Blog post by Bernadette Keefe MD
If we are what we do and what we eat, we’re potatoes: couched and fried.
– Ellen Goodman, Wall Street Journal
Introduction
Fast Food has a rich and storied history. In Roman times, through the middle ages, fast food, sold by venders, was a necessity, as many dwellings had no kitchen.
The British “Fish ‘N Chips” was popularized in the mid-1800s by coastal towns that needed to service the large trawling industry. The undisputed King of the Fast Food Industry, however, is the United States. With the introduction of the automobile in the early 1900s, there was ever greater access to fast-cook restaurant fare. America fell in love with “White Castle” hamburgers; the rest is history. America has the largest fast food industry, and, has peppered the world’s landscape with Subway, McDonalds, Kentucky Fried Chicken, Burger King, Starbucks, Dunkin Donuts, Wendy’s among others, whose outlets can be found in over 100 countries.
Due to its worldwide dominance of the Fast Food Industry, U.S. citizens are particularly immersed in the fast food culture, and sadly have “drunk the cool-aid”. While most of this essay addresses the effect of fast food in America, the same issues are equally concerning for the rest of the world.
Americans eat a staggering amount of ‘Fast Food’, spending $200 billion a year on these meals. Every day, one in four Americans eats at a fast food restaurant. Fast Food’s huge appeal is its particular taste, convenience/availability, and low cost. It’s cheap because the major commodities used to produce it: corn, soy, and beef are heavily subsidized by the U.S. government. Chains have insured availability by operating 200,000 fast food restaurants, in the U.S. alone. These food outlets are strategically, and densely located, most conspicuously along the vast corridors of our nation’s highways, and, in ‘food deserts’. There are very few places in the U.S. that don’t have either fast food outlets or convenience (food) stores. The big problem: Fast Food is killing us with a lethal dose of super-sized portions of unhealthy, non-nutritious food.
Another problem: fast food really isn’t cheap when we consider overall personal expenditures. Once we factor in the healthcare expenses needed to treat the chronic diseases we suffer due to diet, eating fast food, or even a standard American diet costs us a lot of money. The total cost of healthcare in the U.S. for 2015 was 3 trillion dollars or, $9,500 per person; the highest in the world. That money is, in large part, spent on healthcare required to treat the epidemic of lifestyle diseases, such as decades of Type 2 diabetes, heart disease and cancer, all related to obesity.
This ‘Cost Shift’ – from food dollars to healthcare dollars has tremendous ramifications that ripple through our lives, effecting wellness and physical function as well as economic security. In today’s piece I’d like to tease out our love affair with the French fry and hamburger, the effect on our health, some of the politics, and consider possible solutions.
What is Fast Food?
In essence, fast food is food purchased outside the home, that is prepared and served quickly. Although “White Castle” hamburgers were introduced in the 1920s, the concept of fast food was really popularized in the post-war era of the 1950s. The food sold in fast food outlets can be made quickly because the ingredients are preheated or precooked. Fast Food outlets, especially in the U.S., usually feature a “drive-through” option.
In America, the quintessential fast food meal is a hamburger, French fries and a soda!
Why Are We So In Love With Fast Food?
We know fast food is not good for us, so why do we continue to consume so much? To answer this question, its best to start with understanding what motivates us, instinctively, as humans.
All animals, humans included, are intrinsically/genetically motivated by three major driving forces or instincts dubbed, “The Motivational Triad”. These are: the acquisition of food or sustenance, the accomplishment of sex or procreation in order to carry on the genetic code, and the conservation of energy in all that we do. The psychologist, Douglas Lisle PhD, produced the following engaging video on the topic:
The Motivational Triad & The Fast Food Industry – Food, Sex, and the Conservation of Energy
The first driver in “The Motivational Triad” is the acquisition and enjoyment of food. We have evolved, exquisitely, in order to answer this need. The tongue is a unique structure, coated with 10,000 taste buds, able to sense four major tastes: two of which are for pleasure, and two that are meant to repel. These four evolved to promote sustenance, and insure our genetic survival. The two pleasure sensors are for sweet and salty; the two warning sensors are for sour and bitter. In evolutionary terms, we crave sweetness, because it signals ripe fruit, and salt, because it’s an essential compound for basic body function. (Incidentally, sourness was to alert to spoiled food, and bitterness to poisonous substances.) The appeal of fat is that it is an extremely dense source of dietary energy.
The fast food industry is well aware of both the motivational triad, and, our three major taste pleasures: salt, sugar, and fat. In order to sell more product, their food scientists work to create an irresistible food by combining the three major pleasurable components in just the right proportions, to achieve what is termed the, “holy grail of proportionality”,“The Bliss Point”.
The food industry’s success revolves around its production of an ever-evolving ultra-processed food supply built around “The Bliss Point”, a flavor profile that gets us snacking, but unfortunately, not satiated.
A perusal of nutrition labels reveals that all processed, or ultra-processed food has at least two of the three added components, sugar, salt, and fat. While unadulterated varieties of food can be found, they are far less common, and not widely available in the average American grocery store. For example, while it’s possible to purchase plain, unsweetened, yogurt, one must look hard to find it among the vast number of other, unhealthy, choices, and it is nearly impossible to purchase pizza sauce without added sugar and salt.
Food specifically engineered to “The Bliss Point” activates the pleasure-reward pathways, the dopaminergic pathways in our brain; sometimes called ‘The Want” pathways.
The dopamine pathways are the same routes used for addiction, whether the addiction is to certain foods, drugs, cigarettes, or alcohol, among others. Once our pleasure-reward pathways are activated, we have no internal strategy to fight our instincts. When faced with highly engineered food, we consume more, and more, and more!
Not only is the unchecked consumption of fast food a major problem due to the increase in calories ingested, but, this food, engineered by targeting “The Bliss Point”, is not nutritious. No less than 99 % of fast food is unnaturally dense, high caloric, and highly processed(ultra-processed). Today, these processed foods have, as dominant ingredients, high fructose corn syrup, refined flours, and, large amounts of both salt, and fat.
The graph below demonstrates the degree to which fast food kids meals surpass the government-recommended levels of saturated fat, sugar, and sodium.
Though the government-recommended diet (see Dietary Guidelines for Americans) includes abundant fruits and vegetables, and less meat and processed food, only 12 % of us manage to keep this healthy diet. Instead, the diet most of us follow, the ‘Standard American Diet” or the “Western Diet”, is quite different, as is depicted in the graph below.
The typical American consumes a diet largely of processed foods and animal products, dubbed the ‘meat-sweet’ diet. Given that one in four of us eat a fast food meal every day, it’s easy to see how important the fast food contribution is to the “Western Diet” and our unhealthy choices.
The third driver in the “The Motivational Triad“ is conservation of energy. This means that we choose the easiest, simplest path to obtain what’s necessary to sustain us. (The second driver, procreation, or sex, is not relevant to this particular piece). Eating out, utilizing the wide availability of fast food outlets, checks off this third box. Ready-made meals, eat in dining or take out, requires no prior planning, shopping, or clean up. This suits the fast lifestyles of the busy American family. Currently, a whopping 40% of American meals are consumed outside the home.
Outside Seduction By Fast Food Industry
The fast food industry has utilized two additional tactics to further seduce people into buying more product. It has increased the caloric “bang for the buck” by upsizing portions, and exquisitely targeted its demographic marketing through tailored ad campaigns and siting of its restaurants.
Portion up-sizing is, increasingly, a telltale feature of the entire American restaurant industry. Over the past twenty years there has been a dramatic increase in the size of most food items sold in America, with the resulting increased calorie intake with each serving growing to two to five times more.
It was McDonald’s, America’s largest fast food chain, with 43% of the market share, that really capitalized on the popular trend of “portion distortion”, by introducing the “Super-Size” option, encouraging consumers to say, when ordering, “Super Size Me!” A regular order, super-sized, yielded you an item two or three times as large. Under pressure, the McDonalds company was eventually forced to discontinue the “Super Size” options but all fast food chains continue to upsize their portions, using new, different terms. Large, jumbo and King-size are all massive portions. Today’s small, medium and large were yesterday’s medium, large and extra-large.
Unfortunately, McDonald’s doesn’t exempt children from unhealthy upsizing of portions. This is a sample ‘Kids Meal” shown side by side with the right-sized version of the same meal. A “right-sized” meal is one that stays within the government-recommended calories and nutrients for health.
The McDonalds corporation marketing arm is characterized by vastly popular/viral, highly targeted, ad campaigns.
One of the earliest, and most successful, marketing campaigns of McDonalds was the, “You Deserve A Break Today…..” , campaign, introduced in 1971. This campaign targeted the busy housewife, who now, might be also working outside the home. The “Fast Food Night Out” was meant as a “treat for mom”; hard to argue against.
MacDonalds – You Deserve A Break Today – 1971
The McDonalds company claims that it does not market to the pre-schooler, the 2-5 year old demographic. However, that age group watches television and McDonalds ads portray scenes that really appeal to the younger audience with dinosaurs and animated farms. Before most children can speak they can already recognize McDonald’s. Through its “Happy Meal” program, McDonald’s distributes more toys per year than Toys-R-Us!
Fast food restaurant chains also locate their restaurants where they have a ‘trapped’ consumer, one who has few other options. The two key places where this most apparent is in food deserts, and along our nations highways. In doing so, the industry is capitalizing on marketing opportunity gaps that have been caused by conditions in U.S. society: poverty and the “car culture”.
Food Deserts are defined as areas without grocery stores within one mile. Often, the distance is greater. Overall, 23.5 million people in the U.S. live in food deserts. Within this group are two million Americans in low-income, rural areas who live at least 10 miles from a supermarket. Notably, five million households in the U.S. without a car, live over one-half mile from a supermarket.
As the graphs below demonstrate, food deserts are associated with both an increase in obesity, and diabetes. Thus, the negative social determinant of health connection between poverty (no car), food deserts (limited food options), AND poor health.
Additionally, because processed fast food is of such low nutritional quality, the sad perversity, and incredible tragedy of ‘Food Deserts”, is that inhabitants are both overweight and under-nourished.
The U.S. is geographically large, and thus, depends heavily on automobiles for transportation. We have, essentially, a “Car Culture”, serviced by over two and one half million miles of paved roads. Americans spend 175 billion hours per year in car transit, or about 100 minutes per day! 90% of Americans drive to work. The fast food industry has located many of its 200,000 fast food restaurants located along U.S. highways, ready to serve the captive, hungry commuter!
Obesity
The negative health consequences of heavy consumption of a fast food and Western diet are many. Obesity is one of the leading, and most deleterious to our health. Tragically, obesity rates in the United States have skyrocketed since 1960, with the largest increases seen since the 1980s.
The “Body Mass Index” (BMI) is used to determine whether someone is of normal weight, underweight, overweight or obese. An individuals BMI is calculated by solving a formula, using the individual’s height and weight. Today, 33%-40% of the American population is obese, or has a BMI over 30. 72% of Americans are overweight, having a BMI greater than 25. Geographically, the southeastern United States has the highest concentration of obese and overweight persons.
The negative health consequences of obesity are many. Obesity causes an increase in many chronic diseases such as Type 2 Diabetes, heart disease, cancer, and musculoskeletal disease, among others. Obesity also affects a person’s quality of life via hampered physical functioning, lower activity levels, and added emotional stress, including stigma.
Solutions – Multi-pronged
Inspiration – Messaging
The C Word Movie, a just released documentary, addresses the connection between our lifestyle, especially our diet, and cancer. It’s a plea for empowerment.
Action by the Food Industry, Restaurants/Grocery Stores
The U.S. Food Industry, and most prominently, the processed food and fast food components of it, has some similarities and bonds with the tobacco industry. Phillip Morris, the tobacco company, is the largest food producer in America, through its ownership of General Foods and Krafts. Notably, similar lobbying tactics have been employed in both tobacco and food industries (and even the National Football League).
Corporate Accountability International (CAI), is an organization that protects human rights, public health, and the environment from corporate greed and abuse around the world.
With 2010 revenues of more than $180 billion, the fast food industry is a powerful force in our economy. Corporations such as McDonald’s, Yum! Brands (owner of Taco Bell, KFC, and Pizza Hut), Burger King and Wendy’s engage in business practices that undermine the health and well-being of communities.
– CAI
“Value [the] Meal” is a CAI campaign that will reduce the harm and human suffering caused by the fast food industry, protect our children and future generations from the corporate-driven epidemic of diet-related diseases, and help transform the food system.” – CAI
In their report: “Policy Guidelines for Healthier Kids and Families”, CAI proposes a four pronged approach for communities: school policy, “healthy” zoning, curbing kid-focused marketing, and redirecting subsidies to healthier businesses.
The food industry and restaurants can also institute an array of helpful policies. Perhaps the two most important would be: to provide nutrition labels in multiple locations, including all menus, and, to decrease portion sizes. A study showed that when nutrition labels are also printed on the menu, restaurant diners consumed 14% fewer calories. ‘Right-sizing’ dishes, or making the portions no more than 30% of recommended daily allowances per meal, can slash 30-50% of the calorie amount.
Fast food restaurants can also increase the selection, and appeal, of healthy food by adding more fresh vegetables and fruits. They could reverse current pricing models by decreasing the price of nutritious food, and increasing the price of junk food, although similar suggestions, such as soda taxes, have not been always well received When MacDonalds made adjustments to their ‘Kids Happy Meals’ by adding fruit, and downsizing fries, they were able to reduce calories by 20% and sodium by 15%. However, only a small percentage of children actually ate the fruit, or chose the milk option over soda.
Starbucks is an incredibly popular, ubiquitous, coffee shop. However, on more perusal of its menu, including the calorie counts, it could easily pass as a dessert shop. The sweetest Starbucks drinks have 42-59 grams of sugar and 500-600 calories!
Many people in the U.S., and around the globe, who frequent Starbucks daily, including many millennials, are learning to start their day with a large dose of sugar!
Grocery stores can foster healthier customer purchases, by stocking a greater variety of high quality fresh produce, and, by keeping the price of vegetables and fruits reasonable. The industry can make a concerted effort to find, sell, and promote healthier, in store, options. Ideally, all grocery stores would provide educational brochures about food nutrition, and home cooking.
The Individual/Families
There is so much that each of us, and our families can do to improve our eating habits. Changes can be made as a household, simply by cooking and dining together. If single, one can adjust personal food preparation habits, and use home dining while entertaining family and friends, to experiment with healthy cooking and new recipes.
The number one action that all of us must do is to at least read nutrition labels and understand what they mean. Only then, are we equipped with the requisite information to adjust our eating decisions to healthier options. Whether purchasing food at the grocery store, in a restaurant, or fast food drive-through, we might prepare better by knowing the nutrient value of each food or drink item we buy. This type of proactive approach is important because studies have shown that consumers’ estimations of caloric intake at meals is 20-25% lower than actual totals! Most restaurants, including the fast food chains, have their menu’s nutritional content on their websites.
Notably, despite nutrition labeling being widely available now, only 16% of us change our eating choice after reading the information. This tells us that most of us will need to be much more anticipatory/proactive if we want to have control over our weight. We need to adopt a more receptive mind, one that might be open to changing our “desire for food” into an “appreciation of food”. An appreciation-type approach might include savoring taste, understanding satiation, and valuing health and self-care, while eating. Two possible strategies for accomplishing this are pure self–discipline or, perhaps, gamification! The self-disciplinary route would involve using nutrition labeling to rigidly adhere to an optimum daily diet, taking into account our level of physical activity and nutritional needs. To gamifiy the process of healthy eating, we might create a SuperBetter-type game to help us!
As a huge slice of our caloric intake comes from sweetened beverages, one of the simplest, and most efficient calorie cutting strategies is to drink water.
Doing more home cooking is also a very effective method to eat a more healthy diet. Studies have shown that we consume less calories, fat and sugar when we cook at home. However the are numerous barriers to home cooking given our current lives. Factors that make home cooking challenging to do, on a regular basis, are varied, including multiple jobs, increased number of hours working outside the home, inadequate home support, and, likely, food deserts.
Political/Social/Community/Corporate Solutions
The U.S. has massive healthcare costs associated with treating the chronic diseases related to obesity. The best estimate is that the U.S. spends over 190 billion dollars per year on diseases related to obesity: this is over one-fifth of all healthcare spending. It might be time to insist that the manufacturers of processed food and fast food pick up some of the tab of this cost through political action.
Nutritious food affordability is a major issue in the U.S., a country whose citizens labor under dramatic, and increasing economic, inequality. To combat this, states are enacting legislation to raise the minimum wage to what is termed a “living wage”. The State of California has just passed a minimum wage law of 15 dollars per hour to be enacted fully by 2018.
Our economic inequality outstrips every other nation in the world.
The Fast Food Industry is massive and wealthy, worth 200 billion dollars in the U.S. alone. Unfortunately, despite employing 4 million people in the U.S. who struggle with subsistence wages, it lobbies against “a living wage”.
To eat healthily, and, to be able to resist the “high calorie per dollar” appeal of fast food, there must be more affordable fresh produce, that is, more price parity between unhealthy and healthy food. Unfortunately, due to the foods industries, including the fast food industry, it is cheaper and easier to get calories by ingesting low quality, fast, processed food than by eating fruits, vegetables, and healthy proteins. Adjusted for inflation, the price of fresh produce in the United States, over the past 30 years, has increased by 40%, whereas, soda and processed food has decreased by 30%.
If the cost of treating the chronic diseases was incorporated into the price of unhealthy, processed, fast foods, we could likely reach this price parity.
Political action would mean agitating to limit the marketing of junk; forcing its makers to pay the true costs of production; recognizing that advertising for fast food is not the exercise of free speech but behavior manipulation of addictive substances….
– Mark Bittman
Communities, and local and state governments, could do more to eliminate ‘food deserts’. Incentives could be provided to bring a small grocery, perhaps satellite stores, to food deserts. All communities can support “Fresh Markets”. The federal government has sanctioned the use of food stamps, via the “Supplemental Nutrition Assistance Program” (SNAP), at these fresh produce markets. (Fresh markets must apply to use this program.) Other communities have been creative by instituting “mobile mini-healthy groceries”, or fresh produce trucks.
Providing accessible/walkable, healthy, and, affordable options is key to combating the convenience and price of purchasing fast food from outlets in food deserts. A living wage, price parity, more economic and social support, and, local grocery stores, might just be the ticket that many people, who are struggling with food related issues, need.
….93% of those with limited access to supermarkets, do have vehicles but have to drive more than 20 minutes – “and after a long day of work at one or two jobs, twenty extra minutes plus cooking time, must seem like an eternity
– Mark Bittman
The U.S. Federal Trade Commission (FTC) has passed guidelines for the marketing of food to children and teens from age two to 17 years of age. However, these guidelines remain voluntary. It has been challenging to get tougher legislation passed, as the food industry lobbying effort in the U.S is massive, spending 40 million dollars (2012) to sell its wishes to congress.
Many schools, and even some hospitals, have fast food outlets on premises, alongside less processed, healthier options. This remains a controversial, and sadly, not easily rectified issue, in a nation like ours, so heavily steeped in the “Fast Food Culture”.
Healthcare professionals/ Medical education
Recently, there has been more pressure on healthcare professionals, especially, physicians, to not only prescribe a healthy diet, but to model healthy behaviors such as those around weight, diet, and exercise. This “walk the talk” is considered important for patient engagement and education, and, for better patient health outcomes.
Gradually, medical schools are embracing more nutrition education, and even culinary training. The Tulane University School of Medicine has established the Goldring Center for Culinary Medicine where the emphasis isn’t solely on nutrition, but on the practical aspects of food: the health benefits, the preparation, the cooking, and the enjoyment. The video below, with initial narration by the centers executive director, Dr. Timothy Harlan, describes the process and goals of this fascinating culinary medicine program.
Cooking Up Culinary Medicine
Mindful Eating and The Slow Food Movement –
Philosophical Alternatives to “Fast Food Nation”
Mindful Eating is, in essence, being more aware of what is happening when we eat. This holistic awareness encompasses our emotional, physical, and, spiritual states.
The rhythm of life is becoming faster and faster, so we really don’t have the same awareness and the same ability to check into ourselves. That’s why mindful eating is becoming more important. We need to be coming back to ourselves and saying: ‘Does my body need this? Why am I eating this?
– Dr. Lilian Cheung
The Slow Food Movement is a grassroots organization from Italy, that started in 1986, as an alternative to fast food. It espouses local cuisine, fosters local farming, and community sustainability. Home preparation, and slow, communal dining, such as potlucks and community dinners, are part of this movement.
With both Mindful Eating, and Slow Food, there is a celebration of real food and social eating, and an “appreciation of the pleasures involved in nourishing one another and enjoying that nourishment together”. –Mark Bittman
Conclusion – You Deserve A (Better) Break Today
There is ample evidence that consuming fast food, a lifestyle habit that is linked to obesity, is bad for our health. Unfortunately, nearly 90% of us consume the “Standard American Diet”, consisting of mostly processed foods. The typical American diet, sedentary lifestyle, and other poor lifestyle choices such as smoking, increase our risk for heart disease, stroke, kidney disease, cancer, Type 2 diabetes, and dementia, among other diseases, dramatically. These lifestyle habits markedly degrade our quality of life over time. The best estimates are that 75-80% of Americans are suffering from a preventable illness or disease.
The classic MacDonalds commercial of the 1970s and 1980s featured the tune “You Deserve A Break Today….” The message was geared to the busy housewife, who might also be working outside the home. The ads showed images of a clean kitchen (no clean up) and relaxed family moments without the ‘hassle’ of cooking at home.
After nearly 50 years of this messaging, I’d like to reframe this. Picture a family, on a routine basis, able to purchase healthy foods at an affordable price, with time to cook it, together, and sit around a table to enjoy that home-cooked meal, and, each other. In other words:“ You Deserve A Much Better Break Today: Eat Real Food, Not Too Much, Mostly Plants, and, mostly at Home! “
Forks Over Knives – Trailer
Game-Play:
Pop Quiz: Guess the Calories (below)
Answers will be posted 5 minutes before the #HCLDR chat on 4/12/16
Please join the #hcldr weekly tweetchat on Tuesday April 12, 2016 at 8:30pm EDT (for your local time click here) when we will discuss the following topics:
T1 Is the fast food industry partly to blame for the U.S (and global) obesity epidemic? How could it help solve?
T2 What should be the response (political, societal, & individual) to the obesity epidemic?
T3 How can we eliminate food deserts?
T4 How can we utilize our instinctive “Motivational Triad”, for better eating habits, and a more healthy, life?
References
Information /Solutions
Dietary Guidelines for Americans http://health.gov/dietaryguidelines/2015/
Information to Make Choices: Dietary Guidelines for Americans, Food and Menu Labeling, and Marketing Standards http://stateofobesity.org/policy/nutrition-assistance-and-education-for-families/education-through-the-dietary-guidelines-for-americans-food-and-menu-labeling-and-marketing-standards
Calculate Your Body Mass Index – BMI http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi-m.htm
The 5 Best Ways To Measure Body – Fat Percentage http://dailyburn.com/life/health/how-to-measure-body-fat-percentage/
About Adult BMI http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/
Walking, cycling and taking public transit tied to lower weight http://www.reuters.com/article/us-commute-weight-study-idUSKBN0GJ29V20140819
Study Suggests Home Cooking is a Main Ingredient in Healthier Diet http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-a-livable-future/news-room/News-Releases/2014/Study-Suggests-Home-Cooking-Main-Ingredient-in-Healthier-Diet.html
Mindful Eating As Food For Thought http://www.nytimes.com/2012/02/08/dining/mindful-eating-as-food-for-thought.html
How To Get Started In The Slow Food Movement http://www.wikihow.com/Get-Started-in-the-Slow-Food-Movement
The Medical Benefits of Family Dinner: 5 ways of eating together keeps kids healthier http://childrensmd.org/browse-by-age-group/toddler-pre-school/the-medical-benefits-of-family-dinner-five-ways-eating-together-keeps-kids-healthy/
SNAP and Farmers Markets – U.S. Department of Agriculture http://www.fns.usda.gov/ebt/snap-and-farmers-markets
Cancer is a Preventable Disease that Requires Major Lifestyle Changes http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/
Slowing Down Fast Food https://www.stopcorporateabuse.org/sites/default/files/resources/slowing_down_fast_food_corporateaccountabilityinternational.pdf
If you’re not concerned about behind-the-scenes lobbying, you should be – it affects everything from the food you eat to the medicine you take http://www.independent.co.uk/voices/if-youre-not-concerned-about-behind-the-scenes-lobbying-you-should-be-it-affects-everything-from-the-a6697056.html
If Doctors Learned To Cook They Might Give Better Advice http://www.npr.org/sections/health-shots/2015/12/26/460803440/if-doctors-learned-to-cook-they-might-give-better-advice
Science of Food Production and Reward
How The Food Industry Helps Engineer Our Cravings http://www.npr.org/sections/thesalt/2015/12/16/459981099/how-the-food-industry-helps-engineer-our-cravings
Why Do You Crave Sugar, Salt and Fat http://sciencemags.blogspot.com/2010/07/why-do-you-crave-sugar-salt-and-fat.html
Role of brain dopamine in food reward and reinforcement http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1642703/
When Food Becomes Drug http://flipper.diff.org/app/pathways/6092
Is Food Addictive? http://eatcleantrainclean.com/is-food-addictive/
The reality of food addiction http://thepaleodiet.com/reality-of-food-addiction/#.VvafaZMrJp8
You Know What You Should Do: so why is it so hard to do it? http://yumuniverse.com/the-pleasure-trap-you-know-what-you-should-do-so-why-is-it-so-hard-to-do-it/
Hormonal and neural mechanisms of food reward, eating behaviour and obesity http://www.nature.com/nrendo/journal/v10/n9/full/nrendo.2014.91.html
Cheap Food….Really?
Is Fast Food Really Cheap? The Truth about the Dollar Menus https://www.nutriliving.com/articles/is-fast-food-really-cheap-the-truth-about-the-dollar-menu
I consumed nothing but fast food for a week and it was the easiest and cheapest http://www.independent.co.uk/life-style/food-and-drink/features/i-consumed-nothing-but-fast-food-for-a-week-and-it-was-the-easiest-and-cheapest-diet-plan-ive-ever-a6884351.html
Are We Overfed and Starving To Death? http://www.hungryforchange.tv/article/overfed-and-starving-to-death
Is Junk Food Really Cheaper? http://www.nytimes.com/2011/09/25/opinion/sunday/is-junk-food-really-cheaper.html
Yes, Healthful Fast Food is Possible, but Is It Edible http://www.nytimes.com/2013/04/07/magazine/yes-healthful-fast-food-is-possible-but-edible.html?pagewanted=all
Growth In Inflation Adjusted Food Prices Varies by Food Categories http://www.ers.usda.gov/amber-waves/2015-july/growth-in-inflation-adjusted-food-prices-varies-by-food-category.aspx#.VvQ8TJMrJp8
Diet, Obesity and Disease
Americans Are Fat and It’s Costing Us Billions http://www.usnews.com/news/blogs/data-mine/2015/11/02/americans-are-fat-and-its-costing-us-billions-each-year
Fast-Food Consumption and Obesity Among Michigan Adults http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136980/
Why Eating Quick, Cheap Food Is Actually More Expensive http://drhyman.com/blog/2010/08/13/why-eating-quick-cheap-food-is-actually-more-expensive/
Cancer is a Preventable Disease that Requires Major Lifestyle Changes http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/
Stop Eating Fast Food: Why Fast Food is Slowly Killing Us http://www.lifehack.org/articles/lifestyle/stop-eating-fast-food-why-fast-food-slowly-killing-you.html
For Young Athletes, Good Reasons To Break the Fast Food Habit http://well.blogs.nytimes.com/2012/09/14/for-young-athletes-good-reasons-to-break-the-fast-food-habit/?_r=0
National Health Expenditure Data – 2014 https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf
New Federal Guidelines Regulate Junk Food Ads for Kids http://www.theatlantic.com/health/archive/2011/04/new-federal-guidelines-regulate-junk-food-ads-for-kids/238053/
Food Deserts, Fast Food and Obesity
Fast Food Industry Analysis https://www.franchisehelp.com/industry-reports/fast-food-industry-report/
The Shocking Truth About Food Deserts and Obesity https://spoonuniversity.com/lifestyle/obesity-rates-food-deserts/
National Grocers May Not Solve the East Raleigh Food Desert http://raleighpublicrecord.org/news/2013/02/01/national-grocers-may-not-solve-the-east-raleigh-food-desert/
Obesity
World Health Organization –Mediacenter: Obesity and Overweight http://www.who.int/mediacentre/factsheets/fs311/en/
Weekly Roundup; Fast Food Infographic Charts Obesity Rise http://www.preventobesity.net/blogentry/weekly-roundup-fast-food-infographic-charts-obesity-rise
Who’s to blame for obesity? Policy Makers, the Food Industry or Individuals https://www.sciencedaily.com/releases/2014/01/140122112422.htm
Economic Costs of Obesity http://www.healthycommunitieshealthyfuture.org/learn-the-facts/economic-costs-of-obesity/
90% of Americans drive to work http://www.brookings.edu/blogs/brookings-now/posts/2013/10/ninety-percent-of-americans-drive-to-work
The Big Fat Case Against Big Macs https://www.washingtonpost.com/archive/opinions/2002/12/14/the-big-fat-case-against-big-macs/cdcc529b-9146-4bd4-9164-7da6eb33dcfb/
Fast Food – Miscellaneous
Starbucks drinks that have more sugar than most candy http://www.foxnews.com/leisure/2014/10/27/starbucks-drinks-that-have-more-sugar-than-most-candy/
The 9 Highest Calorie Drinks at Starbucks http://www.businessinsider.com/starbucks-high-calorie-menu-items-2013-6?op=1
By any other name, it’s still a supersize http://www.nbcnews.com/id/20825325/ns/health-diet_and_nutrition/t/any-other-name-its-still-supersize/#.Vvj8mpMrJp8
Fast Food Nation: Cities in the US that Spend the Most on Fast Food http://www.designinfographics.com/food-infographics/fast-food-nation-cities-in-the-us-that-spend-the-most-on-fast-food
How Many Steps It Takes to Burn Off 13 of Your Favorite Foods (It’s Lots) https://www.thrillist.com/health/nation/how-many-steps-it-takes-to-burn-off-calories-in-fast-food-items
Which Fast Food Kids Meal is The Healthiest? http://www.motherjones.com/environment/2013/12/which-fast-food-kids-meal-has-most-calories
What’s Worse: Calories in Coffee or Candy? http://dailyburn.com/life/health/calories-in-coffee-candy/
What’s Driving Fast Food Meal Deals http://www.marketplace.org/2016/01/11/world/whats-driving-fast-food-meal-deals
Subway, Burger King, Taco Bell, 17 Others Earn “F” Grades For Antibiotics Policies https://consumerist.com/2015/09/15/subway-burger-king-taco-bell-17-others-earn-f-grades-for-antibiotics-policies/
Additional Videos – Documentaries/Movies
Fast Food Fat Profits: Obesity in America
http://documentary-movie.com/fast-food-fat-profits-obesity-in-america/
The Pleasure Trap – Video- Douglas Lisle, PhD https://www.youtube.com/watch?v=nxf4kj8Rb6Y
Super Size Me http://documentary-movie.com/super-size-me/
Fast Food Nation – Trailer https://www.youtube.com/watch?v=zc_z623Wsro
Fast Food Babies (UK) – BBC Documentary https://www.youtube.com/watch?v=R_Rof46gJbA
Books
Lisle, Douglas J., and Alan Goldhamer. The Pleasure Trap: Mastering the Hidden Force That Undermines Health & Happiness. Summertown, TN: Healthy Living Publications, 2003. Print.
Moss, Michael. Salt, Sugar, Fat: How the Food Giants Hooked Us. New York: Random House, 2013. Print.
Nestle, Marion. Food Politics: How the Food Industry Influences Nutrition and Health. Berkeley: U of California, 2002. Print.
Pollan, Michael. In Defense of Food: An Eater’s Manifesto. New York: Penguin, 2008. Print.
Schlosser, Eric. Fast Food Nation: The Dark Side of the All-American Meal. Boston: Houghton Mifflin, 2001. Print.
Spurlock, Morgan. Don’t Eat This Book: Fast Food and the Supersizing of America. New York: G.P. Putnam’s Sons, 2005. Print.
Weil, Andrew, and Ditte Isager. Fast Food, Good Food: More Than 150 Quick and Easy Ways to Put Healthy, Delicious Food on the Table. N.p.: n.p., n.d. Print.
Willett, Walter, P. J. Skerrett, Edward L. Giovannucci, and Maureen Callahan. Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating. New York: Simon & Schuster Source, 2001. Print.