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The Rudd Center Health Digest

March 2014

Headline Battle: Have Changes to WIC Improved Children’s Health? 

Despite conflicting news coverage of CDC findings, evidence suggests that policy changes are having a positive impact on the health of children.

A CDC press release in February pointed to indications that obesity among young children is decreasing. The study, using nationally representative NHANES data, found that although obesity rates remained stable across most age groups, there was a significant decrease among children aged 2 to 5 years. 

The CDC study was widely reported in the press, and many experts, including Rudd Center Director Marlene Schwartz, PhD, speculated that this change could be due in part to improvements in the Special Supplemental Nutrition Program for Women Infants and Children (WIC).

A Reuters story released on March 16th dismissed the study, quoting a number of experts pointing to the small sample size and the margin of error. The authors of the CDC paper acknowledged these limitations, however, and warned that these results should be "interpreted with caution."

The Reuters story also cited studies indicating there is little to no improvement to children’s health due to changes in the WIC food package. Rudd Center researchers examined these studies closely, and found that the data suggest a number of positive effects of the WIC package changes. In fact, researchers assert that federal changes to the WIC policy have improved nutrition, and are showing signs of reducing obesity among young children.

"This story turned into a battle over headlines," said Schwartz. "While the public needs to know the state of the science on obesity, we need to do a better job representing the whole story. This was an example of highlighting one finding and ignoring the rest of the data. Despite the discouraging findings that obesity rates are not improving overall, there is evidence from this study and others that this generation of very young children is not as likely to become obese before age 5 as previous cohorts. There are a handful of studies on how purchasing and consumption changed after the 2009 WIC program, which support the position that those changes helped move us in the right direction."

FDA Updates Nutrition Facts Label 

To provide consumers with nutrition information that reflects the latest science on the link between diet and chronic diseases such as obesity and heart disease, the Food and Drug Administration has proposed changes to labels on food packages for the first time in 20 years. The proposed re-design aims to make it easier for consumers to make healthier choices.

The proposed Nutrition Facts Label would replace out-of-date serving sizes with those that better align with how much people really eat, and feature a simple design to highlight key parts of the label, such as calories and serving sizes.

Among the proposed changes to the Nutrition Facts Label: 

• Calories would be in a larger, bolder font.

• The "sugars” category would include a separate number for grams of added sugar. Currently, naturally occurring and added sugars are reported as one number. Breaking it down reflects the growing concern over the amount of added sugar people consume from processed food.

• "Calories from fat" would be eliminated, but total fat, saturated, and trans fats would remain, reflecting research which shows that the type of fat consumed is more important than the amount.

• Serving sizes would be more prominent and would more accurately reflect the portion sizes people actually consume.

• Vitamin D and potassium would be listed instead of vitamins A and C, reflecting growing concern that people are not consuming enough of these nutrients.

"The proposed label would be a significant improvement over the outdated one," said former Rudd Center Research Associate, Christie Munsell, MS, RD. "Our eating habits have changed over the last two decades and the proposed changes reflect the reality of the modern diet, and are consistent with the Dietary Guidelines and latest research on nutrition."

The inclusion of added sugars to the label is one of the most significant changes, asserts Munsell. The Dietary Guidelines state that intake of added sugar is too high in the U.S. population and should be reduced. According to the FDA, Americans eat 16 percent of their daily calories from added sugar.

"The Rudd Center has recommended that an 'added sugar' line be included on the label because it’s hard for consumers to determine how much sugar is naturally occurring in an item versus how much is added by the manufacturer," said Munsell.

Organizations, industry groups, and the general public will have 90 days to comment on the proposed changes. The FDA estimates it will cost the food industry $2 billion to implement these changes, but also forecasts a $20-30 billion public health benefit, according to ABC News.

Leading Childcare Provider Implements Wellness Policies Using Rudd Center Tool  

Learning Care Group, the second largest private childcare provider in North America, has committed to creating healthier environments at 900 of their schools across the country.

The childcare provider will work with the Partnership for a Healthier America to implement standards that align with Let's Move! Child Care goals for physical activity, screen time, food, beverages, infant feeding, and parent engagement.

The standards will be shaped in part by the Wellness Child Care Assessment Tool, a resource developed by researchers at the Rudd Center and the Harvard School of Public Health that help childcare providers assess and implement stronger wellness policies in childcare settings.  

Upcoming Rudd Center Seminar Speakers

April 2, 2014, 12:30 pm
William R. Spencer, MD
Suffolk County Legislator
The Politics of Public Health Policy

April 9, 2014, 12:30 pm
Faith Boninger, PhD
Research Associate, National Education Policy Center, University of Colorado, Boulder
Examining Trends in Schoolhouse Commercialism  

Subscribe to our mailing list to receive reminders of upcoming seminars and schedule changes.

Unless otherwise noted, seminars are held at the Rudd Center. The seminars are free and open to the public. Seating is limited. The full schedule for the Spring Seminar Series is available online and for download.

Soda Industry Plays a Role in News Coverage of Soda Tax Measures

The soda industry influenced news coverage of two soda tax ballot measures in the cities of Richmond and El Monte, California, according to a report recently released by the Berkeley Media Studies Group (BMSG). Researchers analyzed news articles and industry publications from November 2011 to January 2013 and found that the soda industry infiltrated news stories while camouflaging its identity.

According to BMSG, the industry recruited a broad range of community spokespeople to voice an anti-tax position on its behalf but did not reveal itself as the funding source. The researchers assert that this allowed soda companies to distance themselves from the political debate and create the appearance that opposition to the taxes came from within the community, rather than from an industry-funded PR campaign.

The study also found that the soda industry, which spent $4 million to defeat the proposals, exploited existing class- and race-based tensions to portray the tax as financially ruinous and regressive. The industry claimed — sometimes directly and sometimes through community spokespeople — that it would be financed on the backs of the cities’ poorest residents, according to the authors.

The study includes recommendations for journalists on ways to improve coverage of soda taxes, as well as lessons from Richmond and El Monte that advocates can use to push for soda taxes in other cities.

BMSG co-hosted a tweet chat with the Rudd Center on March 6 about the study, which is archived on Storify here.  

Smart Snacks Product Calculator Launched 

The Alliance for a Healthier Generation has launched the Smart Snacks Product Calculator, a tool that takes the guesswork out of evaluating products based on the new USDA Smart Snacks in School Guidelines.

Users can enter product information, answer a few questions, and determine whether a snack, side, or entrée item meets the new USDA guidelines. Results from the calculator have been determined by the U.S. Department of Agriculture to be accurate in assessing product compliance with the federal requirements for Smart Snacks in School.

National Soda Summit Scheduled

The Center for Science in the Public Interest will host the 2nd National Soda Summit on June 4-5, 2014, at the National Press Club in Washington, DC. Participants, including advocates, researchers, and state and local officials, will learn the latest on taxes, warning labels, portion sizes, procurement policies, and marketing reform efforts across the country. Click here for more information and to register.

Just Published by the Rudd Center

Impact of Financial Incentives for Employee Wellness Programs 

The majority of employers who offer health insurance also offer employee wellness programs such as smoking cessation groups and walking programs to encourage employees to achieve health goals. One approach that is increasingly being used to incentivize employees is to pay them through insurance rebates for achieving their goals.

In a recently published commentary in the American Journal of Preventive Medicine, authors Rebecca Puhl, PhD, Rudd Center Deputy Director, and Lenny Lesser, MD, MSHS, Assistant Research Physician at the Palo Alto Medical Foundation Research Institute, discuss the effectiveness of these programs.

According to the authors, monetary incentives can help employees begin to make healthy changes, but these changes are difficult to sustain in the long term. "These programs do not address key factors that impact public health: marketing, pricing and the easy availability of unhealthy food," according to lead author, Lenny Lesser. "It also unfairly places the responsibility on individuals to change health indices over which they have little personal control. Ignoring environmental and biological forces that contribute to obesity can undermine a program’s ability to help people reach weight outcomes or change health behavior."

The authors suggest instead that employers create a healthier work environment. Strategies such as providing time and space for physical activity or removing sugary drinks would make it easier for employees to engage in healthy behavior in the workplace, and would prevent the stigmatization and ethical problems associated with incentivizing weight loss.

“People-First” Language Should be the Standard  

Using stigmatizing language to describe people with obesity or referring to them as "the obese" can contribute to the already pervasive weight bias present in health care settings, according to a recently published commentary in the journal Obesity. The authors assert that people-first language should be the standard to describe people with obesity.

"By addressing the disease separately from the person—and doing it consistently—we can pursue this disease while fully respecting the people affected," say authors Theodore Kyle, RPh, MBA, founder of ConscienHealth and Rebecca Puhl, PhD, Rudd Center Deputy Director.

The Obesity Society and all members of the Obesity Care Continuum have adopted people-first language as the standard for their publications and programs.  

Front Burner News

Obesity Linked to Lower Academic Achievement among Teen Girls

Not only does obesity affect a child's overall health, but it may also lead to poorer school performance among teenage girls, according to a study published in the International Journal of Obesity. Read more.

Healthier School Lunch Guidelines Increase Consumption of Produce 

New federal school meal standards which require schools to offer healthier choices to students appear to have had a positive impact on fruit and vegetable consumption among US school children, according to a study published in the American Journal of Preventive MedicineRead more.

Sugar Consumption Declines among Americans 

Americans’ estimated consumption of sugar is nearly 14% lower than it was at its peak in 1999, when the average American consumed nearly 422 calories per day in sugar and other sweeteners, according to data from the USDA. The Rudd Center’s Director attributes the decline to fewer sugary drinks in schools. Read more.

WHO Lowers Sugar Intake Recommendations

The World Health Organization has lowered its sugar intake recommendations from 10% of daily calories to 5%. Read more

Effects of Fried Foods Greater in People with Genetic Predisposition to Obesity

  

People with a high genetic risk for obesity experience bigger changes in their body mass index from eating fried food than people with a lower risk, according to researchers from the Department of Nutrition at Harvard School of Public Health. Read more.

Exposure to Fast Food Restaurants Increases Obesity Risk 

People exposed to fast food establishments near their homes, workplaces, or during their commute, are much more likely to consume fast food, according to a study published in BMJ. Read more.

Sugar Free Kids Coalition Formed 

The Maryland State Medical Society, the American Heart Association, the NAACP, and the Horizon Foundation recently announced the formation of Sugar Free Kids, a state coalition to reverse the epidemics of childhood obesity and teen diabetes. Read more

"Healthy Stores for a Health Community" Launches in California 

The Healthy Stores for a Healthy Community campaign is a statewide collaboration between tobacco use prevention, nutrition, and alcohol prevention partners which aims to improve the health of Californians. Read more.  

Puerto Rico Introduces Obesity Prevention Bills 

Senate President Eduardo Bhatia has introduced two bills to combat obesity and safeguard children’s health in Puerto Rico. Read more.  

VOICES

Junk Food Makers Educate Dietitians 

Junk food makers, often blamed for fueling the nation's obesity rates, also play a role in educating the dietitians who advise Americans on healthy eating, according to Candice Choi, reporter for the Associated Press. Read more.

Rethinking Our "Right" to Dangerous Behaviors 

Mark Bittman, New York Times reporter, discusses our individual right to make bad choices versus our collective right to enjoy clean air, unprocessed food, fuel-efficient cars, safe public spaces, and freedom from Big Pharma. Read more.

Big Food Braces for Big Changes 

The food industry is bracing for an onslaugt of changes that are expected to cost billions and involve both reformulating products and disclosing more information to consumers, according to Helena Bottemiller Evic and Tarini Parti, reporters for POLITICO. Read more.

Big Soda’s Enduring Myth 

"All calories are created equal" is one of Big Soda’s most enduring myths, according to Dana Woldow, school food activist. However, research shows that our bodies process liquid calories differently from food calories. Read more

SUGAR-SWEETENED BEVERAGES/TAXES

Soda Tax Linked to Reduced Consumption 

A 20% price increase on sugary drinks from a tax would cause consumers to spend nearly 4% less per month on the drinks, and their household caloric intake would decline by roughly 5%, or about 4,779 calories, according to economists at Stanford and Cornell. Read more.  

Big Soda Arrives in San Francisco 

Big Soda has responded to a bill that would tax sugary beverages at two cents per ounce by setting up a front group called, "The Coalition for an Affordable City." Read more.

American Beverage Association Spends to Defeat San Francisco’s Soda Tax  

Since January 2014, the ABA has spent more than $400,000 to defeat the San Francisco soda tax, according to Choose Health SF, a political committee organizing to pass the sugary beverage tax. Read more

FOOD MARKETING

Report Shows Lack of Concern for School Commercialism

State legislatures are doing little to protect children from rampant in-school marketing which threatens their physical and pyschological well-being, and the intergrity of their education, according to a report from the National Education Policy Center. Read more.

Effects of Ads Targeting Kids Linger into Adulthood 

When companies advertise to kids using mascots or characters, love of the brand and feelings that the product is wholesome and healthful can persist well into adulthood, according to a study coming out in the June issue of the Journal of Consumer Research. Read more.    

End Tax Deductions for Marketing Junk Food to Children

US Representative Rosa DeLauro has introduced legislation to end tax breaks that subsidize the marketing unhealthy choices. Read more.