Gregory Miller of the National Dairy Council (left) and Walter Willett of the Department of Nutrition

The forum was the first in a series sponsored by HSPH’s Office of Communications to address public health issues in the news. More than 160 people packed Snyder Auditorium to listen to the panelists, while others viewed the forum live on a webcast that proved to be the second most-watched webcast ever at the school. Adding to the energetic discussion was the inaugural use of e-mails from webcast viewers sending in questions for panelists.

	Eric Rimm of HSPH

In September, McDonald’s USA announced a significant reduction of trans fatty acids in its fried menu items at its 13,000 US restaurants, a major step toward the company’s goal of eliminating trans fatty acids from its cooking oil.

"We’ve calculated that if everyone in the food industry in this country replaced trans fatty acids with polyunsaturated fats, it would reduce the risk of coronary heart disease and diabetes by about 40 percent, which has a huge impact," said Willett. "It will affect people who aren’t even consciously making healthy choices, such as your 14- and 15-year-olds."

Willett isn’t rushing to eat at McDonald’s, despite his praise for the Big Mac vendor’s decision to cut trans fatty acids. Other issues remain, such as the highly refined grains and sugar that comprise most of the menu offerings and carry a high glycemic load, which results from carbohydrates that increase blood sugar levels.

Then Willett turned his attention to dairy products. "I have nothing against the dairy industry," said Willett, the offspring of five generations of Michigan dairy farmers, "but I’m concerned that the high promotion of dairy products might actually be doing some harm."

Data does not seem to support the USDA-recommended three glasses a day, he said. Drinking that much milk may increase the risk of prostate cancer (from calcium) and breast cancer (from residual pregnant bovine hormones). Daily calcium needs can be more safely supplied with a supplement or with one glass of milk a day, he said.

Gregory Miller, senior vice president of nutrition and scientific affairs for the National Dairy Council, said that milk offers more health benefits than simply providing a source of calcium.

Dairy foods are an affordable nutritional package that includes nutrients such as phosphorus, riboflavin, protein, vitamin B12, and potassium, he said.

Dairy products account for about 12 percent of the fat in the food supply, but he pointed out that people can choose low-fat and fat-free products.

Citing a review of epidemiological and clinical data, Miller said that calcium has been linked to building bone mass and to reducing the risk of osteoporosis. He said that low-fat dairy foods are part of a specific diet shown to lower hypertension as much as a single drug therapy. A component of milk fat may be an anti-cancer agent, he added, and studies have indicated that people lose more weight when diets contain dairy products.

	Ann Rusniak of McDonald’s

"I believe it is possible to put together high-quality meals," Rusniak said. "But if we don’t provide foods that taste good, people won’t buy them, and there’s no healthy benefit."

One heavily marketed flop was the Deluxe McLean Burger, she said. More successful products with perceived better nutritional profiles include low-fat milk, salads, low-fat muffins, and a selection of $1 items designed to give people value in smaller portions. Soon, the McDonald’s web site will offer comparative calorie and nutritional contents of customized orders and menu combinations.

Steven Gortmaker of HSPH

"Obesity is caused by excess energy intake over energy expenditure at the individual level," he said, meaning that people gain weight when they consistently eat more calories than they burn.

Lots of seemingly inconsequential acts may add up to a difficult problem over time, he said: an extra 12-ounce sugar-sweetened beverage every day can add an additional 12.5 pounds over the course of a year.

The fast-food industry is an important force in the obesity epidemic, he said, but the television and video industries also play a key role by directly advertising foods to children and by encouraging sedentary behavior. The best single behavioral predictor of obesity is television viewing, he said. Reduced television time can lower body mass index, especially for kids. One study that Gortmaker undertook of 1,200 Boston middle-school students revealed that more than half of the children had televisions in their bedrooms.

"Don’t put a TV in the room where kids sleep," he recommended, saying that this simple preventive action can cut down the time that children spend watching programs by 50 minutes each day. "Our studies indicate that it’s not hard to get kids to reduce television viewing. Much television viewing by children and youth is a time-filler. They don’t feel that good when they’re watching lots of excess TV."

At the same time, he added, creating alternatives to television is a community-wide project that needs the involvement of youth, parents, schools, local youth sports and other organizations, as well as teachers and local health professionals. The community can offer more to children and youth than four hours of television a day, he said.

The forum may be viewed online at http://www.hsph.harvard.edu/food/.