Targeting Obesity Alongside Hunger

[Guest guest]

Obama Administration May Look to Tie Food Assistance to Improved Nutrition

By Jane Black

Washington Post Staff Writer

Wednesday, December 24, 2008; Page A02

The worsening economic crunch is causing the tab for food assistance

programs to balloon, and with the rising costs has come an intensifying

debate over whether -- and how -- the U.S. government can tackle

simultaneously the paradoxically linked problems of hunger and obesity.

The statistics spell out the dilemma. The number of Americans on food stamps

topped 31.5 million in September, a record high. Obesity, too, is at

epidemic levels: In 30 states, at least 25 percent of the population is

dangerously overweight. Nationally, 31.9 percent of children are considered

overweight or obese.

For decades, the government has treated hunger and obesity as unrelated

phenomena. But at a news conference last week in Chicago, Tom Vilsack,

President-elect Barack Obama's choice for agriculture secretary, said he

would put " nutrition at the center of all food assistance programs, " a

signal that he will get involved next year when Congress moves to

reauthorize nutrition programs that support school breakfasts and lunches as

well as summer food for children.

" For a long time, we've looked at hunger and obesity separately, " said Sen.

Tom Harkin (D-Iowa), chairman of the committee that will draft the

legislation. " It's not a zero-sum game. "

Public health advocates have long hoped to link food assistance to good

nutrition. To the anti-hunger lobby, however, mandating what kind of food

needy people should eat is impractical and smacks of paternalism. It would

be impossible, they say, to determine which of the 50,000-plus products in

the grocery store should be classified as healthful.

Would Diet Coke pass the test? What about the juice drink Sunny Delight? In

2004, the Agriculture Department rejected a request from the Minnesota

Department of Human Services to ban the purchase of candy and soft drinks

with food stamps.

More important, anti-hunger activists say, low-income people often choose

higher-calorie snacks and fast food because such fare is cheaper and more

readily available where they live than nutritious fruits and vegetables. The

District's Ward 8, for example, had no full-service supermarket for nine

years until a Giant Food store opened last December.

" If there are areas in cities where there isn't an apple for sale within a

mile radius, restricting food stamps goes beyond paternalism to a form of

abuse, " said Jim Weill, president of the Food Research and Action Center, a

D.C.-based anti-hunger policy organization.

But with hunger and obesity reaching unprecedented levels, some anti-hunger

activists are beginning to soften their stance. According to a report by the

Partnership for America's Economic Success, toddlers whose families have

gone hungry are three to four times as likely to be obese. If the current

recession resembles past downturns, the independent Center on Budget and

Policy Priorities predicts, the number of Americans in poverty could rise by

as many as 10 million, driving up obesity, diabetes and cardiovascular

disease.

" It was a very slow and difficult transition for me and my organization, "

said Hecht, executive director of California Food Policy Advocates,

a Los Angeles-based anti-hunger organization. " What we wanted to do was get

more calories to people. Now we find it isn't more calories. It's more of

the right calories. "

To that end, the organization lobbied for a bill that would create

incentives for recipients of food stamps to purchase healthful food. Gov.

Arnold Schwarzenegger ® signed the bill into law in 2006, but the program

never received funding.

The debate in California attracted national attention, however. In the 2008

farm bill, Congress allocated $20 million for a pilot program to explore how

to create incentives to purchase fruits, vegetables or other healthful foods

in order to improve the diets of food stamp recipients and potentially

reduce obesity. Several nonprofit groups and foundations are experimenting

with similar incentives.

One is the Wholesome Wave Foundation, an organization that works to make

locally grown food more widely available. In the spring, it launched a

program that doubles the value of food stamps and fruit and vegetable

vouchers of low-income mothers and seniors who use them at farmers markets

in Connecticut, Massachusetts and California.

The Wholesome Wave matching grants were an instant hit at the City Heights

market in San Diego. On the first day that matching funds became available,

sales using government-issued electronic benefit cards soared by more than

200 percent. In subsequent weeks, the line to receive matching vouchers

formed at 7:30 a.m., and the available funds were exhausted by 9:30 a.m.,

just 30 minutes after the market opened.

" We're not taking away your benefits because you spend them on Twinkies, "

said Michel Nischan, a Connecticut chef and president of Wholesome Wave.

" But if you decide you want to spend it on fresh tomatoes, you'll get double

your money. "

With the Child Nutrition and Women, Infants and Children Act set to be

reauthorized next year, public health advocates are lobbying for the

implementation of stricter standards for school breakfast and lunch

programs, based on recommendations from the Institute of Medicine, a branch

of the National Academies.

Nutrition standards for school meals were not established until 1994, and

public health advocates say the standards have failed to keep pace with

scientific research. Even so, as few as 15 percent of elementary schools and

13 percent of secondary schools met the recommended standards for saturated

fat in the 2004-05 school year, according to an Agriculture Department

study. One percent of schools met the recommended guidelines for limiting

sodium.

Advocates also are clamoring for funds to improve nutrition education.

" Research is clear -- handing out nutrition brochures does not work, " Eileen

Kennedy, dean of the Friedman School of Nutrition Science and Policy at

Tufts University, said in testimony before the Senate Agriculture Committee

this month. She called for more education for parents about how to prepare

healthful meals as well as closer links between school, after-school and

parental programs to reinforce nutrition education.

" In the current economic downturn, the role of the child nutrition programs

becomes even more critical as an essential part of the nutrition safety

net, " Kennedy said.

[Guest guest]

This is a good time of the year to reflect on our good health and fortune.I didn't vote for him, but I hope people in the new administration, trying to embrace and manage health care costs, will connect all the dots between, food quality, food amount, physical activity,  and their direct impact on chronic conditions that cost our economy huge dollars in treatment and lost productivity.While almost silly sounding, if everybody lost 20# think of how much that could improve gas mileage and reduce oil imports. :-)Type II diabetes, no longer just "adult" onset, could be pretty much eliminated by diet and exercise. Heart disease while not completely eliminated could be dramatically reduced, without the costly "fix" from the drug (pusher) companies latest cocktail of cholesterol management pills. Cancer, is also modulated by how foods are cooked, and the energy balance. Again not a cure, but it could be reduced without costly drugs.Looking at this from purely actuarial or cost basis, there is a huge opportunity to reduce health care cost by proactive management of diet and activity.We don't need big brother inspecting our daily diet or exercise schedule, but when government gets in the health insurance business, they need to take off the kid gloves and treat people based on how they treat themselves (personal responsibility).We humans are weak when it comes to food temptation, so it seems that foods with negative health consequences need to carry some of the cost burden for mitigating that damage done. It seems unfair to burden a skinny person or physical laborer with a flat tax on calories, perhaps a progressive tax like income taxes where our first 1500-2000 calories are tax free, and beyond that a tax is charged to subsidize the expected health consequences. As we approach a cashless society, computer management of at least fast foods purchased daily could be managed in a smart debit card.. of course any system could be gamed.This too is a little "big brother" sounding, so I'll stop now, but it strikes me there are huge savings to the world's health care budget by managing energy balance and food quality, so I applaud any acknowledgment that it matters.Merry Christmas, or whatever seasonal greetings you prefer. JRPS:  Not to wax political, about the only thing consistent about Obama's cabinet selections seems that he is building a pretty strong pick-up basketball team..... Finally something I can relate to in the new administration. :-)  On Dec 24, 2008, at 9:21 AM, Francesca Skelton wrote:Obama Administration May Look to Tie Food Assistance to Improved NutritionBy Jane BlackWashington Post Staff WriterWednesday, December 24, 2008; Page A02The worsening economic crunch is causing the tab for food assistanceprograms to balloon, and with the rising costs has come an intensifyingdebate over whether -- and how -- the U.S. government can tacklesimultaneously the paradoxically linked problems of hunger and obesity.The statistics spell out the dilemma. The number of Americans on food stampstopped 31.5 million in September, a record high. Obesity, too, is atepidemic levels: In 30 states, at least 25 percent of the population isdangerously overweight. Nationally, 31.9 percent of children are consideredoverweight or obese.For decades, the government has treated hunger and obesity as unrelatedphenomena. But at a news conference last week in Chicago, Tom Vilsack,President-elect Barack Obama's choice for agriculture secretary, said hewould put "nutrition at the center of all food assistance programs," asignal that he will get involved next year when Congress moves toreauthorize nutrition programs that support school breakfasts and lunches aswell as summer food for children."For a long time, we've looked at hunger and obesity separately," said Sen.Tom Harkin (D-Iowa), chairman of the committee that will draft thelegislation. "It's not a zero-sum game."Public health advocates have long hoped to link food assistance to goodnutrition. To the anti-hunger lobby, however, mandating what kind of foodneedy people should eat is impractical and smacks of paternalism. It wouldbe impossible, they say, to determine which of the 50,000-plus products inthe grocery store should be classified as healthful.Would Diet Coke pass the test? What about the juice drink Sunny Delight? In2004, the Agriculture Department rejected a request from the MinnesotaDepartment of Human Services to ban the purchase of candy and soft drinkswith food stamps.More important, anti-hunger activists say, low-income people often choosehigher-calorie snacks and fast food because such fare is cheaper and morereadily available where they live than nutritious fruits and vegetables. TheDistrict's Ward 8, for example, had no full-service supermarket for nineyears until a Giant Food store opened last December."If there are areas in cities where there isn't an apple for sale within amile radius, restricting food stamps goes beyond paternalism to a form ofabuse," said Jim Weill, president of the Food Research and Action Center, aD.C.-based anti-hunger policy organization.But with hunger and obesity reaching unprecedented levels, some anti-hungeractivists are beginning to soften their stance. According to a report by thePartnership for America's Economic Success, toddlers whose families havegone hungry are three to four times as likely to be obese. If the currentrecession resembles past downturns, the independent Center on Budget andPolicy Priorities predicts, the number of Americans in poverty could rise byas many as 10 million, driving up obesity, diabetes and cardiovasculardisease."It was a very slow and difficult transition for me and my organization,"said Hecht, executive director of California Food Policy Advocates,a Los Angeles-based anti-hunger organization. "What we wanted to do was getmore calories to people. Now we find it isn't more calories. It's more ofthe right calories."To that end, the organization lobbied for a bill that would createincentives for recipients of food stamps to purchase healthful food. Gov.Arnold Schwarzenegger ® signed the bill into law in 2006, but the programnever received funding.The debate in California attracted national attention, however. In the 2008farm bill, Congress allocated $20 million for a pilot program to explore howto create incentives to purchase fruits, vegetables or other healthful foodsin order to improve the diets of food stamp recipients and potentiallyreduce obesity. Several nonprofit groups and foundations are experimentingwith similar incentives.One is the Wholesome Wave Foundation, an organization that works to makelocally grown food more widely available. In the spring, it launched aprogram that doubles the value of food stamps and fruit and vegetablevouchers of low-income mothers and seniors who use them at farmers marketsin Connecticut, Massachusetts and California.The Wholesome Wave matching grants were an instant hit at the City Heightsmarket in San Diego. On the first day that matching funds became available,sales using government-issued electronic benefit cards soared by more than200 percent. In subsequent weeks, the line to receive matching vouchersformed at 7:30 a.m., and the available funds were exhausted by 9:30 a.m.,just 30 minutes after the market opened."We're not taking away your benefits because you spend them on Twinkies,"said Michel Nischan, a Connecticut chef and president of Wholesome Wave."But if you decide you want to spend it on fresh tomatoes, you'll get doubleyour money."With the Child Nutrition and Women, Infants and Children Act set to bereauthorized next year, public health advocates are lobbying for theimplementation of stricter standards for school breakfast and lunchprograms, based on recommendations from the Institute of Medicine, a branchof the National Academies.Nutrition standards for school meals were not established until 1994, andpublic health advocates say the standards have failed to keep pace withscientific research. Even so, as few as 15 percent of elementary schools and13 percent of secondary schools met the recommended standards for saturatedfat in the 2004-05 school year, according to an Agriculture Departmentstudy. One percent of schools met the recommended guidelines for limitingsodium.Advocates also are clamoring for funds to improve nutrition education."Research is clear -- handing out nutrition brochures does not work," EileenKennedy, dean of the Friedman School of Nutrition Science and Policy atTufts University, said in testimony before the Senate Agriculture Committeethis month. She called for more education for parents about how to preparehealthful meals as well as closer links between school, after-school andparental programs to reinforce nutrition education."In the current economic downturn, the role of the child nutrition programsbecomes even more critical as an essential part of the nutrition safetynet," Kennedy said.