[MUSIC] Thank you everyone
for joining us today. I am Hilary Seligman. I am the Co-Director of the
CTSI's New Impact Core, which you can learn
about a little bit here. I'm really privileged to
start our conversation today about women in science and academia with an introduction
by Catherine Lucey. Dr. Lucy is UCSF's Vice Dean for Education and Executive Vice Dean for the School of Medicine. I think more importantly, she has been a friend, a mentor and a role model for many women in science and
m
edicine, including myself, both in her individual
mentoring relationships and in her leadership positions at the Association of
American Medical Colleges and American Board
of Internal Medicine. We have asked Dr. Lucy to
start us off today to frame our discussion that we're
going to be having with Marion Nestle by reflecting on the status of women at UCSF, so thank you Dr. Lucy for
kicking us off today. Thanks Dr. Seligman. It's a pleasure and
an honor and a bit odd to be able to introduce our a
mazing
speaker here today, Marion Nestle, who
are many of us has been an incredible role model, even at a distance, those of us who
haven't had a chance to meet with her individually. As you all know, Marion has been a vanguard as a scientist and an advocate who really founded the field
of food studies, moving us beyond
the narrow focus on the biochemical aspects of food disorders to
an understanding of the complex ecosystem of social and economic
contributions to those biochemical disorder. Her
work, your work, Dr. Nestle, has really truly been
transformative and disruptive. She's been fearless in attacking corporate greed and
the role of fast food, big soda and other industries
whose marketing of toxic product has caused so much pain and suffering in our communities
across the nation. Her policy in advocacy
work as a scientist, highlighted the importance of system solution to issues that make wise individual choices about good nutrition
virtually impossible. She was a systems thinker
before people thought
about systems. In many ways she was a vanguard
about systems biology and also the social systems
that contributed to this. When I think about Dr. Nestle, I'm reminded of Mary
Catherine Bateson, an anthropologist and a
daughter of Margaret Mead, who I found out yesterday actually passed away
just last year. She wrote a book that I read about 20 years ago when
I gave my first talk about women in science at the Ohio State University and that book was called
Composing a Life,
I don't know how many of
you have read this book. You have to go to The Green Bookstore
in order to find it, it may not be on Amazon anymore, but I'd really encourage
people to read it. In it, she reflects on how crafting our academic systems to be in sync with our lives, rather than vice versa, where we expect our lives to sync up with the
academic systems, could be a solution to the rampant sexism and misogyny in the
academy that limits the number of women who have successful careers in
scienc
e and limits the number of women
who are assigned to leadership positions
in institutions, organizations and
governmental agencies. When you read the book
blurb on Marion's new book, which I was hoping she would have here as the
copy is designed, but maybe we'll just figure
that out some other time. I want to say that
Marion Nestle is living proof of the importance
of composing a life. Her contributions
to the world began, like many women, with childbearing and
child rearing and then move to ben
ch
science, education, including at UCSF, to a government policy advisor, to institutional
leadership and ultimately to be the founder of a
field of a discipline that is so important to
our understanding of much of the causes
of morbidity and mortality in the
world today related to over and undernutrition
and metabolic syndrome. Hers is a life that
is fully composed with significant
contributions at every stage, all linked to that early
groundbreaking inspiration that food is not only fuel, but
a cultural, social
and economic phenomenon, that must be nurtured and
structured for health for all. She was at UCSF from 1976 to 86 and actually overlapped with me when I was
a resident here. During her time at UCSF, she authored what I
think was probably the first report on the
status of women at UCSF, highlighting challenges
faced by women and the resulting missed
opportunities not only for our institution, but for science in general. I wish I could say that all of the issues that
Marion iden
tified in that early report
on women in science have been fixed in today's UCSF, or in today's society. Certainly a lot of
progress has been made. We have wonderful
leaders here like Hilary and many of you in the audience are
young scientists and young women scientists and
that's actually wonderful. But I want to talk
about three levels of challenges for women;
the social level, our professional levels
and then our challenges at UCSF and I'm very much looking forward to hearing
Marion's talk abo
ut how she's viewing these and what solutions she
might have in place. We really experienced
in the pandemic, the entrenched social
belief that women are entirely responsible for
caregiving in families. Even into career families, we expect women somehow to super-heroically put in a full day of work at work and then a full day
of work at home. Yes, there are
exceptions to the rule. Same sex couples seem to do better than
heterosexual couples. Certainly some people in
the younger generation are do
ing better
than those of us in the older generation do, but that is not a
universal phenomena. We still see that women feel, whether right or wrongly, that society expects them to be the caregivers for
children and for parents. This is to sometimes the
detriment of their careers. Some of you may know
UC Berkeley faculty, Mary Ann Mason who wrote
out another fantastic book, Do Babies Matter in academia. The answer is yes,
they matter a lot. For men PhDs and
men PhD students, welcoming a child
int
o their home, whether through adoption
or through pregnancy, is a benefit to their career. They appear more
stable and are more likely to advance quickly
through their PhD, whereas women who bear the
children actually fare poorly with a lot more women dropping out of the PhD career, or the track towards the PhD. Recent studies in
other industries also saw how deeply entrenched this social belief
that women must carry the weight of the
home and caregiving. There was a recent study
that documented
that the more a woman
out-earns her husband, so has a higher salary than her husband in
heterosexual couples, the more housework
that that woman does, with a hypothesis
that people are trying to compensate
in a feminine way for undermining the man as the
provider for the family. These are hard things to fix, they are the same
complex problems that Marion identified
as having social, economic and individual choice
issues related to food and nutrition and so we're deeply interested in what
she ha
s to say about this. When we look at our profession, we are slightly doing better. People point to the fact
that we have 50 percent or more women in most medical
school classes now. In fact, UCSF, this year
we had 54 percent women. This is fantastic
celebratory news, but it's also a problem, because when you see a
lot of women around, you think the
problem of women in science and women in
medicine has been solved. What we have now, as women in science
and medicine, is in many ways
parody without
power. There is a lot of us in fundamentally frontline
caregiving, frontline caretaking, health care delivery and
scientific endeavors and we are not ascending to leadership roles at the
rate that we should expect. In the US today of the 151 medical schools
in the country, 18 percent are headed by a woman as the dean, 18 percent. That is a soaring different than the 14 percent we
saw 20 years ago, and that was a sarcastic
comment if you didn't get it. 18 percent, many will tell
you it's a pipel
ine problem, there just aren't that we
have to wait for those 50 percent of the women in medical school to
mature to be leaders, but I will say that
when I went to medical school and
graduated in 1982, 25 percent of my
class was women. There are sufficient
women of my age, women who in that
period of time for the 40 years since
1982 could have taken five or six maternity leaves and still be capable of
becoming a leader and yet we haven't finished to
figure out how to let them lead at the highest
level of
our academic institutions. That's to our detriment because women are
uniquely suited in the way that they approach
leadership to dealing with the types of complex
adaptive problems that we have facing us today. Things that don't have
commanding control solutions, things that require influence, relationship-building,
sense-making. All of these things are
found to be in study after study more often found in women leaders
than in men leaders. Now, here at UCSF, we are quite similar. We're
making progress, but at a rate that is truly glacial. If we wait for that increase 14 to 18 percent
to take it slope normally, it will be well into
the 22th century where before we achieve any hope of parity at leadership, 50 percent of our workforce are women across the UCSF system, that includes in
the health system. Very low percentage of
women are leaders across the health system
or in the schools of medicine and pharmacy. For example, of our 40
plus chairs and directors, that is of clinica
l departments,
research institutes, centers, and basic
science departments, 40 of them, six are women. Now, what you will see, which is also what we see
across the country too, if you look at
roles like I have, I'm the vice dean for education, there's the vice dean
for faculty affairs, there's lots of
associate deans for students, for curriculum, many of those service
roles are filled by women but those are not the roles that lead
to a dean's position. Even though they have
dean in their title,
it is very rare
for a vice dean in any of those environments to
ascend to a dean's position. Perhaps the one person we
know who has done that successfully is our
current president of the University of California, Michael Drake, who
started his career at UCSF as an associate
dean for admissions. That is almost unheard of. What we see is what
Hilary Clinton described in her book
is that people are perfectly happy with women in
leadership roles that serve the broader community and are subservient t
o the person
with strategic leadership. But once they not get
that top leadership door, they find it's closed and locked and opened only to a
certain phenotype, and that is still, at this day and age,
a male phenotype. What do we do for this? Well, I'll tell you
what we don't do. We don't do what we've
been doing, which is, we decide that
what we need to do is to teach women to
be better leaders. There's an inherent
ridiculousness of that. We do not want to teach women
to be leaders like men, we
want women to lead in the
way that they inherently do lead and has shown to be better at complex problems
than we have. But we have this phenomena where we see like it must be
the problem of the women, we have to fix the women, but instead, what we have
to do is fix the system. We need to stop giving
people leadership courses without leadership
positions to practice in, we need to stop requiring women to demonstrate
their commitment to leadership because they
took a year off or two years to get
an
MBA and then say, you know what, you're
just not quite ready for this role yet. We need to deal with
this phenotype problem, and women of my generation need to be the ones
who speak out, who sponsor, who take on
the generative work that Erik Erikson says it's the final fulfillment
of your career. But we also need men in the environment to do so
because they recognize that we are wasting
generations of people whose leadership
might actually lead us out of the problems
that we're having here,
rather than reinforce them
in medicine, in society, and in many other
industries that are so devoid of women
in their positions. I call on all of you,
sit at the table, make your voices home, do not feel humble about
bragging about what you know, feel competent in
what you can offer, and if you see someone
who is talented, sponsor them and make sure other people know
that those women are talented and should
be the ones who are promoted at the next level, don't take no for an answer and don't fal
l into the
trap of saying, but they haven't done as many papers because they
took three maternity leaves. Papers have nothing to
do with leadership. With that, I'm going to
turn it over to Marion. I had hoped to be able to give better news about UCSF today, but at least we know
the problems and we are working on the solutions and hopefully with
Marion's help, we'll be able to figure out something more creative
to do as well. Thanks again Hilary
for inviting me and I will turn it back over
to you
[APPLAUSE] Before we call Marion up here, first of all, thank you. Dr. Lucy. I am continually in of your leadership and you
are very inspirational. We are here to celebrate
the career or hear about the career today of
one amazing scientists, Marion Nestle, and
her work has had a tremendous impact
on food policy. I want before we
start to tell you, and I think you've
seen here that CTSI's new impact program seeks to support
researchers in doing work that makes a difference in the real-world
rath
er than sitting behind firewalls in difficult to decipher
manuscripts that few, if any, people read. Thank you Dr. Lucy for calling
attention to the fact that manuscripts do not
necessarily make the impact. By making a difference
in the real-world, we mean changing policies and
systems that influence and constrain all of our actions
and all of our behaviors. How can we help change these policies and
systems as scientists? We think it's by making sure the key evidence reaches
the people who are e
mpowered to create and maintain these
policies and systems. We are convinced
through the work of people like Dr.
Nestle that we as researchers and scientists can learn to be more
sensitive and more responsive to the needs and the constraints of real-world decision-makers
and policymakers. The impact program, which
stands for impacting policy by accelerating translation
is now open to support our community in
doing this work better. We believe that
authentic partnerships between researchers and r
eal-world decision-makers
can promote health equity, health quality, and
health care value. please call on us, we're open for consultations. Our information is on the slide. It'll come back
after Dr. Nestle. I want to turn it over now
to my impact co-director, Laura Schmidt to
bring in Dr. Nestle. Thank you [APPLAUSE] I have the privilege of
introducing the N of one and to say that Marion really represents what we are hoping to achieve with
the Impact Program. She is a global leader in reforming
food systems
through policy change. She's done it as
a women academic. It's just, she's an extremely
influential scientist moving mountains
through policy change. How did she get to this
esteemed place in her life? Well, she's been through
some life experiences and I'm just going to
share a few milestones. Marion has gotten married
at the age of 19. She has dropped out of college. She has gotten a doctorate in molecular biology.
Can't even say it. She was a founding member of the Free Speech Mo
vement
at UC Berkeley. She's gotten divorced. She's been an Associate Dean
in the School of Medicine, and thanks to Catherine, we know what that
can mean at UCSF. She's been a stay-at-home
mom with two kids. She's also worked for the Surgeon General
of the United States. She has written probably a
dozen books, may be more. She can tell us
the exact number. The first one was published in 1985 while she was here at UCSF, a nutrition science book. She spent pandemic kayaking [LAUGHTER] and writing
yet another book, and that's what she's here
to tell us about today. What a truly remarkable woman. She's grown more, not less, over the course of
her 50-year career, become more influential. She's an extraordinary role
model for women in science, for me, for policy
engaged scientists, and she shows us how women
scientists in her memoir, and hopefully she'll
talk about it soon, how women scientists transform obstacles
into opportunities. Let's say hi to Marion. [APPLAUSE] Thank you Laura for tha
t incredibly
embarrassing introduction. Thank you Catherine Lucey for a really extraordinary talk. I could have given that
identical talk 40 years ago. The statement that
you made that just really got to me
was the one about, when there are enough
women in the pipeline, we'll start seeing them
in leadership positions. That's what they told
me in the early 1980s. That's what they told me. I'm shocked at the
lack of progress and I think your analysis
of it is spot on. I'm here to talk
about my new
book. It's a memoir. I'm going to talk a little
bit about what that's about and how I represent in some ways what the
impact organization is about and how
you can do it too. I've written a memoir. This is the book I'm going
to be talking about. I love showing
these two pictures because I haven't changed a bit. That first picture
was taken in 1975. I want to talk
about why a memoir. Because I write books
about food politics. They're non-fiction books, and the way I like to put it as this is my f
irst
work of fiction. The memoirs are about memory. Mine isn't any better
than anybody else's. It has a specific reason
for being written. First of all, the
pandemic [NOISE] created a space in my life and in
everybody else's life. It also changed my physical
space because I moved from Manhattan to be with my partner who lives
in Ithaca, New York, which is four and a half
hours away from Manhattan, and it's a much quieter
venue than Manhattan. I had a lot of time
on my hands and I couldn't do the
research
that I usually do. The libraries were closed, my office was closed. I couldn't get into
any of that stuff. I thought, maybe
this is the time to address the questions that I get asked all the time by students, by reporters, by colleagues, by just random people
who come to my lectures. How did you do it? Why did you do it? How did you get
interested in nutrition? How did you get
interested in food? How did you get interested
in food politics? How do you feel about
the food industry attac
king you? What do you eat? Those kinds of really
personal questions, and then the one that
really gets to me because I don't know
how to answer it. How would you
assess your legacy? How's that for a
questions to answer. I thought, maybe I'll
grapple with that. I've got the space and time to reflect back on those questions, take them seriously, and to try to put
together something where if anybody ever asks
me those questions again, I could just say,
hello, read this. That would be terrific. I th
ink
then that also underlying this was perhaps
some understanding that by the time I
got the book written, I could see that
my life reflected a bunch of themes that might
be of common interest. One is the effect
of childhood in forming character and the
lasting effects of childhood. Another is the women in science issue which
you just heard about and how you go about
overcoming those barriers. Sheer persistence. The reason that
this book is called Slow Cooked is because I was well into my '60s b
y the
time food politics came out. Then how lasting values can inform a life and make you feel good
about getting up every day. That's what I'm going to
talk about a little bit. It never occurred to
me at any point in my career that I would
be considered the most powerful foodie taking
on the soda giants. It also never occurred to me
that I would be featured in activist facts as one of the country's most hysterical anti-food industry fanatics. That's me. That all
came as a surprise, and it came
as a
surprise because my degree was in
molecular biology. I got it from Berkeley in 1968. I expected to be a
bench scientist. For those of you who
know this field, I was in nucleic
acid enzymologist before restriction
enzymes were discovered. I can't tell you how
antediluvian that was. But I love food. Right from the beginning I had discovered food as a child. I really liked it, and I loved the way that
food had dimensions that were scientific but also historical, sociological,
anthropological.
They embodied social values. They embodied health values. They deal with policy, you could deal with economics. I've always really loved food. My first post-doctoral position and faculty position was at Brandeis University
where I was in the biology department,
basically from 1968-1976. The department had this odd rule about how you could only
teach the same course three times in a row and
then you had to switch and you had to switch to
whatever the department needed, whether you knew anything
a
bout it or not. When my three semesters of teaching Cell and
Molecular Biology were up, students were asking for human biology classes and they asked me if I would
teach in a nutrition course. I agreed to do it. I was
interested in nutrition. It had something to do
with food. I like food. I taught my first class in
the 1975, 1976 academic year. Right from the beginning, I was talking about food
in many dimensions. I used as texts in that
first class, among others, diet for a small planet, which
had just come
out and is now in its 50th-anniversary edition. Center for science in the
public interests had just been founded and had published a book called food for people,
not for profit. That could have been printed
yesterday because it's a compendium of
everything about food, from agriculture to
consumption to public health, what we would now
call food systems. There was in this book. Then I used articles from the New York Review of
Books that came out that year by a historian
named Jeffer
y Barrett, who was teaching at Brandeis. He had written these two
amazing political articles about wealth and power and
the politics of food and oil. Equating food with
oil politics and very food systems approach
to bringing those together was my first
class in nutrition. At the end of 1976, my husband at the time was recruited to UCSF to chair the
neural biology department. I came along as a
trailing spouse. I had no idea what that meant. But the dean at the
time, Julius Craves, created a posit
ion
for me because I had been teaching
nutrition at Brandeis. He created what seemed like
an astonishing position. I was the Associate Dean
for human biology programs. The problem wasn't them, the problem was the
rest of the university. They were pretty terrific
programs and one of them was health policy, and then was medical
anthropology, medical sociology,
medical history, and other such programs. Although it was the
human biology programs as a coherent whole, were meant to be a
fifth school a
t UCSF, at the School of Human Biology. But it didn't exist and it
never was going to exist. So what I actually did at UCSF, since the School of Human
Biology was not created, was I did nutrition UCSF, which meant giving lectures, organizing courses,
doing ward rounds, doing everything about
trying to get nutrition into every part of
the UCSF curriculum. We had a federal grant for
a couple of years that made the program possible. Quite a lot of that existed
during the time I was here. Some of it
still exists. I also took on the direction of the first-year
biochemistry course. I wrote the grant for and did the administrative work for the medical scientists
training program, the MD PhD program. I ran a support group for women medical students who were
starting to come into UCSF and they were
shocked by the way that the instructors in their
courses used pictures of nude women to illustrate
anatomical points and so forth. The university thought that you can't really change
the instructors.
Okay, let's teach the women
students how to deal with it. They organized support
groups for women students. I was assigned to work with Doctor Loma Flowers and
if any of you know her, you know how lucky I was to
be assigned to work with her. She's been a lifelong friend. I also chaired the Chancellor's
Advisory Committee on the Status of Women. All I can tell you
is that none of that did me any good at all. On this side, I was learning
to deal with the media. This is relevant to the things that
impact
is worried about. I was learning to deal with
the mean with the media. I tell the story in the book of my nightmarish first
appearance on KQEDs over easy, which was rehearsed and the host asked something that wasn't in the rehearsal and it was a mess. But eventually, I
learned to do that. This is a screenshot from
one of the programs I did. I wrote papers in 1982 for the Journal of
Parenteral and Enteral Nutrition. I wrote a paper about nutrition instruction for medical students
and prac
titioners. I wrote a paper with Philly
and Bobby Barron in 1983. It was my first nutrition
policy paper and then I'm still writing about nutrition
and medical education. In 1988, I edited
a supplement on nutrition and medical education for the Journal of
Nutrition education. Then Bobby Baron and
I wrote a paper for JAMA Internal
Medicine in 24, 14. Nothing has changed
is all I can say. When I was first
teaching nutrition to medical students
in the late 1970s, it had been about 20 years since the
first conference on introducing nutrition
concepts into the medical curriculum and those conferences have still
continued and it's still not in the medical curriculum for the same reasons now
that it wasn't in then because we don't fund preventive health
care in this country, we fund treatment and until
that changes, we're stuck. I also wrote a book
on nutrition for medical students who didn't have nutrition in
their curriculum. Last year, I was talking
about this thing to somebody, I looked up
to see if there were any copies of the book on Amazon and there was for $930. [LAUGHTER] It's not there now. Does that mean that somebody paid that money for that book? I wouldn't advise it. I want to stop here and talk a little bit about what it
was like to be at UCSF. Since I'm at UCSF. I'm going to read a couple of short excerpts from the book. First of all, to talk about
my associate dean job, because this is just so exactly illustrates what
Catherine was talking about. The dean's office pa
id my
salary and gave me an office. Officially I was the
Associate Dean for human biology programs
bizarre as it now seems. This meant I was responsible for something that
did not exist. UCSF proposed the School
of Human Biology. The proposed school had been
a big project of Philip Lee, a former US Assistant
Secretary for Health, who was then heading up UCSF's
Health Policy Institute, which is now named after him. Always ahead of his time, Lee wanted the School
of Human Biology to focus on disea
se prevention,
health education, and socioeconomic
determinants of disease risk and to unite UCSF's small but distinguished medical humanities
programs in history, sociology, anthropology, psychology, biomedical
engineering, and health policy. In theory, the
school's aims were a perfect fit with my
interests in nutrition. But in practice, California legislators had
never funded the school, and it did not take
long for me to realize that they never would. Medical school leaders and the scientific
elite viewed the human biology
programs as soft, meaning, unscientific,
and non-rigorous. The most dismissive
thing anyone can say about research and
not worth funding. Indeed, they viewed the work of medical humanities
faculty as non-research. From the perspective
of the medical school, which aspired to and soon
attained high national status, the only research
that counted was laboratory-based and worthy of publication in
prestigious journals like science nature cell and the New England
Journa
l of Medicine. Dean Cravins and
Julius Cravins made it clear that my job was to
keep the proposed school on the back burner and devote no effort to making
it happen and I was too new and uncertain
about my position to object or tried
to do otherwise. Something that I have to say
I have regretted ever since. I stayed at UCSF. I was at UCSF for about
eight years before all hell broke loose and
at the end of the year, my marriage was in trouble. Remember, I had been
a trailing spouse. A new dean ca
me in and
the new dean replaced Julius Cravins in my
first meeting with him, he said, I just can't understand
what you're doing here. You've got a doctorate, but you're not doing research. You don't have an MD. It's too bad that you
don't have an MD. If you had an MD, you could be teaching nutrition
to medical students. He had no idea what I was doing or whether it was
any good or not. It was clean and I
got moved out of the office with the
gorgeous view into one that overlooked the Moffit
hospi
tal parking garage. Then I got moved to the
bottom of the parking garage, which is where I was
rescued by Dave Wudiger, who was the head of Family
Medicine at the time. My office was then a
windowless office in the basement of the
parking garage. So the message was pretty clear that I was
being squeezed out, but I didn't really
understand what was going on. This section is called The
Last some good advice. I still had the title
of associate dean, but could no longer ignore the vulnerability
of m
y position. I did not have a mentor. How handicapped I
was without one, I sought advice from Philly, who headed the Health
Policy Institute. I knew him to be
highly experienced in academic and
national politics, thoughtful and generous with
his time and attention. During our meeting, I did
what women particularly at medical schools are never
ever supposed to do. I cried and couldn't stop. Philly heard me out. What he said should not have
come as a surprise but did. You have to resign. Deans, get
to choose their
own associate deans. Schmidt did not choose you. You need to resign. More tears. But then he added, here's how you do it. He pointed to my lack of academic credentials
in nutrition. I needed to do
something about that. Tell Rudi Schmidt, you're sorry, things aren't working out. Ask him to help you with the
next stage of your career. Ask for two years of
salary support while you go to public health
school and get a master's degree
in public health, promise him that you will
leave
UCSF in two years. I was done. Was such a deal even possible? It took me weeks to work up the nerve to act
then his advice, mainly because my personal life was falling apart at the time. When I finally invoked
Philly's script, which I followed to the letter, Schmidt looked surprised,
hesitated for a moment, and said he would discuss
it with the schools Financial Officer
and let me know. No more than 10 minutes later, the time it took
me to get back to my basement office I found a message clippe
d
to my office phone. The dean had accepted my proposal and was drafting
a confirming letter. For once, being
the only woman on the dean's staff worked
to my advantage, I would leave quietly
without a fuss in return for two years
of salary support. This would give me the
time to get my life together personally as
well as professionally. Those are the two
excerpts and now I'll go on to talk about
what happened next. If I can get the thing to move. I did go to public
health school and on the basis
of that degree, I got a job with the office of disease prevention and health
promotion in Washington DC, where I worked from 1986-1988 as the editor of the Surgeon General's report
on nutrition and health, which came out in
late June 1988. I did not actually work
for the Surgeon General. I worked for the office of disease prevention
and health promotion, which was under but the Director of
the Office wanted the surgeon general's
name on the report, so it would be equivalent to the Surgeon Gener
al's report
on smoking and its impact. This is a screenshot
from C. Everett Koop, who was Surgeon
General at the time, give a speech at the launch of the Surgeon General's
report, which I had written. I was staff, one of the things
I did was write speeches. One of the weirdest experiences
of my life was sitting there listening to
Everett Koop channel me, speaking in my voice. It was just the
strangest experience but he did that and the
report came out the report came out on my watch and that
was
very good and it led to my getting the job at NYU. I'm sorry, I keep
getting them confused. I went to NYU in
the fall of 1988, largely on the basis of having done this report and my
Washington experience. I've been affiliated
with NYU ever since. I have to say it's been a
very happy experience for me, largely because NYU's
faculty expectations are just what I wanted to do, research, teach, and
do public service around the issues of
food and food politics. When I get asked the question, how did
I do what I did? I have a one word answer to it. I came to NYU with tenure. I came as a full
professor with tenure. A miracle in itself. I tell the story in the book, how that came about, but it made an enormous
difference to me. There may be people who get tenure and never do another
thing in their entire life. That wasn't my experience. For me it was a platform. It opened up the possibility
of doing what I wanted to do the way I wanted to do
it with real job security. It was the first time
I'd
ever had security. I went there, I should say, to chair a department
of home economics. This is a long story. The turning point for me, and an answer to the question, how did you get started
on food politics? I've already said I was already interested in food politics. But the turning point was
a meeting that I went to in 1991 at the
National Cancer Institute where I heard speeches from
anti-smoking advocates on cigarette marketing to adults and in particular to children. This was a paper by Jo
hn Pierce. John Pierce was
anti-smoking researcher at the University of
California, San Diego. He gave up the slide show on cigarette marketing to children that was
regulatory to me. It wasn't that I
didn't know that cigarette companies
marketed to children. I had just never paid
any attention to it. Somehow seeing slide
after slide after slide of Joe Camel
in places where kids hung out was just regulatory
and I walked out of that meeting saying we should be doing
this for Coca-Cola. That's what
happened.
I started paying attention to how food companies were marketing to adults and children and started
writing papers about it, and started writing about the
relationship of big food, big agriculture, the research university and the effects of that
on what we eat. I'm just still writing
about those things. My most recent papers I write heavily footnoted editorials
is basically what I do. My two most recent papers in the American Journal of
Public Health and in JAMA Internal
Medicine have
to do with the politics of regulating
the food industry and the politics of why
aren't we doing more policy around obesity? My most recent chapter, Laura, have you seen this yet? The book is out. Laura and I and two people have a chapter in this book on
Sugar-Sweetened Beverages. The book just came
out this week. That's my research. On the teaching side. The wonderful thing
about NYU was that I was able to teach
anything I wanted, particularly because I was department chair for
a really long tim
e. I taught courses
on food policy and politics and on aspects of the food movement
on the farm bill, food ethics, and I've taught
courses on food advocacy, how you go about advocating. Then on the public service side, New York University, again, a perfect fit because
it describes itself as a private university in the public service and
the public service part, everything that I do in the way of public
lectures like this. Media interviews,
writing for the media, the blog that I write
almost ever
y day, and Twitter, and I'll
talk about these, all fall under the heading
of public service. I can put what I do into categories and in my
annual faculty reports, I can list lots and lots
of things that I've been doing and it makes my
university extremely happy. I'll give some examples of this. I talk to reporters every day, mostly by e-mail, sometimes
by phone, sometimes by video. This is the most recent one, an article by Anahad
O'Connor who's around here someplace and is now writing for The
W
ashington Post. He interviewed me about a report that came
out last week, or the week before about how
the Dietetic Association, now called the Academy of
Nutrition and Dietetics. As is very tightly linked
to food companies. In fact, the academy
own stock in Nestle, no relation, and in PepsiCo. Even I was shocked by that. Really, they own stock in companies that
make junk food and ultra-processed foods that are exactly the thing that a dietitian should be
advising people not to eat. That didn't
make any sense
to me so that's that. My most recent article for any news outlet
was in October in STAT where STAT asked me if I
would write something about the FDA's new decision
to define healthy. Was that going to be good, bad, or indifferent? I did a podcast with the
guy who is the editor and STAT who was just a
terrific interviewer who was really nice to do that. Scientists are under pressure
to use social media. I use social media. I can't say that I went into
it very enthusiastically. For
one thing, I'm not
very technically adept. The technical details of these things are
very difficult but I got involved in blogging
because I couldn't say no. When my book, "What
to Eat" came out in paperback in 2007, Farrar, Straus, and Giroux, the publisher was interested in using social
media to sell books. They asked if I would be a guinea pig and would
start writing a daily blog. I was horrified at the thought. I thought this was going to
be an enormous time sync. It was going to be
somethin
g that was really difficult of uncertain benefit. I really was reluctant about it, but I agreed to do
it for six months. The deal was a one-year trial and they said they would
pay to build the site. That was the determining
factor because they sunk a lot of money into the first website that I had, which was under the heading
of whattoeat book.com, which I never liked and got
rid of it as soon as I could. Some years later when
I had other books out, I consolidated
everything that I was doing onto
my current website,
which is foodpolitics.com. This talk is on
today's blog post. I've done it since 2007 and a completely
reasonable question is why? The answer is that it keeps
me up on current events. It forces me to stay on
top of what's going on, to answer questions
for reporters. If reporters asked
me a question, I could say I did a blog
post on it last week. Also, they tell me
what's new and exciting, and different in the field. They tell me about papers
I've never heard of. They're usua
lly really
interesting to talk to. It forces me to organize my
thinking in a coherent way. I get to use it
to promote ideas, to promote other people's books, to promote reports that
I think are interesting, and to do a lot of advocacy for the ideas that I want
to advocate for. That's the blog and it's
very easy to subscribe to, you just click into that button. Then there's Twitter, it's hard to talk about
Twitter this week but I started on Twitter in 2009
because somebody said, "You should be on
Twitter." They set it up so
that my blog would go out over Twitter automatically. I wouldn't have to do anything. That seemed good because again, there's the technological
stuff that's really difficult. I thought Twitter was inane. I thought it was
a waste of time. Once again, its benefit
was very uncertain. I'm still tweeting. Many years and 140,000
followers later, I'm still doing it and
it too has benefits. There's the obvious thing that the blog goes out over Twitter. I don't have to do any
work, but I find it to be a very
useful source of information about things that I
wouldn't otherwise know about in my field. It gives me a chance
to share information. When I'm waiting online
and bored out of my mind, it's very distracting though. The situation on
Twitter right now, The Atlantic just had an
article this week that Twitter's problems are
bigger than Elon Musk. Social media has risks and
Twitter illustrates that. It takes up a lot
of time sometimes, the links disappear, and soyou
can go
back and look at old blog posts or old tweets and the links are gone and
that's very unfortunate. Then you have to deal with
negative feedback and trolls. I have had my share of trolling. For some reason or other, I made a slide of this
one some years ago, but it was typical of a lot of messages that I was
getting on my blog site. I didn't like it. The
people who were reading my blog didn't like it and
I had to stop comments. I stopped comments on my blog. I thought somebody
was paying so
meone to do these because a lot of them came from
the same IP addresses. I have a cybersecurity
friend who traced the IP addresses back to a spam
site in Wichita, Kansas. I thought if this
is organized and these people are being paid to do this, really,
I don't need it. I stopped comments on my blog. I do regret that because
the comments were interesting and also
kept me up on things. Anyway, no more. I'm concerned about the
fact that Americans don't trust science
take on food issues. I think th
ere are lots
of reasons for that, but one is that
scientists aren't out front and transparent about their opinions and their
beliefs and arguing about them. Present company
excepted of course. I'm greatly in favor
of advocating. I try to be completely
transparent about my own beliefs
and I try to back them up with an extraordinary
amount of research so that every word that I say is backed up
with a reference. The kinds of things
that I'm advocating for these days are curbs on food industry
marke
ting practices. I'm advocating for
much more attention to social and behavioral
determinants of health and
nutrition and diet. Food systems approaches to
diets and dietary advice. On the dietary advice side, I think that the concept
of ultra-process is the most important
nutrition concept to come along in years. We should be telling
everybody to stop eating and drinking
ultra-processed foods. We should be looking
at diets that perform triple duty, meaning
preventing hunger, preventing obesity-re
lated
chronic disease, and preventing climate
change at the same time. Fortunately, that diet
is so simple that Michael Pollan can do it in his famous seven-word
semi-haiku, eat food, not too
much, mostly plants. If you define food
as anything that's not ultra-processed, you got it. That's really all
you have to do. I think that all of this
is really important. It's something that
I've always done. It's something that I
believe in very strongly. I think this is
what democracy is about and you ca
n use food to discuss democratic
concepts in ways that you really can't talk about
them in many other ways. I will leave you with my mantra, which is, vote with your fork. The food choices that you make have an impact
on our food system. But even more, you should
vote with your vote, which means get involved in politics and get
involved in policy. This is the thing that
runs throughout my book. I hope you'll try to
find it somewhere. There are cards running
around about how you can get it and th
at's
it. I'll stop here. Thank you very much [APPLAUSE] What happens now? Oh, questions. Thank you. That was very
inspirational for me. I feel like we've
had two topics, one on women in science
and one on nutrition. I've always wondered the
extent to which nutrition, because it is
associated with cooking and food which are traditionally
gendered activities. Might be taken less seriously and particularly less seriously in a professional space
like a medical school, because it's women's work. I wo
nder if you might
reflect on the intersection between being a woman in science and particularly
in nutrition. I talk about that in the memoir about how food was
not taken seriously. If your hierarchy is
basic biomedical research and you don't think that humanities researchers
are doing research. You count anything other than basic biomedical research
as non research, then food is way
down at the bottom. That's part of why it's not
taught in medical schools. Nobody takes it seriously. When we sta
rted our food studies
programs, undergraduate, masters and doctoral at
NYU [LAUGHTER] in 1996, the first question
was, What's that? Why would anybody want
to study about food? Fortunately, people aren't
asking that so much anymore as more and more
universities are teaching food in every
conceivable department that you can even think of. Food is now integrated into practically every
academic department. It's becoming a
little bit easier, at least through that. But I don't think you're
going to ch
ange that at a medical school where basic biomedical research
is what it's about. I talk a lot about that
in the UCSF chapter in this book because I was
confronted with it constantly. Even though we had an enormously successful nutrition
education program though in the sense that there were lots and
lots of people in it. I'll give you another example. I did ward rounds at San Francisco General and
I was in family medicine. The first time that I appeared
on the ward to do it, the chief resident h
ad
forgotten that I was coming and she said with just
dismay in her voice, We don't have any nutrition
problems on the floor. [LAUGHTER] I said, why don't
I just go around with you. There wasn't a single
patient who wasn't in desperate need of
nutrition intervention. In that first session, I was able at least to teach
the residents to maybe call a dietitian to come in and meet with these
patients. I don't know. It's been an uphill battle. It's never stopped. I think it's getting better. I really
do, but I don't
think it's getting better at medical schools
unless there is a powerful faculty member who is running a really
exciting program that's getting a lot of money. Then it might work. Yes, remember I started out as the chair of a Home
Economics Department. I am Chris Schaefer
from the UCSF Library. Can you take your mask
off. I just cant hear. Okay. Chris Schaefer
from the UCSF Library. Thank you for a really
wonderful talk. Can you talk a little bit
about the intersection between fo
od and nutrition and
agricultural research? Absolutely. I was very late in coming to agriculture and understanding
what it was about. I went to Berkeley
hoping you study food and the choices were
dietetics or agriculture. I was a city girl, I didn't get agriculture and I would last it
in dietetics one day, I tell that story
to in the book. I don't think you can understand why people eat the way
they do unless you understand their agricultural
system and the need to transform our current
agricult
ural system from one focused on feeding
animals and fueling automobiles to one that is
focused on food for people. We don't have an
agriculture system that does much about
food for people. It's got tokens, rounding errors of money that are involved
in pushing food for people, but it's not what it's about. If we're trying to get
people to eat less meat then our agricultural system is
working at cross purposes. One reason why we
have so much meat is that feed is cheap because
that's what subsidize
d. If I had a diagram of a
food system up there, it would start with
food production and end with food waste in a cycle. I'm not sure that's
what you're asking, but Davis is the land
grant agricultural part of the University of
California system. It's a very complicated place
[LAUGHTER] politically. My department at NYU
now has an urban farm. It took seven years to get it. It's not very large. [LAUGHTER] It's about
the size of this stage. This is about it. But yeah, we're
teaching agriculture. I
should say that when the food studies
program started at NYU, The New York Times
wrote about them and they interviewed Alice Waters. Alice Waters made some some that I thought
was really snippy about how can they run a Food Studies Program and not teach students about farming. I thought, has she
seen where NYU is. What are we supposed to do? Takeover washing square and grow vegetables in the middle of all those rats and people
selling drugs at the time. But she was absolutely right as Alice Wat
ers almost always is. [LAUGHTER] Does that
answer your question? I'm an enthusiastic supporter of agriculture and
agricultural research. I think we need it badly. Thank you. I think
I've two questions. When I read food politics, I was like really interested
in the notion of keeping the public puzzled as a very
important industry strategy. I was wondering if you could elaborate a bit on that notion. Keeping the public puzzled. Keeping the public what? Puzzled. Puzzle? Confused. Puzzle? Confused,
keeping the
public confused, yes. Let's keep the public confused. Let's go back to that, I mean, Michael Pollan is brilliant, and this is one of the
most brilliant things he's ever done. Dietary advice is really simple. People don't believe this, they think I'm joking. I'm not. This formulation leaves all
kinds of dietary patterns. It leaves deliciousness, it leaves cultural practices,
it leaves religion. It encompasses everything. But if you're a food company and you're selling an
ultra process
product, you want the public to be
as confused as possible. How do you do that? You cast doubt on the research, you do your own research, you focus on nutrients
rather than foods. You never talk about me, you talk about saturated fat. You don't talk about sodas, you talk about sugar, although sugar is
not bad either, but people have to know
where that sugar is. You don't talk
about snack foods, you talk about salt
and you leave it up to individuals to
make those decisions. You don't do policy,
any study that comes out, think of the number of
studies that you've seen that say everything you knew
about nutrition is wrong. That should be a red flag for we're trying to
confuse the public. Because if the public
ate like this, nobody would make any money. The food industries
billion-dollar ultra-processed
products wouldn't sell. So, of course, they're going
to confuse the public. Rob. One of the good things
about Obamacare, and we can talk about
the pluses or minuses, was the fact that they
kept insurance company
profits at 15 percent. Any more than that, it had to give back
to the subscribers , and all of a sudden, the insurance industry realized we can't make money by people being sick and the
problem is they don't know how for
people to be healthy. Given that the ultra-processed
food industry, for every dollar, 19 percent of it
goes to the food and 81 percent of it
goes to the marketing. Does it make sense to perhaps do the same thing for the food industry as
we did for Obamaca
re? Cap at a very specific rate. There's just an article
in The New York Times just today about the fact that food company profits have
gone through the roof and Joe Biden's basically telling everybody to eat generic
raisin bran because of it. He's doing what? Telling people to not eat
Kellogg's raisin bran, but generic raisin
bran because it's $1 cheaper. This is crazy. Yeah, in public health terms, that as downstream as you get. What you really want
is upstream policy. I'm all for regulating
t
he food industry, good luck with that. In 2019, I don't know, you need political will, and you need everybody
to be ready to do this. In 2019, a commission of the Lancet and with
the unfortunate name of the Global Syndemic report because you don't know what it means and it's obfuscating, but it's an absolutely
incredible report. It's the first report
I've ever seen that talked about the need to
regulate the food industry. It defined the whole problem
of people eating bad diets. There are diets t
hat
are really not good for them as one for which the food industry
was largely responsible. The fact that you couldn't do anything about it
for three reasons, because government is weak
and captured by corporations. Because civic society is weak and because
the food industry is very strong and very focused. I'm always saying that food companies are not
social service agencies, they're not public health
agencies, they're businesses. Their job is to provide immediate high returns to stockholders
and that's
really all they are about. If you expect them
to do anything else, you don't understand
the situation. There may be executives who
want to make healthy foods. I've heard executives
say things like, we wish we didn't have
to market to children, but our stockholders
insist that we do. That's what this is about. Yes, we should be regulating, and we shouldn't be
capping their profits, and we should be doing all
kinds of things, and know, having them reformulate their
product to take a gra
m of sugar out or a gram of salt out is not going to
make that much difference. That's why the ultra-processed
concept is so important. What it does that
really changes things because the way I define ultra-processed is that it's industrially produced, it doesn't look like the
foods that it came from, and you can't make it
in a home kitchen. Because it's got ingredients or requires machinery that you
don't have in your kitchen. We now know through
hundreds of studies that ultra-processed foods
a
re associated with higher risk of obesity-related
chronic disease, and we now have one absolutely
amazing clinical trial that explains why, because people eat more calories from ultra-processed foods
and don't realize it. Not just more calories but
500 more calories a day, an amount that is absolutely staggering in research terms. You do dietary studies, you're lucky if you find
a 50 calorie difference. But to find a 500
calorie difference, that's absolutely amazing. I think this is a really
imp
ortant concept, we should be advising
everybody to cut back on
ultra-processed foods. The food industry
doesn't like that, and the first thing
they're doing is casting doubt
on the research, complaining about the
squishy definition. Saying, well, really, these foods don't have
anything to do with it, it must be something else. It must be this, that,
or the other thing, it can't be the processing. We'll see how that
research plays out. But the food industry
is very unhappy about it and that tells
you there
must be something going on. Though I'm not sure that
answers your question, Rob, but I'm for regulation. I actually didn't know about the 15 percent cap on
the insurance industry. I want to know more about that. Just a comment. Getting back to the confusing the
consumer and food waste, if you look at the
foods that are stamped with best by this date, sometimes it's a
food safety issue, and sometimes it's a food
quality or texture issue. Eat by this date, and consumers are throwing awa
y tons and tons literally of food that is perfectly
good because they're assuming that's a
food safety date. We need two dating systems, a quality dating system and
a food safety dating system. You want me to comment
on food waste? It's not my issue. It's a feel-good issue. I tend to stay away
from feel-good issues. The reason I say that
is that if you look at the big picture
of food waste, 70 percent of the food waste occurs at the production level. It's bad weather, it's stuff that's
left on t
he field, it's vegetables that are
the wrong size and shape, but that's where the bulk of the food waste problem comes; 10 percent comes at the
grocery store level, and that leaves 20
percent for throwing away things with wrong
sell-by dates on them. I'm in favor of doing something
about the 20 percent. I'm not in favor of doing something about
the 20 percent, but I'd rather deal with it at the production level where
the big percentages are. And I know it makes
everybody feel really good to try
to do
something about food waste, and I'm glad you're
all doing it, I'm doing it too, it's just not something
I want to work on. But thank you for asking. Former student. [LAUGHTER]. No food studies. Food studies. I want to talk a little
bit about food as medicine and the movement
around food as medicine. What the current
opportunities are, not just at an
institution like this, but also in thinking
about soil health, thinking about the
opportunities in connecting agriculture
to human health, and
where you see that going
in the next few five-years? Well, I went to the White
House Conference on hunger, food, and health. It was a big issue at the White House Conference
because one of the people who was working on the
White House Conference is a big food is
medicine person. Food is medicine from that
standpoint is doctors prescribing fruits
and vegetables for their patients,
various incentives. It's all incentives systems for encouraging people to
eat fruits and vegetables. I'm not a food
is
medicine person either. I'm very uncomfortable about it because I don't think
of food is medicine, I think of food is pleasure. Food is something
that's cultural, it brings people together. It promotes health
and eating real food. It promotes health,
it promotes joy. It has all of these things
that when you medicalize it, it takes it out of there. The way that it was explained to me was that it's fundable. For example, the guy
from Tufte said that he wasn't able to get grants on a lot of the
things
that he was doing, but the minute he glommed
onto food is medicine, he got 11 federal
grants to work on it. Somebody else said it
plays well in Congress. Somebody else said, food is medicine plays
well with republicans. That's your answer. I think it's going to be a
really, really hot topic. I've opened up a new
file folder on it. I've started putting
things into it. I think it's going to
be really, really big. I've been told that the groups that everybody
is trying to get at resented eno
rmously and that feel that they feel that
it's condescending. It's telling them what to eat, which they don't like, and some other things like that. I don't know. We're
going to get all those sociologists and anthropologists
out there working on it. But I think it's something we're going to have to live with. Because at a medical
school like this, food is medicine
is going to work, and the other kinds
of things aren't. They just not. To me, that's what it's about. It's about reaching a top-down
funding and
decision-making apparatus. Top-down not bottom-up. As always, nobody is asking communities
what they want. As always. We have time for
one more question. Actually, that's not true. There are people who are asking communities what they want. Thanks so much for such
an inspiring talk. You inspired me to
go into my career. I wanted to ask you
if you could describe some threats that you've experienced from the food industry and how you
dealt with them. I'm sorry, I missed
it. It's really
hard for me to hear
this for some reason. Sure. If you could describe
maybe threats you've experienced from
the food industry and how you have
dealt with them. Actually, I've had very, very few direct attacks
from food companies. The attacks usually come
from three stages removed. For example, the
trolls on my blog, I was pretty sure because of the tone and the
quality of them, and the consistency and
some of them were really funny that they must have come from the center for
consumer freedom,
which is a public
relations group in Washington that's funded
by the food industry. I could never prove it, but that was my suspicion. When food politics
first came out, there were a bunch of trolly reviews on Amazon that you can still see if you'd go back to the earliest reviews of
food politics on Amazon. They were, hasn't she ever heard about
personal responsibility? Hasn't she ever heard about people taking responsibility
for their own behavior? Again, somebody called them out and said that
they must
have been paid for. I was threatened
with a lawsuit from the sugar association when
food politics came out. I've got that correspondence
on my own blog at the bottom of my
publications place. That was a very
funny story because they said I had defamed sugar. I didn't know that sugar had feelings and could be defamed. The reason I had defame
sugar was that I said that soft drinks contain sugars and nothing else, no nutrients. They said you, as a nutritionist
should know better. Soft dri
nks don't contain sugar, they contain
high-fructose corn syrup, which I thought was
hilariously funny. I'm just laughing and
laughing about it because high-fructose
corn syrup has sugars. Sugars, plural. Sugar is glucose and
fructose stuck together. Corn syrup is glucose and fructose separated,
they're sugars. I thought it was very funny. People told me, no, this is not funny. They're preparing a
veggie libel suit against you and you
need to have a lawyer. Read these letters and you
need to writ
e a response that rebuts every single point and you have to have
a lawyer look at it. This is beginning to sound
very expensive and unpleasant. I'm not very litigious, but I did all that and then never heard
another thing about it. But I ran into the head of the sugar association and a
meeting some months later. In the meantime, I've been
putting quotations in my slides and talking about this because I said I
thought it was really funny. These people don't
know bio chemistry. I ran into this guy
in
a trade show and said, I've just had so much fun
with your lawyer's letter. He said very stiffly, we're just glad you're
speaking more precisely now. Meaning that I now say
sugars instead of sugar. It's to trade associations. The corn syrup is represented by the Corn Refiners
Association and cain and beet sugar represented
by the Sugar Association. They don't like each
other very much. They compete. For a long time, the corn sweeteners were
cheaper than sugar. They're not anymore now that so
much corn is
going to ethanol, the price differential is
much smaller. Who knows? I'll even put sugar back
into Coca-Cola. That's it. Thank you very much, it's been a pleasure
to talk to you. [APPLAUSE] [MUSIC]
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