Tackling ‘Food Deserts’ in Illinois June 5, 2009
Posted by Katelyn Mack in Disparities, Neighborhoods, Nutrition, Politics.2 comments
A FRESH FOOD FUND has been established in Illinois to address the problems associated with limited access to fresh fruits and vegetables in low-income, underserved areas of the State. Also known as ‘food deserts’, these areas see higher rates of obesity, diabetes, cardiovascular disease, and overall poor health of children and adults. Often they exist at the intersection of many vulnerabilities for poor health including structural violence, low socioeconomic status, racial segregation, and lack of access to health care.
According to a recent news digest report by the Robert Wood Johnson Foundation, the Illinois General Assembly has recently funded supermarket expansion into underserved areas of the state in order to improve the supply of fresh fruits and vegetables in those locations.
Pennsylvania began a Fresh Food Financing Initiative in 2004 to incentivize the growth of corner stores (remember those neighborhood grocery stores back in the day?) and eliminate food deserts. New York City is also trying to provide tax and monetary incentives to small businesses to provide fresh produce in poor neighborhoods. (Both discussed in a recent New York Times editorial)
To learn more about what is happening around the nation to eliminate food deserts and its associated health disparities check out TheFoodTrust.org.
Three a Day Dairy: Helpful or Harmful? April 10, 2009
Posted by Katelyn Mack in Nutrition.2 comments
Dr. Walter Willett spoke this week to a packed classroom at Harvard School of Public Health. The topic: what is up with the three servings of dairy a day recommendation? Is it based on science (…or based on good science) or might it have been influenced by (ahem) the huge and ever-expanding dairy industry?
In true research fashion, Dr. Willett did not actually touch on the last point. He focused singly on the science in order to sway his critical-minded audience.
The 3-a-day dairy recommendation likely results from the DRI (Dietary Reference Intake) indicating adults consume 800-1000mg of calcium daily. However, these nutrition guidelines vary widely worldwide. In fact, the recommended intake for calcium in the US is much higher than is recommended in Europe or by the WHO.
He gave a great deal of evidence showing that it is unlikely that we benefit from consuming excessive (>800 mg) amounts of calcium a day. Indeed, it may actually result in harm due to the release of growth factor and possible links to colorectal cancer. The 3-a-Day recommendation actually fits that bill and result in a dietary intake of calcium well over 1000mg/day.
So why am I blogging about this here? What does it have to do with social determinants of health?
Well, dairy is a huge industry. Milk consumption has been influenced by the Got Milk? campaigns (their website boasts: boost your calcium with a latte!). And we all can recall the slogan “Milk — it does the body good” (see video above). Even Yoplait has a website: “Calcium every day – the easy way.” The National Dairy Council has been incredibly successful in promoting dairy products in the US and has shaped norms around milk and dairy consumption for decades.
What is needed is a strong understanding by public health organizations (government, NGOs, and for-profits) that these suggestions are not based on strong scientific evidence. It is a marketing tool used to promote a product.
Who needs to know this?
- Nutritionists need to know in order best guide their clients to a health-promoting diet.
- Clinicians need to know this because otherwise they (like my current primary care doctor) might insist on their patients getting 3 servings of dairy a day.
- Policymakers need to be aware of this because they are making decisions about what to fund in school lunches and guidelines for WIC recipients. These decisions should be informed by the best current evidence that we have.
My take-away message: limit milk intake and get my calcium from other sources (e.g. dark leafy greens, almonds, salmon). Make sure I am getting enough Vitamin D in my diet (or better yet – through outdoor physical activity) to build muscles and increase calcium absorption.
What are your thoughts on the milk Ads and dairy marketing? Is this good for peoples’ health? Bad for health? Or is it a wash?
New Evidence for Fast Food and Obesity April 1, 2009
Posted by Katelyn Mack in Neighborhoods, Nutrition.add a comment
There is new evidence that going to school close to fast food chains increases adolescents’ risk of obesity. A National Bureau of Economic Research Working Paper published in February and recently reported on by the New York Times provides strong evidence that living close to (for pregnant women) or going to school near (for high-school students) a fast food outlet is associated with increased rates of obesity, after accounting for income, education, and race.
By comparing students in the same grade in years before and after the fast food outlet opened, there is a strong case for the temporal ordering and even causal effect of fast food chains on adolescent obesity.
Most articles written about obesity and overweight focus on individual-level risk factors, specifically diet and physical activity. I do not deny that those modifiable risk factors are important, but they simply do not paint the whole picture of the myriad social forces that affect overweight and obesity. Indeed, they likely cause those unhealthy diets and physical inactivity in the first place. Furthermore, better understanding the social factors can provide great opportunities for population-based interventions.
I was most excited to see that the New York Times article considered public policy interventions that could result from these findings. Namely,
zoning laws that prohibit fast-food restaurants near schools
according to Kelly Brownell (cited in the NYTimes article).
While this by no means settles the controversy of the contribution of fast food chains in the development and continuation of the obesity ‘epidemic,’ it is one more carefully conducted study to be added to the mix.
