Wonder Bread is scientifically proven to be good for me? Medical Authority and Consumerism in America

 

Naomi Worob is a second year Anthropology student at Grinnell College. Currently, she is interested in health and medical humanities, and in connection to those thinking about how the arts and humanities can provide different tools for physicians to interact with and care for their patients.

About midway through the semester, I was spending my Sunday afternoon watching Michael Pollan’s latest television series, Cooked. On this episode, Pollan was discussing our relationship to processed foods. He flashed a clip of a vintage Wonder Bread commercial on the screen. The voice in the commercial said, “Here’s how to help build strong bodies 8 ways. Eat Wonder Bread. Wonder Bread every meal gives you eight elements you need — as much muscle building protein as roast beef; as much calcium as… [1].

In my house growing up a typical dinner was brown rice topped with  nutritional yeast and Braggs, sweet potatoes on the side, and good-sized portion of salad or steamed broccoli. That is to say my parents were fairly health conscious, and I am not the most unbiased when it comes to judging whether a food is healthy or not right off the bat. However, even accounting for my bias,  if there was one food product that I would be skeptical of for health reasons, it would be Wonder Bread.

The day before I had read on the Center for Disease Control and Prevention’s  (C.D.C.) website that one-third of Americans are considered obese. This may not seem so concerning at first, but it is when one considers the health effects that often correlate with obesity — “heart disease, stroke, type 2 diabetes, and certain types of cancer” [2]. On the C.D.C.’s website, it states, “the key to achieving and maintaining a healthy weight isn’t short-term dietary changes; it’s about a lifestyle that includes healthy eating and regular physical activity” [3].

This all got me thinking of a conversation we were having in my History of American Medicine course. We had been discussing the Golden Age of American Medicine — a period in the mid-twentieth century when the medical profession was at the height of its power and prestige. “Aspiring physicians competed intensely to enter the guild and studied for years to acquire the proper credentials and requisite knowledge. Powerful institutions guarded its interests and regulated its behavior. Laws in every state protected its rights” [4].  Part of the medical profession’s hegemony was built on a prescribed relationship between physicians and the rest of society. When the American Medical Association (A.M.A.) was founded in 1847 its code of ethics outlined “not only the duties of the ‘professional physician toward patients and peers, but also the obligation of patients to obey their physicians” [5].

Coincidentally, or not so coincidentally, we also associate this period with post-World War II rises in consumerism. In 1941 FDR called for ‘the enjoyment of fruits of scientific progress in a wider and constantly rising standard of living” [6]. Within this statement, we see the relationship between medical authority and consumerism. With the rise of medical authority in the Golden Age, science was given an additional level of credibility. Just like with the Wonder Bread commercial, businesses used this credibility to strategically market their products. The consumers invested in medical authority would buy into these markets. As FDR suggested, science is progressing and the public, as consumers, should share in this progress. All of this contributed to the idea, “newer must be better and…doing more must be better than doing less” [7].

If someone had asked me a week prior to seeing the vintage Wonder Bread commercial how I thought manufactures would have sold that product, I would have said a number of things, but I wouldn’t have said anything about them claiming the product was healthy for you, and I definitely wouldn’t have said anything about them using scientific claims to do so. However, in light of thinking about the conversations in my class, it made a whole lot of sense that manufactures would use scientific evidence to promote their products.

What was concerning was thinking about this in relation to the C.D.C’s findings on obesity — that obesity is caused by a lifestyle that is in part connected to consuming unhealthy foods. Not always, but a lot of the time this means consuming more processed, and less fresh foods. As Pollan showed these processed foods were not always around. They were not always a part of American’s lifestyle. The Golden Age of Medicine and post-World War II consumerism seemed to suggest that these processed foods became popular at least in part because of the ways manufacturers manipulated scientific and medical authority to sell their products.

I was curious to find out more about the relationship between medical and scientific authority, consumerism and how they have influenced people’s habits. I spoke to my professor about this, and she mentioned that I might look into the history of artificial formulas, and so I began researching. Here’s what I found out.

Having alternatives to breastfeeding has always been necessary. Whether there were complications during birth and the mother passed away or for other reasons the mother couldn’t produce breast milk, babies needed to be fed [8]. Prior to artificial formula and bottle feeding, this need was addressed with wet nursing.  However, in mid-eighteenth century America, women started advocating for wet nursing as an alternative choice, rather than just an alternative need [9]. This advocacy made space for a consumer market to emerge that met women’s desire for alternatives to breastfeeding.

However, as something that originally emerged to meet women’s needs, it quickly became something to be used and controlled by men. Formula was successfully produced in 1935. Kara Swanson writes, in “Human Milk as Technology and Technologies of Human Milk,” “They [doctors and scientists] could demonstrate medical expertise through scientifically guided instruction on artificial formula use and could successfully care for their patients, freed from the unquantifiable and unreliable nutrition offered by the lactating breast” [10].

In 1929, the American Medical Association formed the Committee on Foods to approve the safety and quality of infant formulas [11]. This committee was given the role of regulating advertising so that manufacturers could not solicit information to non-medical personnel. This shifted fifty years later, and in 1988, the formula industry began advertising directly to consumers [12]. Today, there is a lot of tension between the medical profession and manufactures. In the 80 years since infant formula hit the markets, it went from being an incredibly popular alternative in the 1930s and 1940s to heavily criticized by the women’s movement of the 1950s and 1960s to being viewed today as a mostly convenient and at times necessary alternative [13].

The trouble today connects to an idea presented in Overdo$ed America, by John Abramson. He writes, “The search for scientific truth is, by its very nature, unpredictable, and this uncertainty is hardly optimal from a business point of view” [14]. Similar to Wonder Bread, in the time that has passed since 1935, there has been more and more evidence to show the ways in which formula feeding is harmful. But since this alternative choice has been introduced into the markets and many have come to rely on this product, it is difficult to remove.

Throughout this research two ideas have really stuck with me and complicated my initial view of medical authority and consumerism. The first is in relation to artificial formula. There are numerous examples of businesses manipulating the public to want their product, but in the case of an alternative to breastfeeding this idea emerged from women. “Love the convenience” is one of thousands of positive reviews on Amazon for formula products [15].

The second idea comes from Jacqueline Wolf’s book, Deliver Me from Pain. In discussing childbirth, Wolf suggests that women’s understanding of childbirth most often comes from the media. Having only those images to rely on, women imagine childbirth to be different than it would otherwise be [16]. The same applies elsewhere — when we don’t know what to do, we reference what we have seen pictured elsewhere, and often this is in the media. Advertisements are incredibly influential in their ability to imagine what life can and should be.

Despite the many ways processed foods may be harmful — thinking about it in terms of health and cost — recognizing the individual choice in their development and the purpose it serves today, it is difficult to entirely dismiss them. In “Equity in Breastfeeding: Where Do We Go from Here?,” the authors state “breastfeeding requires the involvement and participation of all people and stakeholder institutions in the support derived from breastfeeding” [17]. The same can be said for addressing obesity. While processed foods may not be the best option, there are many barriers keeping people from accessing healthy foods, and there needs to be careful consideration of what those are and how they can be addressed.

 

Endnotes:

[1] Cooked. Netflix. Directed by Peter Bull et al. 2016. Jigsaw Productions and Netflix.

[2] “Adult Obesity Facts,” The Center for Disease Control and Prevention, 2015, http://www.cdc.gov/obesity/data/adult.html

[3] Cynthia Ogden, et al, “Prevalence of Childhood and Adult Obesity in the United States, 2011-2012,” The Journal of the American Medical Association 311, no.8 (2014): 1.

[4] Ronald Numbers, “The Fall and Rise of the American Medical Profession,” in Sickness and Health in America, ed. Judith Walzer Leavitt and Ronald L. Numbers (Madison: The University of Wisconsin Press, 1997), 225.

[5] Ibid., 228.

[6] Lawrence Glickman, “Born to Shop? Consumer History and American History,” in Consumer Society in American History: A Reader, ed. Lawrence B. Glickman (Ithaca: Cornell University Press, 1999), 5.

[7] John Burnham, “American Medicine’s Golden Age: What Happened to It?” In Sickness and Health in America, ed. Judith Walzer Leavitt and Ronald L. Numbers (Madison: The University of Wisconsin Press, 1997), 286.

[8] Kara Swanson. “Human Milk as Technology and Technologies of Human Milk: Medical Imaginings in the Early Twentieth-Century United States.” WSQ: Women’s Studies Quarterly 37, no. 1 (2009), Emily Stevens, Thelma Patrick and Rita Pickler. “A History of Infant Feeding.” The Journal of Perinatal Education 18, no. 2 (2009), and Pérez-Escamilla, Rafael and Dan Sellen. “Equity in Breastfeeding: Where Do We Go from Here?” Journal of Human Lactation 31, no. 1 (2015).

[9] Kara Swanson. “Human Milk as Technology and Technologies of Human Milk: Medical Imaginings in the Early Twentieth-Century United States.” WSQ: Women’s Studies Quarterly 37, no. 1 (2009).

[10] Ibid.

[11] Ibid.

[13] Emily Stevens, Thelma Patrick and Rita Pickler. “A History of Infant Feeding.” The Journal of Perinatal Education 18, no. 2 (2009).

[14] John Abramson, Overdo$ed America: The Broken Promise of American Medicine (New York: Harper Perennial, 2004), 94.

[15] Similac Advance Infant Formula with Iron, Stage 1 Powder, 23.2 Ounces Customer Reviews.” Amazon. 2016, http://www.amazon.com/Similac-Advance-Infant-Formula-Powder/product-reviews/B0068RR59I/ref=cm_cr_arp_d_paging_btm_2?ie=UTF8&filterByStar=five_star&showViewpoints=0&pageNumber=2.

[16] John Abramson, Overdo$ed America: The Broken Promise of American Medicine (New York: Harper Perennial, 2004), 94.

[17] Jacqueline Wolf,  Deliver Me from Pain: Anesthesia and Birth in America (Baltimore: Johns Hopkins University Press, 2009), 5.

 

Further Reading:

Richard Malmsheimer, Doctors Only: The Evolving Image of the American Physician (Westport: Greenwood Press, 1988).

John Abramson, Overdo$ed America: The Broken Promise of American Medicine (New York: Harper Perennial, 2004).

Wendell Berry. “The Pleasures of Eating.” in Consumer Society in American History: A Reader, edited by Lawrence B. Glickman (Ithaca: Cornell University Press, 1999).