The Leading Voices in Food

I'm delighted today to be joined by Dr. Joseph Skelton, professor of Pediatrics, founder and director of Brenner Fit, a program at Wake Forest University School of Medicine. FIT stands for Families in Training, which is a family-based pediatric obesity program. He's the author of a new book on children and their weight, a topic we discussed in a separate podcast. But in this podcast, we're talking about something he teaches at Wake Forest, a course in culinary medicine. This is a fascinating, pioneering area of focus, so let's dig in. Interview Transcript There's a lot of language about medicine and nutrition now, so people talk about food as medicine. There's a move afoot to get more training and nutrition and medical education, and here you are doing culinary medicine. Tell me how all these things differ from one another. Our interest in this here at Wake Forest School Medicine started a little organically with our program. A lot of what we do is focus on family meals. There are decades of research showing the benefits of family meals, not only for the nutrition and obesity risk, but the quality of nutrition, time spent together, parent child communication. Kids are less likely to get pregnant or do drugs and alcohol. All these things from just spending that time together over the meal. And I inherited a small teaching kitchen that was at a local organization that someone before me had gotten funding for. And we, sort of, took it over and used this opportunity to teach families how to cook. And a lot of families know how to cook but trying foods in different ways and to get kids involved and things like that. Then a couple years after that, the local YMCA approached us. They had some space and wanted to do this as a partnership. So I became a fundraising machine for a year or two and took a lot of dinners to raise the funds. And we built this gorgeous teaching kitchen, and we were mainly doing it in the efforts of sort childhood obesity treatment or prevention, getting families, teaching them new recipes, which then kind of extended to that whole key thing of getting families just to be comfortable in the kitchen and spending that time together. And we just started seeing these amazing things. We always say we've converted more kids to Brussels sprouts than I think any other effort of just getting them cooking it a different way. You and I were both probably raised with steamed Brussels sprouts, which I think is an abomination. If you really want to highlight the sulfur smell of a food, then you're going to steam it. And so, we really started to do that. And then students started volunteering. Actually, it was a student, Josh Patman, he's an emergency medicine physician now at East Carolina University, and he was a cook in a professional kitchen college. And he said, hey, could I help volunteer with that? And then more student medical students wanted to do it. And then we all found that you, much like I did, I'm a self-taught cook myself, and the more time you spend in that, the more you learn, the more comfortable you are. And the more you start to know, you know, I can teach med students nutrition all day, but that doesn't teach them how to get nutrition on their patients' plates, into their mouth. And so it really grew from there. And then I, kind of, stumbled upon what other people were doing. It started in New York, but the biggest program started was really Tulane School of Medicine that had it as a very focused way about teaching nutrition through cooking. Not just on a blackboard through PowerPoint slides and stuff like that of like hey, let's teach it in a different way. And the old-fashioned analogy, and actually the medical educators hate this, it used to be see one, do one, teach one. That was sort of the old surgical thing. And so, it's really you got to see how to make a recipe and you got to do it yourself. And what we found that when students start then teaching each other, or teaching patients or...

So going back more than 30 years, I was involved in work on childhood obesity. It was a prevalent problem at the time, but little attention was being devoted to children and weight issues. And it was fair to say that the field, as it were, was an academic backwater. Little was known about short and long-term effects of childhood obesity. The social and emotional lives experienced by the children hadn't really been documented or studied much. There was very little known about treatment or strategies for parents, but thankfully, things are different now. Thanks in part to the work of a number of really innovative people in the field, and one of the most innovative is our guest today, Dr. Joseph Skelton. He's a professor of pediatrics and founder and director of Brenner Fit. FIT stands for Families in Training, which is the family-based pediatric obesity program at Wake Forest University School of Medicine. He's also editor of the Journal of Childhood Obesity is involved in clinical care, research, education, and community outreach. Dr. Skelton has just published what I think is a really important book through the American Academy of Pediatrics, entitled Your Child Is Not Their Weight: Parenting in a Size Obsessed World. I was asked to review the book and was delighted to see it before it was published and just was so happy to see that such a book existed at all, but such a good quality book at entering the picture. Really a very important advance in our field. Interview Transcript There have been some books about pediatric weight issues in the past. Who is this book for and how is it different than what's been out there? I feel overall the big audience for this book is any parent, especially of my generation, that were raised during some really toxic diet culture in the '70s, '80s, and '90s. And so, I think the main folks that that's for is that parent: I want my kids to eat healthy, to be active, to lead healthy lives. But I don't want them to become concerned about their weight to feed into our culture's focus on the ideal body image. I don't want to feed into that. But you know I do want to pay attention to the health habits. How can I do this in a healthy way? How can I focus on health habits with my kid that's not a focus on weight and do it in a way that's backed up by science. You know, that's what parents always want to know. Am I doing this right? Am I causing harm? And it is actually who the book is dedicated to, you know, all those parents that were raised in a toxic diet culture and want to do things differently with their children. So, in modern day America, what is life like for a child whose weight exceeds the standards that we know might be healthy, and for the parents who are raising those children? From personal experience and 20 years of running a program, as well as what the research shows, it can be kind of rough. Despite a lot of the advances that we've made around weight bias we're still in a place that kids are trying to live up to this idealized body image. And then they have all these toxic messages when it comes to nutrition and body image. I think it's rough. We know that kids in bigger bodies tend to have a lower quality life. They tend to have more symptoms of depression, anxiety; and it's because of this world that we live in. You mentioned messages that they might be getting from places like the media, but what are interactions like with peers and teachers and doctors and others in their lives that are affecting how they feel? Yes. So, the adults in their life were raised in that toxic culture. They're my generation and the generation behind me that was raised in that. You know, there's the myth that a smaller body is healthier than a bigger body. And I think we can't break away from that. And I think that still sort of comes through. We still see this as a lifestyle issue, and everyone has an opinion. Everyone has a thought of, you know, well, I did this... and I lowered my cholesterol......

It's the story of a guy on a road trip across the country, checking out America's classic greasy spoons. And the adventure is all about finding the restaurant owners and creative cooks serving up the very best of down-home style food. That's the premise of the hit series Diners, Drive-Ins, and Dives starring everyman chef Guy Fieri. Today we're going to talk with the show's creator, two-time Emmy Award winning food journalist and executive producer David Page. Interview Transcript David, I can't wait to talk to you about the show. But before we dive in and talk about the specifics, how long did the show run and how many episodes were done? My impression it's still on and it's always been there. Yes. I created it in 2006, 2007. I did the first 11 seasons and moved on. And funny story, in the first month of the show we had a couple of strong initial outings. And everyone was all excited thinking maybe this will be a hit. A food network executive called me up to tamp down my expectations and said, look, this is all fine and dandy, but this thing isn't gonna go more than a season or two. There's just not that many restaurants. And you know, to quote the great screenwriter William Goldman whose rule of Hollywood is 'no one knows anything.' I did 11 seasons. It's now in season 40 or something, I think. Holy cow. I could just think of enough restaurants around me to do a couple of seasons worth. So, tell us the origin story. How did Diners, Drive-Ins and Dives come about? Well, I had left a career in network news and moved to the Twin Cities because I thought I wanted to be in business for a public corporation. And I took a job as the Senior Vice president at a home shopping channel, and I was all excited, and I hated it. It was just horrible. I did not want to sell second rate gold jewelry to shut ins. So, I quit, and I opened a production company and began to starve because I wasn't selling anything. Then I called Al Roker, who has a production company and who had technically worked for me, although stars don't work for executive producers in the real world. When I was the co-producer of the Weekend Editions of the Today Show. Al was on the weekend show at the time. He hadn't yet moved up to the big show. And I said, hey, Al, I'm starving. You got any work you could throw me? And he said, yeah, I'm doing a lot of stuff for the Food Network. I'll subcontract some of it to you. Which was good for both of us. I got to work, and Al got to take a cut without doing anything. So, that hooked me up with the Food Network. I started working for them and Al and I both knew I wasn't gonna get rich doing a pass-through deal, so I started pitching them directly. And I was getting nowhere. There was this very nice development exec who would talk to me on the phone. And everything I proposed she would shoot down. And one day I'm on the phone with her and we're going through a pitch call and I'm proposing this and proposing that, and she's saying, no, no, no. Finally, the Food Network had asked Al to do a documentary on diners and the history of diners and such. And Al had subcontracted it to me. So, this development exec had a frustration and I think pity for me and finally said to me on this call, don't you have another thing on diners? And I immediately, I said, oh, absolutely. I'm developing a show called Diners, Drive-Ins and Dives. And I told her all about it. And this was like late on a Thursday or Friday afternoon. And she said, 'you know, that sounds good. We have a development meeting Tuesday. Get me a writeup on Monday.' And I got off the phone elated because it was the first time she'd expressed interest in anything. But also, I'd kind of put myself in a jam because I was not developing a show called that. I had literally pulled the title out of thin air. Or a body part, depending upon how scatological you want to get. And that gave me the weekend to try to put a pitch together. So, this was in the old days when you didn't email...

If someone asked you about French, Korean, or Thai food, you could probably name some signature flavors and dishes. I certainly can. Well, what about American food? What stands out for you there and what IS it, really? Today we're going to dig into the roots of American cuisine with food journalist David Page, who initially was an investigative journalist but turned his attention to food. And he's author of a book called Food Americana: The Remarkable People and Incredible Stories Behind America's Favorite Dishes. But you might also know David's work from television. He was executive producer on the hit series Diners, Drive-Ins, and Dives for 11 years. He has two Emmy awards and has his own podcast series, which is excellent, called Culinary Characters Unlocked. Interview Transcript So, here's the book: Food Americana. It's really a wonderful read and, you know, every case study you go through in the book, like pizza, Chinese food, Mexican food, every one is completely fascinating. I'd love to dive in and hear more about your thoughts about how all this unfolded. So, is there such a thing as American cuisine and how did you come to write this book, Food Americana? Well, the short answer is yes, there's American Cuisine. I came to write it out of personal experience. I became really deeply interested in food when I was posted overseas for NBC News as a producer and traveling from country to country, pre-Internet. And not ever having expected to leave America. I mean, they called me up one day and said, Hey, you wanna move to England? And from there I moved to Germany and then Budapest, Hungary. I was remarkably unprepared for all of the places I was being sent. And I kind of had a study pretty quickly. And I found that one of the best ways to understand a country or culture was through its food. You know, why do they eat so much wild boar in Tuscany? Well, because it was historically a poor region. And if you wanted to eat, you had to kill something. And what you were most likely to find that you could kill was a wild boar. When you go to Strasburg in France, why are you eating Germanic choucroute, which is, you know, pork on top of sauerkraut. Well, that reveals to you that that area went back and forth in terms of which country owned it forever. And that really awakened in me a deep interest in food. When I got back to the States, I eventually ended up creating Diners, Drive-Ins and Dives. And that got me deep into American food, if you will. And, more and more over time, I stockpiled stories and interests and decided as all TV producers do eventually, whether they actually act on it or not. Everyone thinks it's easy to write TV and it's hard to write a book. Those of us who are TV producers carry a chip on our shoulder because frankly, it's harder to write for television. You can't just sit down and type out whatever you want to type out. You've got to figure out the words that integrate with the pictures and that can move the pictures forward. But, you know, we all think we have a book in us, and I said, what interests me? And it was this. And I dived in; thoroughly enjoyed the process. To answer the other half of the question, I came to the conclusion looking at everything that I had put on Diners, looking at every place that I liked eating in various towns, there was a cuisine. It was something we constructed, much like we constructed American democracy out of other countries and cultures. And you know, when you go to a Chinese restaurant in America, all of us have gone with that real bore who looks up and says, this isn't authentic Chinese food. Well, no, it's not authentic Chinese food. It is authentic Chinese American food. Just as, with the exception of something called polpette, which are very small round meatballs, there are no meatballs as we know them in Italy. When the poorest of the poor left Southern Italy to come to the United States in the 1800s, to their shock when they got here, they found out that...

Transcript Paper: Gearhardt AN, Brownell KD, Brandt AM. From Tobacco to Ultraprocessed Food: How Industry Engineering Fuels the Epidemic of Preventable Disease. Milbank Q. 2026;104(1):0202.https://doi.org/10.1111/1468-0009.70066 https://www.milbank.org/quarterly/articles/from-tobacco-to-ultraprocessed-food-how-industry-engineering-fuels-the-epidemic-of-preventable-disease/ Ashley, let's talk a little bit about, just set the stage for what this paper was all about, and since it was your brainchild, you approached Allan and me about being involved. Tell us what you set out to do and why you thought these issues were worth digging into. Ashley - You know, I've just been so struck that when we think of cigarettes, they were something that's so common, so normal that we kind of think, oh, they've always just sort of been there. But truly, they're just taking a natural plant from the ground and through advancements and corporate engineering and technology and knowhow, they took a poisonous plant and made it into the most deadly and addictive drug in human history. And yet that was, you know, just accompanied by tons of debate. It didn't look like other addictive substances. And I just really felt like, man, we're reliving this history right now when it comes to how we've altered our food supply. I wanted to really bring you all together and see if we could really lay that story out of the, the parallels of these two public health crises. We'll get in a minute into the issue of what you discovered, but tell us what you covered, what the paper was meant to do. Ashley - The paper really goes back from how you take the tobacco plant in the field, or the corn in the field, and walks essentially through all the kind of levers that are being pulled to transform it in very specific ways. And through specific technologies and corporate practices that are being shared by modern cigarettes and ultra processed foods. These products maybe look harmless on their face initially, or don't look like they're just maybe pleasurable or craveable. But truly, I would argue that they've crossed thresholds into things that are addictive and clearly damaging many people's lives. Okay, so several decades ago, I don't know who came up with a term, but there was a lot of discussion about similarities between tobacco industry behavior and food industry behavior. And the press started publishing cover pieces that would say food is the next tobacco. And it was a term that the food industry really didn't like, and they don't want that comparison at all. It'll be interesting to see whether they deserve it. You clearly made that connection in this paper. Allan, let's turn to you. Oh my God. I mean, we could do a 15-hour podcast and not cover the history of the tobacco industry. There's so much to say, enough that you wrote a massive book about it. But give an overall sense, if you will, of the kind of tactics and morality of that industry. Allan - Well, as Ashley already mentioned, early in the 20th Century we wouldn't really be thinking much of cigarettes, and they were just a very peripheral sales consumer item. And over the course of the 20th Century, we came to a point in the middle of the century of the 1970s, and '80s where about half of all American adults were smoking cigarettes regularly. I wanted to understand that. How do you take something that's at the very margin of the economy and culture and make it a dominant consumer force? And I think in that way, we have certain parallels to ultra processed foods. But then there were the questions, how do you make it so popular? Is it dangerous to use? Is it addictive? Does it cause disease? And how do you resist regulation and other public health approaches to try to keep people smoking? And I found a lot of evidence in each of those areas, both of how the industry acted. And when you say, you know, it's ultra processed food like cigarettes, we're learning a lot about ultra processed foods. But we know...

In 1881, African American educator and political leader Booker T. Washington founded Tuskegee Institute in Tuskegee, Alabama. The school's mission was to provide practical education and vocational training in fields such as agriculture and mechanics to African Americans in the post-Reconstruction South. Tuskegee ultimately became a world-renowned agricultural and industrial school for African Americans – and actually for all people. Today, we're speaking with Duke University's Jarvis McInnis about his award-winning book Afterlives of the Plantation: Plotting Agrarian Futures in the Global Black South. Interview Transcript Jarvis, I cannot tell you how much I appreciate this book. And hopefully we'll make a link to the Franklin Humanities gathering (https://youtu.be/rfSy1lWWOwA?si=dVcWH3xDBuBStEEc) that we had for your book launch. As I said at that time, and I'll say it right now, this book resonated with me so deeply because of my rural upbringing. My experience as a son, a grandson of farmers and agricultural workers. And someone who grew up in the 4-H Club down South. Hopefully we will get to some of those topics as we go through. So, let's start off with a real basic idea. Could you give our readers an overview of what the book is? And also, about what you mean by the Afterlives of the Plantation. Yes, absolutely. Thank you so much for that question, Norbert. The book is an effort to think about the cultural and intellectual and political ties between Southern African Americans and Afro-Caribbean people in the late 19th to early 20th Century as they were responding to the legacies of slavery, right? This is the period after emancipation, and across the hemisphere. And so, I'm really interested in the way that they are sharing ideas as they are confronting the new modes of racial oppression that emerged in slavery's aftermath. In the United States, you have Jim Crow, right? Segregation, and other forms of violence and dispossession like lynching and land dispossession and so forth and so on. And then in the Caribbean, in Latin America, you have institutions like the European colonialism, and US imperialism, right? And so that is the afterlife of slavery. They're emancipated, but it's not a period of full citizenship, right? Of full access to the rights and privileges of citizenship. And so in telling that story, I center Booker T. Washington's school, the Tuskegee Institute, which was founded on the site of an abandoned and burned cotton plantation in Alabama in 1881. And this is getting at the second part of your question. I became really fascinated by what it meant to establish a school, to establish a future-oriented institution, that's committed to uplifting Black people. To establish that on the site, on the ruins of a burned plantation. And, in some ways, I became curious about that as an undergraduate student because I'm a graduate of Tougaloo College, in Tougaloo, Mississippi, which is a historically black college much like Tuskegee. And much like Tuskegee, Tougaloo was also founded on the site of a former cotton plantation. And I saw that this idea, or this practice, this logic of transforming these sites of violence into something that is more liberatory and more emancipatory was really a strategy that Black people used throughout the US South and throughout the Caribbean. Throughout much of the Americas where slavery and the plantation had existed. I placed Tuskegee, and particularly its approach to agriculture, at the center of that story to demonstrate how an institution rooted in the US South is not backward. It's not pre-modern. That's firmly rural, but that rurality... they're taking the knowledge that's cultivated there and disseminating it to other Black people in other parts of the world to aid in their struggles toward freedom and citizenship. I think this is an important point to make. And I know we've had conversations about this as you were developing the book. And I'll just say again, out of...

Over the last several years, I have been thinking about food waste and food loss a lot. It's been a topic that we've seen in many spaces in the US and around the world. And it's interesting to compare how the US handles food waste with other countries. To that end, we will learn more about how Belgium addresses food waste in a conversation with an anthropologist and journalist, Dr. Kelly Alexander from the University of North Carolina at Chapel Hill. Her book, Truffles and Trash: Recirculating Food in a Social Welfare State, explores community driven solutions and policy around food waste. And Belgium's capital city of Brussells. Interview Transcript Let's start with your research in Brussels at a high end truffle restaurant... but you ended up in food banks and social restaurants and community kitchens. Tell us a little bit about the evolution. How did this project evolve to finding yourself in these new places? Yeah, it's a, a strange trajectory. I did not start out to be a food waste researcher. But how it started and how it's going, you know, that meme from 2018? This is like what I love to talk about when I talk to my food study students, because I started out, as a researcher, very interested in the development of haut cuisine. I had worked in a lot of restaurants. I had worked as a journalist for several food magazines. And the question that really animated me was how a truffle, this little spore on a fungus, has become one of the world's most expensive ingredients. And so I was doing ethnographic research in the kitchen of a Michelin starred truffle restaurant. And there is not that many of those, and one of them happens to be in Brussels, Belgium. And I'm in the kitchen there and I'm working on the line. And I usually have to specify to my students like it wasn't a stunt. Like you can't write to a Michelin star restaurant and say, 'Hey, can I come on in and work in your kitchen?' I had a lot of credentials as a journalist and as a chef first. What I did have going for me is that I was in a funded doctoral dissertation program, actually the anthropology program at Duke. So, I had funding to go and do that research in this kitchen. And there's probably no restaurant in the world, no matter how high end, that is not willing to accept some free labor. So, I'm working in that kitchen. I'm working with fantastic chefs. And what happens when you work at a super high-end restaurant is that is aesthetics are valued above all else. The food has to be really, really beautiful. And this restaurant charges extraordinarily. It's called La Truffe Noire. It's still in Brussels now. It's a truffle restaurant. The black truffle. Super high prices for very, very refined food. And in order to do that, a large part of my job was brushing priceless truffles, throwing away an unbelievable amount of very beautiful produce that would otherwise have been exceptionally valued in other contexts. And I come from a background - my grandmother was a Russian Jewish woman. She grew up in Brooklyn. She moved to Atlanta, Georgia after World War II. She taught me to cook, and she never threw anything away. And when I say that to people, I think they're like, oh yeah, I have a grandmother like that. But she really never threw anything away, like can of grease under the sink. The whole thing. Every little butt of a vegetable was saved for stock for later. And I was throwing away so much good food working in La Truffe Noire just making beautiful garnishes and vegetable carvings and things like that, that I started following the food waste around the city. I was wondering where all of this went. And I actually asked the chef in the restaurant, you know, we throw away so much food, would it be possible to give some of it to people who could really use it? And his response really interested me and changed the whole course of my research because he said, I am really willing to do that. However, I pay chefs to cook food and not to give it away. So, if...

It seems like the frequency of weather-related disasters is increasing. Across the US we're seeing wildfires, tropical storms and hurricanes, extreme heat, extreme cold with snow or ice. And torrential rain leading to a loss of property, life, and livelihoods. What's more, similar extreme events are happening across the globe. These disasters all can have an impact on our food supply and the ability of people to access food. Today, we're speaking with environmental sustainability management expert, Betsy Albright, who is an associate professor of the practice at Duke University's Nicholas School of the Environment. Betsy's research centers on how policies and decisions are made in response to weather related disasters. Interview Summary Betsy, I've been wanting to have you on the podcast for a while, so I'm excited to get you now. So, let's begin with the first broad question. I'd be really interested to learn a little bit more about your research to make sure that our listeners are up to date on it. And I know you really study disasters, but could you explain or expand on what that really means for our listeners? I'm an environmental social scientist who studies the human and social side of disasters. And I ask questions about how climate related disasters or climate driven disasters, or weather disasters affect communities and households. And how individuals perceive risks from disasters, how they're affected by disasters, how they learn from make changes and adapt after disasters. My work started with my dissertation in central Europe. I had a Fulbright in Hungary. But from then I've expanded and moved most of my work to the US context. And our research team and I have done work on flooding and wildfires in Colorado, hurricanes in North Carolina. And I'm also working on a study of the flows of disaster assistance funds from FEMA to communities. And all of this is with or through a lens of equity or inequities and thinking about that across the disaster cycle. This is really important, and I remember being at a conference with you and learning about your work. And I was struck by what happens after the disaster. And in particular what happens to availability of food. And I work with the food bank here in North Carolina. And one of the things I know is when there is a disaster, like when Helene hit Asheville, there are real challenges in getting food out to people. Does your work touch on those topics as well? Yes. I would not say that our work centers on food, but food definitely intersects across all phases of the disaster cycle from preparing for disaster, experiencing disaster, the immediate response- that food bank getting food out- to long term recovery and thinking about risk mitigation. And we can think about that, you know, through a number of different lenses. Both on the food access side, but also on the food systems agriculture side as well. As I mentioned earlier, I take an equity lens on much of the work that we do. It's really important to recognize that disasters hit unevenly across society, across the landscape. Disproportionately they magnify social and environmental stressors that are already there. Communities with limited access to wealth, limited access to food, who are underserved, rural communities, racialized communities, often experience greater impacts from disasters. Disasters occur on top of histories of disenfranchisement. For example, centuries of marginalization of the minoritized Romani peoples of Central Europe they've seen great impacts from flooding. And in North Carolina, Black and African American communities whose ancestors were enslaved and suffered land loss through racist systems of who gets access to loans, access to land ownership. And because of these systems and processes, communities, families, individuals may live on marginal lands, may not own their lands. Their lands may be more prone to flood risk. May be underserved. Their housing may be more at risk. They may rent and...

As global demand for meat grows, this episode of Duke University's Leading Voices in Food podcast examines cell-cultivated protein—real meat grown from animal cells—and the evolving U.S. policy landscape shaping its future. Host Norbert Wilson (Duke World Food Policy Center) speaks with postdoctoral researchers Kate Consavage Stanley (Duke/Bezos Center for Sustainable Proteins) and Katariina Koivusaari (NC State/Bezos Center) about their article in Trends in Food Science and Technology on U.S. regulatory and legislative activity. The conversation explains the joint FDA–USDA regulatory approach for cell-cultivated meat (FDA oversight through cell cultivation; USDA oversight from harvest through processing, packaging, and labeling) and FDA oversight for cell-cultivated seafood (except catfish). They discuss timelines companies report for approval (often two to three years), the lack of federal public guidance on naming and labeling so far, and how USDA label approvals are currently handled case by case (e.g., "cell-cultivated chicken" and "cell-cultivated pork"). The episode also covers state-level labeling laws and the likelihood of federal preemption if state requirements conflict with federal statutes, as well as a growing wave of state restrictions and bans—Florida and Alabama in 2024, followed by Indiana, Mississippi, Montana, Nebraska, and Texas in 2025—plus funding restrictions in South Dakota and Iowa. The guests explore implications for consumers, interstate commerce, innovation, investment, and U.S. leadership, noting ongoing lawsuits in Florida and Texas and continued legislative activity such as a proposed ban in Georgia. Interview Transcript Kate, let's begin with you. In the paper, you write about the regulatory frameworks that have been developed for cell-cultivated meat and seafood products in the US. To start, let's talk about what's unique about cell-cultivated products from a regulatory standpoint and how the US Department of Agriculture and US Food and Drug Administration have decided to handle cell-cultivated protein products. Kate - Yes, so as you mentioned in the introduction, Norbert, cell-cultivation is a new technology for use of the food supply. So, the US government had to adapt its existing legal frameworks for food safety regulation. As your listeners may already know seafood is regulated by the FDA, so it was within their scope to also regulate cell-cultivated seafood. The FDA therefore regulates all cell-cultivated seafood products with the exception of catfish. When it came to determining the regulatory approach for cell-cultivated products from livestock, poultry, and catfish, it was a bit more nuanced as the processes and components evolved fell under both USDA and FDA purview. In 2019, the FDA and USDA therefore agreed on a joint regulatory approach where the FDA regulates the early stages of the cell cultivation process, including when those cells are taken from the animal, grown in the bioreactor, and matured into specific cell types such as muscle or fat cells. At the point where those cells are ready to be harvested from the bioreactor to use in a food product, oversight transfers to USDA who oversees that harvesting process as well as food processing, packaging, and labeling. I know this joint regulatory approach may sound complicated, but it's important to note that USDA and FDA already coordinate oversight over other foods in the food supply. I'll give you an example that we all love pizza. A frozen cheese pizza is regulated by the FDA, whereas a frozen pizza with meat toppings like pepperoni is regulated by the USDA. It is therefore not unprecedented that FDA and USDA would agree to jointly regulate cell-cultivated products. And while the process is new, the products go through the same safety checks as other foods in the food supply. In the past few years, we've seen four cell-cultivated meat products go through the joint USDA-FDA regulatory process, meaning they can be sold...

Do you ever wonder whether your grocery store cares about whether you have a healthy diet? Every time we shop or read advertisement flyers, food retailers influence our diets through product offerings, pricings, promotions, and of course store design. Think of the candy at the checkout counters. When I walk into my Costco, over on the right there's this wall of all these things they would like me to buy and I'm sure it's all done very intentionally. And so, if we're so influenced by these things, is it in our interest? Today we're going to discuss a report card of sorts for food retailers and the big ones - Walmart, Kroger, Ahold Delhaize USA, which is a very large holding company that has a variety of supermarket chains. And this is all about an index produced by the Access to Nutrition Initiative (ATNi), a global foundation challenging the food industry investors and policy makers to shape a healthier food system. The US Retail Assessment 2025 Report evaluates how these three businesses influence your access to nutritious and affordable foods through their policies, commitments, and actual performance. The Access to Nutrition Initiatives' director of Policy and Communications, Katherine Pittore is here with us to discuss the report's findings. We'll also speak with Eva Greenthal, who oversees the Center for Science in the Public Interest's Federal Food Labeling work. Interview Transcript Access ATNi's 2025 Assessment Report for the US and other countries here: Retail https://accesstonutrition.org/index/retail-assessment-2025/ Let's start with an introduction to your organizations. This will help ground our listeners in the work that you've done, some of which we've spoken about on our podcast. Kat, let's begin with you and the Access to Nutrition Initiative. Can you tell us a bit about the organization and what work it does? Kat Pittore - Thank you. So, the Access to Nutrition Initiative is a global foundation actively challenging the food industry, investors, and policymakers to shape healthier food systems. We try to collect data and then use it to rank companies. For the most part, we've done companies, the largest food and beverage companies, think about PepsiCo, Coca-Cola, and looking are they committed to proving the healthiness of their product portfolios. Do the companies themselves have policies? For example, maternity leave. And these are the policies that are relevant for their entire workforce. So, from people working in their factories all the way up through their corporate areas. And looking at the largest companies, can these companies increase access to healthier, more nutritious foods. One of the critical questions that we get asked, and I think Kelly, you've had some really interesting guests also talking about can corporations actually do something. Are corporations really the problem? At ATNi, we try to take a nuanced stance on this saying that these corporations produce a huge amount of the food we eat, so they can also be part of the solution. Yes, they are currently part of the problem. And we also really believe that we need more policies. And that's what brings us too into contact with organizations such as Eva's, looking at how can we also improve policies to support these companies to produce healthier foods. The thought was coming to my mind as you were speaking, I was involved in one of the initial meetings as the Access to Nutrition Initiative was being planned. And at that point, I and other people involved in this were thinking, how in the world are these people going to pull this off? Because the idea of monitoring these global behemoth companies where in some cases you need information from the companies that may not reflect favorably on their practices. And not to mention that, but constructing these indices and things like that required a great deal of thought. That initial skepticism about whether this could be done gave way, at least in me, to this admiration for what's been...

In this episode of the Leading Voices in Food podcast, Norbert Wilson of Duke University's Sanford School of Public Policy speaks with researchers Jean Adams from the University of Cambridge and Mike Essman from Duke's World Food Policy Center. They discuss the mandatory calorie labeling policy introduced in England in April 2022 for large food-away-from-home outlets. The conversation covers the study recently published in the British Medical Journal, exploring its results, strengths, limitations, and implications within the broader context of food labeling and public health policies. Key findings include a slight overall reduction in calorie content offered by food outlets, driven by the removal of higher-calorie items rather than reformulation. The discussion also touches on the potential impacts on different consumer groups, the challenges of policy enforcement, and how such policies could be improved to more effectively support public health goals. Interview Summary Now everyone knows eating out is just part of life. For many, it's a place to make connections, can be a guilty pleasure, and sometimes it's just an outright necessity for busy folks. But it is also linked to poor dietary quality, weight gain, and even obesity. For policymakers, the challenge is identifying what policy changes can help improve population health. Jean, let's begin with you. Can you tell our listeners about the UK's menu labeling intervention and what change did you hope to see? Jean - Yes, so this was a policy that was actually a really long time in coming and came in and out of favor with a number of different governments. So maybe over the last 10 years we've had various different suggestions to have voluntary and/or mandatory calorie labeling in the out-of-home sector. Eventually in April, 2022, we did have new mandatory regulations that came into a force that required large businesses just in England - so not across the whole of the UK, just in England - if they sold food and non-alcoholic drinks and they had to display the calories per portion of every item that they were selling. And then have alongside that somewhere on their menu, a statement that said that adults need around 2000 calories per day. The policy applied just to large businesses, and the definition of that was that those businesses have 250 or more employees, but the employees didn't all have to be involved in serving food and drinks. This might apply also to a large hotel chain who just have some bars or something in their hotels. And the food and drinks covered were things that were available for immediate consumption. Not prepackaged. And then there was also this proviso to allow high-end restaurants to be changing their menus regularly. So, it was only for things that were on the menu for at least 30 days. You mentioned that this policy or a menu labeling might have at least two potential modes of impacts. There's first this idea that providing calories or any sort of labeling on food can somehow provide information for consumers to make what we might hope would be better choices. Might help them choose lower calorie options or healthier options. And then the second potential impact is that businesses might also use the information to change what sort of foods they're serving. It might be that they didn't realize how many calories were in the foods and they're suddenly embarrassed about it. Or as soon as their customers realize, they start to put a little bit of pressure on, you know, we want something a little bit lower calorie. So, there's this potential mechanism that operates at the demand side of how consumers might make choices. And another one at the supply side of what might be available to consumers. And we knew from previous evaluations of these sorts of interventions that there was some evidence that both could occur. Generally, it seems to be that findings from other places and countries are maybe null to small. So, we were thinking that maybe we might...

In this episode, Kelly Brownell speaks with Jerold Mande, CEO of Nourish Science, adjunct professor at the Harvard School of Public Health, and former Deputy Undersecretary for Food Safety at the USDA. They discuss the alarming state of children's health in America, the challenges of combating poor nutrition, and the influence of the food industry on public policy. The conversation explores the parallels between the tobacco and food industries and proposes new strategies for ensuring children reach adulthood in good health. Mande emphasizes the need for radical changes in food policy and the role of public health in making these changes. Transcript So, you co-founded this organization along with Jerome Adams, Bill Frist and Thomas Grumbly, as we said, to ensure every child breaches age 18 at a healthy weight and in good metabolic health. That's a pretty tall order given the state of the health of youth today in America. But let's start by you telling us what inspired this mission and what does it look like to achieve this in today's food environment? I was trained in public health and also in nutrition and in my career, which has been largely in service of the public and government, I've been trying to advance those issues. And unfortunately over the arc of my career from when I started to now, particularly in nutrition and public health, it's just gotten so much worse. Indeed today Americans have the shortest lifespans by far. We're not just last among the wealthy countries, but we're a standard deviation last. But probably most alarming of all is how sick our children are. Children should not have a chronic disease. Yet in America maybe a third do. I did some work on tobacco at one point, at FDA. That was an enormous success. It was the leading cause of death. Children smoked at a higher rate, much like child chronic disease today. About a third of kids smoked. And we took that issue on, and today it's less than 2%. And so that shows that government can solve these problems. And since we did our tobacco work in the early '90s, I've changed my focus to nutrition and public health and trying to fix that. But we've still made so little progress. Give us a sense of how far from that goal we are. So, if the goal is to make every child reaching 18 at a healthy weight and in good metabolic health, what percentage of children reaching age 18 today might look like that? It's probably around a half or more, but we're not quite sure. We don't have good statistics. One of the challenges we face in nutrition is, unfortunately, the food industry or other industries lobby against funding research and data collection. And so, we're handicapped in that way. But we do know from the studies that CDC and others have done that about 20% of our children have obesity about a similar number have Type 2 diabetes or the precursors, pre-diabetes. You and I started off calling it adult-onset diabetes and they had to change that name to a Type 2 because it's becoming so common in kids. And then another disease, fatty liver disease, really unthinkable in kids. Something that the typical pediatrician would just never see. And yet in the last decade, children are the fastest growing group. I think we don't know an exact number, but today, at least a third, maybe as many as half of our children have a chronic disease. Particularly a food cause chronic disease, or the precursors that show they're on the way. I remember probably going back about 20 years, people started saying that we were seeing the first generation of American children that would lead shorter lives than our parents did. And what a terrible legacy to leave our children. Absolutely. And that's why we set that overarching goal of ensuring every child reaches age 18 in good metabolic health. And the reason we set that is in my experience in government, there's a phrase we all use - what gets measured gets done. And when I worked at FDA, when I worked at USDA, what caught my attention...

In this episode of the Leading Voices in Food podcast, host Norbert Wilson is joined by food and nutrition policy economists Will Masters and Parke Wilde from Tufts University's Friedman School of Nutrition, Science and Policy. The discussion centers around the concept of the least cost diet, a tool used to determine the minimum cost required to maintain a nutritionally adequate diet. The conversation delves into the global computational methods and policies related to least cost diets, the challenges of making these diets culturally relevant, and the implications for food policy in both the US and internationally. You will also hear about the lived experiences of people affected by these diets and the need for more comprehensive research to better reflect reality. Interview Summary I know you both have been working in this space around least cost diets for a while. So, let's really start off by just asking a question about what brought you into this work as researchers. Why study least cost diets? Will, let's start with you. I'm a very curious person and this was a puzzle. So, you know, people want health. They want healthy food. Of course, we spend a lot on healthcare and health services, but do seek health in our food. As a child growing up, you know, companies were marketing food as a source of health. And people who had more money would spend more for premium items that were seen as healthy. And in the 2010s for the first time, we had these quantified definitions of what a healthy diet was as we went from 'nutrients' to 'food groups,' from the original dietary guidelines pyramid to the MyPlate. And then internationally, the very first quantified definitions of healthful diets that would work anywhere in the world. And I was like, oh, wow. Is it actually expensive to eat a healthy diet? And how much does it cost? How does it differ by place location? How does it differ over time, seasons, and years? And I just thought it was a fascinating question. Great, thank you for that. Parke? There's a lot of policy importance on this, but part of the fun also of this particular topic is more than almost any that we work on, it's connected to things that we have to think about in our daily lives. So, as you're preparing and purchasing food for your family and you want it to be a healthy. And you want it to still be, you know, tasty enough to satisfy the kids. And it can't take too long because it has to fit into a busy life. So, this one does feel like it's got a personal connection. Thank you both for that. One of the things I heard is there was an availability of data. There was an opportunity that seems like it didn't exist before. Can you speak a little bit about that? Especially Will because you mentioned that point. Will: Yes. So, we have had food composition data identifying for typical items. A can of beans, or even a pizza. You know, what is the expected, on average quantity of each nutrient. But only recently have we had those on a very large scale for global items. Hundreds and hundreds of thousands of distinct items. And we had nutrient requirements, but only nutrient by nutrient, and the definition of a food group where you would want not only the nutrients, but also the phytochemicals, the attributes of food from its food matrix that make a vegetable different from just in a vitamin pill. And those came about in, as I mentioned, in the 2010s. And then there's the computational tools and the price observations that get captured. They've been written down on pads of paper, literally, and brought to a headquarters to compute inflation since the 1930s. But access to those in digitized form, only really in the 2000s and only really in the 2010s were we able to have program routines that would download millions and millions of price observations, match them to food composition data, match that food composition information to a healthy diet criterion, and then compute these least cost diets. Now we've computed millions...

The gut is in the news. It's really in the news. Catapulted there from exciting developments coming from laboratories all around the world. Links of gut health with overall health are now quite clear and surprising connections are being discovered between gut health and things like dementia and Alzheimer's. But how does the gut communicate with other parts of the body in ways that make it this important, and where does the brain figure into all this? Well, there's some interesting science going on in this topic, and a leading person in this area is Dr. Diego Bohorquez. Dr. Bohorquez is the associate professor of medicine, of molecular genetics and microbiology and of cell biology at the Duke University School of Medicine. Interview Transcript Diego, your bio shows that you blend work in nutritional biochemistry, gastrointestinal physiology, and sensory neurobiology. It took me a little time to figure out just what these things are, but what this represents, to be a little more serious, is a unique ability to understand that the different parts of the body, the gut and the brain in particular, interact a lot. And you're in a very good position to understand how that happens. Let's dive in with the kind of a basic question. What got you interested in this interaction of the gut with the brain and why care about it? Yes. Kelly, I think that that's all technicalese for saying that we are at the interface of food, the gut, and the brain. Apart from the fact that we are what we eat and if we truly believe that then food will be shaping us. Not only our body, but also like our belief systems, our societal systems, and so on and so forth. I don't think that that is anything new. However, what is new is the ability of the gut to guide our decision making. And it was interesting to hear in your introduction that now the gut is all in the news. In 2005 when I came to the United States, and I was at North Carolina State University, and I joined a graduate school. I remember taking a graduate course in physiology in 2007. And when the professor opened the session on gastrointestinal physiology, he said the gut is one of the most misunderstood and mysterious organs. It has almost as many neurons as the spinal cord, or more. But honestly, we don't give a lot of respect to the gut. We only think that it does some digestion and absorption, and we judge it more for the value of its products of digestion than what it does for the entire body. And fast forward almost 20 years later now, partly my laboratory and other laboratories that have entered this field since some of our discoveries started to emerge, it's very clearly showing that the gut not only has its own sensory system that is behind what we call gut feelings. The gut feelings are actually real. But it actually can influence our decision making. Like specifically, we have shown that our ability to choose sugars and consume sugars and feel sugars and choose them over sweeteners, it can be pinpointed to a specific set of cells in the intestine called neuropod cells and specific receptors in those cells. And the intestine is right after the stomach. And this is where these cells are exposed to the surface of the gut and detect the chemical composition of food to guide our decision making. Let's talk about that a little bit more. So, you've got this axis, or this means of communication between the gut and the brain going on. And let's talk about how it affects what we eat. You just alluded to the fact that it's pretty important. What does it tell us? What to eat, how much to eat? What we like to eat? When we're hungry, when we've had enough? How does this affect our eating? We are beginning to understand how much it affects this eating. And obviously we are departing from understanding, right? And an understanding is cognitive. In the 1500s is when the idea of 'we think therefore we are,' came online. And we needed to think things before we actually will understand them. But well...

An avalanche of information besets us on what to eat. It comes from the news, from influencers of every ilk, from scientists, from government, and of course from the food companies. Super foods? Ultra-processed foods? How does one find a source of trust and make intelligent choices for both us as individuals and for the society as a whole. A new book helps in this quest, a book entitled Food Intelligence: the Science of How Food Both Nourishes and Harms Us. It is written by two highly credible and thoughtful people who join us today.Julia Belluz is a journalist and a contributing opinion writer for the New York Times. She reports on medicine, nutrition, and public health. She's been a Knight Science Journalism Fellow at MIT and holds a master's in science degree from the London School of Economics and Political Science. Dr. Kevin Hall trained as a physicist as best known for pioneering work on nutrition, including research he did as senior investigator and section chief at the National Institutes of Health. His work is highly regarded. He's won awards from the NIH, from the American Society of Nutrition, the Obesity Society and the American Physiological Society. Interview Transcript Thank you both very much for being with us. And not only for being with us, but writing such an interesting book. I was really eager to read it and there's a lot in there that people don't usually come across in their normal journeys through the nutrition world. So, Julia, start off if you wouldn't mind telling us what the impetus was for you and Kevin to do this book with everything else that's out there. Yes, so there's just, I think, an absolute avalanche of information as you say about nutrition and people making claims about how to optimize diet and how best to lose or manage weight. And I think what we both felt was missing from that conversation was a real examination of how do we know what we know and kind of foundational ideas in this space. You hear a lot about how to boost or speed up your metabolism, but people don't know what metabolism is anyway. You hear a lot about how you need to maximize your protein, but what is protein doing in the body and where did that idea come from? And so, we were trying to really pair back. And I think this is where Kevin's physics training was so wonderful. We were trying to look at like what are these fundamental laws and truths. Things that we know about food and nutrition and how it works in us, and what can we tell people about them. And as we kind of went through that journey it very quickly ended up in an argument about the food environment, which I know we're going to get to. We will. It's really interesting. This idea of how do we know what we know is really fascinating because when you go out there, people kind of tell us what we know. Or at least what they think what we know. But very few people go through that journey of how did we get there. And so people can decide on their own is this a credible form of knowledge that I'm being told to pursue. So Kevin, what do you mean by food intelligence? Coming from a completely different background in physics where even as we learn about the fundamental laws of physics, it's always in this historical context about how we know what we know and what were the kind of key experiments along the way. And even with that sort of background, I had almost no idea about what happened to food once we ate it inside our bodies. I only got into this field by a happenstance series of events, which is probably too long to talk about this podcast. But to get people to have an appreciation from the basic science about what is going on inside our bodies when we eat. What is food made out of? As best as we can understand at this current time, how does our body deal with. Our food and with that sort of basic knowledge about how we know what we know. How to not be fooled by these various sound bites that we'll hear from social media influencers telling you that...

Interview Summary You know I really like the innovative nature of Food On The Move, and I'm eager for you to tell us more about what it involves. But before we do that, how does a young, highly successful musician turn to battling food insecurity? What led you to create Food On The Move? It took me years to say I even created it. I didn't even use the term founder because I really had this sense of partnership that was a part of how it came to be. But I did found or 'start' Food On The Move because I have just a deep sense of gratitude in my life experience and also maybe a calling? I call it the tap on the shoulder that said there's more for you to do. There's more for me to do. And I didn't really know what that meant. I wanted to invest in Oklahoma and where we're from because as a musician, first you travel, you leave, you go out, you connect with people all over the world. But there's something about building and doing well for your community from the town you're from. And I was inspired by a former US ambassador. A man named Edward Perkins, who was an incredible representative of our country. He worked in some of the most difficult parts of the world representing the US and working with other nations. And his story struck me so deeply because he found ways to partner and transform communities as an ambassador. And I got to know him after his time as an ambassador because he was teaching as a professor at OU (Oklahoma University), in Oklahoma. And I asked him, I said - I want to honor your life. I want to learn from you. If I was to begin to really impact my community, Oklahoma where I'm from and maybe beyond, where would you begin? And he said, I would start with food. That's so interesting. You know, your concept of partnership is so interesting. I'd like to dive into that a little bit deeper in a little bit. But first, tell us about your organization and what it does, how it works, what it tries to accomplish. Yes. So, inspired by Ambassador Perkins' example, we set out to ask the right questions more than have the answers. And in 2014, I just basically cold called everyone in the community that worked in food - from the food bank to the food pantries and said ‘help me understand the gaps.’ Help me understand where it's hard to accomplish change. And the term food desert began coming up more and more. And food deserts are communities without grocery stores. So, think of it as the canary in the mine. Sort of when a grocery store goes, the neighborhood is declining. Because they're small margin organizations they have a hard time staying afloat and when they go it's hard to bring them back because you need either a company like a big chain or a small business that doesn't have a lot of resources. And oftentimes that decline continues, and it impacts the community. So, with Food On The Move I basically brought together partners to create an access point in food deserts where it's was all in kind. From food trucks that could bring great, tasty food and give people dignity and excitement and energy, to partners that are doing food safety training and teaching people to cook. And places like Oklahoma State University extension where they train people about how to prepare food because they may not know. And so, all these partners came together, and we basically spent five years just learning and serving people in those communities. And focusing on an environment that was not about raising a bunch of money; it was really about who is already in this space that we can garner relationships with and get to know the communities. And now those events continue to be flagships. We call them food and resource festivals. They are a pay-as-you-can. You show up, you get access to fresh produce, you have food trucks, you have wraparound services. You have people that are in the community, in different nonprofits, for-profits, and government organizations that we all collaborate with. And we reach people where they are while serving...

In today's episode, we're discussing the complex and urgent topic of global food demand. The United Nations Sustainable Development Goals, or SDGs, ask countries to make measurable progress in reducing poverty, achieving zero hunger, and supporting every individual in realizing good health. While also mitigating climate change, sustaining the environment and responsible consumption and production habits. Researchers have recommended sustainable diets - planetary health diets. For example, the Eat Lancet Planetary Health Diet. However, others have criticized some of these diets for not addressing the economic and social impacts of transitioning to such diets. Is it possible to balance changing diets, rising incomes, and economic growth with economic feasibility, environmental impact, and long-term sustainability? Well, that's what our goals are today. Our guests today are Andrew Muhammad of the University of Tennessee Institute of Agriculture, and Emiliano Lopez Barrera from Texas A&M. They are my co-authors on a new paper in the Annual Review of Resource Economics entitled Global Food Demand: overcoming Challenges to Healthy and Sustainable Diets. Interview Summary Andrew let's begin with you. Why is it important to study the economics of dietary habits and food choices in a global context? Well, it's important for several reasons, right? When we think both about food security as well as environmental outcomes and maintaining biodiversity, in keeping both human beings and the planet healthy, we really do need to think about this in a global context. One could see agriculture as a global ecosystem where decisions in one country clearly have impacts on outcomes in others. While at the same time, we need to see food as a means by which we satisfy the demands of a global community. Whether it be through our own domestic production or international trade. And then the last thing I'll say, which is really most important are all the actual things we want to tackle and mitigate and correct, fix or improve. Whether it be the environmental issues, global food security outcomes, individual diets, mitigating obesity issues globally, right? It's pretty clear that most of the things affecting human beings in the environment as it relates to agriculture are global in nature, and there's an economic component that we need to consider when addressing these issues in a global context. Thank you for sharing that. And I am interested to understand what the role of economics in dietary habits is as we explored it in this review paper. In economics, this is a pretty long history, one could say going back centuries, right? This idea of how income growth impacts food spending on a household or individuals, as well as what economic affluence in development does to sort of how diets transition. And so, for example, it's been long established, right, as individuals get richer, a smaller and smaller share of their income is spent on food. So therefore, food dynamics become less important in [a developed, rich country versus a developing country where a large percentage of income is still spent on food. And what does that mean? That means that while I may find price shocks annoying, and while I may find higher grocery prices annoying, in a developing world that clearly has some implications on the nutritional needs and food decisions far more than it would have on me, for example. But the other thing which is something that has been highlighted for quite some time, and that is this transition from basic staples - from rice, grain, corn, cassava, potatoes, etc. - to more complex food products like high protein dense meat products, fish, milk, dairy, and even highly processed products that are deemed unhealthy. But the point is, as we look at the full spectrum of countries from least developed to most developed, you see this transition from basic staples to these protein dense products as well as complex processed products. This is a really important...

Lots of talk these days about ultra-processed foods (UPFs). Along with confusion about what in the heck they are or what they're not, how bad they are for us, and what ought to be done about them. A landmark in the discussion of ultra-processed foods has been the publication of a book entitled Ultra-processed People, Why We Can't Stop Eating Food That Isn't Food. The author of that book, Dr. Chris van Tulleken, joins us today. Dr. van Tulleken is a physician and is professor of Infection and Global Health at University College London. He also has a PhD in molecular virology and is an award-winning broadcaster on the BBC. His book on Ultra-processed People is a bestseller. Interview Summary Chris, sometimes somebody comes along that takes a complicated topic and makes it accessible and understandable and brings it to lots of people. You're a very fine scientist and scholar and academic, but you also have that ability to communicate effectively with lots of people, which I very much admire. So, thanks for doing that, and thank you for joining us. Oh, Kelly, it's such a pleasure. You know, I begin some of my talks now with a clipping from the New York Times. And it's a picture of you and an interview you gave in 1995. So exactly three decades ago. And in this article, you just beautifully communicate everything that 30 years later I'm still saying. So, yeah. I wonder if communication, it's necessary, but insufficient. I think we are needing to think of other means to bring about change. I totally agree. Well, thank you by the way. And I hope I've learned something over those 30 years. Tell us, please, what are ultra-processed foods? People hear the term a lot, but I don't think a lot of people know exactly what it means. The most important thing to know, I think, is that it's not a casual term. It's not like 'junk food' or 'fast food.' It is a formal scientific definition. It's been used in hundreds of research studies. The definition is very long. It's 11 paragraphs long. And I would urge anyone who's really interested in this topic, go to the United Nations Food and Agricultural Organization website. You can type in NFAO Ultra and you'll get the full 11 paragraph definition. It's an incredibly sophisticated piece of science. But it boils down to if you as a consumer, someone listening to this podcast, want to know if the thing you are eating right now is ultra-processed, look at the ingredients list. If there are ingredients on that list that you do not normally find in a domestic kitchen like an emulsifier, a coloring, a flavoring, a non-nutritive sweetener, then that product will be ultra-processed. And it's a way of describing this huge range of foods that kind of has taken over the American and the British and in fact diets all over the world. How come the food companies put this stuff in the foods? And the reason I ask is in talks I give I'll show an ingredient list from a food that most people would recognize. And ask people if they can guess what the food is from the ingredient list. And almost nobody can. There are 35 things on the ingredient list. Sugar is in there, four different forms. And then there are all kinds of things that are hard to pronounce. There are lots of strange things in there. They get in there through loopholes and government regulation. Why are they there in the first place? So, when I started looking at this I also noticed this long list of fancy sounding ingredients. And even things like peanut butter will have palm oil and emulsifiers. Cream cheese will have xanthum gum and emulsifiers. And you think, well, wouldn't it just be cheaper to make your peanut butter out of peanuts. In fact, every ingredient is in there to make money in one of two ways. Either it drives down the cost of production or storage. If you imagine using a real strawberry in your strawberry ice cream. Strawberries are expensive. They're not always in season. They rot. You've got to have a whole supply chain. Why would...

The Food and Drug Administration or FDA regulates roughly 78% of the US food supply. This includes packaged products, food additives, infant formula, ultra-processed foods, and lots more. However, an analysis by the Environmental Working Group found that 99% of new food ingredients enter our food supply through a legal loophole that skirts FDA oversight and seems, to me at least, to be incredibly risky. Today we're speaking with two authors of a recent legal and policy analysis published in the Journal Health Affairs. They explain what this loophole is and its risks and suggest a new user fee program to both strengthen the FDA's ability to regulate food ingredients and address growing concerns about food safety. Our guests are Jennifer Pomeranz Associate Professor of Public Health Policy and Management at New York University School of Global Public Health and Emily Broad, director of Harvard Law School Center for Health Law and Policy Innovation. Interview Summary So Jennifer, let's start with you, help our listeners understand the current situation with food ingredient oversight. And what is this legal loophole that allows food companies to add new ingredients without safety reviews. Sure. So, Congress passed the Food Additives Amendment in 1958, and the idea was to divide food additives and generally recognized as safe ingredients into two different categories. That's where the GRAS term comes from generally recognized as safe? ‘Generally Recognized As Safe’ is GRAS. But it circularly defines food additives as something that's not GRAS. So, there's not actually a definition of these two different types of substances. But the idea was that the food industry would be required to submit a pre-market, that means before it puts the ingredient into the marketplace, a pre-market petition to the FDA to review the safety. And then the FDA promulgates a regulation for safe use of a food additive. GRAS ingredients on the other hand, initially thought of as salt, pepper, vinegar, are things like that would just be allowed to enter the food supply without that pre-market petition. The problem is the food industry is the entity that decides which category to place each ingredient. There's no FDA guidance on which category they're supposed to ascribe to these ingredients. What has happened is that the food industry has now entered into the food supply an enormous amount of ingredients under what we call the GRAS loophole, which is allowing it to just bring it to the market without any FDA oversight or even knowledge of the ingredient. So, in essence, what we're having now is that the food industry polices itself on whether to submit this pre-market petition for a food additive or just include it in its products without any FDA knowledge. When you said ‘enormous number of such things,’ are we talking dozens, hundreds, thousands? Nobody knows, but the environmental working group did find that 99% of new ingredients are added through this loophole. And that's the concerning part. Well, you can look at some ultra-processed foods and they can have 30 or 40 ingredients on them. That's just one food. You can imagine that at across the food supply, how many things there are. And there are these chemicals that nobody can pronounce. You don't know what's going on, what they are, what they're all about. So, what you're saying is that the food industry decides to put these things in foods. There's some processing reason for putting them in. It's important that the public be protected against harmful ingredients. But the food industry decides what's okay to put in and what's not. Are they required to do any testing? Are there criteria for that kind of testing? Is there any sense that letting the industry police itself amounts to anything that protects the public good? Well, the criteria are supposed to be the same for GRAS or food additives. They're supposed to be meeting certain scientific criteria. But the problem with this is that for...

Every day, with few exceptions, I eat a handful of nuts. Usually a combination of almonds, walnuts, pecans, cashews, and pistachios. And they taste good for sure. But I'm responding mainly to research showing that consumption of nuts is related to less chronic disease. In particular, eating nuts lowers levels of inflammation related to heart disease and diabetes, and may improve cholesterol levels among other benefits. So, I saw it as welcome news that someone has just published a book about nuts, all aspects of nuts, actually. Today we're joined by NPR, food Writer Elspeth Hay author of a new book called Feed Us with Trees- nuts, and The Future of Food. And I had no idea. Nuts were so interesting until I dove in a little bit. Elspeth has gathered stories from dozens of nut growers, scientists, indigenous knowledge keepers, researchers and food professionals. She writes that humans once grew their staple crops in forest gardens of perennial nuts, such as oaks, chestnuts, and hazelnuts in these species. Particularly important to the environment as well as to human wellbeing. Interview Summary Elspeth, thanks so much for joining us and for writing such an amazing book. Thank you so much for having me. And it sounds like you have the same habit as my dad. He makes sure to eat a little bit of mixed nuts every night, ever since I can remember for his health. Let’s start by having you describe your book. Tell us about Feed us with Trees. Why did you write it and what's it about? I wrote it because I've been reporting on food in the environment for a long time, a little more than 15 years. And I had never heard anyone mention anything about eating acorns until a few years ago. And someone sent me a TEDx talk by a woman in Greece named Marcie Mayer, and she said, you can eat acorns. And not only that, but they're a super food nutritionally, and one of humanity's oldest foods. And I live in this giant oak forest that's protected on Cape Cod as part of the Cape Cod National Seashore. And I had always seen this forest as a sort of impediment to local food production, right? There's all this land that can't be farmed. And all that time, it turns out there was food literally raining down on my roof, underfoot in my driveway, and I just wasn't equipped to see it. The stories that I had grown up with hadn't mentioned that. And so that was a real eyeopener for me and I just couldn't stop thinking about it and I kept researching. So, have you started consuming acorns? I have, yes. I've collected them the past probably five falls and, you know, oaks do something called masting. Some years they have a really big production and some years smaller production. Some years I've gotten more than others. But I have started processing them at home and experimenting with different ways of using the flour. And I've also ordered online acorn oil. There are actually three food products that you can make from acorns. You can make starch, which works just like corn starch or potato starch. Thickens things. You can make flour and with some species you can make oil. It's actually a pretty diverse crop. That's so interesting. You know, I have a series of oak trees right outside my window and I never thought that they might be producing food I could consume. It's so interesting to hear your history with that. Yes, I mean I had no idea. And it turns out that actually acorns are very similar to olives in the way that they need to be processed. They're very high in these compounds that are very bitter, called tannins, just like an olive. I had the experience once of going to Italy with my husband, and we saw this olive grove and we thought, oh cool. Olives growing right here. And we picked one off the tree and he put his in his mouth and immediately spat it out and said, oh, that's awful. Tannins are not something that we want to eat. They don't taste good, but obviously they haven't hampered the olives rise to glory in terms of a human food source. And...