Health Care Legislation, Part 2:
Whole Foods CEO John Mackey on health care
10 Oct 2009 in Regulatory Science, Regulatory Policy
Whole Foods' CEO John Mackey published a commentary on August 11 opposing the health care legislation proposed by the Obama Administration and Democratic congressional leaders. The op-ed followed an interview with Wall Street Journal reporter Katy McLaughlin, These articles ignited several rounds of controversy. Some Whole Foods customers organized a boycott. Whole Foods created a discussion group on its web site. The Wall Street Journal editorial board criticized the boycotters and published multiple letters to the editor (here, here and here), then a long Saturday interview by Stephen Moore, a member of the editorial board, defending Mackey and giving him a platform to expand on his views. Another letters to the editor followed.
We draw readers' attention to Mackey's opinions about the American diet expressed in the second Journal interview. These opinions appear to have significantly informed Mackey's thinking on the issue, but it not clear how they relate to his proposed alternative and they have not been part of the controversy.
Moore writes:
"We can spend all the money we want on bypass surgeries, chemotherapy and diabetes, but . . . two-thirds [of Americans] are overweight, one-third are obese." He's on a roll: "And it's not that they have to shop at a Whole Foods Market. But people need to eat whole food plant foods, primarily . . . whole grains, fruits, vegetables, nuts and seeds. That diet supports our lives. We ought to live to be 90 or 100 without getting any diseases."
Healthy eating, curbing the obesity epidemic—it's hard to find much of anything Mr. Mackey says that's controversial.
Let's start with sugar. The US Department of Agriculture performs regular surveys to estimate nutrient intakes. Because they capture only two days of consumption data, these surveys can only be used to characterize the entire US population, not individuals. In 2005-06, males and females 20 years of age and older consumed on average 141 grams and 124 grams of total sugars, respectively.
However, "total sugars" includes much more than, say, doughnuts, candy and soft drinks. The foods Mackey advocates also contain sugars. Here are some examples published in USDA database:
| Total Sugars in Raw Fruits | |||
| Raw Fruit | Grams | Percent of Adult Male Average (141 g) |
Percent of Adult Female Average (124 g) |
| 1 orange (2-7/8" diameter; 140 grams) | 11.90 | 8.4% | 9.6% |
| 1 apple (medium with skin; 182 grams) | 18.91 | 13.4% | 15.3% |
| 1 banana (medium 7" to 7-7/8" long; 118 grams) | 14.43 | 10.2% | 11.6% |
| 1/2 grapefruit (pink or red; 123 g) | 8.47 | 6.0% | 6.8% |
| 1 pear (medium; 178 g) | 17.44 | 12.4% | 14.1% |
| 1 plum (2-1/8" diameter) | 6.55 | 4.6% | 5.3% |
| grapes (1 cup; 92 g) | 14.95 | 10.6% | 12.1% |
There is little doubt that Mackey would say that consuming this list of fruits each day is healthy dietary behavior. But note that it contains 93 grams of total sugars--65% of the average daily consumption of adult males and 75% of the average daily consumption of adult females. Mackey has either misinterpreted the data, or he believes that there is no difference between 93 grams of sugar from fresh fruit and 93 grams of sugar from doughnuts, candy, and soft drinks.
Mackey alleges that heart disease, cancer and diabetes are all preventable through the adoption if his recommended diet. This claim is scientifically false. All three have genetic origins. Adult-onset cancer is a disease of aging, and no diet has been shown scientifically to prevent us from growing old.
Mackey also asserts that if people adopted his diet they would live into their 90s without disease. As a scientific matter, this claim has no support. Indeed, if he could convert his recommended diet into a "product," he would run afoul of statutory standards for health claims (21 USC 343) implemented by Food and Drug Administration regulations (21 CFR 101). First, any such claims must be approved by FDA before they are made. Second, FDA guidance makes clear that Mackey would have to meet a "significant scientific agreement" standard. Mackey's health claims do not meet this standard.
REFERENCES
U.S. Department of Agriculture, Agricultural Research Service. 2008. Nutrient Intakes from Food: Mean Amounts Consumed per Individual, One Day, 2005-2006. Available: www.ars.usda.gov/ba/bhnrc/fsrg.
U.S. Department of Agriculture, Agricultural Research Service, Nutrient Data Laboratory. [Online].
