How Bill Put the Fizz in the Fight Against Fat

By Jeffrey Kluger

If you had grown up taking your Sunday lunches at Bill Clinton's great-uncle's house, you would have developed a weight problem too. The former President's beloved Uncle Buddy knew how to put out a spread that included a ham or a roast, corn bread, mashed potatoes, sweet potatoes, peas, lima beans, fruit pies and bottomless flagons of iced tea. If the future President arrived early enough, he even got to help turn the crank on the ice cream maker.

A big-boned Southern boy couldn't help plumping up on such fare, eventually growing into a teen who, by his own description, was "fat, uncool and hardly popular with the girls." Although the 42nd President surely remedied the coolness and girl problems, the matter of the fat dogged him ever after. From his McDonald's jones to the quadruple-bypass surgery that eventually laid him low, Clinton has long been a one-man case study of the U.S.'s food crisis--the compulsiveness, the consequences, even the shame.

And now he might be the face of recovery. The Clinton Foundation, the American Heart Association and the nation's three biggest beverage manufacturers--Coke, Pepsi and Cadbury Schweppes--last week announced an agreement to begin rolling back America's growing obesity epidemic in the place they can do the most good: the schools. Beginning now and progressing through the 2009-10 school year, the manufacturers will kick high-calorie, sugary drinks out of school vending machines and replace them with bottled water, unsweetened fruit juices, low-fat milk and sugar-free sodas--all served in smaller portions. And that's only the first move in Clinton's campaign to fight fat. His foundation is planning to turn its attention next to vending-machine snack foods and cafeteria lunches and is even in negotiations with fast-food companies to reduce the fat in their restaurant fare.

The soda deal, in the meantime, will affect at least 35 million school-age children, and by any measure it comes none too soon. Two-thirds of U.S. adults are overweight or obese, and so are a shocking 17% of kids, with another 15% at risk. Children who start life fat often stay that way, with all the attendant health consequences. Kids as young as 10 are turning up with obesity-related Type 2 diabetes, which used to be known as the adult-onset form of the disease. The Clinton-backed plan would cut off a significant part of the sugar stream that's causing those problems. "This one policy can add years and years and years to the lives of a very large number of young people," Clinton said after the deal was announced.

The plan does have its detractors, who see it as shot through with loopholes, not least because soda represents less than half of school vending-machine sales, with fatty and sugary snacks making up the rest. And since school administrators are hardly likely to conduct beverage pat-downs, nothing will prevent kids from bringing sodas to school or ducking out to a 7-Eleven for a midday sugar shot. "The soda agreement looks like a step in the right direction," says Marion Nestle, nutrition expert at New York University, "but I can't help being skeptical."

Whatever the merits of the deal, the way it came about is one more step in the always unfolding narrative of the man whose presidency was as much about his personal weaknesses as his political deftness. For all the bonhomie with which Clinton bore the fat-man jokes thrown at him, it's hard to imagine they bounced off as easily as he made it seem they did. He was widely mocked for his oversize--and overwhite--thighs in the infamous jogging shorts, and there was no end to the snarky media remarks about his ballooning girth on the campaign trail. The heart blockages that probably would have cost him his life without his 2004 bypass surgery were a long-in-coming slap in the face, waking him up to his problem and to the way he could parlay it into some public good. If it took an old red hunter like Richard Nixon to go to China, perhaps it would take an old chowhound like Clinton to go to war against junk foods.

Last September, Clinton and adviser Ira Magaziner--one of the architects of the ill-fated 1994 health-care-reform plan--began approaching food and beverage companies about voluntarily controlling what they sell to kids. Of all the unhealthy foods students consume, sugary beverages were the obvious place to start. First of all, kids drink tons of the stuff. The average 11-to-14-year-old consumes almost twice as much soda as water; 15-to-19-year-olds pour down an average of two 12-oz. servings of soda every day--in the process consuming 1.5 lbs. of sugar each week. The benefits of dialing back the sugary drinks would accrue not just to the kids but also to the beverage makers. Even before the Clinton announcement, 43 states had enacted or introduced legislation to improve school nutrition, raising the specter of a crazy quilt of local rules the companies would have to learn and meet. One uniform standard would be in everyone's interest.

Above all, the beverage firms were happier to have a newspaper photo op with Clinton rather than headlines about their fending off lawsuits. Michele Simon, director of the Center for Informed Food Choices, along with a team of other health groups and lawyers, had been in negotiations with the beverage companies for a similar health-conscious agreement as the threat of litigation loomed. When Clinton came calling, those talks broke off. "Apparently Coke and Pepsi were shopping for the best p.r. opportunity," she sniffs. "It looks much better to have President Clinton at your side than a bunch of lawyers." Exactly.

Magaziner pressed the argument for a common standard to the manufacturers and also stressed that cleaning up the vending machines would be easier now, if only because the drinkmakers had already introduced so many healthier options, like mineral water and low-sugar juices. The beverage companies at first pushed back against restrictions in the high schools: Magaziner says they argued that if these kids were almost old enough to fight in Iraq, why should they be denied their choice of soda? The companies ultimately relented, but with so many product lines and so many portion sizes, working out the details took time. Says Magaziner: "We negotiated drink by drink with them, literally." Most of the time it was Magaziner who did the jawboning. Only when things got stuck would he bring in Clinton to give the participants a presidential push.

The agreement the negotiators eventually reached was unveiled with plenty of fanfare and not a little hyperbole. "It's a bold step forward in the struggle to help America's kids lead healthier lives," Clinton said. Maybe, but the terms are hardly airtight. Sweetened drinks will still be available at after-school events that parents attend, such as plays and games, and kids remain free to load up on sugar on their way to school. "We'll just get it someplace else," says Zach Pilkington, 15, a student at Valley Southwoods Freshman High School in Des Moines, Iowa. "It's not going to change anything. It's just going to tick people off."

Health experts disagree. "If it's right there, you're more likely to buy it," says psychologist Lisa Altshuler, director of the Kids Weight-Down Program at Maimonides Medical Center in Brooklyn, N.Y. "If you have to walk across the street, you'll be less likely to bother."

The plan's slow rollout is raising eyebrows. The Clintonites and the American Heart Association seem to trust the companies when they say they need time to renegotiate their beverage contracts with the schools and retrofit their vending machines, but for some people that doesn't wash. "They have to be kidding, no?" asks New York University's Nestle. "Implementation by 2010? Today's kids will be grown up by then. I read this as a ploy to keep the vending machines in the schools at any cost."

Also troubling is the financial cost to schools when the beverage spigot is partly closed. The deals that administrators strike with drinkmakers often go to pay for such comparative luxuries as athletic programs and yearbooks; if the kids don't take to the healthier drinks, revenue will fall. For Brainard High School in Chattanooga, Tenn., vending-machine sales have meant an annual cash infusion of as much as $17,000. "I think the deal will hurt us," says school bookkeeper Robin Cavin. "We pay the insurance for athletics out of that. Who will replace it when it's gone?"

The die, however, has probably been cast for all junk foods in schools. Talks between the Clinton team and the snackmakers that provide the other goodies stuffed into school vending machines are under way, helped in no small part by the fact that the companies confront the same kind of regulatory chaos that the sodamakers faced. Pepsi--a major snackmaker--is a player in this deal too, as are Kraft, General Mills, ConAgra, Unilever, Mars and others.

Next, work should get started on cafeteria food, which, since 1946, has been subsidized by the National School Lunch Program. The law imposes general nutritional guidelines, but they are broad enough to let plenty of fried, fatty and starchy foods slide through. The Clintonites plan to bypass the government and negotiate directly with catering companies, purchasers and school nutritionists. Negotiations with fast-food restaurants--where kids spend an awful lot of social time, often without their parents--are employing another strategy, focusing less on adding healthy menu items that kids don't often eat and more on cutting back the fat and calories in pizzas, fries and other things they serve.

The ability to make deals and knock heads was one of the greatest gifts Clinton brought to his often controversial presidency. Five years removed from the Oval Office, he is 10 years younger than Ronald Reagan was when he entered it. That leaves a lot of good works and a lot of good years ahead--years Clinton bought himself by learning the same healthy lessons he's now trying to teach kids.

With reporting by Reported by Jeremy Caplan/New York, Elisabeth Kauffman/Nashville, Jeffrey Ressner/Los Angeles, Betsy Rubiner/ Des Moines, Karen Tumulty/Washington