To make science-based public policy, make friends with the media and political stakeholders LACMA Health Policy Competition Presented by William J McCarthy, Ph.D. Professor of Public Health, UCLA wmccarth@ucla.edu
For better weight control, Americans should be eating more plant foods of different colors because of their fiber and water content Source: U.S. Department of Agriculture (USDA). 2010 Dietary Guidelines for Americans. www.health.gov/dietary guidelines/dga2010/diet aryguidelines2010.pdf.
U.S. says NO to sugary drinks, YES to F&V minimally processed and whole grtains Source: www.choosemyplate.gov
Plant foods should comprise at least ¾ of the plate Source: U.S. Department of Agriculture (USDA). 2010 Dietary Guidelines for Americans. www.health.gov/dietary guidelines/dga2010/diet aryguidelines2010.pdf. Starches = 12.8% Fruits and non-starchy vegetables = 57% Whole grains = 8.5%
Ogden et al stats showing downturn in 2-5y old obesity 13.9 2-5y olds 8.4 8.9
California s school nutrition bills were nation s first SB 19 led to SB 12 and SB 965 Banned sale of sugary beverages at public schools during school day Limited competitive foods to foods that had no more than 30% of sugar by weight, 30% of calories from fat, and no more than 250 kilocalories. Source: The California Endowment. Banning Junk Food and Soda Sales in the State's Public Schools. 2006: http://publichealthadvocacy.org/_pdfs/legislation/banning_junk_food_soda_sales.pdf. Accessed November 19, 2015.
It takes insiders and outsiders to get policy adopted Assembly person Martha Escutia championed SB 19 in 2001 in part because of her experience w. gestational diabetes The California Center for Public Health Advocacy (Harold Goldstein, DrPH) released obesity statistics to the media, broken down by Assembly district, just before the Assembly vote on SB 677 in 2005. Source: The California Endowment. Banning Junk Food and Soda Sales in the State's Public Schools. 2006: http://publichealthadvocacy.org/_pdfs/legislation/banning_junk_food_soda_sales.pdf. Accessed November 19, 2015.
California legislature has tried to pass a simple labeling bill State of California Safety Warning: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay.
Mexico has passed a soda tax Mexico implemented a new excise tax on sugar-sweetened beverages to help stem the steadily increasing risk of obesity in that country. The tax was 1 peso (worth about 6 U.S. cents) per liter. One year following the imposition of the tax, mean consumption dropped 12% and among low-income citizens, the drop was 17%. Source: Barclay E. Mexico's Sugary Drink Tax Makes A Dent In Consumption, Study Claims: NPR; 2015. Available from: http://www.npr.org/sections/thesalt/2015/06/19/415741354/mexicos-sugary-drink-taxmakes-a-dent-in-consumption-study-claims.
The LAUSD s new F&V-heavy lunch menu flopped Inappropriate testing No attempt to prepare the students via social media despite good faith efforts to get student input on new menu choices Media stories were embarrassing Food Svc. Dir. Binkle did not understand the science of food taste preferences
NYC Health Bucks campaign NYC physicians providing care to obese low-income patients have been prescribing health bucks incentives. Overall program increased awareness of farmers markets, increased purchases at farmers markets, increased consumption of F&V. Source: Olsho LEW, Payne GH, Walker DK, Baronberg S, Jernigan J, Abrami A. Impacts of a farmers' market incentive programme on fruit and vegetable access, purchase and consumption. Public Health Nutr. Oct 2015;18(15):2712-2721.
Urban agriculture incentive zones A new law (AB 551) promoting community gardens and small farms lets municipalities lower property taxes on plots of 3 acres or less if owners dedicate them to growing food for at least 5 years. Source: Romney A. New California law aims to cultivate urban agriculture. Los Angeles Times. October 20, 2013. Bill information: http://leginfo.ca.gov/pub/13-14/bill/asm/ab_0101-0150/acr_128_bill_20140616_chaptered.pdf
Other policies to increase F&V Providing fresh F&V for low-income students; Farm-to institution programs in schools, hospitals and workplaces; Taxes on foods of low nutritional value and subsidies on F&V; Stricter controls on the marketing of unhealthy foods; Supporting community gardens; and Providing vouchers to help low-income pregnant women and their infants/young children purchase more F&V. Source: Vandevijvere S, Knai C. Increasing fruit and vegetable intake: where are we at and how do we reach recommendations? Public Health Nutr. Oct 2015;18(15):2701-2704.
Physical activity & built environment can also influence F&V intake Reducing TV watching is associated with increased F&V intake Increasing daily physical activity is associated with increased F&V intake Access to supermarkets is associated with increased F&V intake Sources: Baruth M, Addy CL, Wilcox S, Dowda M. Clustering of risk behaviours among African American adults. Health Educ. J. Sep 2012;71(5):565-575.; Bodor JN, Rose D, Farley TA, Swalm C, Scott SK. Neighbourhood fruit and vegetable availability and consumption: the role of small food stores in an urban environment. Public Health Nutr. Apr 2008;11(4):413-420; Gebremariam MK, Bergh IH, Andersen LF, et al. Are screen-based sedentary behaviors longitudinally associated with dietary behaviors and leisure-time physical activity in the transition into adolescence? Int. J. Behav. Nutr. Phys. Act. Jan 2013;10.
Making the healthier choice the easier choice ACS: Public, private and community organizations should work to create social and physical environments that support the adoption and maintenance of healthful nutrition and physical activity behaviors.