so that public opinion shifts so that institutions can change. The big problems in the world, like let's say desertification or climate change, we do not tackle them as individuals. We can do the best we can as individuals, whether we're farmers or pastoralist or whatever. But on a big scale, we always do things through organizations and institutions. And I spoke in the UK how only individuals can get institutions to accept new scientific insights, but only institutions can develop the policies. So right at the moment we have institutions virtually dictating that global climate change continues. People can farm without the subsidies. So the policies are literally causing climate change. I was going to ask, are there places around the world that countries where you think they're making some positive strides with policies? No. Wow. No, policies are universally unsound. When I mentioned training 2000 people in this country for the USDA? I had them bring hundreds of their own policies to the training and had them analyze their policies with the holistic framework and it was their decision, not mine. They could not find a single policy that would not lead to unintended consequences. They finally wrote down this statement. They said, "we now recognize that unsound resource management is universal in the United States." Now, frankly, that's everywhere. When I repeated that in India with [inaudible 00:16:06] and Tamil Nadu, we came up with the same results. When I repeated it in the Soto with all of the agricultural officials, they concluded their policies were unsound. It's universal because all governments develop policies in a reductionist way. Well, that's a very discouraging piece of information, but it does sound like this is a movement that's likely to go from the ground up, literally. That there are people who will do this on the ground, on their farms around the world, data will be collected that will help change public opinion, and finally policies might change. Is that the process that you hope will occur? Well, that is the only process that can occur. If you look at the research, the only way I can come into society is through the ordinary people. And it doesn't matter how many trillions of dollars are lost. It doesn't matter how dangerous it is, how many millions of lives are lost, nothing changes institutions to public opinion shifts. Well, let me end by asking you a final question. What role do you see animal agriculture playing in the overall world food system as time goes forward? The animals will play an increasing role simply because--and this will happen if we're to survive--because the issue of global desertification, climate change is so great. And it is absolutely impossible--I repeat that: absolutely impossible to reverse desertification, rebuild the agricultural cropping soils of the world, et cetera using the tools that scientists have.  

Imagine you've come to work for a major foundation and were asked to create a program on obesity prevention. With the vast array of possible things one might do, how in the world would you choose what might have the most impact, and what would be the most cost effective? This was the task of our guest Dr Neena Prasad, who joined Bloomberg Philanthropies in 2008. I'm Kelly Brownell, Director of The World Food Policy Center at Duke University and professor of Public Policy at Duke. Welcome to The Leading Voices in Food. Neena Prasad is a primary care physician who also holds a master's degree in public health. She joined Bloomberg Philanthropies in 2008, and led the development of the program she directs, The Foundations Obesity Prevention Program. This program aims to improve the food environment through policy change. In addition, Neena directs the maternal and reproductive health program and tobacco control efforts in India. Neena and her colleagues at Bloomberg have played the leading role in supporting and evaluating soda taxes around the world. Neena, thanks so much for joining us. So let me begin by asking why Bloomberg Philanthropies decided to do invest in this work on soda taxes after there'd been such a strong history of work on tobacco. It's great to be here with you today, Kelly. Thanks for inviting me. If I had to describe the investment approach of Bloomberg Philanthropies in a sentence, I would say that we aim to address large unmet needs in public health globally and particularly in low and middle income countries. And what do I mean by unmet needs? I mean things that are major killers and that are underfunded, and obesity fits that bill. And when we started to look at this issue seriously back in 2011, the numbers were quite staggering. And fast forward to today, obesity is a major cause of death and disability globally. Today, over 4.7 million people die from a high body mass index. And what's astounding is how quickly it has jumped to be one of the leading risk factors for death. So in the span of a little over 25 years, it's gone from being the 16th highest risk factor for death to the fourth. And pretty much every country is affected and no country has successfully reversed it. The health consequences are well-documented, I don't need to get into that here. But the other thing we've got to be mindful of are the economic impacts. And a recent estimate by The World Obesity Federation put just the treatment costs for obesity-related diseases at 1.2 trillion US dollars by 2025, that's just treatment. And so what this means is that is really a development issue, and it wasn't getting much attention. And we felt a sense of urgency. This felt like a ticking time bomb that could really undermine development in low and middle income countries, and we really felt the need to act. And Kelly, you mentioned tobacco control. This program, I think, as we've come to work on it now for a few years, have come to realize there are a lot of parallels, actually, with tobacco, both on the policy side, which we can get into later, and also interestingly, in terms of how the industry behaves. It seems that the food and beverage industry uses a lot of the same tactics that we've seen the tobacco industry used. And so in some ways, our experience in tobacco, though it's not a perfect parallel, has prepared us for working in obesity prevention. So Neena, let me ask this, you made a very compelling case for why obesity should be addressed and how there's so much unmet need. Why take on soda tax as the primary effort? So I should say that our program is actually much bigger than soda taxes, though I think it's fair to say that that is the one policy with a pretty solid evidence-base and as a result should be adopted by all governments. But soda taxes are not a panacea, and addressing obesity will require a slew of demand and supply side interventions. And so we are really focused on a package of interventions, much like we have in tobacco control. In tobacco, there's a WHO packaged called MPOWER, which are proven policies that every country should be adopting. Things like raising the price of tobacco so that it's less affordable, banning the advertising of tobacco, placing graphic warning labels on tobacco packages. And what we're trying to do in the obesity space is generate evidence to get us to an MPOWER like package for obesity. And often, you'll hear people say that obesity prevention is 30, 40 years behind tobacco in terms of the evidence base. And we know, for the reasons we just discussed, that we can't afford to wait. And so we're really trying to accelerate the adoption of an evidence base and provide that guidance to governments. And the package that we are working on was based on a lot of expert opinion, including yourself, Kelly. And basically, based on all this input, we landed on four policies that looked promising. And they are taxes on sugary drinks, we've now brought in that to also include unhealthy foods. The second priority for us is front of package warning labels. The third is restricting the kinds of advertising, promotion and sponsorship that children are exposed to, and the fourth is improving the public sector food space, particularly schools. And our approach, really, is twofold. The first is we work in a few focus countries, where we support both policy advocacy and evaluation once policies are in place. And then we also have an evaluation fund which supports evaluation in our non-focus countries, which I can talk a little bit more about later. But basically, we've identified the best advocates and the best researchers in our focus countries who are really driving this agenda and working to raise awareness and get these policies adopted. With your permission, I'll invite you at a later time to come back and join us and talk about some of the non-tax related approaches you're taking, because I know those are very exciting and have been taking shape in lots of interesting ways in different countries. But returning to the soda tax approach, how have you chosen to approach that work, and what are you choosing to do in the countries? You mentioned choosing the best advocates and the best scholars to work with. What else are you doing to try to make these soda taxes work in different countries? Every country is different, and so the approach is going to be different in different countries. But one thing that I think is universal, whether you're in the US or in Mexico or in South Africa, and that is you've got to build public awareness. The public needs to understand the unique harm of these products and therefore understand why they're being taxed. We differ very much to our partners, they know their country context and they know what's going to resonate and what's not. But a big component of our investment is just evidence-based communications campaigns for the public to understand that when you have a soda, this is how many teaspoons of sugar you are consuming. So that often softens the ground for something like a sugary beverage tax down the road. I don't think anywhere you can come in and say, "We're going to raise taxes." You've got to inform people, you've got to build up public opinion. And in fact, we found pretty much everywhere where we work, that if you take the time to educate people, by and large, they all support this policy and they feel that government has a responsibility to protect their health. Other ways that we support this, so we support a lot of research to make the policy case. So, for example, in Mexico before the taxes was adopted, partners there did a lot of work around the economic impact of overweight and obesity and related diseases in Mexico and contrasted that with the savings from something like a tax, not to mention the revenue that's generated that could then be put back into public health programs. So it's really a combination of research and advocacy, or maybe put differently, it's research-driven advocacy. Neena, you mentioned the importance of going in and softening the ground by doing public awareness campaigns, is there any evidence that those campaigns themselves, irrespective of whether the tax the gets passed, have an impact on consumption of these beverages? That's a really interesting question, and it's a question that we are... and all of our partners are asking ourselves and trying to tease apart from the evaluation of these taxes. So what is a price effect versus what is just people's growing awareness? And I don't have a scientific answer for you there yet. I hope sometime down the road we will have that. My sense is, though, that communications campaigns do have an impact. Certainly, in the post campaign evaluations we do, we detect that people are thinking twice about what they're consuming. So I do suspect that it's playing some role, but I couldn't quantify it for you quite yet. Thank you for that. Can you paint a picture of how widespread these taxes are around the world? And are there countries that are kind of in the mix but haven't quite passed taxes yet? Where does the picture stand if you look at the whole world? So, by our count, about 50 countries in the world have some sort of sugary beverage tax. Now, that says nothing about the rate or what products are covered. We started doing some pilot work in Mexico back in 2013, and our partners there felt the time was right to work on a sugary beverage tax. There was a new government in place, they were looking for revenue. That's what they wanted to work on. So, we supported them to do that. And long story short, they were really successful, and they got this tax passed, which was then implemented in 2014. We have been supporting evaluation of that tax. And if you look at the first two years of that tax, there was a 10% reduction in consumption of sugary drinks. And this was a relatively smaller tax, it was about 10%, one peso per liter or 10% at the time. And the feeling is that taxes should be at least 20%. But even with a small tax, they saw an impact. And I think having that data published, having these really rigorous studies done and published in peer review journals was a game changer. It was, in my knowledge, the first time this kind of empiric national level data had been published. And what we've actually found is that since Mexico implemented and these evaluations were published, 30 countries have followed, covering 2 billion people. I think that this anecdote really illustrates the role of a funder like Bloomberg. We can support leading partners who are innovating and testing out policies and study them really carefully and if proven effective, make the case to government as to what is a smart policy and what isn't. So that's just a general kind of sense of the acceleration that we've seen post Mexico. I think in the US, it's been a little slower going in. It's been more the city level. We'd love to see some States come on and tax sugary drinks. But I have to say [inaudible 00:13:10] we're optimistic. The evidence is there, and it's more a matter of when, not if, we think, when most governments will see this as a smart policy and start implementing it. Neena, you partially answered a question that I was about to ask, and that's, what special role does the foundation possibly play in this process? And you mentioned the opportunity, the fund rigorous research to evaluate the impact of such taxes. Is there also a unique role in say the advocacy part of things that a foundation like Bloomberg can play? Absolutely. I think it goes without saying that at the end of the day, governments have a responsibility to protect public health. And we as private foundations can never ever replace the role of government. But we can support the adoption of things more quickly. And this is, quite frankly, an area where we see a lot of industry interference. So this is a topic where we see tremendous pushback from the food and beverage industry. They do not want to be regulated. And the food and beverage industry has a lot of influence, they have a lot of resources, so advocacy to counter that is critical. And I do think that we at Bloomberg have been able to bring our experience in policy advocacy from other tough issues like tobacco control to this space to encourage more of a level playing field. I don't know that we can ever match the industry, but we do feel like we can level that playing field and bring a real, genuine and data-driven public health perspective to the conversation. So, yeah, absolutely. I do think that's a role that we can and have played. So the opposition by the industry is obviously an important challenge to accomplishing what you are hoping to accomplish. Are there some other things that you'd list as challenges? I think one thing that I would describe as both exciting and a challenge is there is no playbook here. We are trying to figure out what works. And our partners are... This is uncharted territory in many ways, and our partners are writing that playbook. And yes, that's exciting, to be kind of at the forefront of something. But it also means there's some risk and there's potential for errors or mistakes, or there could be unanticipated consequences. And we just don't know until you get these policies adopted and study them. So I think that's a big challenge. I feel really assured that we are working with, as I mentioned, the best advocates and researchers in the space who were incredibly data-driven and experienced and extremely thoughtful. So I hope we minimize that error or that potential for some unanticipated consequences, but it's inevitable. That's just the nature of kind of being out there and doing something first. Another challenge is a lot of the countries where we work, South Africa and Columbia come to mind, there, while rates of overweight and obesity are quickly growing, they're also facing large burdens of undernutrition. And I think we, generally, need to be better about bridging that divide. It seems to me there's been a bit of a divide between the undernutrition and the over-nutrition communities. But ultimately, we're all after the same thing, and that is to produce environments where people have access to whole, healthy, affordable foods. So that's been a bit of a challenge, and one we're thinking especially hard about, is how do we broaden the coalition of actors, because we really are after the same objective. Well, Neena, one final question. And I'm curious about your impressions on what the future will bring with such taxes. Would it be higher taxes in existing countries, more countries? You mentioned earlier the possibility of taxing more than just sugar beverages. Where do you think this work might go in the future? I do think more countries are going to take this on. You're probably familiar, Kelly, with the tax in the UK, which is based on the quantity of sugar, and I do think that's the way to go over a volume-based tax. If you're taxing on quantity of sugar, that means more sugary drinks will be more expensive, so a consumer would be incentivized to buy something that's cheaper and therefore less sugary, and that's a form of harm reduction. So I do think that's kind of the next frontier in terms of tax design, and I believe there are some studies going on in the UK and we're really looking forward to seeing what the impact is there. And the other piece in the UK that was really illustrative was even before the tax came into effect, the industry undertook massive reformulation to get their sugar out of their products so that they would be subject to little or no tax. So it's interesting to see what's happening in the UK, and I think that countries, assuming they have the administrative capacity, really need to be looking at these sugar-based taxes. I think a couple of other unanswered questions are, what products should be taxed? And some cities in the US tax artificially sweetened drinks and forthcoming evaluations will tell us more about that. So I think there's a big question mark there. And similarly, should we be taxing things like fruit juice? I don't think we want to be sending the message that it's okay to substitute your soda with orange juice, because that's pretty sugar-laden as well. So I think these are some places where there's opportunity for governments to push. And then of course, I think the rates need to be much higher, at least 20% if not higher. Well, Neena, thank you so much for joining us. You and your colleagues have just done remarkable work, and the impacts of this work are being seen in country after country around the world. So, I really appreciate you being our guest today. Thank you again. Thank you, Kelly. It's been great chatting. Our guest has been Doctor Neena Prasad, Director of Bloomberg Philanthropies Obesity Prevention Program. And thank you for listening. If you'd like to subscribe to The Leading Voices in Food series, you may do so at Google Play, Stitcher, RadioPublic or Apple Podcast, or by visiting our website at The Duke World Food Policy Center. This is Kelly Brownell.

It is well known, and has been for many years, how prevalent food insecurity is in the US and elsewhere. People are especially moved when they think of children who are malnourished. Our guest Dr Maureen Black is one of the world's leading experts on nutrition and its impact on the health and development of children and on how to reduce health disparities by improving child nutrition. About Maureen Black Maureen Black, Ph.D. is the John Scholl MD and Mary Louise Scholl MD Endowed Professor at the University of Maryland, School of Medicine and a Distinguished Fellow at RTI International. She is trained as a pediatric psychologist, with a Ph.D. from Emory University and a fellowship in developmental disabilities at the Neuropsychiatric Institute at UCLA. Her expertise is in the intersection of nutrition and child development. Black conducts her work in low-income communities in the US and in low- and middle-income countries throughout the world. Interview Summary Maureen, thanks so much for joining us. Would you mind helping paint a picture for us, if you would, of the developmental and health consequences of being in a food insecure household? Thank you, Kelly. Yes, there are three areas that I can talk about. The first are the nutritional consequences. Typically, what happens in a food insecure family is that families reduce the quality of food by relying on inexpensive, low nutrient dense food so that children don't feel hungry. That means that children are not getting the nutrients that they need to develop and grow. So for example, iron or zinc deficiencies can occur. The second pathway is stress and anxiety that families experience when they are unable to feed their families. This can disrupt parenting and can have consequences on children's behavior and development and overall health. So the third point is that food insecurity is often invisible because it does not necessarily result in children being either underweight or overweight. So if you don't ask about food insecurity, you won't know if a child is in a food insecure household. So you and I were at a meeting together and somebody at the meeting, it might have been you, said that inadequate nutrition during key stages of development basically confers a life sentence on the child. So can you say what's meant by this and do you agree it's pretty strong language. It is strong language. And the strongest evidence from that comes from children being raised in low and middle income countries, whose the consequences of their early undernutrition is so severe that it stunts their linear growth. So in other words, their height is challenged. And that can remain with them really throughout life. So it can be a life sentence when it occurs very early in life. I'm talking about the first 1,000 days. That means from conception until a child turns two. That is a time of rapid brain development and not having adequate nutrients at that time can have longterm consequences. So you mentioned particularly linear growth and a person's height might be affected, but you also alluded to cognitive developmental changes. Are these things that could be damaged permanently with inadequate nutrition during those key stages? Yes. Again, the strongest evidence that we have comes from low and middle income countries, where children have been very severely undernourished. There's a difference between the level of malnutrition that we often see in low and middle income countries and what we see among food insecure children in the US. Are they at risk for developmental or behavioral problems? Yes, they certainly they can be. So why do you think food insecurity is such an intractable problem? I know it's still the case that the world produces enough food to feed people, but food insecurity just keeps happening and happening. Why do you think this is? Food insecurity is often a subset of poverty. So one of the reasons is not having enough funds in order to purchase food. And a second reason is basically there have been increases in food prices. A third reason is that it's often very confusing for families to know what are healthy foods, and we have had many opportunities for snack foods or availability of unhealthy foods that will help children feel full not hungry, but don't contribute to a healthy nutrition. And the food assistance programs have not really kept pace with the level of child poverty that we unfortunately see in our country. So if you're thinking of preventing food insecurity in children in particular, what do you believe are the most important priorities? So is it enough just to get food to children or is it important to think of particular nutrients? Would we ever have the luxury to provide nutrients, for example, to a child's particular stage of development? You know, the WIC program, the Women, Infants, and Children program does exactly that. It's a supplemental program that is available for over 50% of the infants and young children in our country. And they provide nutritional counseling and they also provide food that is age specific. So it changes, for example, when children go from 12 months to the second year of life. But I think what would help up all of us is to focus on healthy habits among children. So it's not just what food you eat, but it's when you eat food. We've become a very snack dominant culture. So there's a tremendous emphasis on snacks as opposed to on healthy meals. So helping families of young children develop healthy habits, I think would also help issues related to food insecurity. Yeah, I know in the field there's talk that goes beyond just what children might be eating optimally, but also around parent-child interactions around food and around feeding practices. Can you explain a little bit more about that? Yes. Actually, I'll tell you about a project that we're doing in Maryland, which is called CHAMP. This is an NIH funded project where we work in 54 childcare centers around Maryland. CHAMP stands for "Creating healthy habits among Maryland preschools," though it's a project introduced into preschools that focus on diet and physical activity using superheroes. And there's a parent component as well, so it focuses on not only what foods children eat, but it also focuses on providing the autonomy that children need to learn to feed themselves and make choices for themselves, so that it emphasizes not only food but also feeding behavior. Let's dive a little bit deeper into that. What exactly would parents be taught in order for children to have more autonomy? Well, they would be taught as children are able to start to feed themselves, which happens during the second six months of life when they're interested in touching things, then parents would learn to provide foods that are safe for children and that they're able to touch and start to feed themselves. Parents also learn to what we call "listen" to their children by looking at their signs of hunger and signs of satiety. A third thing that parents are taught is that they are in charge of what food is offered, when it is offered, meaning the scheduling when it's offered, and how it's offered. But children are in charge of how much they eat, and if children choose not to eat, parents are taught not to pressure or force them, but to back off and wait for the next meal. Oh that's so interesting, because it's so different than the way a lot of parents experience picky eating in their children or children not wanting to eat at certain times. So I can imagine this. So there must be research I'm assuming that shows that this is beneficial for the children and probably ultimately for the parents to feel better about interacting with their children. Absolutely. And when you mentioned pickiness or neophobia, that means hesitation about new foods, and this is very common in young children and it's understandable that they would be hesitant about trying something that they haven't eaten before. So parents learn that the best way to help a child eat a new food is for the parents to eat it, because children learn by watching what their parents do. So having a pleasant meal which is eaten together with parents eating the foods that they're encouraging the children to eat can often be successful. Forcing children, pressuring them is rarely successful and often leads to distress on all sides. Maureen, you mentioned the CHAMPS study which sounds very exciting. Are there other things going on in your own work or in others' work that you think is especially exciting and might help lead us into the future? Yes. Thank you for the question, Kelly. We have a paper released in Pediatrics and in this paper I'm part of a group called Children's Health Watch that monitors the health and development of young children who are raised in low income families. It takes place in five cities. So in the paper that we released we studied 28,000 children and we looked at them within specific ages. So under age one, one to two, two to three, and three to four. And what we found is that the children's likelihood of obesity did not vary by whether they were in a food secure family or a food insecure family, but we saw increases in the rate of obesity throughout that time period. So it tells us that children in low income families have certainly a higher risk of obesity as they, when we say get older, these are children who are age three. So it starts very early in life. We also found in that study that children in food insecure households were at risk for poor health and were at developmental risk. So it reminds us that it's not only the nutritional pathway but the stress pathway. Well, that work is impressive in its importance, its scope, and also the size of the sample that you're working with, so I'm happy you shared that with us. Let's look into the future a little bit if we could. And in many ways that future is square in our face now, because we think about climate change, population increase projections around the world, political strife occurring constantly around the world and other factors, the challenge of decreasing food insecurity is pretty amazing. Is there any reason, do you think, to be hopeful? Oh, of course, Kelly. There's always a reason to be hopeful. I think one of the aspects of being hopeful is that there's more attention on diet and physical activity. We see more attention on thinking about young children. I do think childcare is an opportunity. As we see more women in the workforce, we see more opportunities for child care. Much more to be done, but that provides a forum where we can help children and families develop the healthy habits that we know can stay with children throughout their lives. I think we need more responsibility and attention in the food industry to help busy families have healthy options that are convenient, rather than unhealthy options. So I think that there is room for hope, but I think that it happens at multiple levels. So from an individual level through to childcares, up to policy levels to make healthy food available and affordable. You know, Maureen, I appreciate your optimism and I share it. And in addition to the things you mentioned, you can think about all the work that's going on to address food waste with food rescue programs, for example, which can really help with these issues. So I'm glad that there's reason to be optimistic, as of course these problems are so important. So thank you so much for joining us today and of course for being the leading voice in food. And I know our listeners will appreciate hearing from you. So thank you again. Thank you, Kelly. Thank you very much. Our guest has been Dr Maureen Black, distinguished scholar at the University of Maryland School of Medicine and at RTI International. And thank you for listening. If you'd like to subscribe to The Leading Voices in Food, you may do so at Google Play, Stitcher, RadioPublic or Apple Podcast, or by visiting our website at the Duke World Food Policy Center. This is Kelly Brownell.

Host Jenna Liut welcomes Dr. Marlene Schwartz, Director of the Rudd Center for Food Policy & Obesity at the University of Connecticut, back on the show to discuss the article she co-authored with Dr. Kelly Brownell and Dr. Lee Miller that was recently published in the American Journal of Public Health. The article, “Primer on US Food and Nutrition Policy and Public Health,” explores the critical and inextricable link between agriculture and public health and demonstrates the need for policies that simultaneously address hunger, obesity and the effects of agricultural production on the environment. It's HRN's annual summer fund drive, this is when we turn to our listeners and ask that you make a donation to help ensure a bright future for food radio. Help us keep broadcasting the most thought provoking, entertaining, and educational conversations happening in the world of food and beverage. Become a member today! To celebrate our 10th anniversary, we have brand new member gifts available. So snag your favorite new pizza - themed tee shirt or enamel pin today and show the world how much you love HRN, just go to heritageradionetwork.org/donate Eating Matters is powered by Simplecast

In this episode, Revel CEO Jeff Fritz is talking with our Rev Up 2019 keynote speaker, Kelly Brownell. Kelly is currently the Director of the World Food Policy Center at Duke University. He is a renowned expert on behavioral science and food policy, and is known for his public policy work and research on obesity in the US. We're excited to welcome Kelly to the Rev Up 2019 conference taking place in Minneapolis, MN August 14-15th. For more information about the event and to view the complete agenda visit: www.revupshow.com

Kelly Brownell has stepped away from his role as dean of the Sanford School of Public Policy to launch a new World Food Policy Center at Duke University. He talks with the school's new dean, Judith Kelley, about key challenges that he hopes his new center will begin to address. For example, he hopes to get people in the food and food policy space talking to each other. The academic field is segmented, he says. "There is a lot of depth around particular topics but not much breadth across them and very little communications across them."

“The tragic Parkland, Fla., shooting on February 14th is yet another dreadful reminder that schools are no sanctuary against mass violence. Americans are surely united in wanting reforms … But the reform that is getting the most attention in this bizarro era we live in — arming teachers with concealed handguns — would likely make things worse.” – excerpt from an op-ed by one of this country’s preeminent researchers on gun violence in America, Philip J. Cook. Cook talks with Kelly Brownell about other, more promising strategies for dealing with gun violence in classrooms than arming teachers.

The algorithms that determine what we see on social media platforms wield a lot of power, especially when it comes to the news that people see. Facebook made big news recently when the company tweaked its algorithm. And did you know some real news stories are not written by humans, but by smart algorithm? Kelly Brownell discusses the promise and peril of algorithms with Phil Napoli. Napoli was recently awarded a fellowship by the Carnegie Corporation of New York to explore this topic more closely. Phil Napoli's upcoming book is titled "Media Technocracy: The Rise of Algorithmic News and the Future of the Marketplace of Ideas."

Kelly Brownell explores why research doesn't get turned into policy and why perfect research may not create systemic change. He also explains why it is imperative for the growing population and for the environment that our research is effectively implemented to create change. Brownell is the Duke University Dean of the School of Public Policy. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 33235]

Kelly Brownell explores why research doesn’t get turned into policy and why perfect research may not create systemic change. He also explains why it is imperative for the growing population and for the environment that our research is effectively implemented to create change. Brownell is the Duke University Dean of the School of Public Policy. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 33235]

Kelly Brownell explores why research doesn’t get turned into policy and why perfect research may not create systemic change. He also explains why it is imperative for the growing population and for the environment that our research is effectively implemented to create change. Brownell is the Duke University Dean of the School of Public Policy. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 33235]

Kelly Brownell explores why research doesn’t get turned into policy and why perfect research may not create systemic change. He also explains why it is imperative for the growing population and for the environment that our research is effectively implemented to create change. Brownell is the Duke University Dean of the School of Public Policy. Series: "UCSF Consortium for Obesity Assessment, Study and Treatment" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 33235]

A student-led initiative on college campuses  in North Carolina is tackling one of the most important issue of our time - political polarization. The project, called Leaders for Political Dialogue, convenes students from Duke, N.C. State, UNC and N.C. Central. Students spend a weekend learning how to communicate better with those whose political opinions may differ from their own. Kelly Brownell talks with the founder of the project, as well as three participants.

The latest research on poverty indicates that a federal job guarantee is economically feasible. Such a guarantee could help address big American issues like crumbling infrastructure while at the same time ensuring workers aren't living in poverty. Kelly Brownell talks about the topic with William "Sandy" Darity, the director of the Samuel DuBois Cook Center on Social Equity at Duke University.

This episode was originally published on September 9, 2016. General Martin Dempsey is former Chairman of the Joint Chiefs of Staff, and as such he was the nation’s highest-ranking military officer. In this episode of Policy 360, Dempsey joins host Kelly Brownell to talk about his unlikely rise in the military, changes in the military since 9-11, the one thing he wishes he could have accomplished during his time as chairman, and the words he found to comfort those left behind when a fellow serviceman or woman has been killed. More about the Sanford School of Public Policy: www.sanford.duke.edu Photo: Dan Nguyen/Creative Commons www.flickr.com/photos/zokuga/7976447467/ Music: Impromptu in Blue by Kevin MacLeod is licensed under a Creative Commons Attribution license. Artist: www.incompetech.com/

Last week, President Donald Trump signed a controversial executive action related to immigration. The action implements a number of changes to our current policies: refugees won't be admitted to the United States for 120 days, for example. It also limits immigration from seven predominantly Muslim countries: Iraq; Syria; Iran; Libya; Somalia; Sudan; and Yemen, and the action blocks Syrian refugees indefinitely. The executive action is called, "Protecting The Nation From Foreign Terrorists Entering The United States," and it has led to protests at many airports around the country. David Schanzer is the Director of the Triangle Center on Terrorism and Homeland Security, and Associate Professor of the Practice at the Sanford School. Prior to his academic appointments, Schanzer served in a number of positions in Washington, including that of Democratic Staff Director for the House of Representatives' Committee on Homeland Security. Professor Schanzer discusses the executive order on immigration and its impact on homeland security with Sanford's Dean, Kelly Brownell. "passport-12" flickr photo by oso flickr.com/photos/oso/153973593 shared under a Creative Commons (BY-NC) license​. Music: Impromptu in Blue by Kevin MacLeod is licensed under a Creative Commons Attribution license. Artist: www.incompetech.com/

Colin Kahl, former National Security Advisor to Vice President Joe Biden and Deputy Assistant to President Obama, spoke at the Sanford School Wednesday about his experience working in foreign policy and his expectations of the Trump administration. During his visit, Kahl recorded an episode of Policy 360 with Sanford's Dean, Kelly Brownell.  Special thanks to Professor Peter Feaver and his Duke Program in American Grand Strategy, the Duke Department of Political Science, and the Triangle Institute for Security Studies for sponsoring Colin Kahl’s visit to Duke. Music: Impromptu in Blue by Kevin MacLeod is licensed under a Creative Commons Attribution license. Artist: incompetech.com/

Do children from low-income background benefit from living in economically mixed communities? Professor Candice Odgers, associate director of the Center for Child and Family Policy, says that growing up in the shadow of wealth may have a surprising effect on a child's development. Odgers talks with Sanford's Dean, Kelly Brownell. Music: Impromptu in Blue by Kevin MacLeod is licensed under a Creative Commons Attribution license. Artist: incompetech.com/ "Sentenced to One Year in School" flickr photo by adwriter shared under a Creative Commons (BY-NC) license.

Can it be physically damaging to be African American? Assistant Professor Jay Pearson says there's chromosomal evidence that our bodies react to a combination of ethnicity stress and socioeconomic status. There are important resources associated with those identities that can enhance health, but there are also important risks associated with those identities that can compromise health. Pearson talks with Sanford's Dean, Kelly Brownell. Music: Impromptu in Blue by Kevin MacLeod is licensed under a Creative Commons Attribution license. Artist: incompetech.com/

What happens when there are very high hopes for a particular policy idea, and then researchers conclude the results are not as promising as they once seemed? Are there lessons to be learned from this? A widely hailed initiative that combines franchising business models and telemedicine to deliver better quality health care in rural India has failed to improve care for childhood diarrhea and pneumonia, found a large-scale study by Assistant Professor Manoj Mohanan and researchers at Stanford and University College London. Manoj Mohanan is an assistant professor at the Sanford School of Public Policy at Duke. He’s also appointed in Economics at Duke and as an assistant research professor in the Duke Global Health Institute. Mohanan talks with Sanford's Dean, Kelly Brownell. Music: Impromptu in Blue by Kevin MacLeod is licensed under a Creative Commons Attribution license. Artist: www.incompetech.com/

Is the United States a country in inevitable decline, or are we a country in renewal? Should our foreign policy commitments include indefinite deployments of United States troops, or should we rely on our allies throughout the world to help maintain our interests? These are the kinds of questions the next administration will have to face, Peter Feaver says. Peter Feaver is Professor of Political Science and Public Policy at Duke. He also serves as Director of the Duke Program in American Grand Strategy. He served in the White House during two administrations. Feaver talks with Sanford's Dean, Kelly Brownell.

As we edge ever closer to election day in the U.S., Sanford professor Peter Feaver argues it’s time to critically examine the country’s grand strategy. He says the need to do so is becoming ever more pressing. He hopes the next president will assess the underlying assumptions of the country's grand strategy and have a sense of urgency to deal with what he calls a foreign policy crisis. Peter Feaver is Professor of Political Science and Public Policy at Duke. He also serves as Director of the Duke Program in American Grand Strategy. He served in the White House during two administrations. Feaver talks with Sanford's Dean, Kelly Brownell. Image by Thomas Hawk, licensed under a Creative Commons Attribution license.www.flickr.com/photos/thomashawk/ Music: Impromptu in Blue by Kevin MacLeod is licensed under a Creative Commons Attribution license. Artist: www.incompetech.com/

One of the most highly anticipated Frontline documentaries of the year premieres this week on PBS. "The Choice" takes a close look at Hillary Clinton and Donald Trump in an unusual way. Rather than interview Trump or Clinton directly, filmmakers interview the people in their lives: childhood friends and former colleagues, for example. The idea is, if we can better understand where they came from and what’s shaped them, we will gain insight into what kind of President each would be. Kelly Brownell talks to one of the film's producers, Phil Bennett. 

Kelly Brownell and Billy Pizer discuss the pros and cons of different policy approaches to climate change, from carbon taxes to cleaner automobiles and renewable energy. They also discuss the potential for these options to succeed given the polarized political landscape. From 2008 to 2011, Pizer was deputy assistant secretary for environment and energy in the U.S. Department of the Treasury, where he created and led a new office responsible for the department’s role in the domestic and international environment and energy agenda of the U.S. Pizer joined the faculty of the Sanford School of Public Policy at Duke University in the fall of 2011. The two discuss the pros and cons of different policy approaches to climate change.

Last season Eating Matters  had pediatric endocrinologist, Dr. Robert Lustig, on the show to discuss sugar and its negative impacts and this week, as a follow up, Jenna Liut and Austin Bryniarski focus on the one sugary product that is arguably most harmful for your health – sugary drinks. There has been much in the news on sugary drinks in the past six months – from the NYT, for example, reporting Coca-Cola’s funding of scientific studies that shifts focus away from diet’s role in obesity to the recently reported success of the soda tax in Mexico. Taking a look back at when and why the public health community first started to target sugary drinks in addition to discussing what’s on tap for soda policy in 2016 given recent events, Jenna and Austin welcome two public health and food policy experts – Dr. Kelly Brownell and Jim O’Hara.  Tune in for a great show! “What you should do is make these products show their real cost, and that’s what a soda tax does. That money is then allowed to be used for the the prevention efforts.” [27:30] –Jim O’Hara on Eating Matters  

Coca-Cola, the world’s largest maker of sugary sodas, is under fire for giving millions of dollars to a group of scientists who say that lack of exercise is much more important cause of obesity than poor diets. Are they right? Is Coke using scientists to reverse the recent decline in soda sales? And what are the best ways to solve America's obesity crisis? Kelly Brownell, Dean of the Sanford School of Public Health at Duke University, is our guest. See acast.com/privacy for privacy and opt-out information.

Kelly Brownell is the Dean of the Sanford School of Public Policy at Duke University. Stephen Morrissey, the interviewer, is the Managing Editor of the Journal. K.D. Brownell, J.L. Pomeranz. The Trans-Fat Ban - Food Regulation and Long-Term Health. N Engl J Med 2014;370:1773-5.

Guest: Kelly Brownell, PhD Host: Larry Kaskel, MD It has been billed as the biggest boon to public health since tobacco taxes. And a one-cent per ounce tax on sodas could bring in as much as $400 million of annual revenue for the state of New York alone. How would a tax on sugared beverages impact our health and health care budget? Would the general public throw enough support behind this policy shift for politicians to think about putting it on the books? Host Dr. Larry Kaskel wades into the debate over soda taxes with Dr. Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University, where he is also a professor of epidemiology, public health and psychology. Dr. Brownell, who recently co-authored a New England Journal of Medicine article with then-New York City Health Commissioner Dr. Thomas Frieden in support of a soda tax, shares the scientific evidence that supports his position. He also considers other viewpoints in this debate: if a soda tax won't work, could we find a better way to discourage our insatiable taste for these sugary drinks?

Tomas Philipson, Professor in the Harris School and Faculty Member in the Department of Economics and Law School at the University of Chicago, talks to Kelly Brownell, Director of the Rudd Center for Food Policy & Obesity, about the economics of obesity.