Tuesday, August 25, 2015

Guest Post: Food Policy is not About Sexy Results (by Dan Taber)

Today's guest post if by Dr. Dan Taber. I've been following Dan on Twitter for some time and have always enjoyed what he's had to say. When he recently published a study on school food, I reached out and invited him to write a guest post. He kindly obliged.

Food Policy Is Not About Sexy Results

Well … there’s good news and bad news.

It’s not the sexiest opening line when I’m discussing my research. Nobody who wants a simple solution to childhood obesity likes those words. I don’t like them, either, and yet I use them all the time. Food policy is a sexy topic, but food policy research tends to give complicated, unsexy answers.

Food policies are more like young professional athletes – they come with a lot of hype, and thus everyone is eager to label them a “success” or “failure,” but the truth is usually in the middle. My latest study on school nutrition standards provided a perfect example. Furthermore, the study illustrates how any food policy can have the maximum benefit – by knowing what the policy is good at, acknowledging what the policy is not good at, and realizing where complementary policies/sandbags are needed.

In this recent study, I collaborated with researchers from Bridging the Gap, the National Cancer Institute, and the University of North Carolina-Chapel Hill, to dig into the details of how schools adhered to nutrition standards for foods and beverages sold in schools outside of federal school meal programs (a.k.a. ‘competitive foods’). We also dug into whether adherence differed by local area income. Encouragingly, we found that middle schools tended to sell fewer unhealthy items if states had healthier competitive food standards, particularly among schools in low-income areas.

Good news, right?

Sort of. The encouraging results came with a catch, as there was no evidence that schools were offering more healthy foods and beverages instead. Sugar-sweetened beverages were sold less, but they were not necessarily being swapped for clean water.

Why not? Because that is not what competitive food laws do. Competitive food laws are commonly designed to limit sugar, fat, or calorie content of school foods and beverages, but they do not require healthy alternatives.

That’s not a criticism of competitive food laws; it’s simply a limitation. That said, it’s a limitation that can ultimately affect disadvantaged populations. Our study found that low-income schools were substantially less likely to sell healthy alternatives.

If unhealthy items are banned, but healthy alternatives are not provided, there’s a tsunami of unhealthy options waiting for populations that are already at a higher risk for obesity. Low-income areas tend to have more unhealthy options in the community, and as recently reported by the Rudd Center, food/beverage marketing actively targets racial and ethnic minority children.

When disadvantaged communities face the tsunami of unhealthy options outside of school, they are less likely to benefit from any positive changes within school. Last May, a team of researchers in the Bay Area reported that California’s competitive food laws were associated with a decline in obesity, but predominantly in high-income areas. Obesity trends in low-income areas didn’t budge an inch.

As I wrote for Beyond Chron at the time, these results are inevitable if you expect a magical cure to obesity. Any single policy or program can only do what it is designed to do.

Competitive food laws are good at what they do by limiting unhealthy options at school. This may improve weight status in the general population, as I also found in a longitudinal study in 2012. We need to acknowledge, however, that competitive food laws may be less effective in low-income areas.

That is when other policies and programs become more important. The National School Lunch Program in the U.S., for example, is designed to do the exact opposite of competitive food laws – i.e., require healthy items for school meals, particularly to benefit students from low-income households. As a complementary pair, competitive food standards and school meal standards can benefit all children.

Food systems, like any kind of system, work best when different parts enhance each other in this way. Systems do not change when we think that any single part is going to drive change on its own.

My latest study adds to the mountain of evidence that competitive food policies are good at what they do. But, like any policy or program, they can achieve more if we understand their limitations.

Understanding a policy’s strengths and limitations isn’t about declaring the policy to be a “success” or “failure,” the sexy answers we all want. It’s about giving us a roadmap to understand where further action is needed.

Dr. Taber is an Assistant Professor at the University of Texas School of Public Health, where he specializes in childhood obesity policy research and systems science. For years, he has evalauated the impact of policies that are designed to improve diet and physical activity behaviors in children. Multiple studies led by Dr. Taber were cited in the United States Department of Agriculture’s landmark “Smart Snacks” rule for competitive foods. His research has been featured in the New York Times, NPR, CNN, Wall Street Journal, and several other media outlets, and he writes about obesity policy news on his personal blog. You can also find him on Twitter or his website. He also teaches “Systems Thinking in Public Health” at UTSPH. This article represents his personal views; any views or opinions expressed do not represent the University of Texas.