“April 15” fills many Americans with anxiety as tax returns become due (though this year Uncle Sam has given us until April 18th).  I recently remembered that April 15 has another grim association:  the opening, 56 years ago, of Ray Kroc’s first McDonald’s franchise in Des Plaines, IL.  (Now is as good a time as any to disclose that my organization has hauled Ronald McDonald to court to try to stop the predatory practice of using toys to lure children to disease-promoting Happy Meals.)

With the possible exception of Coca-Cola (itself a McDonald’s menu mainstay), I can’t think of another food company that has had such an enormous impact on the way we eat and the way we farm.  Yes, thanks to McDonald’s, one can eat out quite cheaply.  And it’s hard to be dismissive of that achievement in a time of high unemployment and high income disparity.  But that low price obscures the financial toll exacted on Americans by McDonald’s and McDonald’s imitators in terms of the costs associated with treating obesity, heart disease, diabetes, and other conditions.  So in that way, McDonald’s has been taxing us for the past half-century-plus:  We now spend about $90 billion a year to treat heart disease and high blood pressure alone.

Of course, McDonald’s isn’t to blame for all diet-related disease.  But consider the ways in which McDonald’s has homogenized the American diet.  Fatty, factory-farmed burgers on refined white bread, for instance, have become the omnipresent, default sandwich.  McDonald’s original little burger basically started a world-wide arms race to build the biggest, baddest burgers.  The Big Mac was bad enough, but it’s the cultural grandfather of monstrosities like Hardee’s 1,400-calorie Monster Thickburger.

Consider French fries.  McDonald’s fries are less harmful than they used to be, because the company has ditched partially hydrogenated frying oils, and beef tallow before that, in favor of trans-fat-free vegetable oil.  But McDonald’s has basically acclimated the whole country to consider a deep-fried, low-nutrient white potato as the default vegetable side dish.  Equally important, McDonald’s deserves a good share of the blame for the fact that many Americans consider high-calorie, low-nutrient sodas to be the default beverage.  Before McDonald’s and other fast-food restaurants, soft drinks were occasional treats.  But with sugary soft drinks, usually Coke, being the default beverage sold with fast-food meals, kids grow up thinking that a meal without a soda is like an evening without television.

Billions of dollars of advertising over the years—McDonald’s spent $872 million in 2009 alone—makes all of this seem normal.  No one should think that McDonald’s genius was in satisfying a demand for meals of burgers, fries, and Cokes. Its genius was creating that demand in the first place.  And thus, the occasional treat or convenience is now a once-, twice-, or even a thrice-a-day indulgence.  (Unguardedly using the language of street drug pushers, McDonald’s actually refers to its best customers as “heavy users.”)

It’s a smaller point, but consider how McDonald’s also has shaped where, and how quickly, we consume our food.  Many years ago, it would have been considered bizarre, or at least impolite, to eat a meal while behind the wheel of a moving car.  But the drive-through culture that McDonald’s helped midwife made that dangerous practice commonplace.

In the 56 April 15ths that have passed by since Ray Kroc’s dream became a reality, McDonald’s has coarsened our palates, expanded our waistlines, clogged our arteries, and brainwashed our children with toy-based marketing. I hope that Food Day, the recently launched grassroots push for healthy, affordable food produced in a sustainable, humane manner, slowly begins to undo some of the damage McDonald’s has done to our diets and our culture.  The Food Day campaign culminates on October 24, and will publicize the message that “it’s time to eat real” and will celebrate healthy, delicious, home-cooked meals.  That’s a message that should turn one clown’s smile into a frown.

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Michael F. Jacobson, Ph.D., is executive director of the Center for Science in the Public Interest and is the founder of Food Day.