Weeks Nine and Ten (10th - 21st October 1994)

DR NEAL BARNARD - Diet & Chronic Diseases: Dr Barnard, President of the US Physicians' Committee for Responsible Medicine and an expert on nutrition and health, came from the USA to give evidence over 4 days on behalf of the Defendants.

He said "many products sold at McDonald's are high in fat and cholesterol, and low in fibre and certain vitamins", and as a result these products "contribute to heart disease, certain forms of cancer and other diseases" (including obesity, diabetes, and hypertension). The links between diet and these now epidemic diseases (described by the World Health Organisation(WHO Report) as "the commonest cause of premature death in developed countries") are, he said, "established beyond any reasonable doubt", and were causal in nature.

He said that heart disease is linked to a high fat diet, particularly to high levels of saturated fat as found in animal products. "Saturated fat stimulates the liver to make more cholesterol", increasing people's blood cholesterol levels. He added that "on average, every 1% increase in the amount of blood cholesterol raises the risk of a heart attack by 2% or more". He stated that blood cholesterol levels can be raised or lowered over a matter of only a few days.

He reported that official bodies estimate that "more than 30% of cancers are linked to foods", especially breast, colon and prostate cancer. He pointed out that, in addition to the general problem of consuming too much fat and too little fibre in the diet, there is also increasing concern in the US about the carcinogenic mutagens which form on the surface of grilled and fried meat. He referred to a large body of evidence showing that vegetarians almost always have a lower incidence of the chronic diseases mentioned; furthermore, a vegetarian or vegan diet had been found to help in the treatment of many such diseases. He stated "that McDonald's products clearly contain significantly more fat than government guidelines and health authorities recommend". Evidence had shown that "fatty foods tend to be habituating" and "increase the likelihood of continued high fat intake". "McDonald's food remain part of the problem, rather than part of the solution". It was essential that people had the full information when choosing what to eat. But McDonald's advertising had been misleading - one example was the company's promotion during US National Nutrition Month in 1993 which claimed that food from the meat group "can make it easier to do things like climb higher and ride your bike farther". He said "the concept that high protein foods are essential for endurance" had been discarded a hundred years ago and there was "no evidence whatsoever" to back it up. He said a more accurate description of the effects of frequent meat-eating would note its links to some chronic diseases. He quoted the director of a major study into heart disease,Dr William Castelli who said "When you see the Golden Arches you're probably on the road to the pearly gates."

Legal Manoeuvres by McDonald's - Before the case began, McDonald's had conceded part of the Defendants' case by making a formal admission that "there is a considerable amount of evidence of a relationship between a diet high in saturated fat and sodium [salt], and obesity, high blood pressure and heart disease." They denied any association between diet and cancer, and claimed this damaging allegation was at the core of the case - the resolution of which would be so complex that a jury would not be able to understand the arguments. But, during Dr Barnard's evidence, Richard Rampton QC (for McDonald's) conceded that "we would all agree" that there is a link between a high fat, low fibre diet and cancer of the breast and colon.

Later, the Defendants complained to Mr Justice Bell that McDonald's had now conceded virtually the entire Defence position in this section of the case, and accused the company of deliberately prolonging matters to justify McDonald's pre-trial application against a jury. Following this, Richard Rampton QC dropped his questioning of Dr Barnard and then cancelled his further cross-examination of the Defence cancer experts, Professor Crawford and Geoffrey Cannon due the following week.

McDonald's are now trying to shift the goal posts by applying to change their Statement of Claim (the basis of the legal action, issued in September 1990) to say that the Defendants should now have to prove the statement (not contained in the London Greenpeace Factsheet) that "McDonald's sell meals which cause cancer and heart disease in their customers".

PETER COX - Marketing and Health: Peter Cox, former marketing consultant, and also former Chief Executive of the Vegetarian Society, gave evidence for the Defence as an expert on the marketing of food. He said that McDonald's promotional material was 'one-sided', sometimes 'deliberately misleading', containing significant omissions and even 'weasel words' which 'while...implying one thing, actually say something else', as a result ultimately 'confusing' and 'misleading' the reader. This was particularly true of their nutritional information and advice which failed to alert customers to health implications of eating products high in fat, saturated fat, salt and sugar, and low in fibre and certain vitamins. Yet at the same time, the company, he said, clearly 'set themselves up as nutritional consultants' and therefore had an 'overwhelming responsibility...to tell people the truth' about these matters.

Mr Cox referred to a company document from 1985 (not available in stores) which made it absolutely clear that the company was aware even then of the links between diet and diseases - it specified heart disease, cancer, diabetes and obesity. It was his opinion therefore that the effect of the company's efforts to promote their products as 'good, nutritious food' over the years was "to debase the concept of 'healthy eating' to no more than a cynical sales promotional ploy".

Credibility Gap - Mr Cox said their main products were generally 'unhealthy'. If they genuinely wish to provide nutritious food, he would expect to see more emphasis on a choice of vegetable products and fruit etc. He pointed out that even their salads (still only available in some stores) had a 'ludicrously high' fat content (over 50% calories from fat). The company's claim to be concerned about healthy eating was not borne out by the products sold. Mr Cox told how the company were now promoting their newest menu item - the "Mega Mac" which comprises 4 meat patties and contains huge amounts of fat and saturated fat. He said there was a huge 'credibility gap - the difference between the image portrayed...and the reality of the food sold'. He believed that the few positive steps made had been taken 'perhaps rather grudgingly' as a result of public pressure.

He was concerned that 'gimmickry' was being used to promote unhealthy food to children. He quoted Ray Kroc, McDonald's founder and President until 1984, from his autobiography: "a child who loves our TV commercials and brings her grandparents to McDonald's gives us two more customers. This is a direct benefit generated by advertising dollars". Mr Cox stated that the use of ads to promote 'pester power' is outlawed by UK advertising authorities. However, this doesn't cover general sales promotion such as the use of toys and clowns.

Expansion and Subversion - He said McDonald's were 'redefining...the word "meal" '. He also quoted from 'Behind the Arches', a book authorised by McDonald's in 1987, as evidence that McDonald's were engaged in 'a strategy of subversion' by trying to alter the dietary preferences of whole nations, 'very often for the worse'. Mr Cox read the following quotes from 'Behind the Arches':

In Japan, McDonald's faced "a fundamental challenge of establishing beef as a common food". Their President, Den Fujita, stated "the reason Japanese people are so short and have yellow skins is because they have eaten nothing but fish and rice for two thousand years"; "if we eat McDonald's hamburgers and potatoes for a thousand years we will become taller, our skin become white and our hair blonde". The book says that Fujita "aimed virtually all his advertising at children and young families", and that he stated "we could teach the children that the hamburger was something good". The company also changed eating habits in Australia. Peter Ritchie (McDonald's Australian president) said he "attributes that change to the influence McDonald's has on children". The book concludes that rather than adapt to local tastes and preferences "McDonald's foreign partners made major changes in marketing in order to sell the American system".

Peter Cox said it was clear that their strategy of expansion is to 'change culture to suit the product' by 'conducting unethical marketing and attempting to disguise the fact'. He described the company's marketing as 'ruthless', 'unethical' and 'unacceptable'. McDonald's, more than any other company, has succeeded in 'manufacturing an almost entirely artificial image and boosting that image by continual and huge amounts of advertising dollars'.

DR ERIK MILLSTONE - Food Additives & Safety: The Defendants called Dr Erik Millstone, an expert on food additives safety policy issues. McDonald's uses dozens of food additives in its products and the company has made a formal admission that, in order to achieve the "uniformity of their products throughout the world...they have set formulae and specifications for menu items and use a number of additives". Dr Millstone referred to concerns about the safety of nine of these additives [Note: there followed three days of scientific evidence and this report is only a short summary with few direct quotes.]

Dr Millstone said that as regulatory bodies judged the safety of additives, and consequently their regulatory status largely by reference to tests on animals, they should be consistent in interpreting results and any adverse effects shown should be taken seriously. However in several cases where additives had produced adverse effects (including cancer) in animals, the additives were nonetheless permitted for use (including many of the 9 additives in issue). Regulatory bodies had discounted those tests, stating that animals were not always reliable models for humans and that doses given were higher than humans would consume. Dr Millstone said that in contrast if an additive did not produce adverse effects in animals it was officially assumed it would be harmless to humans. He described how the results of animals testing were sometimes contradictory (and often kept secret), and it was hard to relate the results from small groups (usually 50) of genetically uniform animals in a uniform environment to genetically and environmentally diverse and complex human populations of millions of people. Furthermore, animals could not indicate intolerances or allergic or hyperactive reactions.

Dr Millstone believed that where there were doubts over the safety of additives the benefit of the doubt should be given to the consumer, not to the compound or the industry. Policy decisions were supposed to involve a balance of safety and need, but in his view artificial colourants and flavourings in particular were not necessary at all - they were usually used to compensate for processing and marketing problems. He said "if the object of the exercise was the protection of public health rather than helping companies negotiate their way through regulatory hurdles" then the approach he advocated would be adopted.

In addition to the possible risks of cancer and other long term chronic effects, there was a significant body of anecdotal and other evidence that additives could provoke allergies and intolerances in some consumers (he believed this could affect between 1-5% of the population) and hyperactivity in children.

Dr Millstone referred to many scientific papers as he explained his concerns with the following additives: