Why Can’t We Be Friends? Combating Obesity and Hunger Together!

Closing the Hunger Gap: Nourishing Beyond

Calories September 20, 2013

• Amy Lazarus Yaroch, Ph.D.

About Us

The Center is an Omaha based independent non-profit research organization providing nutrition research, evaluation and partnership

in: childhood obesity prevention, food insecurity, and local food systems

www.centerfornutrition.org www.facebook.com/centerfornutrition

http://twitter.com/GretchenSwanson

Gretchen Swanson Center for Nutrition

Research Areas

Overview

Obesity

Food Insecurity

The Food Insecurity and Obesity Connection

Obesity in the U.S.• Coronary heart disease • Type 2 diabetes • Stroke • Cancers• High blood pressure• High levels of triglycerides • Liver and Gallbladder disease • Sleep apnea • Respiratory disease

Impact on Children

Impact on Children

23 million children/adolescents

Obesity, Adolescents 12-19 Years, US, 1976-20063

Obesity has Changed our Social Norms

Food Insecurity Prevalence, Correlates and Outcomes

Impact on Children

• Under-nutrition• Developmental issues• Cognitive issues• Psychosocial issues• Physical impairments• Poor academic performance

Food Insecurity

Location

Race-Ethnicity

Poverty

EducationFamily Size

Sex

Marital Status

• In 2011 51.1 Million People (14.9%) in Food Insecure Households

• 8.2 Million Children Food Insecure

The Intersect of Hunger and Obesity

Coexistence of Food Insecurity and Obesity

• Poverty• Poor Education• Marital Status• Other Indicators of

Socioeconomic Status

Shared risk factors

• Location• Race/Ethnicity • Non-Hispanic Blacks• Blacks

Common Population Burden

• Food deprivation – overconsumption

• Nutrition deficiencies – weight gain

• Episodic food shortages - increased body fat

Biological Mechanisms

• Limited variety of foods• Low cost high energy

foods• Fewer fruits and

vegetables

Behavioral Mechanisms

Food Insecurity

Food Insecurity

ObesityObesity

MalnutritionMalnutrition

Poor Dietary Quality

Poor Dietary Quality

Hunger and Obesity Movements in Parallel

Obesity and Hunger: Which is more important?

CNN:Global report: Obesity bigger health crisis than hungerObesity is a bigger health crisis globally than hunger, and the leading cause of disabilities around the world…

The Times:Obesity kills more than hunger in march of ‘progress’ Obesity has become a bigger threat to global health than child hunger, according to a major study.

Public Health Daily No: 309:780 THE WORLD’S FAVORITE NEWSPAPER September 5, 2013

VS.

Business Week:The Global Obesity BombIt may seem strange to be worried about too much food when the United Nations suggests that, as the planet’s population continues to expand, about 1 billion people may still be undernourished. Although there are good reasons to think the 1 billion estimate might be exaggerated, it is clear that hundreds of millions do still regularly go to sleep hungry.

Journal of Paradoxical RelationshipsSeptember 2013 Volume 100/ Number 2 ISSN 0025-8215A premier source for the intersection of obesity and hunger.

253 Opportunities to Reduce Childhood Hunger and ObesityRestructuring the Supplemental Nutrition Assistance Program (the Food Stamp Program) David S. Ludwig, MD, PhD; Susan J. Blumenthal, MD, MPA; Walter C. Willett, MD, DrPH JAMA. 2012;308(24):2567-2568. doi:10.1001/jama.2012.45420

First Foods Most: After 18 Hour Fast, People Drawn to Starches First and Vegetables Last Brian Wansink, PhD; Aner Tal, PhD; Mitsuru Shimizu, PhDArch Intern Med. 2012;172(12):961-963. doi:10.1001/archinternmed.2012.1278.

The global obesity pandemic: shaped by global drivers and local environmentsBoyd A Swinburn MD, Gary Sacks, PhD, Kevin D Hall PhD, Klim McPherson PhD, Diane T Finegood PhD, Marjory L Moodie, DrPH, Steven L Gortmaker PhD. The Lancet, Volume 378, Issue 9793, Pages 804 - 814, 27 August 2011 doi:10.1016/S0140-6736(11)60813-1

SNAP and Public Health: The Role of the Supplemental Nutrition Assistance ProgramIn Improving the Health and Well-Being of AmericansFood Research and Action Councilhttp://frac.org/pdf/snap_and_public_health_2013.pdf

361

366

372

Potential Reasons for Lack of Evidence for Food Insecurity and Obesity in Kids

• Mainly cross-sectional studies• Not examining all the relevant factors in same

study• Measurement issues and defining

measurement at the individual (hunger) and household (food insecurity) levels

Could we, should we…. compare?

Geographic Distribution - Obesity

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

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Source: Behavioral Risk Factor Surveillance System (BRFSS, 2008)

Geographic Distribution - Food Insecurity

Below U.S. average U.S. average Above U.S. average

Geographic Distribution – PovertyPercent of People Below Poverty Level in the Past 12 Months

Source: U.S. Census Bureau, 2006-2008 American Community Survey

Geographic Distribution of Everything Else

Consumption

Convenience

Cost Taste

Nutrition Knowledge

Convenience

•Decrease Portion Sizes

•Packaging Solutions•More “Grab and Go” for Healthier food Options

Cost

•Reformulation of Products

•Decease price for Healthy and Increase for Unhealthy Foods

Taste

•Keep Taste and Good Nutrition in Mind

•Make Gradual Shifts Knowledge

•Provide Understandable Food Labels

•Increase Knowledge of Recommendations

•Teach People to Cook

Convenience-CostTradeoff

Taste-NutritionTradeoff

Sources: Wansink, B., Huckabee, M. De-marketing obesity. 2005. California Management Review, 47: 1-13; Yaroch, A, Pinard, C. 2012. Arch Intern Med 172(12):963-964; Wansink B, Tal A, Shimizu M. First foods most: after 18-hour fast, people drawn to starches first and vegetables last. Arch Intern Med. 2012;172(12):961-963

Short-term food deprivation

Over-consumption of Calorie Dense Food

The experience of food insecurity, and periods of deprivation, may change how individuals consider these tradeoffs and their subsequent food choices.

Pressing Issues

•Agricultural Policy•Transportation Policy•Poverty Policy•Food Policy

Policy Interventions

•Resource awareness campaigns•Educational campaigns

Mass Marketing Campaigns

•Increase participation in Food Assistance (e.g., SNAP)

Programs through National Organizations

•Promote food system participatory planning (Food Policy Councils)•Promote food democracy/social justice (EBT at Farmers Market, Double Up Food Bucks)

Community-wide engagement

•Farmers Markets, community gardens, or mobile carts or trucks that sell fruits and vegetables.

Groups working together (e.g., church, schools)

•Education/skill building

Individually tailored programs

Policy

Community/ Organizations

Family/Home

Individual

Call to Action

Questions?