Change Food Policy, Change the World

Glennah Trochet M.D.Grace Presbyterian ChurchFrom Farm to Every Fork

State Policy Reforms to Address Childhood Obesity

CA Conference of Local Health OfficersDecember 1, 2005

Harold Goldstein, DrPHExecutive DirectorCalifornia Center for Public Health Advocacy

Outline

• Historical perspective• Overview of our food system• Food inequities • What can we do?

Prehistory

• For 200,000 years Homo sapiens were hunter/ gatherers

• 70,000 BC migrated from Africa to other continents

http://cironline.org/reports/timeline-food-through-ages-2972

Prehistory

• 9,500 BC Wheat and barley grown with domestication of farm animals

• 8,000 BC Potatoes in Peru, Maize in Mexico• Population: 10 million

http://cironline.org/reports/timeline-food-through-ages-2972

Early history

• 6,000 BC Irrigation in Egypt and Persia doubles crop yields.

• 5,000 BC rice in Africa• 4,000 BC plow invented in Sumeria, makes

planting easier• 100 BC trip hammer in China pounds and

polishes grain• 500 BC population 100 million

http://cironline.org/reports/timeline-food-through-ages-2972

Ancient and Medieval Times

• Population 200 million at the birth of Christ• 1100 Windmills used to grind grain in Europe• 1200 Draft horses help cultivate larger areas• 1315-1322 Great famine in Europe• 1346-1351 Black Death kills 70% of population• 1492 discovery of America and transfer of

plants, animals and microbes world wide• 1600 Population 500 million

http://cironline.org/reports/timeline-food-through-ages-2972

The Enlightement

• 1650 Cattle ranches in the new world• 1700-1850 Advances in mechanization of

agriculture decrease need for human effort• 1789 People are getting bigger• 1840 Chemical fertilizers• 1846-1847Irish potato famine• 1889 Milking machines• 1804 Population 1 billion

http://cironline.org/reports/timeline-food-through-ages-2972

First half of 20th Century

• 1892 Tractors• 1921 hybrid corn• 1927 Population 2 billion• 1932-1934 Soviet famine 7 million die• 1933 Twinkies marketed• 1945 Pesticide use surges• 1948 First McDonald’s opens• 1959 Population 3 billion

http://cironline.org/reports/timeline-food-through-ages-2972

2nd Half of Twentieth Century

• 1960 New varieties of grains combined with fertilizers and irrigation boost crop yields in Asia and Latin America

• 1962 Silent Spring is printed warning of the unintended consequences of pesticide use

• 1974 Population 4 Billion• 1976 High Fructose Corn Syrup declared safe to

use as food.• 2011 Population 7 billion

http://cironline.org/reports/timeline-food-through-ages-2972

Table 1. Global and regional per capita food consumption (kcal per capita per day)

Region 1964 - 1966 1974 - 1976 1984 - 1986 1997 - 1999 2015 2030World 2358 2435 2655 2803 2940 3050Developing countries

2054 2152 2450 2681 2850 2980

Near East and North Africa

2290 2591 2953 3006 3090 3170

Sub-Saharan Africaa

2058 2079 2057 2195 2360 2540

Latin America and the Caribbean

2393 2546 2689 2824 2980 3140

East Asia 1957 2105 2559 2921 3060 3190South Asia 2017 1986 2205 2403 2700 2900Industrialized countries

2947 3065 3206 3380 3440 3500

Transition countries

3222 3385 3379 2906 3060 3180

WHO : Global and Regional Food Consumption Patterns and Trendshttp://www.who.int/nutrition/topics/3_foodconsumption/en/

From subsistence farming to industrial farming

• SF: Growing crops and animals to feed your family and maybe sell a little

• IF: Growing crops and animals in large amounts to sell. Use of fertilizer and pesticides, antibiotics in cattle, made this mode of farming possible.

• Processing food allows for a longer shelf life.• Transportation routes make it possible to send

food large distances away from where it is produced to sell.

Glossary• BMI: Body Mass Index, calculated by dividing weight in Kg by Height in M• Obesity: BMI equal to or greater than 30• Overweight: BMI between 25.1 and 29.9• Farm Bill: Federal law that governs many agricultural and food programs• Food desert: an area that lacks access to affordable foods that make up the

full range of a healthy diet (USDA: 1 mile or more away)• High Fructose Corn Syrup: sugar made from corn, works as a preservative

and is cheaper than cane sugar• Processed food: Commercially prepared food designed for ease of

consumption• Food insecurity: Lack of consistent access to adequate food at times

during the year due to lack of money and other resources. • Food Justice: Equity or fairness in the food system• BRFSS: Behavioral Risk Factor Surveillance System run by CDC, largest

annual survey of its kind in the world.

$15 billion annually

Doubled from 1992-1997

4 out of 5 ads are for sugary cereals, snack

foods, candy, soft drinks, and fast food

$1.79 billion annually on television only In 2009 cross marketing increased from 80 children’s movies in 2006 to 120 in 2009

4 out of 5 ads are for sugary cereals, snack foods, candy, soft drinks, and fast food

According to the FTC quality of food improved slightly from 2006 to 2009

Junk Food Marketing

SUPERSIZING

Food Access

We make food and activity choices in the context of our environment

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Prevalence* of Self-Reported Obesity Among U.S. AdultsBRFSS, 2012

*Prevalence reflects BRFSS methodological changes in 2011, and these estimates should not be compared to those before 2011.

15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35%

Self-Reported Obesity Among U.S. Adults in 2012

No state had a prevalence of obesity less than 20%.

Nine states and the District of Columbia had a prevalence between 20–<25%.

Thirteen states (Alabama, Arkansas, Indiana, Iowa, Kentucky, Louisiana, Michigan, Mississippi, Ohio, Oklahoma, South Carolina, Tennessee, and West Virginia) had a prevalence equal to or greater than 30%.

http://www.cdc.gov/obesity/data/adult.html

INSTITUTE OF MEDICINE

“It is unreasonable to expect that people will change their behavior easily when so many forces in the

social, cultural, and physical environment conspire against such

change.”

Personal Responsibility

VS

Community Responsibility

Individual Will Power

or

The Environment

Individual Will Power

INN

Public Policy

The EnvironmentThe social, economic, and political

context in which we make our food and activity choices

Public Policy

What Can We Do?

Individual Will Power

• Buy fresh food and cook instead of eating pre-packaged food

• Home, school, community gardens• Drink water instead of sugary drinks• Know where your food is grown• Education

Foods that contain High Fructose Corn Syrup

• Bread• Peanut butter • Ketchup • Tomato sauce• Soda• Fast food • Cereal • Salad dressing

• Yogurt• Sauces • Jam/jelly • Ice cream

Local Food Policy

• Grocery stores with fresh fruit and vegetables• Farmers markets• Economic development?• What kinds of restaurants are in our

neighborhood?• Food banks• Remove toys from children’s meals with low

nutritional value

http://www.sacog.org/rucs/farmers-markets.cfm

Statewide Food Policy

• Ban on sodas in schools• Listing calories on menus• Rules for “organic” food• Nutrition standards for school lunches• Regulation of how food is produced

(pesticides, fertilizers, antibiotics used)

SB 12 (K-12 Food Stds)

SB 965 (High School Beverages)

SB 19 (Nutrition Standards, 2001)

SB 1520 (Soda Tax, 2002)

LAUSD (Soda, Junk Food, 2002-3)

SB 677 (Soda Ban, 2003)

Not Yet

All schools K-12

Policy Reforms (2001–2005)

K-8

Pilot Test Standards

Federal Food Policy

• Subsidies for certain crops (corn but not fruit)• Food transportation • Food imports• Regulation of industrial agriculture• Tax structure• Nutritional standards for food marketed to

children

How You Can Affect Food Policy

• Speak at public meetings on issues you care about:– Planning commissions– Board of Supervisors, City Councils

• Join a group that advocates for what is important to you

• Support candidates that agree with your views• Vote• Run for school board, planning commission, etc

Some Next Steps In Public Policy Enforce quality PE in schools K-12 Ensure access to fresh/healthy products in low

income neighborhoods and workplaces Design communities to promote activity Eliminate advertising of junk food to children Provide health plan benefits: nutrition education,

counseling, weight-loss Promote breastfeeding, eliminate hospital

marketing of formula.

Groups That Work on Food Policy

• California Food Policy Advocates http://cfpa.net/

• Sacramento Region Food System Collaborative http://valleyvision.org/projects/sacramento-region-food-system-collaborative

• Hunger Hits Home report http://valleyvision.org/projects/hunger-hits-home

• California Center for Public Health Advocacy http://www.publichealthadvocacy.org/

References• http://www.sustainabletable.org/704/high-fructose-corn-syrup-if-this-doe

sn-t-convince-you-nothing-will• http://sweetsurprise.com/what-is-hfcs (industry web site)• http://www.yaleruddcenter.org/what_we_do.aspx?id=4• http://www.ftc.gov/reports/review-food-marketing-children-adolescents-f

ollow-report• http://www.ncbi.nlm.nih.gov/pubmed/22946146 Infant feeding and

obesity risk in the child Breastfeed Rev. 2012 Jul;20(2):7-12• http://www.publichealthadvocacy.org/• http://cironline.org/reports/timeline-food-through-ages-2972• http://www.cdc.gov/Obesity/• http://www.jhsph.edu/research/centers-and-institutes/teaching-the-food-

system/