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Book Reviews |
UCLA Center for Human Nutrition, 900 Veteran Avenue, Room 12-217, Los Angeles, CA 90095-1742, E-mail: dheber{at}med1.medsch.ucla.edu
Beth Israel Deaconess Medical Center, Center for the Study of Nutrition Medicine, 194 Pilgrim Road, Boston, MA 02215, E-mail: gblackbu{at}caregroup.harvard.edu
by Laura S Sims, 1998, 313 pages, hardcover, $64.95. ME Sharpe, Inc, Armonk, NY.
This is an outstanding book that everyone in the nutrition profession should read. It is a timely, concise accounting of the political processes that led to our current food supply, and it suggests that changing the American diet to deal with obesity and related chronic diseases such as heart disease, diabetes, and aging will require retooling a developed bureaucracy and government-industrial complex. Sims points out that there was no conspiracy to change the food supply, but rather there was a well-intentioned effort launched in the 1930s and 1940s to ensure food security. In the 1950s, with the large-scale introduction of cooking oils into the American diet and the widespread availability of choice beef and whole milk, we were ingesting unprecedented amounts of fat.
Such a historical review would have been an interesting book in itself, but Sims goes beyond this to give the reader a primer on US government policy formation, with all its various players. Three case studies are discussed, including the history of the attempts to lower fat in the school lunch program, the lobbying efforts surrounding the US Department of Agriculture's food guide pyramid, the long effort to obtain approval for olestra, and the controversies over tropical as opposed to domestic oils.
Because each of us works toward healthier nutrition, the food supply is certainly one of the most powerful public health tools we have. Changing the food supply will mean working with all the constituencies involved in food policy. This book outlines some of the potentials for success as well as potential pitfalls in this process. Taken from another standpoint, the book shows that our food supply has changed. Remarkably, the food industry wants to give consumers healthier foods, but often gets a mixed message. Although the consumption of red meat, whole milk, and butter is going down, the consumption of cheese, premium ice cream, and high-fat pastries is rising. Clearly, consumers want good-tasting food that is also healthy. The government's policies have often ignored, lagged behind, or fought against both consumers and industry in this process.
Sims argues that, if we are to move ahead in reforming the way Americans eat, we must work with all of these elements in a constructive attempt to formulate rational food policy for the next century. This will involve making health-promoting choices easier and health-damaging choices more difficult. The details of Sims's proposals have been expanded in Nutrition Today (1998;33:134–43). Dietary fat is a symbol of public policy and politics, incorporating the areas of science, agriculture, health, economics, social psychology, and marketing. Governmental actions greatly affect its availability and consumption. No one is better qualified to educate us than Sims, who has spent more than a decade researching national nutrition policy.
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