I'm thrilled to be here with you today and to honor Dr Ronald Haberman, a tireless advocate for cancer prevention. What we eat has an enormous impact on our health. Unhealthy eating patterns are the number one cause of death in the United States, contributing to over 600 1000 deaths from cancer, heart disease, stroke, diabetes and other diet and obesity related diseases. And there are significant disparities in the rates of those diseases. Food and nutrition related diseases affect quality of life, causing significant disabilities. They also increase health care costs for families, for businesses, through insurance costs for their employees and for governments through insurance, Medicare and Medicaid. 70% of adults and a third of children have obesity or are overweight, which contributes to heart disease, diabetes and about a dozen different kinds of cancer, including cancers of the esophagus, uterus, breast colon and liver. Fortunately, a similar dietary pattern can reduce most of those diet related diseases and is good for the planet. The basic dietary pattern for a 2000 calorie a day diet, which is about typical for people, is half your plate should be fruits or vegetables. A third of your greens should be whole grain, dairy foods are a big source of saturated fat. So primarily choose low fat free and plant based milks and yogurts and try to cut back on full fat cheeses. Choose poultry seafood, nuts, beans and plant sources of protein and cut back on meat to cut saturated fat and to cut the risk of cancer. And in choosing healthy fats, go for fats from vegetable oils, nuts and fish and limit butter, lard and red meat and other animal fats. Now most of our days calories are needed to meet those food group needs to provide our core nutritional requirements. It leaves just about 15% of our calories for solid fats, added sugars and alcohol. So that means there isn't much space for things like soda and other sugary drinks, sweet baked goods, cookies and pastries and ice cream. Processed food provides most of the sodium in our diets. The salt shaker really isn't much of a problem. What we need is for companies to reformulate their products to cut back the salt and sodium to safe levels. Interest in food and eating well is at an all time high. Most people about 85% or so say they want to eat well and they want to feed their children well. You don't often hear people saying, I hope that I'll gain enough weight to grow out of my wardrobe or I'd love to get ovarian cancer. People aren't consciously choosing to be overweight or to get cancer or heart disease. Most of us feel like we're entirely in control of what we eat. And in focus groups, parents tell us that they bare almost all of the responsibility for feeding their children well. But marketers know better. People's food behaviors are affected not only by conscious choice, but also by what food is available, how convenient it is. The pricing the core pricing and what's on sale, the package size, the formulations, the ads and the marketing. There are lots and lots of influences beyond our control, outside influences that affect what we eat. Many food decisions are made on autopilot. It's like when you snap out of a train of thought and you realize you've been driving along the highway for a while without even realizing it. You've been relying on habits. Habits are unconscious, automatic rather than deliberate decisions. We need habits and shortcuts to make the thousands of routine decisions that we face each day, including about food. We can't take the time the effort to make every single one of those decisions through a thoughtful, rational process. We just do a lot of things automatically, including what we eat. Companies and marketers use our biology against us and they use psychology and marketing to drive food sales, which means driving what we eat. Biologically, we are hardwired to eat when food is available. There are four Ps of marketing. Promotion, price product in place. Of the four Ps place, is one of the most powerful forms of marketing. That's why food is ubiquitous. It's everywhere we go these days. It's at gas station, shopping malls, ballgames, theaters. Airports look like food courts, candy bars and junk food are pushed on us at the checkout at grocery stores and convenience stores. As well as at hardware and bed and bath, electronic office supply, toy, clothing, drug in almost every other kind of retail store. Most of us get about two thirds of our calories from the grocery store. I used to think of supermarkets as a nutritionally neutral space where you could buy everything from carrots to candy. But not all foods are equal in the grocery store. If you forget to grab broccoli as you're doing your shopping, you won't see fresh broccoli again as you make your way through the grocery store. It's only in the produce section. But if you are trying to be good and you purposefully avoid walking down the chip aisle, you will definitely see chips a half a dozen more times around the store on the end of aisles in freestanding displays next to the deli and at the check out. All of those will nudge you to put chips into your cart to buy them and then of course eat them. Sugary drinks are placed 25 to 30 different places around the supermarket each time that's nudging, poking prodding you to buy soda or another sugary drink, which will lead to eating more calories than you may have planned. The contracts between food processors and supermarkets determine which products get stocked on the shelves in the first place and where they are like a big display of soda in the front of the store or this mac and cheese in the middle of the canned food aisles. Food manufacturers pay grocers more than $50 billion a year in trade fees and discounts to market their products in stores. In store marketing has become so effective that food manufacturers have significantly shifted their marketing dollars to them. In the 1960s, food manufacturers spent about 70% of their marketing dollars on advertising. You know what you traditionally think of as ads. Now that's flipped. They spend about 70% of their marketing on in store promotions and pricing. And about 30% on public relations and advertising. Through voluntary action or public policy, food manufacturers and retail could shift their marketing rather than using it to heavily promote soda, chips, candy and other unhealthy foods. They could use that marketing mind, that marketing genius to support and encourage healthy options. Another key strategy that affects what we eat is pricing. Both in the grocery store and restaurants and other places where we buy food. In retail, trade contracts between food manufacturers and grocery stores also helped to determine what the base price of the food is. So like this sugary drink, fruit flavored, but just like soda nutritionally, this is an everyday low price that makes it very accessible and leads to higher levels of consumption. The companies also, the food manufacturers helped to decide what's on sale through the price promotions in the stores and coupons. So discounts like 50 cents off two for one or 6 for $6 or by getting extra food for free or for just a tiny bit more money. So when you see 30% More in a box or buy one get 1 free. Those types of price promotions often lead people to buy more food rather than to buy the same amount of food at a cheaper price. So this drives over consumption drives us to eat more. So much. So that in the U. K. They have adopted a policy to limit price promotions such as multi buys and unlimited refills for unhealthy Food and drinks. And that policy starts in April 2022. Another way that our food behaviors are affected is through how defaults are set defaults are what people automatically get if they don't actively choose something else. It's like the fries that usually come with a burger at a restaurant. There are packaged and portion size default so how the how the amount of food is presented to you has a big effect, how food is formulate formulated and how things are paired together. All of these setting of defaults affect what people eat and how much they eat. So for portion sizes for example, portion sizes tend to provide a context for people of how much to eat and people tend to eat the amount that they're served or eat more when they're served more. And interestingly not only do we eat more when we're served more, but we often don't really notice how big the portion is and so in studies where people are served 30 40% more, they eat more, but they don't notice that they're eating more and they don't feel more satisfied or more full. They don't even notice that extra food they just go ahead and eat it. Portion sizes have grown so much back in the 1950s, a typical soda was about 6.5 ounces and now it's about 12 or 20 oz depending on whether you get a can or a bottle. The food industry also has changed food pairing default. So for Example, back in the 19 50s, sandwiches typically came with a pickle. And now after years of marketing, Frieda Les has changed that default to potato chips. So it was an active marketing campaign that shifted that automatic pairing of a sandwich and a pickle to a sandwich and chips, brilliant marketing but adds a lot of extra calories to our diets rather than leaving it to companies to set the default driven primarily by profit considerations, public policy and public health advocacy can get companies to set more beneficial defaults. So for example, Disney started offering healthier beverages and a fruit and vegetable as a side dish with their Children's meals at their theme parks. And what they found Was that 2/3 of families stuck with the healthier drink option and about half stuck with a fruit or a vegetable over fries. So these healthy default were very well accepted by families and shifted intake toward healthier options. Yeah, after retail and restaurants, the next biggest place where americans get food is from institutions, state and government programs or in government work sites and buildings, correctional facilities, hospitals, childcare centers, senior centers, universities and schools. Many states and localities are adopting policies to improve the nutritional quality of the food that states, localities and institutions purchase, serve and sell through their cafeterias, snack bars, bending through public spaces, meetings and conferences so they change what they buy, they change what they serve. They shift what's available to significantly increase access to healthy food. Companies and institutions practices either support health or they undermine quite often there is no neutral. It's not impossible to eat well in America today, but often it's like trudging through deep snow. If you're in excellent shape and you can afford good boots, you can do it for a while, but eventually you get tired. Mhm. Food system changes and public policy can clear a path for people to make it easier actually to make it possible for people to eat well. It's not that unhealthy foods wouldn't be available in the healthy food system, but you'd have to seek them out. You'd have to work to get them the way you have to work harder. Now in order to have healthier foods in reasonable portions. We want to support people's efforts to eat well so that they can maintain or achieve a healthy weight and avoid the risk of cancer, diabetes and heart disease. It's worked before national policies that I've worked on have helped to move trans fat from the whole US food system. Companies like google just moved the M. And M. S out of sight at their office **** stations. They Just made them less visible. They were still there, but harder to see. An employee consumption decreased by three million calories over seven weeks. Stronger nutrition standards for school lunches have led to a 40% improvement in the nutritional quality of school lunches with kids eating more fruits, vegetables and whole grains. Supporting healthy eating can be through national state or local policy changes in industry practices and food formulations. Worksite wellness programs, institutional changes and community actions. We can prevent diet and obesity related cancers, but the market doesn't ensure that public health is considered in addition to economic considerations. That's why advocacy and policy are needed. Thank you for joining us today in the effort to reduce and prevent cancer. It was great to be here
