It's no secret that McDonald's and KFC peddle cholesterol and salt. But they are not the only culprits in the diet-linked health problems afflicting millions of Americans. Also at fault are food companies with more wholesome profiles, reveals nutritionist Marion Nestle in her exposé, Food Politics: How the Food Industry Influences Nutrition and Health.

The book gives readers a convincing look at how the $800 billion-per-year food industry undermines public health on a scale comparable to Big Tobacco. "Many of the lessons learned from the 'tobacco wars' apply just as well to food, especially the lesson that the industry will relentlessly counter even the slightest suggestion to use less of its products," Nestle writes. "That actions typical of anti-smoking campaigns are only rarely applied to nutrition issues is a tribute to how well the food industry has sown confusion about the research linking diet to health, about advice based on that research, and about dietary choices based on that advice." Nestle shows that good health is, at best, incidental to Big Food.

Nestle, a former nutrition policy adviser to the Health and Human Services Department who now chairs New York University's nutrition and food studies department, has seen the industry's influence firsthand. She recalls going to work for the Public Health Service on a surgeon general's report in the mid-1980s probing links between diet and health. "My first day on the job, I was given the rules: No matter what the research indicated, the report could not recommend 'eat less meat' as a way to reduce intake of saturated fat, nor could it suggest restrictions on intake of any other category of food." Breaking the rules could have stirred up enough industry opposition to sink the study.

After years in the health policy trenches, Nestle remains upset with the industry's persistent role in increasing American food consumption and in promoting unhealthy food. She shows that the current market rewards producers of unhealthy and processed foods, and that bigger portions generate more profits.

Big Food subverts nutrition basics in ever-more sophisticated ways, from marketing unhealthy foods to children to funding research journals and organizations such as the pro-industry American Council on Science and Health. Some of Nestle's best reporting shows that soda companies have grown more creative in getting their products into schools. She details "pouring rights" contracts—such as Coca-Cola's $8 million deal with one Colorado school district—under which soda companies pay school districts for the right to place vending machines and logos in schools.

Elsewhere, she describes how food companies spike junk foods with nutrients and supplements and market them as healthful products. For example, Nestle shows how packaging can persuade shoppers that fortified Froot Loops are good for their children, even though the cereal contains little or no fiber and much sugar.

Nestle's reporting on the history and effects of fortification and supplements—which burrows deep into the relationships between industry, Congress, the Food and Drug Administration, and other agencies—demonstrates that marketing can undermine Americans' efforts to be health conscious. If anything, however, Food Politics should devote more space to addressing the problem of Americans who know full well the health implications of large meatball pizzas and fries but eat them anyway because oil and salt taste good.

Nestle suggests reforms, alleging, for example, that the Agriculture Department is broken: The department's "conflicting missions—to promote agribusiness and to advise the public about diet and health—cause no end of trouble; such problems are unlikely to be resolved until the USDA's education functions are transferred to an agency less intimately tied to industry interests." She acknowledges, however, that any broad restructuring is at best a long-term goal.

Other proposals include cracking down on the revolving door between regulatory bodies and industry; keeping junk-food ads off children's television shows; providing subsidies for fruits and vegetables; and expanding campaigns to get people to eat less and exercise more—efforts that could be funded through local, state, or federal taxes on soda and junk food.

Many of these proposals will be a tough sell politically, but Nestle makes the need for them clear. She cites research demonstrating that adult and child obesity has grown substantially since 1991. "Rates of obesity are now so high among American children," Nestle warns, "that many exhibit metabolic abnormalities formerly seen only in adults."

Nestle's policy goals are ambitious, but she may have an opening. As the Enron scandal and campaign finance debates highlight industry's influence in policy-making, Food Politics makes clear the high stakes involved in health policy. At the same time, the obesity issue may be gaining steam. In a December 2001 report, outgoing Surgeon General David Satcher wrote, "Left unabated, overweight and obesity may soon cause as much preventable disease and death as cigarette smoking." At the very least, Nestle's well-documented analysis could spur enough public discussion to prevent more Americans from sleepwalking down the supermarket aisles.

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