In this video from 2016, University of California San Francisco health policy professor Laura Schmidt, PhD, questions whether consumers really do have freedom of choice – and what policymakers can learn from corporations in nudging consumers toward healthier behaviors. Following is a transcript of her remarks. Laura Schmidt: When you get up in the morning, you probably feel pretty free to choose what you're going to do. But my guess is the first thing you do is reach for one of these, my cell phone. It gives me continuous access to an online, all-you-can-eat buffet. I can enter a virtual gambling casino, get hooked on a little app or a game. Hey, shop till I drop. I've got to be honest with you. I am one, I cannot not look at this thing when it pings with a new text message. I am one of the 78% of Americans who can't get up out of bed in the morning without checking this thing first. Sometimes I don't even notice I'm reaching for it. I just do it. Now, here's a product you probably don't have in your pocket. This is powdered alcohol. I'm not kidding. Palcohol. It's going to be out on the market this year. I can just carry around this convenient little package and mix myself up a cocktail whenever, wherever I want. Maybe I should add it to my morning coffee at work. It might jazz things up a bit. Here's my point. At no time in human history has our species been so bombarded by stuff designed to get us hooked. Companies compete on the very basis of creating evermore habit-forming products, and it's no different with our food. Food corporations hire scientists to engineer the most irresistible habit-forming foods. Sugar is currently their go-to ingredient. These guys have flipped the script on us. They are using the very brain-imaging technologies that we use to try to find cures for addiction, only they put people in the MRI machine and feed them Dorito chips to figure out ways to tweak the recipe to make it even more habit-forming than it already is. Here's my question to you. When you live in a world that is surrounding you on a 24/7 basis with food products scientifically engineered to be habit-forming, do you really have freedom of choice? Now, most addictive substances are actually quite safe in their natural form. Heroin comes from poppy seeds. Cocaine from the coca plant. Alcohol from fruits and grains. For centuries, farmers high up in the Andes mountains have chewed coca leaves. It's a tradition. It's a mild stimulant -- like drinking a cup of coffee. It helps them work longer hours and cope with the high altitudes. Probably the worst thing that could happen to you after a lifetime of chewing coca leaves is maybe you'll get bad teeth. Things do get really bad when we industrialize the coca production process. When we learned how to refine the coca plant down into its most concentrated form, a little rock of white power, that's when the humble coca leaf becomes the lethally addictive drug we know as crack. Now what's interesting is that up until the 20th century, cocaine was actually an innocent, domesticated white powder, just like sugar is today. People put it in everything. You could go to your drugstore and buy it in a soothing tonic. People put it in cough syrup and gave it to their kids. Coca-Cola is one of the most successful products in modern history. It was formulated in the 1880s and the company's founders were so proud of their special recipe that they vowed never to change it. But at one time in history, the Coca-Cola corporation was forced to change its recipe, and that was in 1903 when the political current, the tide was shifting away from cocaine, eventually to make it an illegal drug. That's when Coca-Cola took the cocaine out of the Coke. Of course, they just replaced it with a different addictive substance, namely caffeine. Here you have it, a concentrated dose of sugar combined with a concentrated dose of caffeine. Double the pleasure. Double the chances we'll get hooked. The fact is as long as food corporations aren't breaking narcotics laws, they can do pretty much whatever they want to formulate their products to make them even more habit-forming. My work takes me into San Francisco's Tenderloin district. Every big city has a place like this, right? It's a few square blocks of extreme poverty and urban blight. There's a liquor store on every corner, usually with a bunch of drug dealers hanging out in front. We have a name for places like this. We call them alcohol and drug-saturated environments. Now, the Tenderloin has a program called Safe Passage. Volunteers go to the school bus and pick up children to safely walk them to their homes. They have to travel circuitous routes through the city streets to avoid all the drug dealers and liquor stores. It's like living in an obstacle course. When it comes to processed food and sugar, we're all living in an obstacle course, our own Tenderloin. It's on every corner, in every store, in every workplace. 74% of the foods in your grocery store have sugar added to them, stuff that doesn't even taste sweet. Why do I care about this so much? It's actually not the rising rates of obesity worldwide that keeps me up at night. It's two other very disturbing trends, and the first is the appearance of adult diseases in children. Type 2 diabetes is linked to heavy sugar consumption and especially sugary drinks. It's called adult-onset diabetes because in my parents' generation, we only saw it in adults. Today, 1 out of 4 American teenagers is prediabetic or diabetic. Next is the appearance of whole new diseases that seem to come out of nowhere. The diagnosis non-alcoholic fatty liver disease didn't even exist until 1980 ... again, a condition linked to heavy sugar consumption and poor diet. By 2020, in five years, it's going to be the leading cause of liver transplantation. This is the global warming of human health. These trends are warning signs like melting icebergs and rising sea levels. They're telling us that there's something very wrong with our food environment. Our food supply is making some of us very sick. Here's the good news. There is some good news. The solutions to this situation are easily within our reach. Now everybody always says, "Educate the public in healthy choices." But we know that doesn't work. If it worked, then why would 48% of Americans still be drinking a sugary drink or more a day? The fact is I could say until I'm blue in the face, "Don't drink that stuff. It's unhealthy." You already know that. But when you live in a sugar-saturated environment, more often than not, you'll probably just reach for what's been put in front of you. If it's a concentrated source of pleasure, a product carefully engineered with white powders to get you hooked, that puts a huge burden on you all the time to say no, and many of us don't. What do we do about this problem? How do we fix it? The solutions are actually remarkably simple and here's how it works. Food companies have gotten very good at seducing us towards their products in ways that we barely even notice. All of the most effective public health strategies just do the opposite. They gently nudge us away from the unhealthy stuff. It's simple. We just flip the script back. For example, soda companies. They intentionally keep their prices down so that we'll buy more. If we put a tax on this soda, that raises the price a little and gently nudges us away. If food corporations are barraging our children with advertisements for Cap'n Crunch and Cocoa Puffs, we can just take those ads off the air. If they pay grocery stores to put candy at eye level for our little children, we can put it a little higher on the shelf. If they pay famous sports figures to promote Gatorade, we can pay them to say, "I drink water." Small changes can add up to big shifts in the environment. We know this from decades of research on addictive substances. I understand we really would all like to believe that we're in charge, that we have complete freedom over what we eat, but how free can we be living in a saturated environment, one that continuously surrounds us with food products carefully engineered to get us hooked and keep us coming back for more? Those kids in the Tenderloin, they apparently live in what's called a food desert. They don't even have access to a grocery store. Really. What's a grocery store when it's stuffed with junk food, 74% of it loaded with added sugar? All the health experts will tell you, "Shop around the perimeter of the grocery store. That way you can steer your way around all the junk that's in the middle." How different is that from a strategy that steers children around drug dealers in the Tenderloin? We can do so much better than this. We don't have to live in an environment that is rigged to get us fat and then blames us for the health consequences and the medical bills. We don't have to sit by and watch our children suffer from diseases of adulthood. We can re-rig this environment to make it safe. It's not about personal choice anymore. It's about our public choice. Thank you. Source
