A Spoonful of Policy

Lindsey Smith Taillie by cereal
Since joining UNC Gillings School of Global Public Health, Lindsey Smith Taillie’s research goal has remained consistent: to use an array of research methods to design and evaluate food policy that promotes healthier and more sustainable diets across populations.

No more sporks! We want forks! No more sporks! We want forks!

Lindsey Smith Taillie remembers yelling this chant during a sixth-grade protest when her middle-school cafeteria switched from silverware to single-use plastic sporks. Taillie and her fellow students hoped to make their feelings known. It worked. They got their metal utensils back.

“I was like a mini environmentalist,” she said. “I didn’t have any idea at the time, but it was essentially the beginning of this career in food policy, thinking about the places where we’re eating, what we have access to, how that shapes what we’re eating and how well we’re able to eat.”

Today, Taillie is a food policy expert in the UNC Gillings School of Global Public Health. She collects and assesses data on food supply, marketing, prices, purchases and dietary intake to transform old laws or establish new ones, like a tax on sugar and warning labels for foods high in fat. She conducts this work all over the world, from Latin America to Asia.

“The reason I’ve always liked food policy is that it gives you the opportunity to impact millions of people at one time,” she shared. “As a public health person, that’s the goal: to improve health for entire populations.”

Pre-med to public health

Taillie originally wanted to be a doctor. She took a variety of pre-med classes as an undergraduate and, for her senior honors thesis, interviewed 30 psychiatrists to learn how health insurance affected their work with patients.

She found their treatment regimens, including the amount of time they spent with patients, weren’t as robust for out-of-pocket clients.

“I realized how inequitable health care access is. It occurred to me that if we could prevent disease in the first place, that would be a lot better,” she said.

Upon graduating with her bachelor’s degree in 2007, she knew she enjoyed the research process, but realized she didn’t want to go to medical school.

She enrolled in the master’s program at the Yale University School of Public Health and began working with an elementary school in Yunnan, China, on a project testing the effects of portion size on young children. She visited the school and spent two weeks assessing students’ food intake, the outcomes of which mimicked studies completed in the U.S.: Kids eat more when given larger portions.

“That ignited my interest in global nutrition,” Taillie said.

She began reading research papers related to her China project and came across Barry Popkin, a Carolina nutritionist who led his own studies in China in the early 1990s.

As she neared the end of her master’s program, she emailed Popkin to learn more about his work. He suggested she enroll in the nutrition PhD program in the UNC Gillings School of Global Public Health. She did in 2011 — and she’s been there ever since.

Global grocery science

After Chile implemented the world’s first-ever nationwide policy to mandate warning labels on unhealthy food in 2016, Taillie began working with researchers there to assess its impact. The law forced manufacturers to mark foods high in calories, sugar, sodium, and saturated fat with a black label and restricted marketing these products to children, even banning sales in schools.

“Food labeling policies incentivize companies to cut the amounts of sugar, salt, and fat in their products because they want to avoid the policy,” Taillie said. “They want people to keep buying their products — and they don’t want those products to have big, ugly warning labels on them because people won’t buy them.”

The policy worked. Taillie led a study in 2021 that looked at the number of unhealthy food and beverage purchases before the 2016 law was enacted and found that consumption declined.

“Before the pandemic, I spent some time living in Chile with my daughter as well as traveling around Latin America. Even when she was 3 or 4 years old, she understood what the labels meant,” Taillie said. “They’re a big black stop sign, so they cut through the noise of all the other marketing on the food packaging and help people quickly identify what’s unhealthy.”

Mini mart magic

To apply this work to the U.S., Taillie co-founded the UNC Mini Mart with Carolina health behavior professor Marissa Hall. Meant to mimic a real shopping experience, the mart is a physical space on campus with more than 300 food and drink products. The researchers use it to test food labeling and other strategies to encourage people to buy healthier products.

For their most recent study in the mock store, they invited 300 parents and their children to purchase groceries. Unhealthy foods were labeled with images signifying the disease or condition they may lead to. For example, products high in cholesterol had photos of diseased hearts on them, while those high in sugar included images of gangrenous feet — a side effect of untreated diabetes.

The study showed a 17% decrease in parents picking up sugar-sweetened beverages for their kids. This is just one small step of many that U.S. policymakers could take to improve eating habits.

In December 2023, Taillie testified before the U.S. Senate Committee on Health, Education, Labor, and Pensions about what’s fueling the diabetes epidemic. In April 2024, she wrote an op-ed for The Hill in support of the Childhood Diabetes Reduction Act, which proposes limits on ads for unhealthy foods targeted at children.

“The bill would cut kids’ exposure to the most harmful types of food marketing — which is imperative, because they are currently surrounded by it,” Taillie said. “Companies spend $14 billion each year on marketing to children, over 80 percent of which is for fast food and other ultra-processed foods like snacks, candy and sodas.”

In addition to the UNC Mini Mart, Taillie has launched an online supermarket called Lola’s Grocery. Home to more than 20,000 products, the website allows her lab to drastically scale up their studies, testing even more policies and interventions — like how warning labels and fiscal policies can work together to promote healthier, more sustainable choices.

Thanks to a recent grant, Taillie and her team are building an AI version of Lola’s to create a more personalized food-shopping environment to help people make healthy choices based on their own preferences and budget.

Family food joy
One food Taillie is particularly interested in researching is cereal. Students in her undergraduate lab, called Food Labeling and Marketing Evaluation or FLAME, are currently analyzing marketing for breakfast cereals around the globe.

“Breakfast cereal is a perfect example of a product that is often marketed as being healthy while, in reality, contains high levels of sugar,” she said. “In my house, we call it ‘dessert cereal,’ because that’s really what it is.”

Taillie’s goal to improve food regimens across the nation extends to her own household. She admits to having a sweet tooth and struggles with the same problems most Americans do.

“I think our country has a really unhealthy relationship with food,” she says. “The flipside to these concerns about overnutrition are concerns with weight stigma and eating disorders. In my house, I want to create a healthy food environment where we all understand the role of food.”

Taillie teaches her kids about the biology and nutrition — and joy — behind food and talks openly about the marketing tactics the industry uses. She practices what she calls “mindful sugar consumption,” encouraging her kids to make healthy choices for most of the day so that they can enjoy the occasional sweet. They avoid sugar-filled cereals and bars at breakfast and supplement their meals with food from their garden.

“Trying to create balance is hard, even as someone who’s spent their entire life thinking about this kind of thing,” she said. “All families should have the opportunity to live, work and play in environments that are structured to make the healthy choice the easy choice.”

Lindsey Smith Taillie is an associate professor and associate chair of academics in the Department of Nutrition and director of the Global Food Research Program within the UNC Gillings School of Global Public Health.

Written by Alyssa LaFaro

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