Lisa Kiefer interviews Harold Goldstein, PhD., the founding executive director of the California Center for Public Health Advocacy, a nonprofit, nonpartisan organization dedicated to improving the health of Californians
TRANSCRIPT
Speaker 1:Method to the madness is next.
Speaker 2:You're listening to method to the madness, a biweekly public affairs show on k a l experts celebrating bay area 10 Oh Lisa keeper. And today I'm interviewing the founder and executive director of the California Center for Public Health Advocacy, Harold Goldstein, Dr Goldstein's, innovative public policies address the conditions that perpetuate, [00:00:30] you'll be Citi epidemic here in California. [inaudible] welcome to the program, Harold,
Speaker 3:as a pleasure to be here. Lisa, thanks so much for having me. You founded the California Center for Public Health Advocacy way back in 1999 did, it seems like a long [00:01:00] time ago now. 15 years. What do you do over there? You know, what we do is we were one of the lead organizations in California that's addressing the obesity and diabetes epidemics. And we, we look at it from a public health perspective, from a community perspective. We say, what is it that's going on that's leading to have so many kids, especially in kids and teens being overweight and having now diabetes. A quarter of all teenagers in this country now have diabetes or prediabetes, and that's not happening. [00:01:30] Um, by chance it's happening because we live in a world that is promoting and perpetuating these epidemics by putting soda and junk food everywhere we turn by making, making physical activity, um, more and more difficult making sedentary lifestyles as easy as possible.
Speaker 3:What led you to found this policy institute? It's a good question. You know, I had been working at the La county health department, um, at the time and I was working on some issues that were starting to teach [00:02:00] me about this epidemic. I, I met a researcher there who had been working in east la and um, he was the first guy I'd ever met who showed that 30 to 40% of kids in the Mana bellow school district in east La were overweight in that school district. Now I'm sure there's 50% of kids who are overweight, but in 1999, that was a first time I'd ever heard about childhood obesity. And I realized that most policy makers, they didn't know about childhood obesity [00:02:30] either. And things have only gotten worse. Why didn't they know about it? Well, I think in 1999 obesity was really a new issue for all of us in public health.
Speaker 3:I think a lot of people were more concerned about hunger and they were about obesity. It was really a new issue to a whole lot of us and when I saw those numbers I realized that if that many kids were overweight in this one particular community and I started looking at some other data of what was going on elsewhere, I realized this is one of the top [00:03:00] public health issues that need to be addressed and there just weren't that many other organizations doing that. So then you started your organization, started the organization. Again, we focus on public policy. We think that state and local policies should encourage and support people in making healthy choices rather than undermine those choices. What are some of the conditions that you have discovered over the years that lead to this? One of the first things we did is we held a series of town hall meetings all over La and we talked about this issue of childhood obesity and we asked people what?
Speaker 3:What do you think [00:03:30] we should be doing about it? And one of the issues that came up over and over again with school food, and it turned out that in 1999 and really up until 2006 when we got final legislation passed, schools were as much about perpetuating and causing the problem as they were about solving the problem schools that were selling soda and junk food and very unhealthy meals. No one was really looking at those and, and saying, we as, uh, the government [00:04:00] that policy makers and we as citizens can have an influence over what kind of foods and beverages our schools are selling our kids. And simultaneously PE programs, fiscal education programs, or nonexistent sending. Yeah. So we, in in 2005 did a study that showed that at least half of all school districts weren't meeting minimum physical education requirements. So here on the one hand, we've got schools selling soda and junk food to our kids and at the same time, no longer [00:04:30] even providing quality physical education, selling junk food and sodas were their vending machines.
Speaker 3:How did they, how did they actually sell? Yeah, I mean, and so a school sell food and a variety of different ways and their cafeteria, um, and they're all a cart line you can buy even today. Of course, you can still buy lots of food and the all the cart line or his whole meals in those days before 2005 when, when Governor Schwarzenegger signed our bills to get [00:05:00] soda and junk food out of schools, there was soda and candy bars and Gipps everything else that you could imagine the worst of the worst soda and junk food you'd buy right there in the cafeteria or in vending machines and school stores as fundraisers, pretty much schools had become soda and junk food. Superstores and what we did through public policy is to say, we got to draw a line someplace. At the very least, schools should be prohibited from selling the worst of the worst of these projects yourself.
Speaker 3:I do, I have an 11 year old, [00:05:30] so I know, I mean, it's um, kids are gonna eat what's put in front of them. Schools have a responsibility to be a part of the solution, not a part of the problem. So you started at 99 and you're talking about legislation that was enacted in 2005 to support your research and findings. Can you talk just a little bit about, you know, six years. What was the process of getting? Yeah, so it was, it was a series of changes that went into effect. Um, our very first bill in 1999 [00:06:00] was w what I now look back on as being rather naive. We, we had a bill that was going to simultaneously get soda and junk food out of schools, established the nation's first soda tax, put stronger requirements on physical education. W We threw everything in to one bill.
Speaker 3:We learned a lot in that process. And one of the things was you got to do this one piece at a time and the soda and junk food out of schools. We became really our, our top priority. And so over the course from then 2001 [00:06:30] we got, we defined what the nutrition standards would be in 2003 we got sodas out of elementary and middle schools. And then in 2005 under the Schwarzenegger administration, we got sodas out of high schools and we got just really good strong nutrition standards k through 12. So it took a long time. You know, at one time I would have said six years is a long time. I look back on it and say, you know, for, for making a real major public [00:07:00] policy change, six years isn't that long. And then what we did in California, um, spread across the country and now federal law, federal law, same kinds of the first lady.
Speaker 3:Ms. Obama took those same kinds of standards and has made that federal law. Did you meet any challenges from big food producers that actually make these products? Oh yeah. You know, the food and beverage industry fought tooth and nail against this and every other things that we've done. You know, there are a lot [00:07:30] of people that make a lot of money making our kids fat and giving them diabetes, right? We live in a a market economy that really encourages people to find products and to market products that they can sell as much of as possible. And so we know going into this that, uh, those are going to be our biggest opponents and that's our job is to encourage, convince, cajole legislators to take their responsibility seriously [00:08:00] about drawing some limits about what these corporations can do, the big food industry, probably through a lot of ad money against this law.
Speaker 3:Did you meet one on one? What was, what were your sharing? I mean, we certainly met one on one with them. Um, I think that the most important thing, and one of the things I've learned through this work in, in the obesity and diabetes world, it's been true that the truth wins out by, over and over again. I'm highlighting the extent of the childhood [00:08:30] obesity epidemic and now over and over again highlighting the extent and of the diabetes epidemic and the pain and suffering going on in California families. And communities and the costs and medical costs, the healthcare costs of these problems. By highlighting all of those things over time, legislators get the message and we also organize tens of thousands of Californians to call their legislators to get involved in this process because [00:09:00] we all know we, we want our communities to be safe and healthy for our kids.
Speaker 3:You always organize organizer. How did you get those skills? How did I get those skills? I'm not sure as a little kid, I grew up here and in Oakland and um, I remember being eight, nine, 10 and listening to talk radio talk radio started in, in San Francisco. And I learned very early on somehow deeply what the political process is all about. And I grew up in the, in the 60s where social [00:09:30] justice, uh, the black panthers were doing their work in Oakland. And I think I absorbed that deep into my bones and all my life, I've wanted to do some things to make the world a better place for our kids, for the next generation. And when I met that researcher back in the late nineties and saw how many kids were overweight, I realized this is one of those issues that I could commit my life to see it a lot here in Oakland to oh my gosh, it's um, it used to be, I remember [00:10:00] back in the nineties talking about when you were just starting this stuff, I would fly back to the Midwest and that's where I would notice it first.
Speaker 3:It's like, it seemed like everyone was kind of oddly obese. It was not like just overweight, you know, it seemed very sudden. Yeah, no, it's really, it really started right around the 1970s we commissioned a study from the UC Berkeley Center for weight and health a few years back. And we posed the question to them, how much of the obesity epidemic are sugary drinks responsible for? If you look just at sugary drinks, how [00:10:30] much of the epidemic are they responsible for? And what they showed was that between 1977 and 2001 and that's really when the obesity epidemic was taking off between 1977 and 2001, um, the average American was consuming 278 more calories per day. That's all a lot of extra calories. Um, all of a sudden, and it really wasn't took off in 1977 of that 278 more calories, 43% [00:11:00] of those are just new soda calories, sugary drinks.
Speaker 3:So when I say sugary drinks, I mean soda in sports drinks and energy drinks, vitamin waters, all of those things. And it's just, it's a prime example. And I actually think one of the most important examples of how the world changed between the time I was a kid in the 1960s to where we are today. When I was a kid, we rarely, only on special occasions would have a soda or sugary drink. And if we did it would [00:11:30] be a little bit, it would be a treat. Today there are sugary drinks almost everywhere we go. They're served not in six. And a half pounds a bottles or even 12 ounce scans. Now when you go to a vending machine, they're 20 ounce bottles and when you go to a fast food restaurant, they are refillable 32 ounce cups every and they're sold my favorite. There's, there's a soda vending machine at the, uh, auto parts store in Davis.
Speaker 3:There are soda vending machines on every floor of the Sacramento [00:12:00] airport. Now, I don't know where they are in other airports too, but everywhere you go there, soda the world we live in the environment, the, the places that we live are now hocking us soda. Everywhere we turn everything we're not turning and we aren't turning very much. Uh, the beverage industry. Uh, there's a great book by Michael Moss, a New York Times investigative reporter called sugar fat and salt, and he got the inside documents from the beverage industry just like research has gotten inside documents, offend that tobacco [00:12:30] industry. Michael Moss got the inside papers from the food and beverage industry and in his chapter on sodas he talks about how the beverage industry uses the most sophisticated research to figure out what they are inside the beverage industry, what they call the bliss point, the exact amount of sugar and flavor and Fizz.
Speaker 3:My guess is they even, they even test the sound of the cap opening like what is it that all suck us in as [00:13:00] much as possible and they seduce us, right? They do everything in their power to get us to buy their products and then when we do, they blame us for it. Right now obviously we have some choice about what are we going to do and what aren't we going to do, but a lot of that choice is influenced by the marketing of these companies. Like that's the reason the beverage industry spends $400 million marketing their products to kids and teens. You were talking about some other things you've done since you did some labeling. Yeah. So we got soda and junk food [00:13:30] out of schools finally in in 2005 and then we work with governor Schwartzenegger to get first ever funding for physical education in 2006 first ever funding.
Speaker 3:There had never been, never been dedicated funding for [inaudible] schools. You know, they would use whatever funding they already had, but there was no dedicated funding just for PE. So that was 2006 and then we, and that's true for all the nation wide. There are some other states that that did have funding. And so that's part of what we did was fine [00:14:00] first ever here in California have had funding for elementary school PE. And then we, we worked, it took a couple of years to, to get the first ever state legislation requiring calorie information on Menus and menu boards. So if your listeners go to restaurants now, chain restaurants, at least the nutrition information, the calorie information is on the menus and menu boards significant. It is significant. I mean, one of the things I learned in doing that was, um, just personally, if I go out to a restaurant and I'm looking at a [00:14:30] menu and I think I know what's the healthier choice or what's not, I actually,
Speaker 2:I have no idea if you're just tuning in, you're listening to method to the madness, a biweekly public affairs show on k a l x Berkeley Celebrating Bay area innovators. Today I'm interviewing the founder and executive director of the California Center for Public Health Advocacy, Harold Goldstein. Because just [00:15:00] because the
Speaker 3:menu says garden fresh something or other, it doesn't say anything about how many calories are in it. It doesn't say how much is fat isn't it has an even more, it doesn't, doesn't say how big the portion is, right? So you go to, um, you know the cheesecake factory and they bring you a truck and, and offload a salad and your plate and you think, well, it's a salad. It must be good for you. But you know, can speak, it could be thousands of calories. Quite literally. You said it's just chain restaurants. Where do we, you see these menus [00:15:30] with the calorie. So the, that menu labeling law was also then adopted by the Obama administration mandating, um, calorie information on chain restaurants all over the country, just chain rest, just chain restaurants. It's 20, 20 restaurants or more. But the, unfortunately the implementation of that law is now caught up in the implementation of Obamacare and the feds haven't yet put out the regulations to say, here's how it's going to be implemented.
Speaker 3:So, um, there's still [00:16:00] some more work to do to the, to State California. It's, well, if it had happened for a while, but then once the feds took it and, and included it as part of healthcare reform, it's now it's slowed down. There's some restaurants that have taken them away. So we're, we're waiting for the federal government to issue their regulations to define how that's going to be going into effect. Just recently you had another bill SB 1000. Yeah. So throughout all of this work, um, it's why I've been talking already, Lisa, about sugary drinks. More [00:16:30] and more information is coming out about really how harmful sugary drinks are. So we got sodas out of schools in California in 2006 or 2005 we at least got the bills passed and uh, to put calorie information about sodas and other things on chain restaurant menus. But a lot more needs to be done to educate people about really how harmful these sugary drinks are.
Speaker 3:Can you talk a little bit about, yeah, so, so s yeah, so SB 1000 would've been the first [00:17:00] would have made California the first state in the nation to require warning labels on sugary drinks. The bill made it through the Senate in its first year, which is really quite an accomplishment. And what the, what the warning label says is the consumers should be aware that soda and other sugary beverages contribute to diabetes, obesity and tooth decay. So let's talk your question of how bad are they? You know, I think a lot of people know that sugary drinks aren't great for you. It's not like [00:17:30] eating Broccoli. I don't think most people know how really bad it is. I didn't know. I mean, unless you're reading medical journals, there's no way you'd know. One 20 ounce soda has 16 teaspoons of sugar, so imagine putting 16 teaspoons in your coffee in them.
Speaker 3:Drink two sodas a day for just two weeks, two sodas a day for two weeks, and your LDL cholesterol, your bad cholesterol goes up 20% drink two sodas a day for six months, and the amount of fat in your liver goes up 150% [00:18:00] these, this isn't just kind of bad for you. This stuff is really bad for, and here's how it works. No wonder we're getting so much diabetes. It is exactly why we're getting diabetes because it's, we consume this in liquid form. Liquid sugar is a lot worse for you than if you eat a candy bar. It takes hours to digest. If you drink a soda or other sugary drink because it's in liquid form, we absorb that sugar and as little as 30 minutes, we get this enormous pulse of sugar that spike in sugar. [00:18:30] Over time, it starts to wear out your pancreas, which is what regulates your sugar levels.
Speaker 3:And a lot of that sugar gets converted into fat, right in your liver. And so that's why drink two sodas a day for six months, and you get 150% increase in liver fat. That liver fat also contributes to diabetes. So the combination of fatty liver and worn out pancreas is exactly what causes diabetes. And if you look at the numbers, [00:19:00] um, two thirds of California teens drank a soda, other sugary drink a day. So what they're doing is virtually injecting 16 teaspoons of sugar right into their veins over time. Of course, it's having these consequences. As I said earlier, a quarter of teenagers in this country today have either diabetes or prediabetes. Pat Crawford, the head of the UC Berkeley Center for weight and health, um, says, how bad did this, does this epidemic have to [00:19:30] get before we start telling the truth about sugary drinks? So why did it die in the legislature?
Speaker 3:The reason it died is because the beverage industry did everything they could imagine to fight this bill. You know, this does that mean? So what it means is they hired as many lobbyists as they could. We actually know that they contacted every Latino lobbying firm in Sacramento to try to hire them. They made up their own stories, really about [00:20:00] sugary drinks. Um, they're coming up with their own research. They hired a phd nutritionist from UC Davis to testify virtually to say there's no difference between eating an apple and drinking a soda. They both have sugar and the body doesn't notice the difference. Now, I, you know, in the old days, in the old days, um, the tobacco industry would hire doctors to be their spokespeople for smoking cigarettes. The beverage industry is doing those same kinds of things where they're, they're doing [00:20:30] their own research that even though it's, you know, the real scientists who don't have skin in the game, or I'm proving it wrong, they're coming up with their own research.
Speaker 3:They're hiring their own quote unquote experts to try to undermine what is universally recognized as the fact that these sugary drinks are just kind of bad for you. They are really bad for you. And when your kids are drinking them, you're putting your kids on a straight path to getting diabetes. What [00:21:00] do you do next to get this bill through? You don't give up obvious. No, obviously, you know, I went to, I've told the lobbyists for the fast food industry and when we were working on menu labeling, you know, if, if you want to keep fighting us, we'll keep fighting you and we'll keep getting the message out about how unhealthy fast food is. And I say the same thing to the beverage industry. You know, if you want to keep fighting us and you want us to, to keep hammering on you and keep educating consumers about how bad [00:21:30] your products are, we'd we'd be happy to.
Speaker 3:That's, that's the business we're in. We're in the business of educating consumers and we're educating consumers all along the way. And then how long before you can bring it up again to the assembly? So the legislature is going to be for this year, it's, it's over. But we can reintroduce it and begin to every year if we want to. Um, and I think it's, it's imperative that we do, consumers need to know, the most important way to educate consumers about how [00:22:00] harmful these products are is to put a warning label right there on the front of every bottle so that moms can see for themselves which products are healthy and which aren't telling you a story. I was at the park with my son not long ago and another mom was there with her child and she asked me what I did and I started talking about this public health work and she says, yeah, I don't let my kids drink any of that sugary stuff.
Speaker 3:I make sure they drink this. And she pulls out of her purse a box of some sort of juicy juice, you know, [00:22:30] and I said, well, let's see what's, what's in that. It was the same stems, all high fructose Corn Syrup, right? So because it said juicy juice, she assumed it was a 100% cheese and it wasn't at all is virtually Coca Cola or Pepsi Cola with 5% fruit juice in it. And she thought it was healthy because it had the word juice on. If there was a warning label right on that container, she wouldn't be confused. She'd choose a healthier product for herself. Educating people about what are the [00:23:00] different sugars and which, which products are are good for you and which products are leading to diabetes. There's also a lot of caffeinated beverages like red bull and you know what about that stuff? Yeah, so you said a whole other issue now it's really part of the exact same issue.
Speaker 3:You know, one of the things that the beverage industry has done over the last 30 years is they have dramatically expanded their product line. So what used to be just coke and Pepsi [00:23:30] is now there's broad array of products that commonly sound healthy sports drinks. Those must be good for you. Well, they're not. They're just sugar and salt. That's what an electrolyte is, is just salt. You and your kids don't need any more salt. Most Americans are eating twice as much salt as they need vitamin water. My Gosh, that must be good for you. It's got vitamins in it. No, it's not. It has very small amounts of vitamins and it's got the same amount of sugar as everything else. Um, and energy drinks, like you're talking about, [00:24:00] energy drinks are some of the sweetest beverages you can buy. They're the most sugar of, of any products.
Speaker 3:Really odd, I have to say. I've never tried one. Maybe I should taste terrible. They are very artificial. Yes. So they are spiked with caffeine, they're spiked with other cold supplements. But these are things like Guarana and towering that most people have no idea what these things are. What those things do is they accentuate their, their, uh, [00:24:30] a kind of caffeine like substance and they accentuate the caffeine. So now, especially for kids and teens, this is dangerous stuff. There've been teenagers that have died, literally died from drinking too much of this stuff. It's got the sugar and it's got just way too much stimulant for our kids and teens to be able to handle what happens physically when you have too much of it. Too much. Your heart goes into Techie Cardia you've heartily, um, go into a arrhythmia and a can stop. [00:25:00] So there are a number of cases of kids going to the emergency room and some unfortunately have died.
Speaker 3:And it's part of your battle part includes these. Absolutely. So these, these beverages have just as much or more sugar than other ones. And part of what we're doing is educating consumers about how bad these products are and the harmful effects of them. Where do you get the money to fight the big companies? So we are fortunate to have funding from some foundations. We're also very [00:25:30] fortunate to have donations from people all over California, all over the country, really, um, who want to be a part of this movement to make sure that our kids, um, live longer lives than their parents instead of what's, what's predicted now is kids born in the year 2000 are going to have shorter lives and their parents. So people all over the country who are willing to and want to be a part of taking on the beverage industry.
Speaker 3:The food industry are a part of the work we do. And together we're making a difference. How many people work for the California [00:26:00] Center for Public Health Advocacy? We've got about 30 people all over California. We have an office in Davis Office and a lot on volunteers. We would depend a lot on volunteers and a lot on like I say, donations from people who, who like us see this as really a critically important issue and want to make uh, the lives of kids healthier. Do you have any other future issues on the back burner that you are really looking forward to starting work on? [00:26:30] You know, I think the, the, this issue of warning labels and soda is certainly one of them. It's, it's a part of a broader issue of diabetes prevention. You know, we just issued a report a few months ago showing that a third of everyone in California hospitals today has diabetes.
Speaker 3:One out of three hospital beds is filled with someone with diabetes. 43% of Latinos, 40% of African Americans and Asians and hospitals today have diabetes. This is a crisis [00:27:00] of enormous proportions. The American Diabetes Association has said that higher healthcare costs are driven largely by rising rates of diabetes. If we want health care costs to get under control in this country, we need to get the diabetes epidemic under control. You know, I think unfortunately people think if people don't have contact with, um, a friend or family member with diabetes, I think they often, they go ahead, take my insulin, take my medication. And that's the end of the story. Um, but unfortunately, diabetes [00:27:30] leads to nerve damage, blindness, amputations, kidney disease in the last 30 years. The number of people in the United States who are, who have end stage renal disease, this means that their kidneys aren't working and they need to be on dialysis.
Speaker 3:The number of people in the last 30 years, they're getting federal reimbursement to medicare covers. Um, healthcare costs for this. The number of people with diabetes caused end stage renal disease who are [00:28:00] getting treatment has gone up 39 fall. Unbelievable. So we're talking about a disease that at its worst leads to amputation, dialysis, and the need for kidney transplant. Like how bad does it have to get? And we have shortage of transplants. So if we do have an armature multiple transplants, so w we we need to do everything we can. I think that the simplest thing we can do is let people know about this direct link between liquid sugar, soda and other sugary [00:28:30] drinks and diabetes, and then we need to start moving upstream and make sure that people get the testing and the treatment that they need before they end up in the hospital.
Speaker 3:It's going to be a lot of listeners who want to know more about your organization. Do you have a website? I'm sure you do. Absolutely. Tell us what that is. It's a public health advocacy.org we also have a great website just on sugary drinks called kick the can.info, so public health advocacy.org and kick the can.info. All too often we buy into [00:29:00] the food industry mantra that says that obesity and diabetes are all about personal responsibility. It was very painful to me. I think it's time that we make it clear collectively to the food and beverage industry that they have responsibility to will make healthy choices, but we need to draw some lines on how extreme their marketing and advertising [00:29:30] efforts are that are convincing our kids to consume their products that are leading directly to diabetes. Well, thank you for being on the program today. On my sessions,
Speaker 2:you've been listening to method to the madness. If you have questions or comments about this show, go to the k a l x website. Find method to the madness and drop us an email. Tune in again in two weeks. At the same time, [00:30:00] have a great weekend.
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