The future of federally funded food programs -- Can they also fight obesity?
Boston -- The Food Stamp program and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which are primarily funded through the Food and Nutrition Service of the United States Department of Agriculture, have made significant strides toward eliminating nutrition-related health disparities between low-income and higher-income groups. Despite this success, federally-funded nutrition programs have faced criticism for potentially contributing to the nation's obesity epidemic. To dispel this notion, Eileen Kennedy, DSc, RD, Dean of the Friedman School of Nutrition Science and Policy at Tufts University, and Tufts colleagues recently authored a report and accompanying issue brief through the bi-partisan National Governors Association (NGA) Center for Best Practices, and proposed policy changes that would allow the Food Stamp and WIC programs to continue reducing nutrition-related health disparities while simultaneously addressing obesity.
"The population as a whole is struggling with overweight and obesity, not just those who are enrolled in federally-funded nutrition programs," says Kennedy. In fact, the Tufts authors write that an expert panel investigating the potential link between nutrition programs and obesity concluded that the "available research on the Food Stamp program and WIC did not indicate that the programs were causing obesity." WIC and Food Stamp participants did improve nutrient intakes, but the panel determined that overall calories increased only among pre-natal WIC participants, which is thought to be a positive factor contributing to higher birth-weight babies. Tufts authors also cited that "data indicate that from 1976 to 2002, the probability of a woman being overweight grew the least among food stamp recipients."
Although research suggests that participation in the WIC and Food Stamps programs is not associated with obesity, Kennedy acknowledges that diets of program participants are still not optimal for good health, and that low-income populations may be more at-risk for weight gain. "Many low-income households face what is known as the 'double burden of disease,'" she explains, "meaning that those who are food-insecure are often overweight or obese. This creates an opportunity for federally-funded nutrition programs to restructure goals to address obesity, which is now a more prevalent problem for low-income households than under-nutrition."
Kennedy and Tufts co-authors, including Beatrice Rogers, PhD, and Parke Wilde, PhD, both of the Friedman School, call for the USDA to give states more power and flexibility in promoting healthy lifestyles, and for states to combine efforts across nutrition programs so that participants receive a consistent message and maximum support. They also recommend that the USDA convert to a multi-year renewal cycle for approving food stamps nutrition education plans, as the current annual renewal cycle may limit programs by hindering long-term sustainability and evaluation.
In addition to cohesive state policy and planning, WIC and Food Stamp programs can help participants overcome barriers to better nutrition by using "innovative efforts to provide greater geographical, financial, and informational access to healthful foods options," write the Tufts authors. Geographically, many low-income areas have restricted access to supermarkets with a wide variety of foods like fresh fruits and vegetables. To attract more food providers into areas that are largely low-income, more states can offer tax incentives and financing options, suggest Kennedy and colleagues.
Other state initiatives to improve access of healthful foods have been launched as well, such as farmers' market programs that offer reduced cost shares, or programs connecting low-income households with unsold produce that may have otherwise gone to waste.
Such programs can be enhanced, note the authors, "by increasing the purchasing power of WIC and food stamp dollars that are spent on fruits and vegetables or whole-grain items, while decreasing the purchasing power of dollars spent on less-healthy options."
Kennedy stresses that along with necessary environmental changes within federally funded nutrition programs, the limited time allotted for nutrition education should emphasize the concept of nutrient density, in order to maximize nutrients but minimize calories. "Choosing nutrient-dense foods is challenging for everyone, but it can be especially difficult for families on a budget. However, despite the fact that many people believe that healthful diets cost more money, research has shown that there can be great variability among the price of foods with similar nutrient density." Therefore, Kennedy believes that "working with participants to influence their food choices could result in a more nutritious diet for less money."
"The nutrition community needs to look ahead and analyze what we can do to best serve Food Stamp and WIC participants and how these programs can play an integral role in preventing obesity," says Kennedy. "There are some exciting activities taking place in many states across the nation. We need to build on these existing initiatives and determine how we can leverage the existing Food Stamp and WIC programs to promote healthier lifestyles."
Kennedy E, Wilde P, Rogers B, Racsa P. NGA Center for Best Practices: Issue Brief. August 2006. "Creating Healthy States: Building Healthier Nutrition Programs."
If you are interested in learning more about this topic, or speaking with a faculty member at the Friedman School of Nutrition Science and Policy at Tufts University, or another Tufts health sciences researcher, please contact Siobhan Gallagher at 617-636-6586.
The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight centers, which focus on questions relating to famine, hunger, poverty, and communications, are renowned for the application of scientific research to national and international policy. For two decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies.
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