Fed Up Reviewed

By: Matt Raymond, senior director of communications, and
     Marianne Smith-Edge, MS, RD, senior vice president , nutrition and food safety,
     International Food Information Council
(IFIC) and IFIC Foundation

Date: 1/21/2014

The following is a review of the new documentary "Fed Up," which was produced in part by Katie Couric and debuted Jan. 19 at the Sundance Film Festival: 

While "Fed Up" is only the latest documentary to excoriate the modern food system, it joins many that have gone before in perpetuating misperceptions and scientifically unsupported assertions. In particular, its excesses include the fallacies of confusing anecdote with scientific data, and conflating correlation with causation. Alarmism and emotion might further the filmmakers' goal of getting national distribution or awards, but they also sweep important facts and context under the red carpet.

We are keenly aware of the poor health status of many Americans and the need to find long-term solutions to the health problems facing our nation. Chronic disease prevalence is of great concern to us, and many health professionals and organizations have focused their full attention on obesity.

Although a definitive cause has yet to be determined, the film would have you believe that a single dietary villain (sugar) is uniquely responsible for obesity in America. Interestingly, we're not so far removed from fat's supposed role as bogeyman. Just as decades of research has revealed beneficial and complex roles of dietary fats in healthful diets, the science on sugars is evolving, and answers for many important questions about the role of sugars in health continue to be investigated.

More than most other dietary components or lifestyle factors, sugars have been studied to determine whether an association with obesity exists. While scientific evidence to date doesn't support a causal link between sugar intake and obesity, the root cause of obesity is an extremely complicated question that remains unanswered. It involves many social, genetic, and environmental factors that are likely very different for each individual. Researchers and nutrition professionals agree that no single food, nutrient, or ingredient causes obesity.

Couric has stated that "we do target sugar specifically because, with the low-fat food craze, we have really doubled our intake of sugar-Americans have-since 1977." Not only do the data not support that statement, but the assertion is wildly outside the factual realm.

According to USDA ERS Food Availability data, 21.4 teaspoons of caloric sweeteners per day were available per capita in the U.S. in 1977. In 2011 (the most current data set), 22.8 teaspoons of caloric sweeteners per day were available per capita per day. This equates to an increase of about 6.5 percent.

In terms of calories, according to the same USDA ERS Food Availability data, 342.5 calories from caloric sweeteners were available per capita in the U.S. in 1977. In 2011, 364.2 calories from caloric sweeteners were available per capita in the U.S., an increase of 21.7 calories per day or about 6.3 percent.

In a similar timeframe, 2,089 calories per capita per day were available in the U.S. in 1977. In 2010, 2,538 calories were available in the U.S. per capita per day, an increase of 21.5 percent. In other words, Americans are eating more calories, but they are not eating significantly more calories from sugars than they did in 1977. Regardless of source, the overconsumption of calories has contributed to rising obesity rates, a risk factor for type 2 diabetes and cardiovascular disease. 

The important issue when it comes to sugar, as with any other nutrient, is calories. It's important that we be aware of how many calories we consume from different sources of nutrients within a balanced diet.

Amusingly, the film downplays the role of physical activity in maintaining a healthy weight by pointing out that gym memberships have increased side-by-side with obesity rates. Given everything we know about the basic equation of "calories in, calories out," this example of putting forth correlation as causation is a textbook case of junk science. As an example of this fallacy, one researcher stated that a correlation can be made between increased bottled water consumption and obesity.

Comparisons in the film of food to tobacco are especially specious and irresponsible. Whereas every major medical and scientific organization has determined that there is no safe level of exposure to tobacco smoke, food consumption is the very basis of life.

While some processed and packaged foods are more healthful than others, plenty of nutritious foods that are processed can be part of a healthful diet. In fact, studies show that there are no inherent nutritional differences between processed and unprocessed foods.

Perhaps Dr. Roger Clemens said it best during his recent testimony to the 2015 Dietary Guidelines Advisory Committee: "Processed food encompasses too wide a spectrum to be considered 'good' or 'bad.'"

The film's producers will no doubt downplay their poor timing: New science and statistics have been undercutting much of the thesis of "Fed Up," even while it was in production. Figures from the Centers for Disease Control and Prevention point to a historic plateau in overall obesity rates, including among children, and even suggest recent declines among low-income children.

Perhaps most ironic was the time on-screen spent pooh-poohing the food and beverage industry's commitment to calorie reduction. Just days before the film's premiere, the Healthy Weight Commitment Foundation and First Lady Michelle Obama announced that a pledged 1.5 trillion calorie reduction among major food and beverage makers was far exceeded by about 400 percent, or 6.4 trillion calories reduced.

The 6.4 trillion-calorie achievement represents a reduction of 78 calories per person per day, which includes both adults and children. A study by Claire Wang, MD, ScD; Tracy Orleans, PhD; and Steven Gortmaker, PhD, that appeared in the May 2012 American Journal of Preventative Medicine (AJPM) concluded that in order to close the "energy gap", reducing calories by 41 per child per day would halt rising obesity levels in the United States. Additionally, James O. Hill, PhD, has documented that reducing an average of 100 calories per adults per day will close the adult energy gap.

The Robert Wood Johnson Foundation, the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, committed to support a rigorous, independent evaluation to determine whether HWCF has met its calorie-reduction goal.  Barry Popkin, PhD, published a paper on the methodology he would use in determining that the commitment had been met.

While none of us should by satisfied with current rates of overweight and obesity, the film's simplistic and misguided diagnosis of the problem doesn't stand up to scrutiny.

The International Food Information Council Foundation makes resources available to help provide understanding and context to consumers, health professionals, and journalists on important food and nutrition issues: