SSB taxes from the distinct perspectives of diverse stakeholder groups

Previous studies found sugar-sweetened beverage taxes are cost-effective from the societal perspective. Our new article in the American Journal of Public Health argues that policy-making in a democracy depends on costs and benefits for particular stakeholders.

Mark Winne discusses SNAP reform

Long-time anti-hunger and community food security activist Mark Winne has a new essay on the Supplemental Nutrition Assistance Program (SNAP).  Winne is passionate about protecting the program from the deep cuts proposed in the House of Representatives and eloquent about the hardship SNAP participants face in these hard economic times.

And yet, Winne includes the following strident call for reform and improvement of SNAP:

Whether we have more food stamp spending or less begs the question of why such a major act of social policy that nobody, including the recipients, seems to like, continues unreformed and unevaluated. With a national poverty rate locked at 15 percent and a near-poverty rate bringing the combined numbers to well over 30 percent, food stamps provide some relief but no solutions. With overweight and obesity affecting 65 percent of the population and eclipsing hunger as America’s number one diet-related health problem, food stamps do little to encourage healthy eating and less to discourage unhealthy eating. And with high unemployment, low wage jobs, and few prospects for growth – other than big box stores and casinos – leaving the economy stuck in neutral, food stamps $70 billion in federally generated buying power helps Kraft Foods (food stamps are 1/6 of its sales), but nearly nothing to infuse local economies with new energy.

But the anti-hunger orthodoxy that SNAP is a vital part of the nation’s safety net and must never be altered goes unchallenged. Whenever an innovation is proposed, e.g. Mayor Bloomberg’s request to prohibit the use of food stamps to purchase sugary soft drinks, the program’s pit bull defenders bare their teeth threatening to rip the limbs off heretics who might modify even one of SNAP’s holy sacraments. It may be that they are in bed with Wal-Mart and others who have tragically dumbed-down American wages and whose workers are subsidized by the food stamp program, or it may be that they are riveted to the notion that they are all that stand between a modicum of food sufficiency and mass starvation. Either way, the tenaciousness of their enterprise, which opposes food stamp change at any cost, is only matched by an equally fervent brand of conservatism embodied by the Tea Party. The result: A program now more than 50 years old remains largely unchanged even though the nation that it helps feed has changed in myriad ways.

Imagine a corporation or major private institution that did not conduct research and development, kept the same product line for generations, and never engaged in strategic thinking. That enterprise would be out of business (or subsidized by the federal government).

It's something to think about.

Like Winne, I think it would be fine for USDA to use its existing authority to permit pilot innovations that would change the definition of "food" under SNAP to exclude sugar sweetened beverages such as soda. The New York City proposal was designed to appeal only to public health nutrition advocates and did not do well at building bridges with anti-hunger advocates.  Yet, I think both public interest traditions should support such a pilot.  The anti-hunger advocates say the proposal is stigmatizing, but I see no evidence that SNAP participants actually would mind.  Remember, low-income parents, just like all parents, work hard to choose healthy foods in a rough marketing environment, and they may find the restriction helpful as they discuss food and beverage choices with their children in the aisle of the grocery store.  Congress has to draw the line between "food" and "non-food" somewhere, and it makes sense for USDA to use pilot studies to help Congress figure out the best way to do so.  If the pilot finds that the proposed reform increases stigma, reduces program participation, or damages food security, the proposal should be dropped.  But, quite possibly, the opposite will happen.  Anti-hunger advocates may be stuck in the way things have always been, overlooking an opportunity that could be appealing to program participants and politically popular with the public at large.

I once interviewed Winne for this blog, shortly after he wrote his book, Closing the Food Gap.  Winne's new book is Food Rebels, Guerrilla Gardeners, and Smart Cookin’ Mamas.

Link between television and weight

In the current issue (.pdf) of the magazine Tufts Nutrition, Jacqueline Mitchell describes recent research on television viewing and weight status.

Americans spend an average of more than 150 hours a month in front of the television — that’s six days—and never mind other sedentary hours we spend with computers or mobile devices. As our screen time has exploded, so has the national waistline. Two-thirds of adults are overweight, and childhood obesity has more than doubled in the last 20 years.

One reason obesity may be on the rise is that people who watch a lot of television may eat more, particularly pizza, soda and other fast foods, according to a recent Tufts study that evaluated 30 years of research linking TV viewing with weight gain. The paper, written by four students and their adviser, Robin Kanarek, Ph.D., interim dean of the Friedman School, was published online in the June 4 edition of Physiology and Behavior....  The research by Kanarek and the students—Rebecca Boulos, N13; Emily Vikre, N08, N13; Sophie Oppenheimer, N11, MPH11; and Hannah Chang, A10—also indicated that television can shape societal views about overweight and obese people.

Two communication strategies for reducing sugary drinks

First, I like the plain matter-of-fact tone of the federal government's MyPlate graphic. It paints a pleasant portrait of a healthy meal, and then underlines several key messages for consumers by stating them in blunt English.  One of the key recommendations is to "drink water instead of sugary drinks."

A reasonable person may add that one should drink water instead of sugary drinks most of the time, but the mainstream message of the dietary guidelines reflects the best judgement of scientists in this field.

Balancing Calories

• Enjoy your food, but eat less. 
• Avoid oversized portions. 

Foods to Increase

• Make half your plate fruits and vegetables. 
• Make at least half your grains whole grains. 
• Switch to fat-free or low-fat (1%) milk. 

Foods to Reduce

• Compare sodium in foods like soup, bread, and frozen meals and choose the foods with lower numbers. 
• Drink water instead of sugary drinks. 

Second, in a new video from the Center for Science in the Public Interest (CSPI), public health marketers seek to both imitate and expose the emotive power of soda advertisements.  In the video, a family of polar bears endures the harsh effects of diabetes and learns that the soda advertisements offer only a false promise of happiness.  The video strays close to playing on guilt themes as motivation for healthy behaviors, but the polar bears are fundamentally sympathetic, and they take charge of their own lives in the nice ending. 

If you dislike the video's harsh imagery, I'd be interested to hear about it.  But I do think the beverage association spokesperson's rebuttal -- in a USA Today article -- rings false:

But ABA spokeswoman Karen Hanretty says, "CSPI is better at producing videos than they are doing math. People are drinking fewer calories from soda -- and have been for a decade -- so how can soda be to blame for rising obesity?" 

The basic message that it is better to limit sugary drinks is well-established and denying this with misleading trend statistics just makes the video look like the more serious party in this conversation.

Reuters: Washington soft on childhood obesity

From yesterday's long report by Duff Wilson and Janet Roberts at Reuters:

At every level of government, the food and beverage industries won fight after fight during the last decade. They have never lost a significant political battle in the United States despite mounting scientific evidence of the role of unhealthy food and children's marketing in obesity.

Lobbying records analyzed by Reuters reveal that the industries more than doubled their spending in Washington during the past three years. In the process, they largely dominated policymaking -- pledging voluntary action while defeating government proposals aimed at changing the nation's diet, dozens of interviews show.

Why Calories Count

Why Calories Count, the new book by Marion Nestle and Malden Nesheim, nicely bridges the world of food policy commentary and nutrition science. It offers a great counterpoint to the loud and untrustworthy bazaar of diet books, each blaming some simple villain for the obesity epidemic (too much carbs, too much fat, too little calcium, whatever).  Why Calories Count teaches a wealth of detail about how calories are measured and how their effects are studied.  It also tells great stories, from the history of nutrition science to the poignant service of wartime conscientious objectors who participated in a clinical study of human starvation.  If I were a graduate student in nutrition or public health, I would find this book inspiring as an eloquent and engaging secondary reading alongside a nutrition science textbook.  Strongly recommended.

Links: Jane Brody, Mark Bittman.

Soda, SNAP (food stamps), and New York City

Last October in U.S. Food Policy:

New York City this week petitioned USDA for permission to disallow soda purchases with food stamp (SNAP) benefits. USDA may well disapprove the proposal, having in previous years turned down requests from other states for similar waivers from federal rules.

This week, the New York Times and Marion Nestle both cover recent developments in the resulting controversy.

Here are several thoughts, addressed to health policy advocates such as the American Public Health Association, NYC officials, and others.

1. You never should have called the proposed policy a ban. Has there ever been a controversy over the "ban" on SNAP spending for hula-hoops and yo-yos? The "ban" on SNAP spending for gasoline? No, you could say SNAP has made a sensible bureaucratic division between eligible goods and ineligible goods. People can use cash for all the ineligible goods. The proposed policy would slightly narrow the class of foods and beverages eligible for taxpayer support through SNAP benefits.

2. You should have emphasized the pilot nature of the proposal, and the research questions that will be investigated. In the NYT article, the quote from Kelly Brownell at Yale gets this right. The pilot should ask two questions: (a) does the proposed policy improve food and beverage choices?, and (b) did the proposed policy annoy participants or make them less likely to participate?  Some, but not all, SNAP participants will like the new policy. Remember, low-income parents struggle with their children over food choices in the grocery aisle just like middle-income parents do. The soda companies have no evidence that this proposal will cause any problems whatsoever for SNAP participants.

3. You should have negotiated with the anti-hunger community before taking this proposal public. The quote in the NYT article from the Food Research and Action Center is a bad sign.  Some health advocates have already written off the anti-hunger community as hopeless on health and obesity issues, but this is a mistake in political strategy. Key leaders in anti-hunger policy advocacy and the charitable emergency food system watch public concern about health and nutrition very closely, and calibrate their own programs accordingly. Health advocates have leverage with the anti-hunger community, which cannot afford to be indifferent to health issues.  I think a bargain should have been possible.

Choices Magazine issue on economics and obesity

The new issue of Choices Magazine, the outreach magazine for the Agricultural and Applied Economics Association (AAEA), includes a collection of articles on the theme, "Addressing the Obesity Challenge."

Some of the articles grew out of an interesting conference here at UC Davis last May.  Mary Muth organized and edited the series.  Helen Jensen and I contributed an article on food assistance programs, emphasizing that these programs do much more than just boost food intake.  I started drafting a few words about several more articles, but, better, here are links to the whole set.

Theme Overview: Addressing the Obesity Challenge
Mary K. Muth

Increasing rates of obesity and the associated effects on health of the U.S. population are often in the news recently. The set of papers in this theme describe measures of the costs of obesity, consider some of the contributors to increases in obesity, and evaluate current and potential solutions.

The Costs of Obesity and Implications for Policymakers
Eric A. Finkelstein, Kiersten L. Strombotne, and Barry M. Popkin

The increase in obesity prevalence has had profound economic consequences on state and federal government agencies and on employers. We present the most recent estimates of direct and indirect costs of obesity. We then discuss the implications of these costs for public and private payers.

Food Environment, Food Store Access, Consumer Behavior, and Diet
Michele Ver Ploeg

Lack of access to affordable, healthy food in some neighborhoods is hypothesized to lead to poor diet, obesity, and other diet-related diseases. Estimates show that access to healthy food is a problem for a small percentage of the population. Many, but not all, low-income households shop where food prices are relatively low.

Farm Policy and Obesity in the United States
Julian M. Alston, Bradley J. Rickard, and Abigail M. Okrent

This article shows that U.S. farm policies have had generally modest and mixed effects on prices and quantities of farm commodities, with negligible effects on the prices paid by consumers for food and thus negligible influence on dietary patterns and obesity.

More Than Just Food: The Diverse Effects of Food Assistance Programs
Helen H. Jensen and Parke E. Wilde

U.S. food assistance programs enhance nutrition and reduce food insecurity through diverse activities. The programs provide food directly, offer nutrition education, place limits on foods obtained with program benefits, and alleviate "boom and bust" cycles associated with food insecurity. Thus, their potential effects on obesity come through various mechanisms.

Can Nutrition Labeling Affect Obesity?
Joanne E. Arsenault

Nutrition labeling should help consumers make healthier food choices and encourage food manufacturers to produce healthier products. Some evidence exists for such effects, but it is less clear and difficult to assess if nutrition labeling impacts obesity.

Can Taxes on Calorically Sweetened Beverages Reduce Obesity?
Jessica E. Todd and Chen Zhen

This article reviews the emerging body of economic research that attempts to determine how large of a tax on calorically sweetened beverages—and in what form—would be effective in causing a noticeable decline in the prevalence of overweight and obesity in the United States.

Behavioral Economics: A New Heavyweight in Washington?
Sean B. Cash and Christiane Schroeter

Behavioral economic research has shown that individuals rely heavily on subtle external cues or nudges that influence what and how much we eat. Promising results from experimental settings in lunchrooms, grocery stores, and labs are now shaping food and obesity policies, but not without controversy.

USDA/ERS study estimates obesity-reducing effects of a soda tax

A 20% soda tax would reduce daily food energy intake for adults by 37 calories, enough to reduce the prevalence of obesity by almost 10%, according to a new report this week from USDA's Economic Research Service (ERS).  The prevalence of obesity for adults could fall from 33.4% to 30.4%, the report estimates.  The report corroborates other recent research suggesting that the obesity prevention impact of taxes on sugar sweetened beverages could be substantial.

There are a couple reasons why the estimated impact is higher than one might have expected based on previous research.  First, the report, by ERS researchers Travis Smith, Biing-Hwan Lin, and Jong-Yin Lee, estimated a somewhat stronger consumer response to beverage price changes than previous research used.  The new estimated own-price elasticity of -1.26 means that a 10% increase in price leads to about a 12.6% reduction in consumption.  Second, even a fairly small change in average daily soda consumption accumulates over time, leading to a notable estimated change in weight for a year's time.

Purely paternalistic taxes motivated by public health tend to generate political push-back, especially from more conservative policy-makers, but also from consumers who resist having their choices directed by public policy.  I think such taxes may be easier to explain to people when the tax revenues are needed in any case, to provide essential government services.  The idea is: "Paying for teachers and police requires some revenue source.  A tax on soda makes as much sense as a tax on other more meritorious goods, especially if people don't want their income or property taxes raised either."  The health benefits could be mentioned in passing as an additional advantage.  In this spirit, the Rudd Center at Yale has recently posted an online revenue calculator for beverage tax proposals.

The growing interest in beverage taxes during tough fiscal times is putting stress on beverage manufacturers.  The American Beverage Association in June pointed to earlier estimates, contradicted by the new USDA report, showing "a 20 percent tax on a soft drink would decrease Body Mass Index (BMI) for an obese person by just 0.02, an amount not even measurable on a bathroom scale."  The association's press release is headlined, "Reducing soda consumption is a simplistic and ineffective solution to public health challenges."

CNN calls obese kids "coronary time bombs"

The top story on CNN online this morning has the headline: "Obese kids are coronary time bombs."

What is your opinion of that headline?

It is good to be frank about the health consequences of childhood obesity, to motivate a vigorous response from parents and policy-makers alike. At the same time, we should respect and support the quality of life for the many children who will be overweight for much of their lives.

It seems helpful to say, as an expert quoted in the body of the CNN article does, "Our study suggests that more of these young adults will have heart disease when they are 35-50 years old, resulting in more hospitalizations, medical procedures, need for chronic medications, missed work days and shortened life expectancy."

But it seems unhelpful to call obese kids time bombs. It's stigmatizing. As a metaphor or image, "time bomb" doesn't bring to mind a correct impression of the health consequences as a scientist would see them. The article seems at times to be concerned about the teasing that heavy kids get in school, but that nuance is not carried through consistently. The "coronary time bomb" language was not from any of the experts quoted or evidence cited, but was in the CNN author's own voice.

The article is supported by direct advertising for an anti-cholesterol drug, Vytorin. Clearly, the advertising is linked with the content of the article. The fear-enhancing message in the article text serves well to generate interest in the ad. The ad has the same color scheme as the CNN website, increasing the visual sense of linkage. The teaser for the ad is: "What are you doing about cholesterol and the Two Sources -- food and family?"

Here is information, which does not appear in the ad on CNN, but rather on the Zytorin website linked from the ad:

VYTORIN contains two cholesterol medicines, Zetia (ezetimibe) and Zocor (simvastatin), in a single tablet. VYTORIN has not been shown to reduce heart attacks or strokes more than Zocor alone.

Selected Important Risk Information About VYTORIN
VYTORIN is a prescription tablet and isn‘t right for everyone, including women who are nursing or pregnant or who may become pregnant, and anyone with liver problems.

Unexplained muscle pain or weakness could be a sign of a rare but serious side effect and should be reported to your doctor right away. VYTORIN may interact with other medicines or certain foods, increasing your risk of getting this serious side effect. So, tell your doctor about any other medications you are taking.

Troubles with Encouraging Water Consumption

A recent Boston Globe article highlighted the increasing body of research demonstrating the link between American's increasing sweetened beverage consumption and obesity, as well as some local intervention efforts to change drinking behaviors. As these efforts continue to revamp with a number of sugar-free drink campaigns gearing up locally, a question about message and framing comes to mind.

In the Cambridge study cited by the Globe, the kids were given bottled water and diet sodas, iced teas, lemonade, and punch reduced their consumption of sugar-sweetened beverages by 82% (no surprise there), and "the one-third who weighed the most at the start lost an average of three or four pounds."

However, one must look at how this type of intervention would play out in real life. A recent conversation with an advocate from Corporate Accountability International's Value the Meal campaign against fast food companies, highlighted to me the difficulties in making these kinds of campaigns jibe with CAI's other campaign of Think Outside the Bottle to encourage individuals, communities and larger entities to switch from bottled water to tap water. Often bottled water is presented as the "easy" alternative to soda or other sweetened drinks, thus increasing the number of people drinking bottled water.

Especially with kids, it is often harder to make the switch to tap water, which may have a stigma associated with it, even in locations where its quality, based on mandatory testing, is far superior to that of bottled water.

Of course, this complicates efforts to change the product mix among corporations such as Coca-Cola and Pepsi, which produce both sweetened beverages and bottled water. Although they have come out strong against efforts to pinpoint sweetened beverage consumption as a leading cause of obesity, they would be most sensitive to sales, and presumably change their product mix to more water and less soda if the market "demands" it. What happens if the market switches to tap water? Do they come out and lobby harder or change their marketing strategies?

Update: Boston Globe reports that bottled water sales are down due to the recession, rather than due to common sense.

"Oh, no!" says the broccoli ...

... "Secretary Vilsack loves cookies and not me!"


When I saw this in an email from agrarian writer Stephanie Ogburn, I thought it was Photoshop humor, but really it is from a USDA press release today.

The press release describes a new anti-obesity public service announcement featuring USDA Secretary Vilsack and Sesame Street characters.

Sesame Street came under fire from Commercial Alert in 2003 for its sponsorship from McDonald's, including a mini-advertisement adjacent to the public television show. Here is the current Sesame Street page thanking its sponsors, including McDonald's.

Question for the comments: do you think the cold shoulder for broccoli in the USDA photograph is an oversight or intentional non-verbal communication?

Update: a Facebook comment says, "hmm-- Kathleen showed this PSA at Mayoral Child Nutrition Summit today...the broccoli is portrayed very well in the spot...I think this is an oversight."

Rudd Center webinar on childhood obesity

Briefly liveblogging today's webinar on soda taxes and childhood obesity, from the Rudd Center on Food Policy and Obesity at Yale.

David Ludwig's presentation, reviewing the scientific literature, is convincing that consumption of soda and other sugar-sweetened beverages increases body weight and risk of obesity for children. For my own purposes, I take this conclusion as fact and spend most of my mental energy engaging the interesting policy questions.

Kelly Brownell reviewed objections that have been raised to soda taxes. First, the "Nanny State" objection -- the idea that the government shouldn't be telling people what to eat. Brownell's response is that the government already does tell us what to eat, through Dietary Guidelines and subsidies. I think that response won't carry the day, with politicians or the public. Dietary guidance, which summarizes the complex scientific literature but respectfully leaves concrete decisions to families, is different from a soda tax. Similarly, agricultural subsidies will be seen as very different in motivation and impact from a tax designed to encourage healthy beverage consumption.

Second, the argument that soda tax will be regressive, hurting poor families disproportionately. Brownell's response includes the observation that low-income people have higher rates of disease, so the benefits of a soda tax are progressive. Also, if poor people shift to water, Brownell says, they will actually save money. Again, I think soda tax proponents have a tin ear for how poorly such arguments will play with potential allies, including advocates for low-income people and otherwise sympathetic legislators.

Overall, proponents of a soda tax need to reach beyond the public health framework -- where childhood obesity is an illness that needs a medically prescribed remedy -- and reach out to economists, politicians, and others who are better prepared to engage likely public reactions to a proposed excise tax as a public health tool. Above all, any tone of eagerness to tax is politically deadly. It would be much wiser to adopt the tone that "nobody likes taxes, but, just as in our own families, hard choices must sometimes be made, and this one may help our children stay healthy." Several webinar speakers generally sounded more eager to tax.

Michael Jacobson provided a helpfully skeptical summary of the political situation. Several current bills at federal level do not include a soda tax. Grassley and Baucus oppose a soda tax. Some tax-writing committee staffs have given a little attention to soda taxes as a possible revenue source, but that is not much to go on. The most likely scenario for imposition is during a federal or state fiscal crunch, as a convenient revenue source, along with alcohol taxes. That setting wouldn't bode well for building public support for the corresponding public health agenda.

Additional information sources include an anti-tax group, the Robert Wood Johnson Foundation effort on childhood obesity, a recent Michael Jacobson editorial, and a Center for Science in the Public Interest website.

Dietitians working in food policy, the new frontier

In conjunction with Registered Dietitian (RD) Day, U.S. Food Policy is participating in an RD Blog Fest on behalf of National Nutrition Month. Check back periodically as other dietitian’s blogs will be linked throughout the day.

As a RD mastering in Food Policy and Applied Nutrition, I see now more then ever as the time for RD’s to fully embrace the world of policy as an agent for change. A short trip down memory lane shows us the causal story of how our food system and societal health got where it is today, all through policy. As the ‘food and nutrition professionals,’ it is imperative that dietitians understand how food is grown, why certain foods are grown, and how these policies are contributing to the very disease we are attempting to rebuke.

In 1973, Secretary of Agriculture Earl Butz, encouraged farmers to "get big or get out," as he urged farmers to plant commodity crops like corn "from fencerow to fencerow." These policy shifts coincided with the rise of major agribusiness corporations, and the declining financial stability of the small family farm. Evidence shows that while the present capital and technology-intensive farming systems are productive and able to produce cheap food, they also bring a variety of economic, environmental, and social problems.

Industrial farms are subsidized by commodity payments (your tax money) and are contributing to environmental degradation through: bi-cropping (corn and soy), heavy use of pesticides, inefficient use of increasingly scarce water, depletion and erosion of soil, difficulty recycling nutrients and destruction of biodiversity. Recent research has also shown a decrease in nutrient values in fruits and vegetables over the last 30 years. This alone is great reason for RD’s to be the leading soil advocates.

What is infuriating is that the food that is being subsidized and grown throughout the Midwest is not really food at all, in that it is not fit for human consumption. It is an input and it must be processed, which leads us another problem: processed food. Almost every product you find in the center aisles of the grocery store is made from corn and soy. From steaks to chicken nuggets, condiments, juices, frozen entrees, pastries, etc., are ultimately derived from corn, either as high fructose corn syrup or from the corn-based animal feed that is being fed to animals. The animals confined to the industrial food system are also not supposed to eat this corn. Cows are ruminant animals and are suppose to eat grass. This is like trying to make a patient with Celiac’s Disease eat a diet of wheat gluten. The cows, like the patient would, get sick with a condition called acidosis which causes one of their four stomachs to inflate, ultimately causing suffocation. To combat this problem, the industrialized food system provides animals living in CAFO’s (Confined Animal Feeding Operations) with a low dose of antibiotics. Presently, 80% of the antibiotics in the US are used non-therapeutically in animals being grown for consumption.

Those working in the community and clinical dietetics and with at-risk populations see the ramifications of these policies every day. The American people, especially low-income populations, are sick. Both corn-fed beef and high-fructose corn syrup contribute to the obesity epidemic in the United States. Those working on obesity know that behavior change alone is not working. Patients are stricken by a federal policy that makes cheap food possible. While American’s spend a smaller fraction of their budget (about 11%) on food compared to any other industrialized nation, the cheap food is catching up to us on the other end: our health care costs, or what I call, “sick care.” Another issue for those working in the area of hunger and food security is our dependency on petroleum inputs to grow food.

With a new administration and a new secretary of agriculture, now is a great time for RD’s to join in the political process that is entrenched in our food. In order for your representatives to begin to change these archaic policies, they must first know that there is political will. Dietitian’s can be the story-tellers and the educators for their policy makers, communities and clients. As the nation's food and nutrition experts, registered dietitians are committed to improving the health of their patients and community. Registered Dietitian Day commemorates the dedication of RDs as advocates for advancing the nutritional status of Americans and people around the world. There is no better place to an RD to start, then in policy.

What could an RD do to learn more?

• Join one of American Dietetic Association(ADA)’s fastest growing Dietetic Practice Groups: Hunger and Environmental Nutrition (HEN)
• Read my personal blog Epicurean Ideal
  
• Learn about the Farm Bill and how RD’s can help make it a “Food Bill"
• Join a food policy council in your community
• Participate in the 2009 Child Nutrition Reauthorization legislation
• Watch the Food Lobby Goes to School (about school lunch and industry lobbyists)
• Learn about the American Dietetic Association’s priority areas and encourage them to make an ecological, preventative sustainable approach to food systems and nutrition
• Check out Angie Tagtow's “Good Food Guide for RD's”
  
• Watch the movie King Corn

Here are some other posts by fellow RD's--

Beyond Prenatals - Food vs. Supplements and Real Advice vs. Fake Advice
Annette Colby - No More Diets! A Registered Dietitian Shares 9 Secrets to Real and Lasting Weight Loss
Diana Dyer - There and Back Again: Celebration of National Dietitian Day 2009
Marjorie Geiser - RD Showcase for National Registered Dietitian Day - What we do
Cheryl Harris - Me, a Gluten Free RD!
Marilyn Jess - National Registered Dietitian Day--RD Blogfest
Julie Lanford - Antioxidants for Cancer Prevention
Renata Mangrum - What I'm doing as I grow up...
Liz Marr - Fruits and Veggies for Registered Dietian Day: Two Poems
Meal Makeover Moms' Kitchen - Family Nutrition ... It's our "Beat"
Jill Nussinow - The Registered Dietitian Lens I Look Through
Wendy Jo Petersen - March 11 is our day to shine!
Diane Preves - Registered Dietitians and the White House Forum on Health Reform
Andy Sarjahani - Dr. Seuss Tribute continued: Green Eggs and Ham and a Sustainable Food System
Rebecca Scritchfield - Big Tips from a "Big Loser"
Anthony Sepe - RD Showcase: Registered Dietitian Day, March 11, 2009
Kathy Shattler - RD Showcase for Nutri-Care Consultation
UNL-Extension, Douglas/Sarpy County - Nutrition Know How - Making Your Life Easier
Monika Woolsey - Dietitians--Can't Do PCOS Without Them!
Monika Woolsey - In Honor of National Registered Dietitian Day
Jen Zingaro - My life as a Registered Dietitian

Rudd report on soft drink taxes

The Rudd Center for Food Policy and Obesity has a very timely report on soft drink taxes (.pdf).

An engaging section at the end offers point-by-point contrasts between what "opponents" and "proponents" say about soft drink taxes. Here are some examples and my comments on them.

Opponents say:
Soft drink taxes are regressive. They will disproportionately hurt the poor and minorities who spend a larger proportion of their income on food.

Proponents say:
Soft drink taxes have the potential to be most beneficial to low-income people, who:
-- may currently consume more soft drinks;
-- may be more sensitive to higher prices and therefore stand to benefit most from reducing consumption.

This is especially true if the revenues are used for programs that
will benefit the poor, or for subsidies on healthier foods which can
offset concerns that the tax is regressive.

While everyone must eat, sugared beverages are not a necessary
part of the diet and generally deliver many calories with little or no
nutrition.

To make the proponents' point even more broadly, it is good public policy to expect the tax system as a whole to be progressive, but it would be bad policy to expect every disaggregated sales tax to be progressive.

Opponents say:
The government should stay out of private behavior. It should not try to regulate what people eat or drink.

Proponents say:
The government is already deeply involved in what we eat, from farm subsidies to setting nutritional standards for school meals. Historically, major government interventions have been successful in improving and protecting the public’s health. Examples include smoking restrictions and tobacco taxes, mandated seat belt usage, fluoridated water, and vaccinations.

It is true that government interventions can promote the public interest. However, on this question about personal food and beverage choices, I'd encourage the proponents to listen very carefully to the opponents' concern. The proponents should spend more ink calling for reforms to misdirected government policies (such as subsidies for inputs to corn sweeteners) than calling for taxes to change public behavior. Public policy to address obesity wins more public agreement when the public strongly senses a heartfelt deference to consumers' own preferences.

Here is a rhetorical argument that proponents can pursue in states where sales taxes are lower for groceries than for other goods: "Soft drinks should be taxed fairly, just like all other consumer goods subject to sales tax. Soft drinks should not be taxed using the special lower tax rate for food necessities. This policy reform does not tell consumers what to do. It merely puts soft drinks in the appropriate category of goods subject to sales tax." In such states, proponents should never get caught in a sound bite that makes them seem more eager to direct consumer choices.

Opponents say:
Soft drink taxes can’t be compared to cigarette and alcohol taxes. The use of tobacco and alcohol can have adverse consequences for non-users (for example, second hand smoke, and drunk driving accidents, called “negative externalities”). This is not true for soft drink consumption.

Proponents say:
Obesity also has negative externalities which affect us all. Among them are significant overall health care costs, including higher medical, disability, and insurance premium costs. For example, obesity-related medical expenditures were estimated in 2002 to be $92 billion, half of which were paid for with taxpayer dollars through Medicaid and Medicare.

The proponents, here, have chosen an argument that may be too broad to win public agreement. By the same argument about shared insurance risk pools, one could justify fairly severe government interventions to influence personal choices that affect health. Contrast this argument with the much stronger public appeal of policies to protect children from soft drink sales and marketing in schools.

At the end of the day, I'd support much stronger public policies to address soft drink consumption and obesity, but the proponents' arguments in this report could be strengthened with some pruning.

Subsidies to corn sweeteners in the U.S.

The Global Development and Environment Institute at Tufts University has released a policy brief: Sweetening the Pot: Implicit Subsidies to Corn Sweeteners and the U.S. Obesity Epidemic. Alicia Harvie, a Masters candidate in Agriculture, Food, and the Environment at the Friedman School of Nutrition Science and Policy and a Research Assistant, along with Timothy A. Wise the Director of the Research and Policy Program at the GDEI produced the document.

They explore how much cheaper high fructose corn syrup (HFCS), a critical ingredient in the American diet, was from 1997-2005 due to corn prices below corn’s cost of production and the possible connection to USDA subsidies.

"While this (corn subsidies) may not have reduced soda prices to an extent that would account for rising consumption, there is little doubt U.S. agricultural policies have indirectly subsidized a sector that may be contributing to health problems."

The research was mentioned in Farm Subsidies, Bitter and Sweet, by Grist blogger, Tom Philpott.

Cross posted from Epicurean Ideal.

Time use, food preparation, and risk of overweight

USDA's Economic Research Service has just posted 2007 results from the special module on eating and health in the American Time Use Survey (ATUS).

I frequently hear questions about time use and food policy. For example, many people wonder if the high cost of healthy food prevents Americans from choosing good diets. On reflection, many healthy and affordable food options are mixed in with the junk on the market. Next, many people wonder if some combination of price and the time burden of buying and preparing healthy food is to blame.

So, let's turn to the facts.

Here is my graphic based on Table 6 of the 2007 results on the ERS website. I left out the activities for sleeping, working, and eating and drinking as secondary activities while doing something else as a primary activity. You can follow the link for the table to confirm that the omissions just simplify the picture without cherry-picking. The graphic shows the number of minutes spent in several activities, for adults, computed separately according to the responding adult's weight status based on self-reported weight and height.

The questions are: (a) is it true that lack of shopping time and food preparation time are preventing us from eating healthy? (b) what time use activity is most noticeably and systematically associated with weight status?

In short: (c) what is the elephant in the room when it comes to time use?

The New York State "fat tax"

New York State Health Commissioner Richard Daines has endorsed Gov. David Paterson's revenue-generating budget proposal to create a so-called "fat tax" - an 18 percent levy on sugary drinks like non-diet soda. His endorsement, published on You Tube December 26th, is a five minute dialog which describes the increased consumption of sugar laden drinks, the concurrent rise in obesity, and the cost and impact of the obesity epidemic on the public. The tax is arguably focused on health care policy as opposed to revenues. Elizabeth Benjamin of The Daily Politics covers the issue in her blog post The Doctor is in (Cyberspace).

Daines also quotes a research editorial from the Journal of the American Dietetic Association called How Discretionary Can We Be with Sweetened Beverages for Children which concluded: "Only one high-risk dietary practice emerged as being linked to overweight in children: the intake of sweetened beverages."

[Note from Parke: Cool video, Ashley. I like Daines' effective use of props for data visualization. Because of this New York proposal, I've been getting questions from consumer advocates about the economics of soda consumption. In a nutshell, if people greatly change their consumption in reaction to such a tax, their response is called "elastic." If consumers don't change their consumption much, the policy does better for revenue generation. In a 2004 study of low-income Americans, in the journal Agribusiness, Steven Yen, Biing-Hwan Lin, David Smallwood, and Margaret Andrews estimated the price elasticity for soft drinks to be -0.8, which means that a 10% increase the soft drink price leads to about an 8% fall in soft drink consumption. At the same time, the price increase for soft drinks makes milk and juice products comparatively more attractive to consumers.]

Will global food prices keep us healthy?

Nothing makes a geeky food policy student like me more excited than seeing the NYTimes writing about cross-price elasticities of demand, except that they didn't actually use the technical term for it. The cross price elasticity of demand, or the change in demand for one food when the price of another changes, is a formula for calculating the response consumers will have to changing food prices. For example, suppose the price of corn syrup goes up 1 percent, so people buy less corn syrup and more of other stuff-- the cross-price elasticity for fruit would show the percentage increase in fruit spending in response to the higher corn syrup price.

In light of the recent surge in global prices of food, especially grains and meat, Wednesday's NYTimes article is about the light that some healthy and local food advocates see at the end of the global food "crisis" tunnel. So their theory goes: If the price of products produced with large quantities of corn, like corn syrup and grain-fed meat increase drastically--which is already beginning to happen--then people will switch to eating more fruits and vegetables and more locally grown food that doesn't require as much fossil fuel to transport it to the grocery store.

While this phenomenon may be true for some, it may take more than rising prices for consumers to change their behavior. One of the factors affecting this response is the degree to which food A, fruit for example--is a complement or a substitute for food B, corn syrup in this example. One can use cross elasticities to show how much the price of corn syrup would have to go up in order for consumers to "demand" more fruit.

Of course the response also depends on how much prices continue to rise, whether fruit and vegetable prices continue to rise less than those of other foods, and if farmers change their production decisions for the coming year. But I wonder if substitution to healthier or more sustainable foods will actually happen on a large scale, or if we, and our food companies, will just figure out shortcuts to our favorite processed flavors. We also should remember what a small percentage the price of corn represents in the price of corn flakes- in other words, most of the cost of processed foods is for value-added in production, marketing and distribution, not the raw ingredients themselves.

Obesity Society's president protests menu labeling

Last month's second attempt by the New York City Board of Health to require menu labeling in chain restaurants with 15 or more locations is the subject of a suit by the New York Restaurant Association.

Okay- not surprising, you say. Of course a restaurant association would oppose the new rules--they stand to lose business if customers are actually aware of the number of calories in many of their popular menu items.

Except that the author of an affidavit in support of the restaurants' suit was filed by Dr. David B. Allison, the new president of the Obesity Society, an organization concerned with addressing obesity. The argument made by Dr. Allison is that customers may not actually reduce their calorie intake because of the information obtained via menu labeling. In fact, Allison says that they may actually increase their calorie intake with this knowledge--"by adding to the forbidden-fruit allure of high-calorie foods or by sending patrons away hungry enough that they will later gorge themselves even more," according to the NYTimes.

So if the concern is that the required menu labeling will not actually decrease business at the restaurants covered by the rules, why is the Restaurant Association suing to block the requirement? And why did they pay Dr. Allison to write the affidavit.

Obesity Society members have reacted in opposition to Allison's statement, releasing one of their own. According to the NYTimes, Allison's other industry ties have included advisory roles at Kraft, Coca-Cola and Frito-Lay.