Bad News for Obama’s Antiobesity Effort

A new study suggests that giving consumers greater access to healthy food doesn’t change eating habits.

LEIPZIG, GERMANY - MAY 23: A man with a large belly eats junk food on May 23, 2013 in Leipzig, Germany. According to statistics a majority of Germans are overweight and are comparatively heavier than people in most other countries in Europe.
National Journal
Clara Ritger
See more stories about...
Clara Ritger
Feb. 3, 2014, 11:01 a.m.

With the obesity epi­dem­ic in full swing and mil­lions of Amer­ic­an liv­ing in neigh­bor­hoods where fruits and ve­get­ables are hard to come by, the Obama ad­min­is­tra­tion thought it saw a solu­tion: fund stores that will stock fresh, af­ford­able pro­duce in these de­prived areas.

But now, three years and $500 mil­lion in­to the fed­er­al Healthy Food Fin­an­cing Ini­ti­at­ive, there’s a prob­lem: A study sug­gests it’s not work­ing.

Adding su­per­mar­kets to areas with short sup­plies of fresh pro­duce does not lead to im­prove­ments in res­id­ents’ di­ets or health out­comes, ac­cord­ing to a re­port pub­lished Monday in the Feb­ru­ary is­sue of Health Af­fairs.

Re­search­ers stud­ied two com­par­able neigh­bor­hoods in Phil­adelphia, a city at the cen­ter of the fight against “food deserts” — the wonk­ish term for the pro­duce-poor areas.

When a gro­cery store was opened in one Phil­adelphia food desert, 26.7 per­cent of res­id­ents made it their main gro­cery store and 51.4 per­cent in­dic­ated us­ing it for any food shop­ping, the re­port found. But among the pop­u­la­tion that used the new su­per­mar­ket, the re­search­ers saw no sig­ni­fic­ant im­prove­ment in BMI, fruit and ve­get­able in­take, or per­cep­tions of food ac­cess­ib­il­ity, al­though there was a sig­ni­fic­ant im­prove­ment in per­cep­tion of ac­cess­ib­il­ity to fruits and ve­get­ables.

The re­port was au­thored by a team of re­search­ers from the Lon­don School of Hy­giene and Trop­ic­al Medi­cine and Penn State Uni­versity’s de­part­ments of so­ci­ology, an­thro­po­logy, and demo­graphy. The study was fun­ded by the Na­tion­al In­sti­tute of En­vir­on­ment­al Health Sci­ences with sup­port from the Pop­u­la­tion Re­search In­sti­tute, al­though neither had a hand in the re­search design, col­lec­tion, or ana­lys­is.

The re­search­ers com­pared the Phil­adelphia neigh­bor­hood that would soon re­ceive a new su­per­mar­ket to a sim­il­ar com­munity three miles away, hop­ing to avoid any cros­sov­er ef­fect from the open­ing of the new store. They polled the two com­munit­ies be­fore and after the store opened to see the ef­fect of the change.

The study needs to be rep­lic­ated in oth­er neigh­bor­hoods and oth­er parts of the United States to con­firm or re­fute these find­ings, said lead re­search­er Steven Cum­mins, pro­fess­or of pop­u­la­tion health at the Lon­don School of Hy­giene and Trop­ic­al Medi­cine. The res­ults do, however, mir­ror find­ings in the U.K., where re­search­ers cre­ated a sim­il­ar com­par­is­on of two neigh­bor­hoods in Scot­land and ob­served no net ef­fect on fruit and ve­get­able in­take.

And if the con­clu­sion is borne out, it would sug­gest that poli­cy­makers re­think the Healthy Food Fin­an­cing Ini­ti­at­ive if they want to pro­mote health­i­er eat­ing and health­i­er cit­izens.

There’s some evid­ence already to sup­port the con­clu­sion that ac­cess to healthy food needs to be paired with edu­ca­tion about con­sump­tion. The Phil­adelphia De­part­ment of Pub­lic Health stud­ied some 120,000 school­chil­dren ages 5 to 18 and found that obesity rates de­clined 5 per­cent between 2006 and 2010. When eval­u­at­ing by race and gender, Afric­an-Amer­ic­an boys dropped 8 per­cent and His­pan­ic girls 7 per­cent.

Those res­ults came after the city im­ple­men­ted nu­tri­tion edu­ca­tion in 1999 for all chil­dren eli­gible for food stamps, re­moved sug­ary drinks from school vend­ing ma­chines, switched from 2 per­cent to 1 per­cent milk in the cafet­er­ia, and cre­ated well­ness coun­cils made up of teach­ers and stu­dents in 171 schools.

Some 23.5 mil­lion people in the U.S. live in a food desert, ac­cord­ing to data from the USDA.

The Healthy Food Fin­an­cing Ini­ti­at­ive is the most ag­gress­ive of the White House’s pro­grams to fight obesity. But oth­er pro­grams also work to in­centiv­ize the con­sump­tion of fresh pro­duce, in­clud­ing provid­ing sub­sidies to ex­ist­ing bo­degas and mom-and-pop corner stores to in­crease the pres­ence of fresh pro­duce; en­cour­aging the ac­cept­ance of food stamps and vouch­ers at farm­er’s mar­kets; and in­sti­tut­ing fresh-fruit and ve­get­able pro­grams in low-in­come schools. It’s too early in­to the HF­FI pro­gram to see res­ults, an of­fi­cial at USDA said, but White House rep­res­ent­at­ives will meet Tues­day with rep­res­ent­at­ives from six healthy food ac­cess pro­jects across the coun­try to dis­cuss their pro­gress.

Com­munit­ies with less ac­cess to healthy foods are at an in­creased risk of obesity, dia­betes, and car­di­ovas­cu­lar dis­ease. But, Cum­mins said, there’s little evid­ence to sup­port that in­stalling a su­per­mar­ket im­proves pop­u­la­tion health, and his study would in­dic­ate that the con­verse is true.

Cum­mins said in an email that law­makers ought to con­sider policies that will change com­munity be­ha­vi­or to in­cor­por­ate healthy food in­to every­day di­ets.

“These might in­clude eco­nom­ic ini­ti­at­ives such as taxes on un­healthy foods and sub­sidies on healthy foods, mar­ket­ing ini­ti­at­ives that fo­cus on in-store pro­mo­tion of healthy food, and pro­grams that fo­cus on skills re­lated to buy­ing and cook­ing com­pon­ents of a bal­anced diet,” Cum­mins said.

Cum­mins isn’t alone. Food-policy ex­pert and former Hart­ford Food Sys­tem ex­ec­ut­ive dir­ect­or Mark Winne said the move­ment to­ward im­prov­ing ac­cess to healthy food star­ted in the mid-1980s, when re­search­ers first un­covered the con­nec­tion between poverty, diet, and poor health out­comes.

“Our health policy is not con­nec­ted to our ag­ri­cul­ture policy,” Winne said. “The level of sub­sidy that we provide to corn, rice, wheat, and sug­ar pro­du­cers out­paces what we’re coun­ter­ing with those pro­grams to in­centiv­ize con­sump­tion of fruits and ve­get­ables. You see al­most noth­ing in terms of ac­tu­al sub­sidy for fresh fruits and ve­get­ables.”

Bil­lions of dol­lars of corn sub­sidies help lower the price of pack­aged foods that con­tain high amounts of high fructose corn syr­up, and the price of fruits and ve­get­ables just can’t com­pete, Winne said. Keep­ing the price of fruits and ve­get­ables down is one in­ter­ven­tion the gov­ern­ment can con­sider, in ad­di­tion to mak­ing them read­ily avail­able.

“Ac­cess, af­ford­ab­il­ity, edu­ca­tion would prob­ably be the three legs of the stool,” Winne said, de­scrib­ing how poli­cy­makers can ap­proach ef­forts to im­prov­ing health out­comes through food. “Reg­u­la­tion of the food in­dustry would be a fourth leg, par­tic­u­larly in ad­vert­ising to chil­dren and in loc­a­tion of fast-food res­taur­ants so that they’re not close to schools.”

These com­ple­ment­ary policies, he said, could spur be­ha­vi­or change as law­makers look to bring gro­cery stores to un­der­served com­munit­ies.

What We're Following See More »
WEST WING REDUX
Allison Janney Takes to the Real White House Podium
11 hours ago
WHY WE CARE

Carolyn Kaster/AP

STAFF PICKS
When It Comes to Mining Asteroids, Technology Is Only the First Problem
12 hours ago
WHY WE CARE

Foreign Policy takes a look at the future of mining the estimated "100,000 near-Earth objects—including asteroids and comets—in the neighborhood of our planet. Some of these NEOs, as they’re called, are small. Others are substantial and potentially packed full of water and various important minerals, such as nickel, cobalt, and iron. One day, advocates believe, those objects will be tapped by variations on the equipment used in the coal mines of Kentucky or in the diamond mines of Africa. And for immense gain: According to industry experts, the contents of a single asteroid could be worth trillions of dollars." But the technology to get us there is only the first step. Experts say "a multinational body might emerge" to manage rights to NEOs, as well as a body of law, including an international court.

Source:
STAFF PICKS
Obama Reflects on His Economic Record
13 hours ago
WHY WE CARE

Not to be outdone by Jeffrey Goldberg's recent piece in The Atlantic about President Obama's foreign policy, the New York Times Magazine checks in with a longread on the president's economic legacy. In it, Obama is cognizant that the economic reality--73 straight months of growth--isn't matched by public perceptions. Some of that, he says, is due to a constant drumbeat from the right that "that denies any progress." But he also accepts some blame himself. “I mean, the truth of the matter is that if we had been able to more effectively communicate all the steps we had taken to the swing voter,” he said, “then we might have maintained a majority in the House or the Senate.”

Source:
STAFF PICKS
Reagan Families, Allies Lash Out at Will Ferrell
14 hours ago
WHY WE CARE

Ronald Reagan's children and political allies took to the media and Twitter this week to chide funnyman Will Ferrell for his plans to play a dementia-addled Reagan in his second term in a new comedy entitled Reagan. In an open letter, Reagan's daughter Patti Davis tells Ferrell, who's also a producer on the movie, “Perhaps for your comedy you would like to visit some dementia facilities. I have—I didn’t find anything comedic there, and my hope would be that if you’re a decent human being, you wouldn’t either.” Michael Reagan, the president's son, tweeted, "What an Outrag....Alzheimers is not joke...It kills..You should be ashamed all of you." And former Rep. Joe Walsh called it an example of "Hollywood taking a shot at conservatives again."

Source:
PEAK CONFIDENCE
Clinton No Longer Running Primary Ads
16 hours ago
WHY WE CARE

In a sign that she’s ready to put a longer-than-ex­pec­ted primary battle be­hind her, former Sec­ret­ary of State Hil­lary Clin­ton (D) is no longer go­ing on the air in up­com­ing primary states. “Team Clin­ton hasn’t spent a single cent in … Cali­for­nia, In­di­ana, Ken­tucky, Ore­gon and West Vir­gin­ia, while” Sen. Bernie Sanders’ (I-VT) “cam­paign has spent a little more than $1 mil­lion in those same states.” Meanwhile, Sen. Jeff Merkley (D-OR), Sanders’ "lone back­er in the Sen­ate, said the can­did­ate should end his pres­id­en­tial cam­paign if he’s los­ing to Hil­lary Clin­ton after the primary sea­son con­cludes in June, break­ing sharply with the can­did­ate who is vow­ing to take his in­sur­gent bid to the party con­ven­tion in Phil­adelphia.”

Source:
×