The decision of the National Institute for Health Services and Health Policy Research to invite McDonald's-Israel managing director Omri Padan to tell the country's leading health professionals how he made his restaurant menus "healthful and tasty" aroused considerable controversy on Wednesday. Padan sent two female representatives to hand out 40-page brochures on the fat, fiber, vitamin and calorie components of his hamburgers, chicken salads, corn nuggets and fish patties before his 50-minute speech to 80 senior officials from the Health Ministry and other government authorities, medical schools, health funds and hospitals. Some, including one prominent hospital director-general, walked out in protest of the "commercialization" of the two-day conference, which is devoted to "Healthy Behavior As a National Target." Prof. Alexander Aviram, one of the conference organizers, insisted that McDonald's did not pay any money or serve as sponsors of the conference, and that Padan was invited as a guest lecturer so officials could learn about the role of business in changing public eating behavior. The national institute, funded by health taxes and other public money, has organized six previous annual conferences for prominent decisionmakers in the health system on rather dry subjects such as health economy, hospital management and health fund supervision, but the current meeting, at the Mt. Canaan Spa Hotel near Safed, is the first to discuss the neglected subject of disease prevention and health promotion. "We wanted to hear from a company with a reputation, justified or not, of being a 'bad boy,'" the institute's Prof. Gur Ofer explained of the invitation to Padan, a Hebrew University economics graduate and Peace Now founder before he entered the fast-food business. Only last week, McDonald's placed giant ads in the Hebrew papers comparing the "low" fat content in its french fries to that in "reduced-fat" potato chips now being marketed by Osem. "Not all fast food is the same," Padan declared, noting that until recently, the public has never heard of trans fats - solidified vegetable fats that clog arteries - and that even many doctors and dietitians know little about them. The international restaurant chain has over 30,000 branches and a $50 billion annual turnover around the world and over 400 branches in Israel. The worldwide chain was highly embarrassed several years ago when the movie Supersize Me claimed that regular McDonald's customers could become obese after only a few weeks of eating all their meals there. Very few Israeli customers at McDonald's non-kosher branches (it also has several kosher ones) eat cheeseburgers, Padan said. And they prefer white hamburger rolls, he added, "but we make them more nutritious by adding more expensive white fibers to them, but we also offer whole grain for those who want them and use healthful canola oil for frying." He criticized the Health Ministry for not forcing food manufacturers to list the amount of trans fats in their products, even though the US has already made this mandatory. Prof. Hava Tabenkin, a veteran public health expert at Ha'emek Hospital, Afula, chastised Padan at the end of his address for providing "misleading and incorrect figures" on calories in McDonald's menus. She said later that Padan could have spoken for "five minutes" about what his chain had done to reduce fat and calories in various dishes by adding vegetables and fish, offering smaller servings and promoting mineral water or diet drinks to children rather than regular Coca Cola. "The rest of the time, instead of giving us a commercial and handing out brochures, he should have given us tips on how to persuade the public to change its eating habits and lifestyles." Tabenkin said McDonald's has changed its menus to be less harmful "simply because it didn't want to lose customers, not because it is so concerned about public health." Dr. Leah Rosen, head of the Health Ministry's Health By 2020 Program to change Israelis' living habits and prevent disease, said she was nevertheless pleased by Padan's company policy of transparency, of telling customers exactly what is in the food they are ordering. Such a policy should be adopted by all food manufacturers, she said. "But it was unfortunate that he made his speech so self-promoting." Prof. Elliot Berry, dean of the Hebrew University-Hadassah School of Public Health and Community Medicine, said that Padan should not have been invited without also bringing in other food company representatives and a clinicial dietitian to discuss Padan's claims.