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The most thoughtful comments I’ve seen on the proposal to block food stamp recipients from buying sodas come from Andy Fisher’s post on Civil Eats.

Mr. Fisher is currently a Kellogg Food and Society Fellow with the Institute for Agriculture and Trade Policy in Minneapolis.  He is the Co-Founder/Executive Director of the Community Food Security Coalition (CFSC).

I have added the red-highlighted emphases:

Banning Soda for Food Stamps’ Recipients Raises Tough Questions

October 8th, 2010  By Andy Fisher

On Thursday, New York City Mayor Michael Bloomberg announced that he had asked the US Department of Agriculture to allow the city to exempt soda from the permitted list of items its 1.7 million food stamp recipients can purchase with their benefits. This ban would last for two years, enough time to assess its effects and determine whether the ban should be continued on a permanent basis. New York City food stamp recipients spend an estimated $75 million to $135 million of their $2.7 billion in food stamps annually on soda, according to AP.

Anti-hunger and public health advocates at odds over proposal

Public health advocates contend the obesity epidemic is costing the US hundreds of billions of dollars per year in increased health care costs, and sugar sweetened drinks are a major factor.   They correctly note that low income persons tend to have higher rates of diet related diseases than the general public: poor New Yorkers have twice the rate of adult-onset diabetes than compared to the wealthiest. Mayor Bloomberg noted, “Sugar-sweetened drinks are not worth the cost to our health, and government shouldn’t be promoting or subsidizing them.”

On the other hand, anti-hunger advocates argue that food stamp recipients should have the same freedom of choice at the supermarket checkout counter as any middle class person. Exercising that freedom is a matter of personal dignity that the poor all too often are not afforded. Restricting soda is the first step in a slippery slope toward further demeaning regulations on what food stamp recipients can buy.  They correctly point out that poor people often can’t afford produce, as nutritious foods tend to be more expensive per calorie than less healthy food.

The anti-hunger community is correct that historically, as a nation, we have treated the poor paternalistically. American social, educational and health policy is littered with countless examples of this failed approach. Regulating what food stamp recipients can and can’t buy with their benefits puts forth the message that they are not capable of making good decisions, and the government needs to set forth boundaries to protect them from their own poor choices. To the contrary, some studies have shown that food stamp recipients actually buy more nutritious food per dollar than non-food stamp recipients.

Anti-hunger advocates are also right that poor people typically can’t afford nutritious foods. Highly processed foods, such as ramen, fill up a belly more cheaply than broccoli and whole wheat pasta.  In our food system, high calorie foods with low nutritional value are cheaper than nutrient dense foods. For example, a 12 pack of 12 ounce cans of Coke (144 oz) at Kroger’s costs $2.79 on sale, while a half gallon (64 ounces) of Minute Maid orange juice (also a Coca Cola Inc. product) is $2.49. The bad choice is the cheap choice.

On the other hand, public health groups are dead-on accurate that it is irresponsible public policy to be subsidizing with tax dollars the purchase of unhealthy products that will burden society with increased health care costs in the future.  As a nation, we’re subsidizing soda companies $4 billion annually through the food stamp program. In return, decades later, the public will be stiffed with the hospital bill for billions of dollars more for extra health care costs from these poor dietary choices.

Thorny issue raises questions

Why are anti-hunger advocates in the absurdly precarious position of protecting the right of poor people to drink soda? Do I have a right as an American to poison myself with “soft” drinks that can dissolve the rust off a car? Does it matter whether I use my own money or tax dollars?  Should freedom of choice apply to products of marginal utility if not harmful products?

Why does it cost Coca-Cola more to produce a half-gallon of orange juice than a half gallon of Coke? How do we reverse this situation, such that healthful products are more affordable and unhealthy products are more costly?

Are food stamps an income support program- or as the program’s new name indicates, a Supplemental Nutrition Assistance Program? If it is a “supplemental nutrition” program, then shouldn’t USDA define which products are nutritious based on Institute of Medicine standards, and limit purchases to these products? USDA does this with the Women Infants and Children (WIC) program, which is widely touted for saving billions in health care costs.

If food stamps are an income support program, and anti-hunger advocates want to maximize poor people’s freedom of choice, then why shouldn’t food stamps be distributed as cash rather than as a debit card good for food purchases? Doesn’t receiving cash maximize a person’s dignity as it bestows trust upon that person that he or she will make the right choice with their money?  Would food stamps not then become a welfare program, and be subject to the negative public perception of welfare?

The real story behind food stamps is that it is neither a nutrition program nor an income support program. It is a massive subsidy for the food retailers, grocery manufacturers, and industrial growers. That is why commodity groups, the Grocery Manufacturers of America and the Food Marketing Institute all line up behind the food stamp program every five years when the Farm Bill is being debated. They know the extra buying power food stamps provides to low income Americans will end up in their pockets.

In their noble effort to reduce human suffering and to improve the livelihood of the 41 million Americans on food stamps, anti-hunger advocates are caught in an ever-tightening bind. They frame food stamps as a nutrition program, because a nutrition program has more public support and more powerful allies in Congress than a welfare or income support program. Yet, burgeoning rates of chronic diseases and the growing presence of the public health community as a player in federal food and farm policy, translates into increased accountability for the nutritional impact of the food stamp program.

What boat are both camps missing?

There is one very important point neither the anti-hunger nor the public health advocates are making. Our tax dollars, especially the $80-90 billion spent annually on federal food programs, are a powerful force in shaping the food system. Food stamps, like school meals and WIC, should be the cornerstone of a food system that is grounded in principles of environmental sustainability, social justice, and health. Directed toward the small farm economy, community-oriented retailers, brokers, and processors, even a modest percentage of these funds could ignite a transformation of our food system.

Consider this. While nationally food stamp recipients are spending $4 BILLION per year on soda, in 2009, only $4 MILLION of food stamps were redeemed at farmers markets. This difference is shaped by the fact that USDA has not equipped farmers markets with free debit card terminals (which are needed to accept food stamp benefits), and prohibited federal nutrition education programs to promote farmers markets. Does this mean the Department of Agriculture values soft drinks one thousand times more than farmers markets?

Mayor Bloomberg has proposed only half the solution. USDA should grant him the waiver he requests if and only if New York City agrees to redirect the $75-$135 million that would have otherwise been spent on soda to programs that encourage food stamp recipients to purchase locally grown foods at farmers markets, community supported agriculture farms, and other community-oriented venues.

New York City is serious about trying to reduce rates of obesity and the expensive and debilitating conditions for which obesity raises risks.  Its latest move?  It is asking the USDA for a Food Stamp waiver for two years during which recipients would not be allowed to use their benefit cards to buy sodas.

I hardly know where to begin on this one.  I learned about this from the front page of this morning’s New York Times and from reading the accompanying op-ed by city Health Commissioner Tom Farley and New York State Health Commissioner Richard Daines.

This is an old, old idea that has been consistently rejected by USDA and by public health advocates for the poor.  It is based on the commonly held notion—never conclusively demonstrated by independent data—that recipients of Food Stamps (now called SNAP, the Supplemental Nutrition Assistance Program)–make worse food choices than everyone else.

New York City, according to the Times account, has 1.7 million people who receive SNAP benefits.  The rationale for banning soda purchases?

City statistics released last month showed that nearly 40 percent of public-school children in kindergarten through eighth grade were overweight or obese, and that obesity rates were substantially higher in poor neighborhoods. City studies show that consumption of sugared beverages is consistently higher in those neighborhoods….Anticipating such criticism, Dr. Farley and Dr. Daines said that the food-stamp program already prohibited the use of benefits to buy cigarettes, beer, wine, liquor or prepared foods.

The op-ed points out:

Every year, tens of millions of federal dollars are spent on sweetened beverages in New York City through the food stamp program — far more than is spent on obesity prevention. This amounts to an enormous subsidy to the sweetened beverage industry.

I asked for data on soda purchases by New York City SNAP recipients, and was sent the city’s waiver request to USDA:

An estimated $75 to $135 million dollars of SNAP funds were spent on sweetened beverages in New York City (NYC) alone in 2009 [Based on Nielsen beverage market data for 2009, the prevalence of SNAP participants in NYC, and prior studies of SNAP purchasing behavior].   This use of federal funds to purchase a group of products that are leading contributors to the diabetes and obesity epidemics (and whose extensive consumption contradicts the USDA’s own recommended dietary guidelines) far outstrips current federal funding for prevention of these health problems.

I am, as readers of this blog well know, no fan of sodas.   If people want to do something about controlling body weight, the best place to begin is by cutting out sodas.  Soft drinks contain sugars and, therefore, calories, but nothing else.  As the Center for Science in the Public Interest has long maintained, sodas are liquid candy.   And I am on record as favoring soda taxes (see previous posts) as a strategy to discourage use, especially among young people.

But if I were in charge of Food Stamps, I would much prefer incentives: make the benefit worth twice as much when spent for fresh (or single-ingredient frozen) fruits and vegetables.

How far will the city get with this request?  I can’t wait to find out.  If you want to watch lobbying in action, keep an eye on this one, as I certainly will.

As for this proposal?

The New York Times Magazine has a long article this week about Plumpy’nut,  the peanut butter-based product designed to feed malnourished kids in emergency situations.  The product is made and patented by Nutriset, a French company.

You might think that a food product aimed at saving the lives of starving kids would be uncontroversial, but not when patents are involved.  Nutriset holds intellectual property rights to this product and defends them to the hilt.   The company extends its patent to line extensions of the product, as well.

Patents mean that people in developing countries who want to produce their own product based on local ingredients can’t do it.  It also means that anyone making the product has to follow the formula, even if ingredients are expensive and not locally available.

In September 2007, I wrote about Plumpy’nut, describing how peanut butter had become the basis of a “ready-to-use therapeutic food” (RUTF) for aiding recovery of severely malnourished children in Africa.

The study itself is published in Maternal and Child Nutrition and the authors make the point that people administering this RUTF do not need to be medically trained so this therapy can be used at home. I’m always amazed when researchers discover that feeding malnourished children helps them to recover. Peanut butter is highly concentrated in calories and the investigators mixed in some vitamins along with it, so I guess it can be considered a superfood.

Since then, much has been written about the controversy over this product, particularly about its formula, cost, and sustainability.

Its formula includes:

• Peanut Butter
• Dry Skim Milk
• Vegetable oil
• Powdered sugar
• Minerals & vitamins

It contains about 500 calories in a 92-gram foil package.

Of these calories, one-quarter to one-third are from the added sugar.  No wonder kids like it!

What about its cost? A recent article about local production of Plumpy’ nut in Niger illustrates this particular problem.

UNICEF pays US$60 to purchase and ship a box of 150 packets from the main producer and patent holder of Plumpy’nut, Nutriset, in France. It costs $65 in Niger. The difference adds up to an extra $15,000 for the 3,000 boxes purchased in Niamey every week.

“The luxury of having no production delays and not fully depending on an external provider is a price we are willing to pay,” UNICEF’s nutrition manager, Eric-Alain Ategbo, told IRIN. Ategbo said it took at least eight weeks for the nutritious peanut butter-like paste to arrive from France.

Here are some other cost concerns:

Electricity is expensive, taxes are high and money is expensive as interest rates are high. It would be cheaper if the products we use were bought locally, but they are not available.  Peanuts are the only ingredient from Niger. Others, such as milk, sugar and oil, are purchased internationally. We also have the obligation to buy specific products [such as micronutrients and packaging] from Nutriset in order to respect the formula.

As for its sustainability:

• Who is going to pay for these products?  And for how long?
• Does it make sense to promote a peanut-based product in countries that do not grow peanuts?
• Is it a good idea to give packaged, sweetened products to kids whose families cannot continue to provide such things once the crisis is over?
• Is it a good idea to give kids the idea that sweet things in packages are what they supposed to eat?
• Will products like this pave the way for other sweetened products in packages—soft drinks, for example?

These are all complicated issues.  Read the article and ponder.

Today is Easter Sunday and my monthly San Francisco Chronicle column appears today.  It deals with Michelle Obama’s campaign against childhood obesity.  Enjoy!

Kudos for first lady’s anti-obesity campaign

Nutrition and public policy expert Marion Nestle answers readers’ questions in this monthly column written exclusively for The Chronicle. E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.

Q: What do you think of Mrs. Obama’s “Let’s Move” campaign against childhood obesity? It doesn’t say much about junk food or food marketing. Isn’t this a cop-out?

A: Skeptic that I usually am, I have nothing but applause for Michelle Obama’s decision to adopt childhood obesity as the first lady’s official cause. Lady Bird Johnson’s legacy is the flowers that bloom throughout the nation’s capital. Obama must want hers to be the flowering of better health for our nation’s children.

Yes, Obama is sensitive to political realities. She calls her campaign “Let’s Move” rather than “Let’s Eat Less Junk Food.” But its goals are crystal clear. Her campaign aims to improve food in schools and eliminate “food desert” areas without access to healthier foods.

The White House organic garden is an integral part of this effort. It is no accident that Will Allen, the charismatic head of Growing Power, the group that runs urban farms in Milwaukee and Chicago, spoke at the campaign news conference. Good food, he said, is about social justice. Every child should have access to good food.

This campaign reveals real leadership on a desperately important issue. Obama brings diverse groups to this table. She presses government agencies to take action. She exacts promises from Congress to make it easier for kids to eat low-cost meals in schools. She got her husband to create a task force to tackle ways to prevent childhood obesity.

In addition, she is asking professional and business groups to do more to help kids eat better. I’m particularly impressed by her speech to the Grocery Manufacturers Association, which represents the makers of processed foods and beverages.

With masterful tact, Obama nonetheless insisted that the association “entirely rethink the products that you’re offering, the information that you provide about these products, and how you market those products to our children.” We parents, she said, want assurance that food companies will stop “teaching kids that it’s good to have salty, sugary food and snacks every day.”

Yes, she avoids saying anything about soda taxes or other measures that might make it easier for kids and parents to make better food choices, but she is bringing childhood obesity to public attention in a fresh, new way.

Consider what her campaign is up against. Preventing obesity means eating less, often a lot less, of processed fast-food, snacks and sodas. This puts the makers of such foods in an impossible bind. Eating less is not good for business.

Short of going out of business, what can such companies do to help? They can reformulate their products to make them a little healthier. They can stop marketing their products directly to children. But this, too, is bad for business – unless it can be used for public relations.

Indeed, food and beverage companies are falling all over themselves – with much fanfare – to reformulate and to promise to restrict marketing that targets kids.

PepsiCo, the maker of soft drinks and Frito-Lay snacks, says it will stop pushing sales of full-sugar soft drinks to primary and secondary schools worldwide by 2012. The new policy is voluntary, encourages rather than mandates, and assures school districts in the United States and abroad that the company will not tell them what to supply.

It keeps vending machines in schools and allows for continued sales of branded sugary drinks such as Gatorade, juice drinks, and sweetened milk.

Kraft Foods says it will reduce the sodium in its foods by 10 percent, also by 2012. This sounds good, but has a long way to go. Kraft’s Macaroni & Cheese (the SpongeBob package) contains 580 mg sodium per serving and two servings per package. A 10 percent reduction takes 1,160 mg sodium down to 1,050 mg. Salt is 40 percent sodium, so this brings salt down to 2.6 grams – about half a day’s upper limit for adults.

Still, these are steps in the right direction. Are they meaningful? You decide.

In the meantime, the Center for Responsive Politics, a nonprofit research group focused on the effect of money on public policy, says soda companies have increased by ten-fold the amount of money they spend on lobbying – no doubt to counter the threat of soda taxes.

What are we to make of these responses? They raise my favorite philosophical question: “Is a slightly better-for-you processed food necessarily a good choice?”

What would be better for preventing childhood obesity would be to make eating real foods the default. These, as defined by Oakland’s Prevention Institute, are relatively unprocessed foods that contain nothing artificial. And they are produced in ways that are good for farmworkers, farm animals and the environment, and are available and affordable to all.

Getting to that point requires policy as well as voluntary actions. Perhaps I’m reading too much into Obama’s campaign, but that’s how I interpret it. I’m supporting it. How about you?

Food companies interested in doing something meaningful to prevent childhood obesity are in a bind.  Preventing obesity usually means staying active; eating real, not processed, foods; and reserving soft drinks and juice drinks for special occasions.  None of this is good for the processed food business.  At best, food and beverage companies can make their products a bit less junky and back off from marketing to children.  In return, they can use the small changes they make for marketing purposes.

Perhaps as a result of Michelle Obama’s campaign (see yesterday’s post), companies are falling all over themselves – and with much fanfare – to tweak their products.

GROCERY MANUFACTURERS ASSOCIATION (GMA):  By all reports, GMA members applauded Mrs. Obama’s remarks.  GMA says its member companies are already doing what she asked.

Parke Wilde, a professor at the Tufts School of Nutrition (and food policy blogger), gave a talk at that meeting in a session dismissingly titled,  “The New Foodism.”  His comment:

I enjoyed hearing Michelle Obama’s talk, which was well written and delivered and fairly forceful in places. In my afternoon panel, I said grocery manufacturers would find some threatening themes in books and documentaries promoting local and organic and sustainable food, but that there is also much of substance and value. Then, Susan Borra [Edelman Public Relations] and Sally Squires [Powell Tate Public Relations] in the next session said that grocery manufacturers are frequent subjects of unfair criticism and have nothing to apologize for.

Take that, you new foodists!

MARS must think it knows more than the FDA about how to label food packages.  It is developing its own version of front-of-package labels. It volunteered to put calories on the front of its candies; its multi-pack candies ay 210 calories per serving on the front.  That number, however, remains on the back of the small candy store packs.  Mars’ new labeling plans use the complex scheme used in Europe.  I’m guessing this is a bold attempt to head off what it thinks the FDA might do – traffic lights.

KRAFT announces that it is voluntarily reducing the sodium in its foods by 10% by 2012.  Kraft’s Macaroni & Cheese (SpongeBob package) has 580 mg sodium per serving and there are two servings in one of those small boxes: 1160 in total.  A 10% reduction will bring it down to 1050 mg within two years.  The upper recommended limit for an adult is 2300 mg/day.

PEPSICO announced “a voluntary policy to stop sales of full-sugar soft drinks to primary and secondary schools worldwide by 2012.”  In a press statement, the Yale Rudd Center quotes Kelly Brownell saying that “tobacco companies were notorious for counteracting declining sales in the U.S. with exploitation of markets elsewhere, particularly in developing countries:”

it will be important to monitor whether the mere presence of beverage companies in schools increases demand for sugared beverages through branding, even if full-sugar beverages themselves are unavailable…This appears to be a good faith effort from a progressive company and I hope other beverage companies follow their lead…this announcement definitely represents progress [Note: see clarification at end of post].

According to PepsiCo, this new policy brings its international actions in line with what it is already doing in the U.S.  The policy itself is voluntary, uses words like “encourage,” assures schools that the company is not telling them what to do, and won’t be fully implemented until 2010.  It keeps vending machines in schools and still allows for plenty of branded sugary drinks: Gatorade, juice drinks, and sweetened milk for example.

Could any of this have anything to do with Kelly Brownell’s forceful endorsement of soda taxes?

LOBBYING: The Center for Responsive Politics says food companies spent big money on lobbying last year, and notes an enormous increase in the amount spent by the American Beverage Association (soda taxes, anyone?).  For example:

How to view all this?  I see the company promises as useful first steps.  But how about the basic philosophical question we “new foodists” love to ask: “is a better-for-you junk food a good choice?”

OK.  We have the Public Relations.  Now let’s see what these companies really will do.

Addendum: I received a note clarifying Kelly Brownell’s role in the PepsiCo press release from Rebecca Gertsmark Oren,Communications Director,The Rudd Center for Food Policy and Obesity,Yale University:

The Rudd Center did not work with PepsiCo on their initiative to stop sales of full-sugar beverages in schools worldwide, nor did we jointly issue a press release. A statement released by Kelly Brownell in response to PepsiCo’s announcement was simply intended to commend what appears to be a step in the right direction. As Kelly’s statement also mentioned, there is still plenty of work to be done. It’s also worth noting that the Rudd Center does not take funding from industry.

Just in time for the Albany conference on soda taxes (see previous post), the Beverage Association has issued a report on the great progress it is making in reducing calories from sodas sold in schools.

In fact, the Beverage Association is doing a terrific job on reducing soft drink consumption.  Sales of sodas are down by impressive percentages, but so are sales of all drinks sold in school vending machines, as illustrated by this chart from today’s Wall Street Journal.

Source: Wall Street Journal, 3-8-10

This is good news.  The next steps to improve school food?  Here are a few of my favorites:

• Get the vending machines out of schools altogether, those for snacks as well as sodas.
• Get rid of “competitive” foods, those sold in competition with school meals.
• Put some restrictions on the frequency and quantity of foods brought in for birthdays and other celebrations.
• Institute universal school meals.

If kids don’t buy drinks from vending machines, the schools don’t need them, right?

Update March 9.  Thanks to Coca-Cola for sending a copy of the press release and the final progress report summary.

I had best comment on this before anyone asks.   First Lady Michelle Obama wants to do something about childhood obesity and has gone into action.  She announced her “Let’s Move” initiatives accompanied by much fanfare.  Check out:

• The USDA Secretary’s promise to ask Congress to get junk food out of schools and provide breakfast and lunch to more kids (the New York Times discusses some of the reactions)
• The President’s appointment of a task force on childhood obesity
• The Ad Council’s public service announcements
• USA Today’s neat graphics on rising rates of childhood obesity
• USA Today’s maps of the environment of childhood obesity
• The USDA’s website atlas of the environment of food choice
• The American Beverage Association’s promise to put calories on the front of soft drink packages
• The American Academy of Pediatrics commitment to aid the White House effort
• And the Surgeon General’s Vision that I commented on two days ago

This is big news.  I see much to admire here.  The campaign focuses on kids.  It is sensitive to political realities (it’s called the uncontroversial “Let’s Move,” not the inflammatory “Let’s Eat Less” or “Let’s Eat Better”).  It’s brought a large number of groups on board (the New York Times account emphasizes this point).  It aims to do something useful about school food and food “deserts” (areas without grocery stores).  And it derives directly and explicitly from the White House garden.

I wasn’t able to watch the press conference but I hear that Will Allen was an invited speaker.  Allen is the charismatic and highly effective head of Growing Power, which runs urban farms in Milwaukee and Chicago.  I’m told he said:

• It’s a social justice issue.
• Every child in this country should have access to good food.
• We have to grow farmers.

Yes!

Before the announcement, Marian Burros wrote in Politico.com about the barriers this effort will face (I’m quoted in her article).   And the Los Angeles Times discussed the enormous and enormously successful lobbying effort undertaken by the soft drink industry against soda taxes.  It predicted that the First Lady would not mention soda taxes when she announced her obesity campaign.  Indeed, she did not.

But she did say:

The truth is our kids didn’t do this to themselves.  Our kids didn’t choose to make food products with tons of fat and sugar and supersize portions, and then to have those foods marketed to them wherever they turn.

So let’s call this campaign a good first step and give it a big round of applause.  I hoping everyone will give it a chance, help move it forward in every way possible, and keep fingers crossed that Mrs. Obama can pull it off.

The research demonstrating the not-so-great effects of sodas just pours in, as it were.  The Robert Wood Johnson Foundation has two new research reports, one on justification for taxation of soft drinks, and the other on the negative effects of soft drinks on kids’ health.

David Ludwig writes in JAMA that artificially sweetened drinks are unlikely to help the situation.  They just make people want sweeter foods.

And the New York City Health Department has put its anti-soda campaign online.   This is its controversial “drinking fat” campaign designed to make the point that excess calories from sugary soft drinks will put on the pounds.  Why controversial?  Take a look at the cute guy demonstrating the drinking-fat point on the YouTube video.

What’s your take on this?