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US: Is Fast Food Just What the Doctor Ordered?


by Melanie WarnerNew York Times
May 2nd, 2005


 

 

For the last 28 years, Dr. Dean Ornish has been trying to persuade people to eat healthier. In his five books, he champions low-fat diets; he was one of the first researchers to show that stringent healthy eating can reverse chronic illness, particularly heart disease. Among his advice to patients is to eat a lot of vegetables and minimally processed foods, and avoid all things greasy.

Dr. Ornish also works for the McDonald's Corporation. As a paid consultant, he meets with top executives, gives talks to employees and recently wrote nutritional words of wisdom about diet and breast cancer for table displays to go into all McDonald's restaurants in the United States for Mother's Day.

He is not the only one straddling this line between science and commerce. In the last two years, at least two dozen leading nutrition scientists and experts have started working for large food companies, either as consultants or as members of health advisory boards. Most do not directly promote products, though Dr. Arthur Agatston, a practicing cardiologist and author of "The South Beach Diet," has a licensing deal with Kraft Foods to sell a line of South Beach foods, which are appearing on supermarket shelves this month.

As concerns mount over the nation's elevated obesity rates and the surge in diet-related illnesses, food companies have received heightened scrutiny from Congress and face threats of litigation from trial lawyers. In response, companies have fashioned "health and wellness" initiatives. And companies like McDonald's, Kraft, PepsiCo and the Coca-Cola Company have created advisory boards, putting people who might otherwise be critics on the payroll.

Their dual roles have created a deep divide in the scientific community. Some critics say that working for a large food company compromises the credibility of scientists' research and makes them look like part-time company representatives. They say advisory boards and tacit endorsements from health gurus do more to make companies look good and help them sell products than inspire change.

"These companies can say we have all these really important people who care about health working with us, and that takes some of the heat off," said Marion Nestle, a nutrition professor at New York University. "But all they're doing is making junk food marginally healthier."

But scientists working for the food companies say they hope to improve the American diet from within.

Dr. Ornish, who is president and director of the Preventive Medicine Research Institute, which is based in Sausalito, Calif., and studies the effects of diet and lifestyle choices on health and disease, says he wants to help McDonald's become a healthier company, a place that one day will sell a lot more of the kind of food he counsels people to eat. He won't say how much McDonald's pays him, but he says the money is not why he's doing it.

"A lot of colleagues were puzzled at first by my decision, but now they see it as a logical extension of what I've been doing my whole career," said Dr. Ornish, who also works for PepsiCo and ConAgra Foods. "It's an amazing platform to make a difference."

Sometimes a scientist's name appears on a food package. Health tips from the fitness expert Dr. Kenneth H. Cooper appear on packages of Frito-Lay's baked snack chips, for example, with his name attached. Other times a scientist appears in marketing material: a photo of Dr. John P. Foreyt, a researcher on heart disease at the Baylor College of Medicine in Houston, is in a Coca-Cola ad in magazines like Good Housekeeping this month.

Dr. Agatston, who is an associate professor at the University of Miami School of Medicine, says he decided against appearing in ads for Kraft. Instead, the South Beach logo appears in large type on two dozen products.

One medical specialist recruited to a food company advisory board has already decided that membership was not worth the cost. Dr. George L. Blackburn, director of the Center for the Study of Nutrition Medicine at Harvard Medical School and a prominent researcher on obesity issues, decided to step down from a McDonald's advisory council on balanced lifestyles two months ago.

In an interview, he said he left because he was disappointed that McDonald's had not incorporated his recommendations into its recent "Balanced Lifestyles" campaign. "Our message here at the center is threefold: cut the calories, eat quality food and exercise," said Dr. Blackburn. "The first two messages weren't making it through."

McDonald's new worldwide health education campaign, introduced last month, focuses largely on exercise, with little discussion of diet. "If I were on the exercise side, I'd be ecstatic," said Dr. Blackburn. "But I'm focused on the role of food in a healthy lifestyle. Every scientist knows that increasing exercise is not going to replace cutting the calories."

McDonald's executives said that they were surprised by Dr. Blackburn's resignation, and that they were committed to changing the company's menu and encouraging better nutrition habits among customers.

Other members of McDonald's advisory council say they are willing to be more patient. "I feel like we're being slowly yet consistently effective," said Dr. Dennis M. Bier, director of the Children's Research Center at Baylor College of Medicine and a member of the McDonald's council. "McDonald's is such a big company that it takes longer to have changes implemented."

Dr. Bier said he and other council members were involved in encouraging McDonald's to add fruits and vegetables - premium salads, apple dippers and other items on the way - to the menu.

Dr. Cooper, who runs the Cooper Institute, a preventive medicine organization in Dallas, also said he thought his work with PepsiCo over the last three years had had a meaningful impact. A tall, energetic 72-year-old, Dr. Cooper said he was instrumental in getting the company to remove trans fats - a substance found in chemically modified vegetable oils that is believed to increase cholesterol levels - from its snack chips and to introduce baked potato chips. Now, he says, he is prodding the company to use low-fat cheese for snacks like Cheetos and Doritos.

Dr. Cooper, who is also a medical adviser to President Bush, says he and the other members of PepsiCo's advisory board do not hold back their criticisms. Currently, he says, the board is trying to prevent the company from putting a SmartSpot label on its line of light chips, which contain olestra, a fake fat that once had to carry a warning label about unpleasant gastrointestinal side effects. The SmartSpot designation identifies products that PepsiCo has determined to be healthy choices.

"Unless I get some good data that shows benefits and no harm, I would not allow that," Dr. Cooper said. "Pepsi listens very carefully to us and follows our recommendations."

Pepsi's health board gathers in person four times a year, Kraft's three times. Coke's and McDonald's both meet twice a year. Fees paid to the specialists often are closely guarded secrets. Kraft, Coke and Pepsi would not say how much their advisers and consultants were paid. McDonald's was more forthcoming and said its board members receive an annual fee of $7,500.

Like Dr. Ornish, Dr. Cooper declined to talk about the compensation he receives as a consultant. Dr. Agatston said he would receive royalties based on sales of South Beach products, which include whole-wheat frozen pizza, several varieties of whole-grain cereal and frozen dinners with minimal saturated fat.

Some scientists say any amount of money received is too much and has the potential to create the appearance of a conflict of interest. Dr. Walter Willett, chairman of the Department of Nutrition at the Harvard School of Public Health, says he has turned down a variety of offers from food companies because accepting would compromise his research.

"It's particularly an issue if we come out and say some food has no problems and I'm on one of their boards," said Dr. Willett, an epidemiologist who is involved in the large, continuing nurses' health study. "People would wonder whether we were really biased or not."

Dr. David Ludwig, director of the childhood obesity program at Children's Hospital in Boston, has also turned down paid consulting offers and says he has ruled out being on a company's advisory board, even unpaid. "If Coca-Cola were interested in my thoughts about how it could design more healthful products, I would be delighted to offer my opinion to them," said Dr. Ludwig. "But I won't accept money in return, nor will I accept a seat on their advisory board. I think it implies that you are representing the interests of the company."

Some of Dr. Ludwig's work includes findings that are not exactly good news for food companies, such as those correlating fast-food consumption with weight gain and sugar-sweetened beverages with a higher risk of Type 2 diabetes, the kind associated with obesity, in women.

Dr. Ornish argues that detractors don't give food companies enough credit. "It's very easy to be a purist and demonize things, but as I get older I realize that life is shades of gray," he said recently. "Are these companies moving as quickly as I might like? Of course not. But they're moving much faster than I ever thought possible."





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