Spring Seminar Series February 5, 2013 Hunger and Obesity: A Continuing Conundrum Amy Yaroch, PhD Executive Director, Gretchen Swanson Center for Nutrition About the Gretchen Swanson Center for Nutrition o 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. o Established in 1973 by the late Gretchen Swanson as an independent nutrition center with global reach. o Research areas of the center include food and its relation to local economics, obesity, availability, hunger, prices, community, deserts, access and insecurity. Causes of Obesity o Energy balance A lack of energy balance most often causes overweight and obesity. Energy balance means that your energy in equals your energy out. o An inactive lifestyle Many Americans are not very physically active. One reason for this is that many people spend hours in front of TVs and computers doing work, schoolwork, and leisure activities. o Environment Not having area parks, trails, sidewalks, and affordable gyms makes it hard for people to be physically active. Oversized food portions, unhealthy food marketing and access to healthy foods contribute to obesity. o Genes and family history Overweight and obesity tend to run in families. o Health conditions Genes may also affect the amount of fat you store in your body and where on your body you carry the extra fat. Because families
also share food and physical activity habits, a link exists between genes and the environment. o Medicines Some hormone problems may cause overweight and obesity, such as underactive thyroid, Cushing's syndrome, and polycystic ovarian syndrome. o Emotional factors Some people may overeat due to stress, anger or depression, which can lead to overweight and obesity. Obesity in the US o 23 million children in the US are overweight or obese. o First generation of children that is not expected to outlive their parents. o Diet related diseases among children include heart disease, type 2 diabetes, stroke, cancers, high blood pressure, sleep apnea and respiratory disease. o Obesity has changed our social norms. Food Insecurity o Household food security can be broadly described as a continuum of experience around food access ranging from very low food security to high food security. This continuum of food security has been defined by the USDA as four categories: very low, low, marginal, and high. o US households who experience uncertainty around their ability to acquire adequate food due to insufficient resources are considered food insecure. Food Insecurity Indicators o Food insecurity can be measured by several indicators: Worried food would run out, food purchased did not last, could not afford a balanced meal, cut size of meal or skipped meal, cut or skipped a meal in the last 3 months, ate less than felt should, hungry but did not eat, lost weight, did not eat for a whole day, did not eat for a whole day in the last 3 months. Food Insecurity Prevalence, Correlates and Outcomes o In 2011, 51.1 million people lived in food insecure households. o In 2011, 8.2 million children were considered food insecure. o Marital status, location, race/ethnicity, sex, family size, education and poverty are all determinants of food insecurity. o Under-nutrition, developmental issues, cognitive issues, psychological issues, and poor academic performance are all results of food insecurity in children. Hunger and Obesity o Hunger and obesity intersect and there is coexistence in the same population. 1 billon people are hungry and1 billion are overweight.
o Hunger-obesity paradox, is a term coined in 2005 by neurophysiologist Lawrence Scheier to describe the simultaneous presence of hunger and obesity. o Parallel tracks of obesity and food insecurity include the Let s Move and the push to reverse obesity trend by 2015 vs. President Obama to end childhood hunger by 2015. o Research to date does not show association of obesity and food insecurity among children but this is probably due to design/measurement issues. o Obesity and food insecurity can be caused by food cycling which is bingeing behavior at times when food is available, cheap foods. Evidence of Hunger-Obesity Paradox o Children and Adolescents Evidence from cross-sectional and longitudinal studies of the relationship between food insecurity and risk of obesity in children and adolescents is mixed. While some studies have identified greater gains in body mass index among children and adolescents from persistently food insecure households, other studies failed to identify a direct relationship or the opposite relationship wherein lower levels of obesity are observed among persons from food insecure households. Adding to the complexity of observed associations between obesity and food insecurity, considerable variability is observed in this relationship across various child and adolescent populations and subgroups. o Adults Cross-sectional and longitudinal studies assessing the relationship between obesity and food insecurity among adults reveal similarly, inconsistent results. While some investigations have identified increased body mass index among adults living in food insecure households, others have found the opposite relationship or no association. As with child and adolescent populations, considerable variability in the obesity and food insecurity relationship has been observed across adult populations and subgroups. o Research shows that geographic distribution of poverty, food insecurity and obesity overlap. Food System Issues o American s do not eat enough fruits and vegetables. American farmers could grow the additional fruits and vegetables we need. Increasing fruit and vegetable production could bring important benefits to local economies. o Large scale industrial agriculture yields highly processed food for quality other than nutrition. o Need for local and sustainable food systems.
Solve environmental, animal and labor concerns. Help local economies and consumer-producer relationships. Food security (e.g., EBT at farmer s markets). o Need for younger people in agriculture. For every one farmer and rancher under the age of 25, there are five who are 75 or older. o Foods eaten are shaped by our surroundings. Food parents provide for their children, distance to nearest grocery store or fast food, subsidies for farms, etc. o Food deserts provide fewer healthful options. People tend to choose less healthful options due to abundance of fast food and scarcity of healthful, filling food options. Levers for Change o Physical Change Modify agricultural, housing, transportation, and social policies that influence food production and distribution. o Socio-Cultural Change Food marketing and advertising environment in economically disadvantaged areas to promote health and prevent obesity. Institutional climate around nutritious eating and healthy body weight maintenance. o Economic Offer monetary incentives for healthy food options (e.g., subsidies) and disincentives for unhealthy options (e.g. taxes). Institutional financial support for health promotion and nutrition programs; financial support for support local food production. o Political Promote agricultural, social, and food security and nutrition policy informed by obesity prevention science. Institutional rules and policies influencing availability of healthy food options. Call to Action/Future Directions o Policy Interventions Agricultural policy Transportation policy Poverty policy Food policy o Mass Marketing Campaigns Resource awareness campaigns Educational campaigns o Programs through National Organizations Increase participation in Federal Food Assistance programs (SNAP) o Community Wide Engagement
Promote food system participatory planning (Food Policy Councils) Promote food democracy/social justice (EBT at Farmers Market, Double Up Food Bucks) o Groups working together (church and schools) Farmers Markets, community gardens, or mobile carts or trucks that sell fruits and vegetables o Individually Tailored Programs Education/skill building