 What I would do this morning would be to talk about the way that I'm thinking about food and nutrition these days. And as you can see, I've been busy for the last, since 2002, these books have come out. I approach this from the standpoint of what are called food systems these days. And by food systems, I mean everything about food, from the basic science of food to the way it's grown and produced to the way we consume it and to the way we advocate for healthier diets for people on the planet. And I talk about food systems because the most important problems in public health these days, the public health problems that affect the largest numbers of people all have to do with food. Food insecurity, obesity and its consequences and the environmental impact of the way that we grow food are all food systems, problems that result from dysfunction in our food system. And if we want to fix these problems, we need to fix our food systems. So I'll say a little bit about each of those. Under nutrition, the Food and Agriculture Organization of the United Nations says that under 800 million people suffer from malnourishment and hunger. This is the lowest figure in recorded history and is considered a great achievement of the last several decades. On the other hand, and ironically, we have about two billion people in the world who are so overweight that they have risk factors for chronic diseases, an enormous problem. If you add all of that up and round the numbers off a little bit, that means that half the world's population has problems related to food, an enormous number. And this has to do with dysfunctional food systems, dysfunctional food systems have to do with inequities, not only in income, but also in the way in which people eat and consume food and have access to food. And so food has become a social justice issue where inequities in the food system play out in what we in the United States call a divide. And the picture that I'm showing you here is a cover from the New York Times magazine from 20 years ago, 1996, in which we were already talking about how the rich and poor eat in very, very different ways. Let me move on just to say something about the issue of climate change and agricultural production because that's so important these days and it's such a big topic at this meeting. But if you look at the contribution of our food production system to greenhouse gases, the estimates range from about 15 to 25%, the one I'm showing you here is at the upper end. The blue sector is the result of the way we use land until the contribution of industrial agriculture to greenhouse gases is larger than that of energy production and considerably larger than transportation. Big surprise if you didn't know that. And the way we eat within our agricultural system also has a great deal to do with climate change. The estimates are that meat and dairy products, animal production, are the greatest contributors to greenhouse gas production within our food system, largely because of the grain that has to be raised to feed animals. Beverages also account for a significant percentage. In general, processed foods, meat and dairy, comprise roughly 60 to 70% of the greenhouse gas emissions from the kinds of food choices that we make. So obviously, if we want to make healthier food choices for people and for the planet, we want to be eating much more in the way of fruits and vegetables and to minimize the consumption of foods that are going to be, that are going to affect our health in ways that are not so good and also affect the planet. And so how do we put all that together? Well, I like to show Michael Pollan's seven words because it's so simple that he was able to, he's a brilliant writer and he was able to do it in seven words, eat food, not too much, mostly plants, really that takes care of it. It really, really is that simple. I have a slightly different way of putting it. I say if you're concerned about obesity, you need to make better food choices. You need to eat less in general and you need to move more. I'm not going to say too much about physical activity, but it's very important and please don't eat my book. But if it seems like it's more complicated than that, it's because of what happens with eating better. The American Dietary Guidelines, and I'm an American and I'm going to be speaking mostly about United States examples, but the American Dietary Guidelines tell you to eat more fruits and vegetables, to choose meats in small amount, meat and dairy in small amounts, and to minimize consumption of heavily processed foods. But the problem is that heavily processed foods are the most profitable foods in the food system and there's an enormous financial incentive for food companies to make those kinds of products. Fruits and vegetables are not very profitable and that's a big problem in the system. So the food industry has responded to a lot of activism around food that I'm going to be talking about by putting an enormous fortune into advertising highly processed foods. And these are numbers for individual products. So Pop Tarts had a $30 million budget advertising in the United States and that's just Pop Tarts and just the kind of money that goes through advertising agency, Coca-Cola $254 million last year. I mean, these are staggering sums of money in nutrition education terms. I can assure you that the government doesn't spend anywhere near the amount of money that's spent on one product. So that creates a food system that promotes the kinds of foods that people really should be eating less of. Another change in the food system has to do with the enormous increase in serving size in the United States. Those of you who visited the States recently are kind of astonished when you go into a restaurant and order what you think is a reasonable amount of food and on your plate is something that you would eat for three days. And I'm not exaggerating. The size of portions has increased dramatically since 1980. And if I had one thing that I could teach, just one, it would be that larger portions have more calories. I know it sounds hilariously funny, but it's not intuitively obvious. I can prove that it's not intuitively obvious. People think if it comes in a container, it has 100 calories and that's it. But really, larger portions have more calories and that's all the explanation that you need for why the levels of obesity have increased so greatly in the United States. So another change in policy that's occurred since 1980s is the change in relative prices of foods. And I show this because there's a lot of feeling that healthier foods cost more than the foods that are less healthy and, in fact, they do. These are Department of Commerce figures from 1980 to the present. And what they show is that fresh fruits and vegetables and processed fruits and vegetables have increased in price at a much, much greater rate than the food system as a whole, which is that bar in the middle, and then the ones that are at the bottom are fats and oils, sugars and sweets, and carbonated beverages have increased in price at a much, much slower rate. So there's a great financial incentive to consume foods that are highly processed. And that's part of the food system. So we've created a food system in which the food industry and the government and the entire food environment are promoting a diet that encourages people to eat more, not less and more of the wrong kinds of food. So that brings me to the whole question of policy. And we in the United States have two different kinds of policy. We have nutrition policy that is aimed at helping people decide what to eat. It's on the consumption side. And we have agricultural policy that's aimed at talking about food production. And these are two completely separate policies handled in most aspects by separate agencies, and they have nothing whatsoever to do with each other. They need to be brought together. So let me show you how that works. And I ask the question, where in the United States nutrition policy is agriculture? Nutrition policy in the United States is expressed in the Dietary Guidelines for Americans, which started in 1980 and have come out every five years since then the most recent ones came out last year. And nowhere in any of these documents is anything about agricultural production. Now that's not for lack of trying. For the 2015 Dietary Guidelines, the Dietary Guidelines Advisory Committee was familiar with the evidence about contribution of foods to climate change. And they proposed in their report to the agencies that produced the Dietary Guidelines that a diet higher in plant-based foods and lower in animal products would be best for health and would be best for the environment. And they used the word sustainability. They said it would be better for sustainability, which has become in the United States the S-word. The meat industry was so upset about this that they immediately went to Congress and complained. Congress passed an act, if you can believe anything like this, that told the Department of Agriculture that they could not say anything in the Dietary Guidelines about sustainability. The Secretary of Agriculture announced six months before the Dietary Guidelines were released that the Dietary Guidelines would not use the word sustainability and nowhere in the 144 pages of the Dietary Guidelines from 2015 does the word sustainability exist. So that's agriculture and nutrition policy forbidden. What about nutrition and agricultural policy? Well, it turns out the Department of Agriculture in the United States is a very complicated agency and it has offices that work at cross purposes from each other. One office says make half your plate fruits and vegetables. Not bad. That would be good for health and it would be good for the environment. But the real money in the Department of Agriculture, which is the money that goes into agricultural subsidies, does something quite different. It subsidizes corn and other grains that are the food for animals. So it's supporting animal agriculture. The percentage of subsidies, this was 2008 to 2012. We don't have these kinds of figures more recently, but nothing has changed very much. 0.45% of the subsidies in the Department of Agriculture went to fruits and vegetables. And that was less than the amount that went to tobacco. We're still subsidizing tobacco to a very small extent. So very contradictory policies that don't take nutrition and health into consideration, they should. So given that situation, what is the poor consumer to do in a food environment that promotes eating more of foods that are wrong for health and wrong for the environment? And this is a very, very difficult situation. And it brings me to the whole question of what do you do? I don't know if you can read this. You've got to start eating out of a different parking lot. So there's two parts of that. One is you have to choose which parking lot you're going to be eating in. And the other is that the parking lot has to change. So that's two things. That's personal choice and its policy. So I talk about both in my books. My most recent book is Soda Politics, Taking on Big Soda and Winning. And I'll show you what the end winning is about. And it's really a book about food advocacy and how you advocate for a healthier food environment that's the commercial. But it brings us to what's happening in the United States where there's an enormous public outcry about sugars. A book has just come out by the journalist Gary Taubes, who makes a legal case against sugar. I don't think he makes nearly as good a biological case as he does his illegal case. But it has put sugar on the front pages of the New York Times. And all kinds of stories are being written. This one was one that just came out a couple of weeks ago, in which a columnist for the New York Times went off sugar for a whole month and was surprised to find that there were sugars in practically every food in a supermarket. So sugar, big deal. The main source of sugars in American diets by far are sugary beverages. The estimate is that nearly 50% of the sugars in American diets come from sugary beverages. The amount of sugar in sugary beverages is absolutely staggering. And the amounts are so high that it really takes only one of those to meet the upper limit of sugar recommended by major public health organizations, such as the World Health Organization and the US Dietary Guidelines, both of which recommend that people consume no more than 10% of their daily calories from added sugars. And one of those drinks would really take care of nearly that much as 50 grams a day. One 16-ounce Coca-Cola or Pepsi will take care of that. Now, I subtitled my book and winning because of the graph shown in red here, which is consumption of carbonated sugar-sweetened beverages in the United States from about 1980 to the present. And you can see that the peak was in 1999 or 2000 right in that area. And sales and consumption of these beverages has been declining quite steadily ever since. And believe me, the soft drink industry is very well aware of this. One of the things that they're doing is pushing bottled water. And on this graph, they cross. And Americans are now buying more bottled water than they are sugar-sweetened beverages. And this is great for health. We won't talk about what that means about bottles in the environment. But at least on the health side, it's better. And in fact, obesity rates in the United States are leveling off at least a bit. Well, the companies are well aware of this and are moving a lot of their marketing overseas. This is a worldwide slide of the expenditures of Coca-Cola. And I'm sorry to pick on Coca-Cola because it could be Pepsi as well. The Center for Science and the Public Interest produced this very nice graph. And it indicates the amount of money that these companies are spending on marketing all over the world between roughly 2010 and 2020. So the one that's right in the middle of Africa, it's $17 billion from 2010 to 2020. That's billion dollars. Think about what $17 billion could do for development in Africa. Just try to get your head around that one. And the soda companies are doing other things as well. They're sponsoring research. This is a particular interest of mine because my next book is going to be on food industry sponsorship of research and practice and nutrition. And this was a study, not mine, that came out just a few weeks ago in the annals of internal medicine that looked at studies that were looking at whether sugary drink consumption was related to obesity and diabetes. And they found 26 studies that said no. No relationship at all. Every single one of them was funded by Coca-Cola or the American Beverage Association or some other food company that would stand to benefit from it. And of the studies that found that, yes, there was a relationship, only one was funded by industry. So that's something to look at as well. Now, taking all this together, Michael Pollan again wrote what I thought was a complicated story in the New York Times Magazine a few months ago talking about the food movement in the United States, which I think is a very, very important trend over the last several years. And he said that whenever the Obamas were tried to do anything, the food industry fought back so hard that they really weren't able to accomplish what they wanted to. And that's true to some extent. But I think it was a much too pessimistic view because we've seen many gains of the food movement in the United States over the last several years, an enormous increase in sales of organics, for example. We have a big $15 an hour minimum wage movement in the United States that has been extraordinarily successful in getting some states and cities and communities to pass higher wage laws. And of course, the big one is taxes. Even in this last election, what many of us feel was one bright ray of light and hope was that soda tax initiatives passed in several cities in the United States, often by very large margins. So cities such as Albany, Oakland, San Francisco, and Boulder all passed tax initiatives. And Berkeley had done one a couple of years earlier by an extraordinary percentage. 76% of the voters in Berkeley, California voted for a soda tax as a social justice measure, as a community organizing measure, and as something that where the funding from the tax would go to child health initiatives. Extremely popular and framed as a social justice issue. Type 2 diabetes is a regressive disease. It mostly affects the poor. And this is one way to try to overcome that. Taxes have gone worldwide. And there are countries all over the world that have figured out that a soda tax is a way to promote better health and to raise revenue at the same time. And it's become a worldwide phenomenon, one way in which activism is working. Now companies are responding. And they're responding in lots of complicated ways. There are huge sustainability initiatives in most of the large food companies, and I'm sure you've heard about them at this meeting. They're proudly doing sustainability. They're removing additives and dyes and various kinds of cosmetics from the foods. Whether they're removing sugar and salt is another matter. It's much harder to do that. But they're trying to. And if they are lowering salt and sugar, they're doing it very quietly so nobody knows about it. Even the business press is now saying to food companies that food activists are your new brand manager, that the food movement in the United States is so strong that every food company has to pay attention to what the public wants. Or it's not going to be selling foods. And this raises lots and lots of problems for food companies. So this brings us to the question of what do you do personally? Every time you make a food choice, you vote with your fork for the kind of food system you want. Do you want a food system that's healthier for people and the planet? Then you make certain kinds of choices. The broccoli that was on this side of the slide at the beginning. It's not enough. We also need to be working for policies that will make the healthy choice and the sustainable choice the easy choice so that it will be easier for everybody to make those kinds of choices. And these are the kinds of things I talk about in my books, another commercial. And I thank you very much for listening. Thank you.