Increasing awareness of nutrition programs

 

This week in class we discussed federally funded nutrition programs such as SNAP, NSL, WIC, and OAA. Most of these nutrition programs are primarily targeted to low-income households, as they have higher proportions of food insecurity and nutritional risk. Before this unit I knew of quite a few nutrition programs, but there are actually quite a few I didn’t know about. As someone who has been educated in nutrition issues the fact that I didn’t even know about some of them leads me to believe that lack of knowledge of these programs is probably a big factor in why there are still many food insecure families and individuals in America today. Increasing participation means addressing a large variety of issues, such as the negative stigma of being on a social program, but raising awareness could be the push for some people to utilize these programs.

This week I would like to take the time to examine a social nutrition program that is funded by a nonprofit organization in Spokane that my friend Molly worked at in past summers. The program is called Power Up and is targeted to women and children in nutritional need. It is funded by the Women Helping Women Spokane Chapter that also fund several other social programs aimed at the community level. Here is my interview with Molly.

Question: How does Power Up work?

M: The grant provided $10,000 to help disperse produce and dairy products to women and children in need. Food pantries, which do much to reduce hunger, are usually limited to giving out canned fruit and vegetables, but this program worked to provide fresh produce and dairy products to address that nutritional gap. Power up allowed patrons of the Women and Children’s Free Restaurant (another Spokane run program) to receive a gallon of 2% milk and a specific fresh vegetable once a week.

 

Q: What was your role in the program?

 M: Once the program began it became apparent that several patrons didn’t know how to use these fresh vegetables that were being distributed. The staff was finding huge amounts of the raw vegetables in the trash. My role was to attempt to teach the patrons ways to use these vegetables and why they should be used. How I did this was by making pamphlets that could be given out with the produce that described how to prepare the produce and the benefits the vegetables could have on their health.

 

Q: Do you feel the program had positive effects?

M: I think for some people it was successful in introducing more fresh produce and dairy into their diets at home. There were still patrons who threw away the produce even with the educational material, which was disappointing. However, I think overall the program had a positive effect on the community.

 

This is an example of a community based programmed funded by private organizations.

There are plenty of programs like this across our nation. The federal government provides many valuable resources through their nutrition programs, but small operation, community-based programs can bring about positive change in the health status of community members as well. There are many resources available to those who are food insecure, and I believe that increasing knowledge of these resources is a step in the right direction.

 

m.spokesman.com

www.listentoyourmothershow.com

 

Becoming an informed consumer

Companies that produce food products have one main goal: to make a profit by marketing to their consumer base. Companies have realized that many consumers today are actually trying to make an effort to choose healthier foods, and consequently have marketed to that consumer in a variety of ways. I am a big fan of labeling foods so that the consumer can be aware of exactly what they are putting in their bodies; however, there are some labels that can be misleading if people aren’t critical of the labels. For example, the label “0 grams trans fat!” can lure a consumer into believing the food is a healthier food choice. While avoiding trans fat is obviously a good idea, this product could be chalk full of saturated fat or total fat, making it not really a healthy choice after all. To be intelligent, informed consumers we must look past the front labeling that is there for the sole purpose of enticing us to open our wallets. There are strict regulations from the FDA regarding the disclosure of the ingredients and nutrition content on the nutrition label. So before falling for the alluring, healthier-sounding food choice, be sure to actually look at the nutrition label. Then you will find out if those tempting “natural” tortilla chips with 0 grams trans fat are actually a better choice. As with most things, taking the time and initiative to be informed is a much better and more reliable choice than relying on marketing schemes.

Another point consumers should be aware of is labels such as “natural” don’t necessarily mean what they appear to. There isn’t a formal definition of ‘natural’ enforced by the FDA, as long as the food does not contain synthetic substances, added color, or artificial flavor they do not object to the label. While it is beneficial to know your food doesn’t contain any synthetic substances, should be noted that the label “natural” does not imply that it is organic or grown locally or anything else. (However, meat and poultry are regulated under the USDA so they have different requirements.) The term “certified organic” is strictly regulated and can only be applied to food that was grown on a farm that has been pesticide and herbicide free for at least three years. Certified organic means the food was made without genetic engineering (GMOs), irradiation, hormones, antibiotics, or herbicides and pesticides. The label indicates that at least 95% of the product is organic, and there is a 100% organic label as well. So if consumers want to buy products that are as ‘natural’ as possible, they should stick to certified organic foods instead of “natural” product

As a consumer it is your responsibility to understand what you are buying and consuming. It is very easy to fall into marketing schemes by companies that want you to believe their product is ‘healthy.’ It is your job to take the few easy steps, such as reading the nutrition label, to consciously choose foods that are more nutritious.

http://www.huffingtonpost.com/eatingwell/food-nutrition-labels-natural-organic-local_b_747181.html

http://www.mayoclinic.com/health/food-labels/MY01242

http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm064908.htm

wellnessmadenatural.com

 

 

 

 

Post 5: Soda Tax

In the past several years soda (sugar-sweetened beverages) taxes have been implemented in a variety of cities and states in order to help combat our obesity epidemic. The tactic is similar to the relatively successful strategy of using increased taxes to curb smoking and tobacco use. Some of the revenue generated from the tobacco tax was then used for educational material that discouraged the use of tobacco because of its health consequences. There are obviously still smokers today, but there are significantly less than 30 years ago. A soda tax could work in the same way. A 1-2 cent tax on each ounce of sugar sweetened beverage could create revenue that could then be used to implement more educational programs as well as counteract the toll the obesity epidemic has cost our health system. Of course a soda tax like this wouldn’t solve the problem; it is much too complex for that. However, it could be a step toward improvement. I honestly don’t think it will stop all that many people from drinking soda, but possibly the revenue it created could be a catalyst for change. On the other hand, taxes such as this disproportionally affect low-income households. One study (linked below) by Roland Sturm, et al., found that low taxes (around 4%) did not have a substantial effect on soda consumption. However, a few subgroups including at-risk overweight children coming from low income families did appear to be more sensitive than others to soda taxes (1). This was especially true when soda was available at school. So a small soda tax could affect the behavior of at least a few subgroups of the population. I personally have an issue with the thought of using taxes to try to force behavior change. In an ideal world, as long as accurate nutritional information is available and everyone has the access to healthy choices they should have the freedom to make their own consumption choices. However, in this complicated world, people whose choose lifestyles that cause serious health problems do not just affect themselves, they affect the entire health system. So as much as I don’t like the idea of using taxes as a tool for behavior change, a soda tax could at least bring in funding for a variety of programs that could help improve the health of our health system, such as nutrition education programs, increasing access to healthy options in food deserts, or offsetting costs of obesity on the health system.

http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2864626/

 

http://www.triplepundit.com/2010/03/soda-tax/

 

http://www.ameribev.org/news–media/videos–multimedia/

 

 

http://taxfoundation.org/blog/rhode-island-considers-soda-tax

Post 4: Childhood Obesity: Targeting the Source

Our nation’s obesity epidemic has by no means skipped over our children. Childhood obesity has become one of the biggest health concerns our county faces today. Childhood obesity not only creates a multitude of risk factors and health concerns for children, but it also affects their psychological health and well-being  Physical complications include Type 2 diabetes, high cholesterol and high blood pressure, asthma, sleep disorders, and hormonal imbalances (1). No longer are these types of complications and risk factors use to be fairly restricted to adults. Social and emotional complications include low self-esteem and increased risk of bullying, increased anxiety and poorer social skills, and depression (1). These issues can have an enormous effect on a child’s development and can lead to lifelong social and emotional issues. As it is very clear, this epidemic is and should be an important topic in nutrition policies, but where are most of the interventions focused?

                Through policy changes, such as school lunch reform, we have used schools to target this epidemic. Many intervention programs at the community level are also targeted at schools. This is all fine and dandy and I believe can be very helpful, because establishing that knowledge of healthy lifestyles in children will hopefully give them the tools to create healthy lifestyles in their adulthood. However, who is providing food to a third grade student? Children have limited control over what is available to eat at home, which is where most food is consumed. Parents assume the bulk responsibility of what foods their children are exposed to and consume. Yes, it is very important to provide healthy food to children while they are at school, but habits are formed in the home. Having one or more obese parents significantly increases the risk of childhood obesity (2).  Parental obesity more than doubles a child’s risk of becoming an obese adult (2). Interventions should be more focused at the parent level, as parents have the most control over the lifestyles of their children.

                Addressing childhood obesity is a tricky task. With children (and adults) the focus of the intervention must be on health and not too focused on appearances. In my opinion it is just as risky to have a six year old concerned about counting calories. That creates a prime environment for developing an eating disorder, such as bulimia or anorexia nervosa. Parents need to create a healthy environment at home, focusing on balanced nutrition and physical activity. Parents need to expose their children to a variety of foods from an early age to reduce the prevalence of “picky eaters.” The bulk of the responsibility of a child’s eating habits is on parents, and therefore we should be addressing this epidemic at the source through family and parent based interventions.

 

(1)    http://www.mayoclinic.com/health/childhood-obesity/DS00698/DSECTION=complications

(2)     http://www.medscape.com/viewarticle/710209_2

Percentage of high school students who were obese* — selected U.S. states, Youth Risk Behavior Survey, 2011

Map of the United States

Percentage of high school students who were obese* — selected U.S. states, Youth Risk Behavior Survey, 2003

Map of the United States

http://www.cdc.gov/healthyyouth/obesity/obesity-youth.htm 

 

 

Post 3: School Lunch Reform- Pros and Cons

There has been a lot of debate over the pros and cons of the school lunch reform implemented in 2012. The Healthy, Hunger-Free Kids Act of 2010 directed The USDA to update the National School Lunch Program requirements and nutrition standards in order to improve the nutrition content of school lunches and help fight the rising childhood obesity epidemic (1). The changes include setting specific calorie limits and involve gradual reduction in sodium content of meals (which must meet target level by SY 2014). It also increases the availability of fruits, vegetables, and whole grains in the menu (1). This all sounds good and dandy but there has been significant outcry from some of our nation’s youth through social media outlets. Kids, especially high school athletes, are claiming to be hungry before the end of the school day. The calorie restrictions require schools to serve a minimum of 700 and maximum of 850 calories to high school students, which typically include a cup of fruit, a cup of vegetables, two ounces of a grain, two ounces of meat, and a cup of milk (2). This is appropriate serving sizes for many high school students; however, for some highly active students, this may not be enough. The problem arises when hungry high school students run to a gas station to get snacks to tide them over through their sports practice, which for many students starts right after school. The high school students I know would probably choose a candy bar or bag of chips for a quick fix before practice, which mostly defeats the purpose of serving healthier foods. There are so many good things about this program, such as increasing the amount of whole grains, fruits, and vegetables and lowering the amount of processed foods and sodium in the meals offered. These are obviously very good changes. However, I am just not sure that a broad calorie restriction works for everyone. In my opinion, broad policy isn’t the most effective. I do believe kids should be offered appropriate serving sizes, but maybe if some students wanted a second protein serving after they had finished their meal that could be available. Talking to my younger cousins over the holidays made the issue very apparent. In discussing the new policy with my family over winter break, my 10 year old cousin Erin shared that most days before she has sat down to start eating, at least two people have asked her if they can have her meat. Some of the problem is some kids being picky eaters and there really isn’t a way to make every kid happy about the meal option every day. This policy has a lot of really great benefits; however, I believe that some necessary tweaking should be incorporated in order to meet the variety of nutritional needs of students.

(1)    http://www.fns.usda.gov/cnd/lunch/AboutLunch/NSLPFactSheet.pdf

(2)    http://www.thedailybeast.com/articles/2012/09/28/nutritious-school-lunches-or-the-new-hunger-games.html

 

 

SNAP: Possible Venue for Change

The Supplemental Nutrition Assistance Program (SNAP) is the largest nutrition assistance program in the nation and is a very important topic in community nutrition. With our rising obesity epidemic it seems that targeting policy and programs through the SNAP benefits program could be very beneficial at a large scale. The SNAP program serves around 46million Americans each year (1). There is also a correlation between low incomes and high obesity rates; therefore, working through the SNAP program to bring better nutrition to people across the nation could be very effective. What is the best way however? There have been many attempts by cities and states in the past couple years to restrict the foods that can be purchased with SNAP benefits. However, because the SNAP program is a federally-regulated policy, any state wishing to apply their own restrictions must apply for a waiver from the USDA, and as of now none have been approved (2). I have mixed feelings about the method of improving nutrition through SNAP policy. While I would love if those funds weren’t used to make poor nutritional choices, such as buying soda, I also want people to be able to make their own choices as adults. Shouldn’t the overall goal be that people understand how to make healthy nutrition choices on their own and then implement that knowledge? On the other hand, if your family needs the assistance of SNAP funds should you be allowed to use them to buy unhealthy empty calories instead of real sustenance for which those funds are intended? In any case, I think it is very important to include an extensive education program within any policy change. That way if restrictions are not imposed people would be given the tools to make better nutrition and other lifestyle choices and if restrictions were imposed people would know how to build healthy nutrition in their homes when they eventually get off of SNAP benefits. Without proper education behind any imposed restrictions I believe some people will go crazy buying the unhealthy foods they craved but couldn’t purchase before if they should get out of the program. I truly believe that the SNAP program could be a vessel of positive change in the nutrition status of many Americans.

There has already been a positive movement through the SNAP program the past couple years. The option of using SNAP benefits at farmers’ markets has increased dramatically. From 2008-2009 the total value of SNAP funds used at farmers’ markets doubled from $2million to $4million and currently there are over 1,150 farmers’ markets and stands accepting EBT cards (3). While the percentage of people using SNAP benefits at farmers’ markets is still relatively low, it is nevertheless a promising trend. Maybe increasing educational programs that target those receiving SNAP benefits about the importance of fresh fruit and vegetables in the diet and increasing knowledge of access to farmers’ markets accepting SNAP redemptions could help this trend along. I have great faith that we can make a positive impact on obesity rates of low income families through skillfully planned policy change and additional programs.

1: http://www.snaptohealth.org/

2: http://www.snaptohealth.org/snap-innovations/snap-and-restrictions/

3: http://www.snaptohealth.org/snap-innovations/snap-at-farmers-markets/

http://farmersmarketcoalition.org/snap-sales-soar-2010

 

The preponderance of Food Deserts

One of the major factors in the health status of individuals is availability and affordability of fresh, healthy food. In evaluating our country as a whole, I was very surprised to find out how many food deserts we have in this country. A food desert is defined by the USDA to be a low-income community where a substantial number or share of residents has low access to a supermarket or large grocery store (ERS). To qualify as a low income community it must either have a poverty rate of over 20% or the median family income must be at or below 80% of the area median family income.  Additionally low access is defined as having 500 people and/or 33% of the community more than a mile away from a supermarket or in rural communities more than 10miles away (ERS). Being from a small farming town it has never really occurred to me that being a few miles away from a grocery store would be so problematic, because growing up my house was 10miles away from entering the town so that distance doesn’t seem like it should be an issue. However, in my rural community, everyone that I knew that lived out of a walking friendly distance from a grocery store had access to at least some kind of vehicle, even if it was just a dingy old farm vehicle. I now realize how quickly it can become a health problem if access to a vehicle was compromised in this rural setting. In many rural communities there is no established public transportation to transfer residents to a grocery store. Most people would choose the available unhealthy food such as a nearby fast food restaurant than try to bum a ride off of a friend to the grocery store.

There are many factors that can affect a communities overall health status, and being a food desert has the potential to create many problems. Many people are very busy and low on available food budget money; therefore it is much easier to pick menu items off the value menu at a fast food restaurant on a family member’s way home. This tends to be very calorie dense, nutrient low foods that have a negative effect on a person’s health status if this type of food is consumed regularly. Another problem to consider is that by developing a habit of eating unhealthy, unbalanced diets these families have to overcome these unhealthy habits when/if the community raises access to supermarkets or grocery stores. These communities would most likely benefit from some sort of educational program once they had access so they would have the knowledge and the tools necessary to improve their health status. The First Lady’s initiative Let’s Move! included the Healthy Food Financing Initiative (HFFI), which has funds dedicated to expanding the availability of nutritious food to food deserts/low-income communities by developing and equipping grocery stores, farmers markets, etc. with fresh and healthy food (ERS). So hopefully in the next few years we will be able to see a decrease in food deserts across the nation and a rise in more balanced, healthy communities.

http://www.centerforcommunitymapping.org/?p=490

 

Economic Research Service (ERS), U.S. Department of Agriculture (USDA). Food Desert Locator. 2012, http://www.ers.usda.gov/data-products/food-desert-locator.aspx