The Food Issue

In June 2010, a small group of frozen-pizza technicians, cooks and marketers met in a conference room in Chicago. They had been summoned to report to Paul Bakus, an executive at Nestlé. This team had developed DiGiorno pizza for Kraft, and came along when Nestlé bought Kraft’s frozen-food business in January of that year. Nestlé is known for its chocolate Crunch bars, of course, but it makes all sorts of food: frozen meals, bottled water, bouillon cubes, Hot Pockets, instant noodles, baby food and dog food. It is, in fact, the world’s largest food company. But unless Stouffer’s French Bread Pizza counts, Nestlé didn’t make pizza in the United States at that time. Bakus was new to pizza, too. He had done a tour of duty at Nestlé’s Swiss headquarters before he was sent home to head the American baked-goods division. From there, he was transferred to run the frozen-pizza business from Solon, a suburb of Cleveland where Nestlé develops all its frozen foods.

DiGiorno, the line Kraft created in 1995, became a market leader for its “rising crust,” which, unlike other frozen pizza crusts, started raw and rose in the oven. The crust was the centerpiece of DiGiorno’s pitch to consumers: that it could pass for delivery. But now that DiGiorno was a Nestlé product, it would have to be brought into compliance with Nestlé’s nutritional standards. Bakus was sent to Chicago to talk about sodium.

Sodium is in pretty much everything we eat, in part because it tastes good and in part because it’s an effective and cheap preservative. Some 75 percent of the salt in our diets comes from packaged and restaurant food, leaving just about 25 percent under most people’s control. Many public-health officials say the single most important thing we can do to fight heart disease — still the country’s leading killer — is cut back on sodium. In June, the Food and Drug Administration released new preliminary guidelines for reducing sodium that it urged food makers to follow. As of now, the rules do not have the force of law. But food makers have seen the writing on the wall for some time.

Ahead of the day when guidelines become mandatory reductions, these companies have for years been working on systematically lowering the sodium in their products. Kraft did. Mars and Campbell’s did, too. Walmart reformulated its private-label line with an across-the-board 25 percent sodium reduction. For any company, however, this long-term strategy brings with it near-term risk: Consumers associate low sodium with less flavor, and they tend to avoid products touting it.

At the same time, Bakus’s competition was cutting away at frozen pizza’s main advantage over delivery: convenience. Domino’s has been investing in technology, shortening delivery times with Uber-influenced algorithms. The company has even outfitted delivery trucks with ovens so they can muscle through traffic while cooking their cargo.

Frozen pizza had to adapt — something everyone in the room knew perfectly well, they told Bakus. They’d been trying. But pizza is tricky. In the sauce, salt is there for taste and can be turned up or down at will. In cheese and sausage, it’s part of traditional preservation that became encased in the F.D.A.’s “standards of identity,” which determine what manufacturers are allowed to say about ingredients on labels. Take out too much salt, and they might have to call their provolone something like “cheese product.”

The problem, the team told Bakus, is that on top of the meat and cheese — considerable in DiGiorno’s three-meat pizzas and cheese-stuffed crusts — the dough had higher-than-usual amounts of sodium. Packaged bread, in which sodium is used for texture and preservation more than for flavor, is one of the greatest sources of salt in the American diet. In the DiGiorno’s crust, the higher-than-usual sodium came from the baking powder Kraft used to make the dough rise. The DiGiorno food scientists had managed to create a pepperoni pizza with 10 percent less sodium, already something of a feat. Bakus thought they’d done fine: At a tasting, he couldn’t tell the difference between the original and the reduced-sodium version. But pepperoni loyalists could.

The chief requirement for reformulating a beloved product is to change it imperceptibly, so that in blind tastings customers prefer the new version to rival products or to the old version. (Nestlé’s rule is that six in 10 people must prefer an item in blind tastings before it is cleared for production.) And once a reformulated food passes the test, companies often avoid saying anything on the label or in advertisements about the nutritional improvements — especially when it comes to salt. Most people don’t think they need to cut back on sodium. Better to say nothing. It’s known in the trade as “stealth health.”

Big food makers are pinned between two groups with overlapping interests. One is consumers looking to improve their health, many of whom have long been deeply suspicious of big food companies, and are even more so today. The other is public-health officials and regulators who are willing to force companies to make bigger changes than they might want to, before they might want to. Do too much, and they’ll lose their customers; do nothing, and they’ll keep making money — but risk losing a future lawsuit. Nestlé and its competitors are busily trying to figure out a way to split the difference. But can frozen pizza really be expected to improve the health of the American public? And will anyone want to eat it if it does?

Your taste for salt is not hard-wired from birth. The excessive amount we eat today is a result of what Matthias Berninger, vice president of public affairs for Mars, calls an “arms race” between food producers and restaurant chains. One turns up the salt; customers get used to that; the next producer does the same thing. Over time, the whole population’s palate changes. Today Americans consume two to three times the sodium we need, and one in three Americans suffers from high blood pressure, which can lead to heart disease — which can lead to the grave.

Some public-health advocates think lessening Americans’ dependence on sodium will be easier than doing the same with sugar — in large part because it won’t require weaning an entire nation off soda. It takes only days or weeks to recalibrate your palate. Making that happen for the American public means negotiating, essentially, a new arms treaty. Marion Nestle (no relation to the company), a professor of nutrition and food studies at New York University and one of the fiercest and most lucid critics of the food industry, believes that food companies and restaurant chains could play a role in fixing the problem they’ve created. “The trick is to get the makers of processed and pre-prepared foods to agree to gradually reduce the amount of salt in their products,” she says. “If everyone did that, nobody would notice.”

Thomas Frieden, director of the Centers for Disease Control and Prevention, recently published a paper in The Journal of the American Medical Association calling for more companies to agree to voluntary sodium-reduction targets. Frieden is no stranger to this sort of crusade: He led the charge against trans fats for Mayor Michael Bloomberg while he was New York City’s health commissioner. His article points to British data showing that a 15 percent reduction in sodium intake from 2003 to 2011, a result of voluntary targets Britain set in 2003, was followed by a 40 percent reduction in deaths from ischemic heart disease and stroke. “Sodium reduction,” he told me, “could save hundreds of thousands of lives and billions of dollars in health care costs.”

These kinds of recommendations were given heft in June when the F.D.A. released its sodium guidelines. “We’ve used educational strategies for years,” says Susan Mayne, director of the F.D.A.’s Center for Food Safety and Applied Nutrition. “But we found that education alone is not sufficient.” The F.D.A. recognizes that, as with any arms-reduction deal, all parties need assurance that other parties are following the rules, too, so the agency aims to coax the sodium out of our diet slowly. It knows that every company thinking about lowering sodium has Campbell’s in its rearview mirror.

Campbell’s is the cautionary tale of what can happen when a company gets ahead of the competition. For years, it has wanted to demonstrate its commitment to public health, and its core product, canned soup, was a fat target for sodium reduction. Baseline levels of salt are generally so high that they’re easy to make a big dent in. And with canned soup, you can do so without worrying about, say, a deflated crust. So in 2010, Campbell’s reduced its soups’ sodium by as much as 45 percent. Tip-off on the label or not — only some reductions were announced — customers didn’t buy more. The salt went back in.

Another reason to keep quiet about sodium reduction is the efforts of some groups to dispute recommended levels. No sooner had the F.D.A. reduced its guidelines than the Salt Institute, a trade organization “dedicated to advocating the many benefits of salt,” put out a news release lamenting the “government’s war on salt,” calling it “malpractice” and pointing to numerous studies indicating the risks, not benefits, of lowering sodium consumption. (Frieden has said that those studies had “fundamental flaws.”)

Nestlé and other multinationals have decided to tune out in-country noise and look at the big picture, for which they look to the World Health Organization. “A lot of the food industry wants to follow not-excellent but self-serving information,” Berninger, of Mars, says. “We believe the best and most profitable way forward is to stop the constant bickering. Just pick targets to meet.”

Bakus was feeling the pressure. At a Nestlé gathering of health experts in 2013, William Dietz, then focusing on obesity reduction at the Centers for Disease Control, pulled Bakus aside to say that pizza was a nutritional train wreck — the single greatest source of sodium for children ages 6 to 18. A paper Dietz later published in Pediatrics, the official journal of the American Academy of Pediatrics, associates pizza with higher caloric and saturated fat intake as well as higher sodium in children’s diets. Bakus told me that running Nestlé’s pizza business made him feel as if he were walking around with a bull’s-eye on his back.

The Nestlé R.&D. lab is on a subterranean floor of the campuslike research center in the hills above Lausanne, Switzerland. It looks more like a sterile medical-research lab than a kitchen. But the smells are not medicinal: deep mushroom-broth and fermented-fish odors mingling with unidentifiable but sharp, acidic, vinegary scents. When I visited several years ago, the company was already deep into what it calls its “kitchen cupboard” project, trying to cut out unpronounceable ingredients and build flavors without scary-sounding chemicals and hillocks of salt. I had recently visited David Chang’s test kitchen for his Momofuku restaurants, where cooks were making variations on traditional fish sauce for new sauces, and the Nordic Food Lab, started with the Copenhagen restaurant Noma, where I saw racks and racks of koji, the mold that ferments rice to sake, being used to flavor all manner of grains.

By now, fermentation has become a very fashionable flavor-creation trick among chefs. Nestlé’s scientists hoped it could lead to substitutes for the dough conditioners they use to make their crust rise, which are not only bad for flavor but also have names that look particularly menacing on labels. Sean Westcott, an energetic Australian who was then in charge of frozen and chilled foods, told me about a barley particularly rich in enzymes, which the company is using to ferment pizza dough — helping it rise and create flavors at the same time, and removing acres of syllables from the label.

Nestlé was also toying with potassium chloride, a compound similar to sodium chloride — table salt. Jeff Hamilton, president of Nestlé’s United States prepared-foods division, told me that it gives most people the sensation of saltiness, with the added advantage of supplying potassium, a mineral many Americans don’t get enough of. The problem is that a subset of the population perceives potassium chloride as bitter or metallic. And “potassium chloride” doesn’t exactly have a kitchen-cupboard ring to it. Nestlé is encouraging the F.D.A. to call it “mineral salt (potassium)” on labels.

When the DiGiorno team told Bakus they’d gone as far as they could to reduce sodium without having customers notice, and failed, he knew they needed to find out what was going on in the research-center labs and at Nestlé’s pizza businesses in other countries. So he took the team to Germany, Italy and Switzerland to learn new tricks. Within a year and a half of the initial discouraging tasting, the first reduced-sodium DiGiorno went on the market — with no mention of the reduction. I tried several varieties in Solon during a wide-ranging tasting. For the most part, I found them a little too salty; but that’s just what people are used to.

There is, however, a larger problem with the American diet that lowering sodium cannot address: portion size. Frozen pizza is a particularly menacing vector for overeating. Chavanne Hanson, head of nutrition, health and wellness in global public affairs at the Swiss headquarters, says that customers know that candy and ice cream are occasional treats. They don’t tend to eat too much of it at one sitting — or are conscious of indulging when they do. Pizzas are different. They’re big, and they’re inviting. It’s easy to take one more slice, and then another. “There’s staggering social- media chatter on pizza,” says Mary Colleen Hershey, who monitors online discussion of company products for Nestlé. “You can’t believe how many people will admit they eat a whole pizza.”

With Bakus’s encouragement, Hanson began a “portion guidance” program, telling customers to eat less of its product on the back of the package. The graphics on the package show what one-sixth of a pizza looks like — about the size of a hand put over the pie as you cut a wedge, an easy mnemonic — and tell people to eat one slice for dinner and no more. “Our surefire recommendation,” the company’s guidance reads, is one slice “along with a salad, roasted vegetables, fresh fruit and a glass of water or low-fat milk.” Well, it’s a nice thought.

Such a civilized dinner might be an unlikely choice for the throngs who still think one pizza is one serving. And frozen pizza is an unlikely solution to the vast and intertwined set of problems in our diet. But it’s a start. Food makers’ relentless advertising and bloated products, full of unnecessary sugar and salt, contributed to many of the incredibly expensive chronic illnesses our health care system has been left to deal with. Lowering those costs might mean depending on big food companies and restaurant chains to clean up the mess they’ve helped create. Even their biggest critic agrees. I asked Marion Nestle if she really thought a low-sodium frozen pizza could improve public health. “Yes,” she said. “A lot. But only if everyone else does the same thing.”

Corby Kummer is a senior editor at The Atlantic and editor in chief of IDEAS: The Magazine of the Aspen Institute, where he directs the food and society program.