February 2012 Issue

A Candid Interview With Michael Jacobson
By Sharon Palmer, RD
Today’s Dietitian
Vol. 14 No. 2 P. 44

The Center for Science in the Public Interest, led by Founder and Executive Director Michael Jacobson, turns 40 this year. Today’s Dietitian sat down with Jacobson to discuss how the CSPI has forever made its mark on the nutrition world—and to gain insight into how dietitians can jump on board the movement for change in nutrition policy.

Michael Jacobson, PhD, founder and executive director of the Center for Science in the Public Interest (CSPI), doesn’t mind a bit of controversy. It seems like every time you read about a progressive movement to change nutrition policy, from calling on the FDA to remove sodium from the GRAS (Generally Recognized as Safe) list to putting a stop to the marketing of junk foods to children, Jacobson’s name is linked. And he’s testified in front of numerous congressional hearings and appeared frequently in the news media.

Jacobson’s overarching goal for the CSPI is to fight for change in the nutrition landscape to promote optimal health for the public. This philosophy can be traced to the CSPI’s origins, which date back to 1971. As a consumer advocacy organization, the CSPI’s mission included conducting research and advocacy programs in health and nutrition and providing consumers with current, useful information about health and well-being.

Of course, one thing that sets the CSPI apart from other organizations is that it built its structure transparently from the ground up. Since it’s funded entirely by subscribers and donors—it doesn’t accept advertising, corporate funding, or government grants—it isn’t beholden to supporters who can influence or shape its health messages. The CSPI is in the pretty position of saying what it feels and believes.

Many people know about the CSPI due to its award-winning Nutrition Action Newsletter, which debuted in 1974. While dietitians have been reading this publication for years, we’re not the only ones. Today, more than 900,000 people subscribe to Nutrition Action Newsletter, making it a preeminent voice in nutrition education across the country. In each issue, the publication takes on current nutrition topics, from the latest research on multivitamins to optimal diet strategies for losing weight and reducing chronic disease risk. Featured articles call on some of the leading nutrition researchers and experts of our time, such as Walter Willett, PhD; Barbara Shukitt-Hale, PhD; and Penny Kris-Etherton, PhD. The content is always relevant, science based, and fresh—the writers don’t shy away from a little sarcasm. Just check out the newsletter’s popular column titled “Food Porn,” which reviews examples of food products that are off the charts in terms of calories, fat, saturated fat, sugar, or sodium, as proof.

Over the years, the CSPI has made its mark on many public nutrition issues that you may have forgotten or perhaps didn’t even know about. For example, it petitioned the FDA to require sodium labeling on all foods and fat content labeling on processed meats back in 1978 because this basic information wasn’t available at that time. In 1989, the CSPI campaigned to stop the frying of French fries in beef fat. For 10 years, it battled for a federal law that would require nutrition labeling on packaged foods and ban deceptive health claims. It even led efforts to get a federal law passed that would define organic foods. And the list goes on.

Today, it’s hard to believe that at one time the CSPI had to step in and campaign for such basic nutrition policies that we, as dietitians, take for granted and rely on every day. If you examine the CSPI’s accomplishments over the past 40 years, you’ll note that Jacobson and his team led the way to many significant nutrition breakthroughs, such as adding trans fat to food labels and including calorie labeling in chain restaurants. There’s no doubt that the CSPI has been one of the leading voices for change in nutrition policy during the past four decades and that Jacobson can be considered the Steve Jobs of the organization.

Up Close and Personal
I recently sat down with Jacobson to talk about the CSPI’s role in food nutrition policy and to listen to his advice on how dietitians can make a difference in public health today.

Palmer: What was the impetus behind the creation of the CSPI?

Jacobson: I was working with [political activist] Ralph Nader in 1970 and met two other scientists who were interns or volunteers. We were interested in setting up a public interest organization run by scientists instead of lawyers in which we could encourage other scientists to get involved in social issues. We spent most of our time on food safety and nutrition. We got scientists involved in writing letters to government agencies, signing petitions, doing research, and doing lectures primarily on public policy. Somehow we survived setting up an organization with no experience and no money. And now we celebrated our 40-year anniversary.

Palmer: How did the CSPI take off and become so well known?

Jacobson: In the 1970s, we published Nutrition Scoreboard, a book that got tremendous publicity and sold 100,000 to 200,000 copies. In the book, I created a food rating system with a composite score that factored in protein, vitamins, saturated fat, and other nutrients and rated foods on a scale so that something like soda scored very low and spinach scored very high. People really related to that kind of rating system, and it generated a huge amount of publicity. Then, in 1975, we sponsored the first national Food Day, and it was a tremendous success. We sponsored additional Food Days in 1976 and 1977. There was a lot of interest in world hunger in those years—it was high profile, with churches heavily involved. Then we worked on food labeling in the 1980s and ultimately got the Nutrition Labeling and Education Act passed, which led to Nutrition Facts labels. We became very involved in the policy area rather than just education. Then, in 1993, we started our first study on restaurant food in Chinese restaurants, and then Italian restaurants with “fettuccini alfredo is a heart attack on a plate,” and we revealed the facts on movie theatre popcorn—that got worldwide attention.

Palmer: How did the idea arise for Nutrition Action Newsletter?

Jacobson: I had the idea for Nutrition Action Newsletter in 1973. I went to the annual meeting of the Society for Nutrition Education [now known as the Society for Nutrition Education and Behavior] and collected signatures for a petition on whether junk foods should be advertised to kids and ended up with a list of nutritionists and thought we’d communicate with them. We started with a newsletter and got a very nice reception but realized that we couldn’t afford to continue giving it away. So we charged for it and started publishing a nice version in 1974. We’ve been lucky to have Bonnie Liebman [director of the CSPI] writing many of the articles since 1978, and she commands great respect from journalists.

We work hard to give objective scientific information that isn’t colored by political beliefs, and we don’t try to bend the science to match our beliefs. In the nutrition world, it can be tough to find straight advice. Our bias is in favor of public health; when it requires judgment, we favor the idea “let’s protect consumers.” We want to see good evidence, but sometimes you don’t need 100% proof before you can give advice on something to protect people.

Nutrition Action Newsletter circulation gradually increased, and it soared in the 1990s. At one point we had 1 million subscribers.

Palmer: How has the CSPI been involved in nutrition policy over the years?

Jacobson: Since our nutrition labeling efforts, we’ve been very involved in food policy initiatives, such as trans fat menu labeling, getting junk foods out of schools, getting healthier foods into schools—we’ve led the efforts in all of these areas. In fact, Margo Wootan [director of nutrition policy at the CSPI] testified at a congressional hearing to oppose industry's efforts to kill government guidelines on marketing food to kids. Also, we’re trying to help the FDA figure out the salt issue. The trans fat issue has made tremendous progress.

Palmer: How has the nutrition world changed since the CSPI started?

Jacobson: Back then the establishment position, including the USDA and the Academy of Nutrition and Dietetics (the Academy), was that all food is good food and that people should eat a variety of foods in moderation. With the “all food is fine” thinking, there was no distinction between fatty meats and beans, refined grains and whole grains, or ice cream and skim milk. It was hard to find brown rice in grocery stores.

But we’ve made some progress over the years, especially with the USDA, the Academy, and Health and Human Services. They’re providing much better advice than they used to, and some people are even listening to this advice. Consumption of fruits and vegetables has gone up somewhat, and soda consumption has declined. Trans fat used to be thought of as innocuous, but that’s certainly changed; the use of partially hydrogenated oil, the source of trans fat, has plummeted, but the problem needs to be eliminated entirely. These weren’t issues in the early ’70s; the main nutrition concern was sugar and tooth decay. The obesity epidemic began quietly in 1980 as people began to eat more food, and now we’re fat. There’s lots of attention being paid to obesity now.

Palmer: How has the public’s view of the CSPI changed over the years?

Jacobson: The general public has always liked the CSPI and respected it because we give the public accurate information. If we don’t know the answers, we tell journalists or consumers whom to call. Over the years we’ve gained great respect from the industry, the FDA, and the USDA. We file petitions and push for legislation, but we don’t have crazy proposals. We base them on good science and good public policy. When we meet with government or corporate officials, we don’t dish out rhetoric or unfounded views. We frequently talk to major food companies and sometimes persuade them to make a certain change. Other times the food company may persuade us that we don’t have all of the information on an issue and that what we suggested wasn’t true. For example, a company stopped using deceptive labeling, and we just dropped the matter.

But sometimes things don’t work out, and we file lawsuits. Like McDonald’s using toys in children’s meals—we had a number of meetings that just didn’t get anywhere, so we filed a lawsuit. In the case of marketing junk foods to kids, we had a long negotiation with Kellogg that lasted a year and a half and ended up with the first-ever binding agreement to limit salt, saturated fat, calories, and fat in foods marketed to kids, which led to other companies making voluntary guidelines.

Litigation efforts are interesting. We’d done a little bit without our attorneys. For instance, in 1980 we sued the Treasury Department regarding ingredient labeling of alcohol beverages. In 1982, we sued, with help of an outside attorney, the FDA for not taking action on a petition to limit sodium. But in 2004, we started using litigation in earnest when we hired an experienced litigator who’s been leading litigation in lawsuits against numerous companies, which has made the industry think twice before acting.

Palmer: How do healthcare professionals view the CSPI?

Jacobson: In our first year, mostly nutritionists read Nutrition Action Newsletter. Today, about 1% to 2% of our readers are health professionals, which includes nutritionists, nurses, and doctors. Some of our articles can be pretty dense, but it’s easy reading for them. Most of the articles aim at the average person out there who cares about nutrition. The Academy kindly gave us a booth at its annual meeting [FNCE], and our staff said that countless dietitians told them how much they love the CSPI. Clearly, there are some dietitians that don’t like us—those who are more conservative, that consult for food companies, or have the old-school opinion that all food is good food, just eat a variety. But in general, many dietitians love what we do and love our leadership in the field. They can’t be as outspoken as we are, so they cheer us on. Unfortunately, despite the great strides the Academy has made in the past several years, receipt of corporate sponsorships probably still limits its ability to speak out candidly on important issues.

Palmer: Is it more difficult to advocate for public health today?

Jacobson: No, there’s so much interest and support in the food field. We started Food Day to bring a lot of people together on hunger and farm policy and to link these issues with a national event. Food Day can advance goals, form coalitions, and educate the public. It’s exciting to see more than 2,000 events on the map on the Food Day website.

Palmer: What do you believe are the major challenges the nutrition profession faces?

Jacobson: One thing is that clinical dietitians often are frustrated because they’re working with people one on one. They read the newspaper articles about two-thirds of Americans being overweight or obese, high soft drink consumption, and high sodium levels in foods, and they wish they could have a bigger impact. Working one on one, they may not be having as much effect as they’d like. They’re working with patients who may be hypercholesterolemic, diabetic, overweight, or hypertensive. It’s frustrating for dietitians because so many people have such a challenge; they have to get their kids to eat healthful meals with so little money and time. It’s got to be very frustrating because they really want to get kids to eat healthful diets, but they get worn down with no money or resources. Dietitians could help by advocating these concerns to the government and Congress to get them to chip in a little more money and get rid of competitive foods in schools.

Palmer: How do you feel dietitians can be more effective in today’s nutrition world?

Jacobson: Dietitians are doing all kinds of things—some write blogs, some are writing newspaper columns, and some get involved in local food policy councils. They shouldn’t be timid; they should speak out in their place of employment or otherwise take a leadership role to improve the food supply. I think many people who aren’t accustomed to being outspoken fear the worst will happen. But it can be empowering. It can be effective and fun to speak out and try to reach broader interests. They can do the same thing within the Academy—dietitians have opportunities to vote and express their concerns to the executive director. They also can work through practice groups.  

Palmer: What are some of the nutrition campaigns you’re most proud of?

Jacobson: Leading efforts to get nutrition labels on foods was extremely important. We were also pretty successful in our campaign to get trans fat out of foods. Especially gratifying was our campaign in the 1980s to remove sulfite preservatives from fresh fruits and vegetables that were killing people; someone would eat a salad and literally die within minutes. It was so heart rending to get reports of consumers dying and file complaints that went unheeded for several years. Finally, Congress held hearings to get the FDA to ban the use of sulfites from fresh fruits and vegetables, and I haven’t heard of a single death related to sulfite sensitivity in recent years. Before, we had documented 16 deaths. We saved hundreds, maybe even thousands, of people from dying because of sulfites in fruits and vegetables, so we’re very proud of this accomplishment.

— Sharon Palmer, RD, is a contributing editor at Today’s Dietitian, a freelance food and nutrition writer in southern California, and author of the forthcoming book The Plant-Powered Diet.

 

CSPI Nutrition Campaigns on the Front Burner
What’s the Center for Science in the Public Interest (CSPI) hot about these days? Here are some of the nutrition campaigns the organization is working on.

• Food Day: Celebrated on October 24, Food Day brings together people from all walks of life to push for healthful, affordable food produced in a sustainable, humane way.

• Decrease marketing of low-nutrition foods to children: Promotes guidelines for responsible marketing of foods to children.

• Improve school foods sold outside of meals: Supports national legislation to get junk foods out of schools in areas such as vending, a la carte, fund-raisers, snacks, rewards, and parties.

• Set state/local government or worksite food standards: Creates standards for foods and meals purchased, prepared, or served by government or the worksite.

• Tax soft drinks: Since Americans consume large amounts of soft drinks, which contribute to obesity and other health problems, the CSPI promotes taxes that could help reduce consumption and create revenue for public health promotion.

• Reduce sodium intake: To reduce sodium intake, the CSPI advocates that food makers use as little salt as possible in foods, that the government should set declining limits on salt content in foods, and that chain restaurants should post warnings and improve labeling of foods that are very high in sodium.

• Eliminate trans fat: Foods that contain trans fats have declined by 50% since 2005, but now is the time for city, state, and federal governments to completely eliminate trans fats through bans.

— SP