Wednesday, April 18, 2012

'New York Times' On The First Lady, Food Deserts And The Obesity Battle

A front-page story on two new studies about the impact of building supermarkets on obesity...
UPDATE, March 20: USDA weighs in
Two new studies on the ineffectiveness of building supermarkets in food deserts as an intervention to combat childhood obesity are the subject of a front-page story in today's The New York Times. First Lady Michelle Obama's efforts with food deserts are discussed in the story; she has made improving access to healthy food one of the five pillars of the Let's Move! campaign, which includes a pledge to eradicate all US food deserts by 2017. (Above: Mrs. Obama during her most recent food desert field trip, in February in Inglewood, CA)

The relationship between food deserts and obesity is a complicated and often contentious issue, and the subject of much debate among public health advocates and policy makers--and it includes the US Department of Agriculture having numerous definitions for "food deserts." Still, the largest private sector partnerships for the Let's Move! campaign have involved commitments from Walmart and other national chains to build or revamp outlets in areas identified as food deserts because, Mrs. Obama says, 23 million Americans--including 6.5 million children--live there, according to USDA statistics.

In the Times story, "Studies Question The Pairing Of Food Deserts And Obesity," health writer Gina Kolata says the new studies may "raise questions about the efforts to combat the obesity epidemic simply by improving access to healthy foods" through building supermarkets. Kolata makes fairly broad claims about food deserts and obesity rates that are based on just the two studies she covers, and it should be noted that there have been many studies in the last three years that have found that building supermarkets does in fact impact the consumption of fresh fruit and produce among certain populations. In theory, this helps reduce obesity rates.

The studies covered by the Times are by Helen Lee, from the Public Policy Institute of California (click here), published in the March issue of Social Science and Medicine; and a study by Dr. Roland Sturm of the RAND Corporation and other authors, financed by the National Institutes of Health (click here) and published in The American Journal of Preventive Medicine in February. The East Wing declined to comment for the story, instead referring Kolata to the USDA.

Wrote Kolata:

It has become an article of faith among some policy makers and advocates, including Michelle Obama, that poor urban neighborhoods are food deserts, bereft of fresh fruits and vegetables. But two new studies have found something unexpected. Such neighborhoods not only have more fast food restaurants and convenience stores than more affluent ones, but more grocery stores, supermarkets and full-service restaurants, too. And there is no relationship between the type of food being sold in a neighborhood and obesity among its children and adolescents.

Within a couple of miles of almost any urban neighborhood, "you can get basically any type of food," said Roland Sturm of the RAND Corporation, lead author of one of the studies. "Maybe we should call it a food swamp rather than a desert," he said.

Some experts say these new findings raise questions about the effectiveness of efforts to combat the obesity epidemic simply by improving access to healthy foods. Despite campaigns to get Americans to exercise more and eat healthier foods, obesity rates have not budged over the past decade, according to recently released federal data.

The First Lady's focus on eradicating food deserts has also been criticized by other observers, most vocally by conservative critics. But it should also be noted that there have been other studies that debunk the idea that merely building a supermarket increases consumption of fresh fruit and vegetables, in addition to the studies covered by the Times. Last year, one of the largest and most comprehensive studies on food deserts was published in the Archives of Internal Medicine. It found that "greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed."

USDA's own massive food study desert in 2009 found that many communities are not so much lacking supermarkets as they are filled with food outlets that sell loads of junk food, referred to as "food swamps." Since launching its "Food Desert Locator" in 2010 when Mrs. Obama launched the Let's Move! campaign, USDA has also changed its definition of what actually constitutes a "food desert."

Food deserts vs. "Underserved communities"
Mrs. Obama has now stopped using the term "food desert" in her speeches. The Times reaches back to October of 2011 to quote Mrs. Obama on food deserts, recapping a trip to Chicago for the first-ever "Let's Move! Food Desert Summit."

But during her most recent food desert field trip in February, when Mrs. Obama visited the construction site of a Northgate Gonzalez supermarket in Inglewood, CA, she used the phrase "underserved community" to describe areas where there is low or no access to fresh fruit and vegetables, rather than "food desert." The White House said the supermarket event was designed "to highlight progress being made to increase access to healthy, affordable food in underserved communities," and Mrs. Obama did not use the term "food desert."

Neither the White House nor USDA has a hard definition for "underserved community." And, too, the First Lady's emphasis on the importance of building supermarkets in food deserts has in the past included glowing descriptions of the community revitalization and the job creation that will be a happy side effect of such projects. With each food desert commitment that has been announced, Mrs. Obama or her aides--or the market builders themselves--have also announced the numerical count for the jobs that will be created.

At the end of the day, food deserts are just one small slice of the obesity battle pie. Other interventions to combat obesity are needed, too, according to the White House: Comprehensive nutrition education, teaching families to cook, encouraging physical activity inside and outside school environments, intervening from birth to pre-school, and promoting breastfeeding are just some of the many recommendations.

In 2010, as part of the let's Move! campaign, the White House released a video, "Eliminating Food Deserts in America," starring the First Lady:

*Photo at top by Eddie Gehman Kohan/Obama Foodorama; Mrs. Obama is with, at left, Inglewood Mayor James T. Butts and LA Mayor Antonio Villaraigosa.