Food Politics

Maybe it should be An Action Plan for Increasing the Promotion and Accessibility of Healthy Food. Just sayin’.

Some communities are using zoning to limit the growth of new fst food restuarants, limiting the spacing between them and their proximity to schools, churches, etc. Also, designs that require street access instead of access through a parking lot, or designs that do away with drive throughs can also limit fast food restaurant proliferation.

The menu disclosure laws for calories, sodium, etc are all good ideas. Let’s hope the food industry doesn’t keep the stranglehold they’ve held on Congress going forward.

Rick Tannenbaum
http://www.foodrecalls.blogspot.com

Thanks for bringing this to our attention Marion. Terrific report. Succinct examples and great data. NYC is really taking charge.

BTW, we finally have data on Canadian beverage consumption.
http://www.statcan.gc.ca/pub/82-003-x/2008004/article/6500820-eng.pdf

C Richards, RD, British Columbia

Does it ever occur to anyone that there actually isn’t any evidence that doing any of these things makes any difference to childhood obesity? Isn’t policy supposed to bear some relation to data? Oh, never mind. We all know it SHOULD work, so who needs data?

As for evidence, there is increasing recognition that evidence is very hard to collect when you do population wide initiatives, particularly when other things that may impact data are happening at the same time. Nonetheless, the precautionary principle says that we should go ahead a remove harmful or potentially harmful conditions in our environment. This is called “better practise” or “promising practise” by researchers, as opposed to the “best practise” data we can get from double blind controlled trials. Even “best practise” doesn’t mean “the only practise”. It’s common sense that an environment that encourages healthy behaviour will be better for people than an environment that encourages unhealthy behaviour. Obama speaks of hope and change, as does the New York report. Let’s be hopeful and optimistic — that alone is shown to improve health.

Public policy needs to be based on more than “common sense.” Some documentation would be nice, especially if it involves spending public monies and going through a lot of effort. If an intervention has never been shown to be effective, that’s either because it actually doesn’t work or because it does work but it’s hard to get the data. You seem to be assuming that the second situation is the case, but so far the weight of data is on the first.

There is no problem with a goal of reducing ‘unhealthful’ food consumption. But it seems somewhat questionable to “sell” this goal with the implied promise of reversing childhood obesity, which is pretty unlikely to be the case. This seems like just padding for political purposes.

One reason the report isn’t called “increasing access to healthy food” is that making healthy food more accessible in a variety of ways is much more politically feasible and in fact, NYC has several coalitions that are working on this. However, tackling corporate practices to promote unhealthy food are less politically popular, but just as essential in order to truly achieve health from a social justice (and public health outcomes) perspective. Addressing the food environment on both ends is crucial.

As for the discussion around evidence, I agree the more evidence the better! The evidence base for community level interventions is built piece by piece, and we are getting there concerning some of the ideas in the report. There is definitely no questions that an abundance of very unhealthy food at rock bottom prices, when healthier options are more expensive, has an effect on people’s food choices, and eating the unhealthy food discussed in the report has a negative effect on health. Well designed research is out there and more is coming to help public health practitioners flesh out how to integrate “upstream approaches” into our work. Out yesterday: Ban On Fast Food TV Advertising Would Reverse Childhood Obesity Trends, Study Shows (http://www.sciencedaily.com/releases/2008/11/081119120149.htm)

The Bush administration makes a similar “common sense” and ‘It must work” argument regarding abstinence-only programs for teen sex education as a way to reduce teen pregnancy rates. The only problem is that – evidence shows it doesn’t work.

THere is essentially no evidence showing that the interventions in the report on childhood obesity and unhealthful food would have any impact whatsoever on childhood obesity rates. Sorry! No interventions have worked so far. Have they? The “would reverse childhood obesity trends” article doesn’t actually demonstrate any impact of an intervention , does it? It’s just hypothetical. So the question remains, should public policy in the area of childhood obesity remain an “evidence-free zone,” just based on ‘right thinking’ approaches that haven’t been demonstrated to have an impact and in fact may not work at all?

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