How the twisted U.S. food system feeds a national epidemic

June 13, 2016

Editor’s note: This post is part of a weekly, year-long series called the Nourishing Effect. It explores how hunger affects health through the lens of the 2016 Hunger Report. The report is an annual publication of Bread for the World Institute.

By Bread for the World Institute staff

The FDA announced last month new food labeling regulations that will help Americans more easily decipher the true nutritional quality of food products. Most promising changes include bolder labeling of calorie content, adjusting unrealistic portion sizes to better reflect actual consumption habits, and displaying the grams and percent daily value of added sugars. Lobby groups for food and beverage industries—especially the sugar lobby—fought viciously to deny consumers this basic information. Our twisted food system is feeding a national obesity epidemic, but the healthcare sector can be a powerful force in shifting priorities away from profits and toward health. The 2016 Hunger Report explains:

What is behind Americans’ poor diets? One major factor is the way the U.S. food system is set up. Our farmers are very productive: between the early 1980s and 2000, the number of calories available per person per day increased from about 3,300 to 3,900. The problem is that the additional calories came predominantly from added fats and sugars. Since the first Dietary Guidelines for Americans were issued in 1980, per capita consumption of fruits and vegetables has barely changed. Meanwhile, between 1980 and 2000, obesity rates doubled among adults and tripled among children. These increases coincided with the changes in the food supply.

In 2012, the average American consumed more than 20 teaspoons of sugar per day. That is almost double the USDA recommended allowance, and more than double and triple the American Heart Association’s recommended amounts for men and women respectively. A 2014 report by the Environmental Working Group analyzed 80,000 food products sold in supermarkets around the nation and found that 58 percent had added sugar. This included at least 75 percent of deli meats, just one class of products consumers might be surprised to learn have been sweetened.

Beverages are the biggest source of added sugar in the U.S. diet, and the linkage between obesity and overconsumption of sugar-sweetened beverages is scientifically proven. The 10 largest food and beverage companies spend billions of dollars each year to convince Americans to consume more sugar, with soft drinks and other sugar-sweetened beverages leading the way. Research shows that children are innately more receptive to sweet tastes than adults. The food industry spends more than $1 billion annually on youth-directed advertising. Soft drinks, cereals, candy, and sugary snacks account for the largest share. The Institute of Medicine (IOM) has criticized marketing practices directed at children and youth. A 2006 report concluded that “food and beverage marketing practices geared to children and youth are out of balance with healthful diets, and contribute to an environment that puts their health at risk.”

The food and beverage industry's deep pockets

Policy responses to obesity thus far have predominantly emphasized education and personal responsibility, making people aware of the health consequences and encouraging them to adjust their lifestyle and be more mindful of what they consume. “The food industry supports this conceptualization with considerable resources,” says Kelly Brownell, dean of Duke University’s Sanford School of Public Policy, “to train the spotlight away from the parties producing, marketing, and selling food to those consuming it.”

In 2003, U.S. sugar producers threatened to pressure Congress to withhold $406 million in U.S. contributions to the World Health Organization (WHO) after WHO issued a report advocating that people limit their intake of products with added sugars. The food and beverage industry is a generous contributor to members of Congress, and it spends millions more on lobbying. In 2014, the industry spent a total of $32.2 million on lobbying, with Coca-Cola and Pepsi leading all individual contributors. We can say without reservation that Congress may have been too good a friend to the industry. The Personal Responsibility in Food Consumption Act, also known as the “Cheeseburger Bill,” was a bill in Congress designed to ban lawsuits against the fast-food industry. The bill passed in the House of Representatives in 2005 before it failed in the Senate. Since then, versions of it have been adopted in more than 20 states.

The American Beverage Association, a lobbying group for the soft drink industry, has been remarkably successful in defeating proposed taxes on soda and other sugar-sweetened beverages, maintaining that the taxes infringe on people’s freedom of choice. In 2009, the association spent $19 million lobbying to defeat a proposed soda tax in the ACA that would have helped fund the fight against obesity.

Public health groups are frustrated, which is why SNAP has become entangled in policy debates about how to address the nation’s obesity epidemic. In 2013, a letter to the Secretary of Agriculture signed by dozens of public health groups proposed allowing states to conduct pilot projects to collect the data “needed to make an informed decision concerning ways to improve the nutritional quality of purchases through the SNAP program.” States cannot regulate what SNAP recipients purchase without a waiver from USDA. State and local policymakers from several areas of the country have sought waivers to restrict purchases of soft drinks and other sugar-sweetened beverages with SNAP benefits. USDA has rejected all of these.

Regardless of how well intentioned they may be, the proposals to restrict SNAP purchases to fight obesity are misplaced. Studies show SNAP does not increase the risk of obesity. Obesity develops over years. Although some households have to rely on SNAP for years at a time, USDA reports that half of all new SNAP recipients leave the program within 10 months. USDA found SNAP recipients no more likely to consume sugar-sweetened beverages than eligible nonparticipants. Because SNAP benefits are intended to cover only a portion of food purchases, anyone who wanted restricted beverages could purchase them with their own money. Finally, restrictions could end up doing more harm than good by increasing the stigma associated with the program.

Regulate sugar, not the poor

A tax on all consumer purchases of sugar-sweetened beverages would address the obesity epidemic more equitably and have a much better chance of achieving lasting impact. Taxes on other products, such as alcohol and tobacco, are used to promote public health goals. In 2011, Brownell and colleagues at the Rudd Center for Food Policy and Obesity reported that a nationwide tax of one penny per ounce on all sugar-sweetened beverages would generate $80 billion nationally over five years.

In 2013, Mexico surpassed the United States as the most obese nation in the world. On January 1, 2014, the country imposed a 10-percent tax on sugar-sweetened beverages that affected all consumers. The Mexican National Institute of Public Health and the University of North Carolina reported that the tax led to a 6 percent reduction in consumption for 2014 as a whole, and the reduction was as much as 12 percent by the later months of the year.

Some of the revenue from a tax on sugar-sweetened beverages in the United States could be used to provide incentives to SNAP participants to purchase healthy foods. Incentives, although not widely tested in SNAP, have been shown to work. In 2011 and 2012, USDA conducted an experiment in Hampden County, Massachusetts, the Healthy Incentives Pilot, providing a randomly assigned group of SNAP recipients with an additional 30 cents for each dollar of SNAP benefits spent on fruits and vegetables. Compared to a control group, SNAP participants in the incentive program spent an additional 11 percent on fruits and vegetables. Three-quarters of the households receiving the benefit reported that fruits and vegetables had become more affordable due to the incentive and were more inclined to purchase them in higher quantities.

The food and beverage industry is a powerful lobby, but so is health care. By 2013, the healthcare sector was the dominant source of employment in 35 states. Hospitals are the second largest employer in the private sector, supporting one in every nine jobs in the United States. Health care’s more vocal advocacy to end hunger and improve health could help turn the policy tide, shifting national priorities away from favoring corporate profits and toward pursuing the health and wellbeing of the U.S. population.

This article originally appeared in Chapter 2 of the 2016 Hunger Report: The Nourishing Effect. Read the full report and find references for the information shared above.

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