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Saturday March 24, 2018

Is food quality really getting worse?

"Our food is killing us," proclaims the publicity flack for the new food documentary Fed Up, produced by An Inconvenient Truth producer Laurie David and starring former Today Show host Katie Couric. "Not all food, but almost everything we buy in the grocery store that is not a vegetable or a piece of fruit."

"I got an e-mail out of the blue from Katie Couric," producer David recalls for the Boston Globe. "She basically said, 'I’ve been working on the issues of food and diet for 30 years and I’m completely baffled as to why the problem keeps getting worse.' She asked, 'Would you consider doing An Inconvenient Truth on food with me?'"

Even the more measured scientific researchers warn us: Poor nutrition is contributing to at least four out of the 10 most common causes of American deaths, giving us heart disease, cancer, strokes and type 2 diabetes. But if any inconvenient truth exists surrounding this issue, Minnesota economics professor Timothy Beatty may have stumbled upon it in a new study published in the American Journal of Agricultural Economics. In it, Beatty, USDA economist Biing-Hwan Lin and grad student Travis Smith apply sophisticated economic modeling to two decades' worth of food consumption data from two nationally representative USDA surveys, the Continuing Survey of Food Intakes by Individuals and the National Health and Nutrition Examination Survey. By applying the modeling tool known as "stochastic dominance," which is particularly well suited to studying diet quality, where exact thresholds between “good” diets and “poor” diets is fuzzy, the economists directly contradict the contention that American diets are getting worse.

In fact, they've actually improved over the past 20 years.

"Conventional wisdom maintains that the quality of the American diet has been deteriorating for at least the past two decades," Beatty writes. "In contrast, we document a previously unknown pattern of improvement in U.S. dietary quality. We find statistically significant improvements for all adults over the period 1989 to 2008, at all levels of dietary quality."

For any level of dietary quality, they demonstrated, more Americans have higher scores on the Dietary Guidelines for Americans Healthy Eating Index for the years 2005 through 2008--the most recent period they studied--than then did in 1989 through 1991--the earliest period. Analysis of the survey data show the entire population has shifted gradually but systemically toward a more nutritious diet. And in another challenge to the modern conventional wisdom, Beatty showed that the improvements in nutrition occurred not only in affluent households, but also in low-income households, which he defined a 1.85 times the poverty level. Although they did find higher-income individuals consistently have higher dietary quality than low-income individuals, they also discovered find some evidence the gap is shrinking.

How does the research team explain such "counter-factual" results?

Their modeling suggests fully half the improvements in diet can be attributed to changes in demographics; that is, the population in the last 20 years has grown older, more educated and more ethnically diverse, all of which are associated with better eating. An additional 10 percent of the change is attributable to food manufacturers' altering the dietary composition of foods: removing saturated fats, trans-fats, sugar and sodium. The remaining 40 percent of causes could not be distinguished between the two factors, so could be related to either or both. Changes in food formulation helped explain considerably more of the improvement in dietary quality for low-income individuals than it did for higher-income individuals, the researchers noted.

The truth about menu nutrition labeling

Despite a temporary postponement of the U.S. Food & Drug Administration's plans to require menu items at chain restaurants be labeled for nutritional content, the agency continues moving forward with the proposed regulation. The National Grocers Association--with the backing of some midwestern Congressmen who introduced federal legislation in November to specifically exempt grocery stores and other related businesses--has raised several important questions about how the regs should apply to grocers: Did Congress intend to cover them? Can service departments of groceries rightly be considered restaurants? Can independent supermarkets be considered chains? And what will the paperwork requirement do to grocers?

But amid those questions about the practicality and implementation of the regulations, a larger question appears to be going unanswered, even unasked: Do menu labels even work to meet the stated goals of making consumers healthier?

Some recent research casts that answer in doubt.

London School of Economics economist Matteo M. Galizzi examines the new school of thought behind such practices as menu labeling under the umbrella of "behavioral economics," including interventions like financial incentives to get healthy, sin taxes, nudges and information labels. When it comes specifically to information labels in that overall matrix, he writes, it's not difficult to argue that information-based policies sound perfectly logical, whether you look at them through the new lens of behavioral economics or through the traditional lens of conventional economics: The more information, the better, when it comes to making better decisions and plans. Right?

“Yes and no," Galizzi writes. "But mainly no.”

How can such a logical theory as informational labeling fail, he considers? Three reasons:

  1. Merely providing more information may be perfectly effective in raising awareness, he says. But that awareness doesn't necessarily lead to significant and sustained change in behavior. Whether it's full calorie-specific labeling or simply red-light/yellow-light/green-light schemes, direct evidence on the effectiveness of the both systems is relatively scarce, his review of the research demonstrates. Giving shoppers pure calories and nutritional information has been shown to make only a minimal or modest impact on food purchase and behavioral change. And giving them traffic-light type information tends to produce only a substitution effect, the research says: Consumers tend to avoid really bad foods, but they only switch to a less-bad "yellow-light" food, rather than going fully to healthiest options. And when they do switch, they tend to switch to healthier options within the same categories, but they rarely radically alter the overall structure of their diet enough to make changes in their health, he says.
  2. Mere information release can actually trigger unintended consequences. Not only is simple nutritional or calorie labeling unlikely to have beneficial effects, it's been shown to cause inadvertant behavior that completely offsets the possible benefits. A 2012 study in Philadelphia, for example, that aimed to shift consumers toward zero-calorie drinks by one of several methods found giving shoppers calorie counts on beverage choices actually caused consumption of suger-sweetened drinks to increase, not decrease. Another study from 2006 found similar results with labels indicating low fat: Labeling products as low-fat caused a 50 percent, 84-calorie increase in overall food consumption.
  3. Information like menu labeling only works when it really understands consumer behavior--a tough job. For example, one reason labeling fails is because subjects underestimate the true calorie content of "healthier" snacks by as much as half and thus feal less guilty about eating too much of a not-so-healthy food. Similar failure to predict consumer attitudes confound portion-size control, he notes. Consumers given identically large portions of spaghetti ate significantly more when it was labeled “regular” than when it was labeled “double-size" in a 2013 study. And a "health-halo" effect also confounds many labeling intentions, he notes. When asked to rate the taste and caloric content of yogurts and crisps, subjects estimated that the food labelled as “organic” had significantly lower calories than food labelled “regular,” even when they were identical. That effect implies high-fat, high-sugar foods labeled organic would give consumers license to eat more than is healthy for them.

Prescribing vegetables and fruits for better health

Research has shown that more than half of shoppers who come in to fill a prescription will also buy related food products in the same trip. For instance, while picking up heart medicine, they buy a quart of low-fat milk. More affluent elderly shoppers, coupled with increased prescribing and awareness about preventable chronic disease, presents opportunities for the supermarket as "wellness center" to cross-sell wellness-related items. And to make the picture even better, when asked by the International Food Information Council to name the foods they thought offered health benefits beyond nutrition, 1,000 consumers didn't leap to the obscure. Instead, they named the basics found on your aisles: Fruits and vegetables; fish, fish oil, seafood; milk and dairy; whole grains, oats, oat bran and oatmeal; fiber; green tea; meat, red meat and chicken; water; herbs and spices; and nuts.

So why not take the opportunity to more obviously connect the dots?

A program in seven states throughout the United States and the District of Columbia has attempted a novel effort to do just that, by working with local health clinics to "prescribe" fruits and vegetables to patients suffering chronic disease--typically diabetes related to obesity or unhealthy eating habits. Health clinics and farmers markets work together to enroll overweight and obese children in the program. During each monthly visit with a health-care provider, the participant gets a "prescription" for $1 per day per family member, which can only be redeemed for locally grown produce at the partnering farmers market.

For the 2012 program, the most recent results available, follow up surveys showed:

  • More than 90 percent of patients said they were eating more fresh fruits and vegetables as a result.
  • Healthcare workers who asked patients during each visit to describe their daily fruit and vegetable consumption found 55 percent were eating more fruits and vegetables at their final visit than at their first.
  • Plus, 38 percent of child patients decreased their Body Mass Index between their first and last visit.

Although the Wholesome Wave program was intended to promote better access to Farmers Markets, which gives it a political mission, an independent community supermarket could learn much about adopting the concept into its own marketing program. Lessons learned:

  • Focus on community. The program likely succeeds because it is community-based. It encourages partnerships between doctors, nutritionists, community health workers, farmers, farmers market operators, and community members. Local, community-focused supermarkets should have a natural leg-up on that approach.
  • Take ownership. The local grocer will likely have to coordinate the program to see the benefits from it. In the states where the concept has worked, it has been spearheaded by an organization known as Wholesome Wave, an advocacy group for small farms, local food systems and farmers markets. The group does not advocate for better access to produce through supermarkets, beyond advocating for general increases in SNAP funding. Instead, it promotes farmers markets as healthier, higher quality sources than supermarkets. Grocers interested in capitalizing on the interest will have to pull together interested health providers and public or private funding sources to underwrite the program.
  • Use your store nutritionist as the point person. The Wholesome Wave program puts nutritionists in connection with the health-care provider and, in some cases, a community health worker who discuss the importance of healthy eating and active living, with a focus on the importance of eating fresh fruits and vegetables.
  • Survey, survey, survey. Collecting and analyzing data from participants about the changes in their food habits and health indicators is an integral part of the current programs. It also helps justify continued funding. Data collection occurs throughout program implementation, for about 16 to 20 weeks during the peak of farmers market fruit and vegetable season. Primary care providers track weight, Body Mass Index, and fruit and vegetable consumption at each, compiling it all into a secure online database all participating clinics can access for generalized data.

Click here for more information.

Oklahoma State University ag economists asked a sampling of more than 1,000 consumers in February two questions about some common "authorities" regarding livestock and meat production:

  1. How much do you know about these sources?
  2. How much do you trust them?

These 15 sources were ranked on a scale from “nothing” to “a great deal."

Click the thumbnail below to see where each ranks on the typical consumer's trust scale.

Who do consumers trust?

Do farmers markets really improve farm incomes?

Farm-to-consumer marketing programs like the Nebraska Department of Agriculture’s Buy Fresh Buy Local Nebraska and USDA's Know Your Farmer Know Your Food are founded on the premise that increasing the number of food shoppers who buy directly from farmers helps the economic viability of small farms. "Whether consumers are purchasing tomatoes at a local farmers' market or picking some apples at a roadside stand, they are contributing back to their local economy," said Casey Foster, ag promotion coordinator with the state agriculture department.

But you may be surprised to find that cherished assumption has little scientific backing.

Ag Economics researchers from Louisiana will publish a study in an upcoming issue of the journal Agricultural Economics challenging the widely held notion that encouraging the food chain to cut out the supermarket middleman makes for healthier economics for farmers. In contrast to the “plethora” of journal articles studying the consumer at direct outlets like farmers markets, the researchers say, research is almost nonexistent about the behavior of the farmers themselves and how direct marketing affects their farm business income.

Specifically, no previous studies the Louisiana team uncovered focused on how farmers’ management and marketing skills affect their decisions to use either roadside stands, or on-farm stores, farmer’s markets or community supported agriculture programs, vs. less-direct markets like direct sales to local grocers, regional distributors and state branding programs, or some combination of the two. None of the studies they reviewed have examined the impact of marketing and management skills on the financial performance of the farmers’ business when they market through such non-conventional channels.

So the Louisiana researchers pulled data from the nationwide 2008 Agricultural Resource Management Survey collected by the Economic Research Service and National Agricultural Statistics Service of USDA. After excluding data for farms organized as non-family corporations or cooperatives and farms run by hired managers, their results found:

  • One in 10 of the farmers used only direct-to-consumer selling like roadside stands and community supported agriculture subscriptions. Seven percent used indirect methods like selling to a local grocer. Four percent used some combination of the two. That leaves 79 percent of farms in the 2008 figures using no direct-to-consumer sales.
  • Farmers who sold direct reported earnings that were on average significantly lower than earnings from the other marketing strategies. The average earnings of $273,011 are about 75 percent lower than earnings for farmers who do not engage in any direct sales.
  • Their statistical analysis at least implies that farmers with higher skills or more experience in marketing likely prefer to sell through intermediate channels, like selling to a local supermarket. Farmers in the direct-only category typically were those using the fewest marketing techniques compared to others. More than half of the exclusively direct-to-consumer farmers did not use any advanced marketing tools like marketing advisory services, options, futures, on-farm storage, contract shipping, networking or farmer cooperatives. The researchers suggested this may be due to the fact that selling through intermediate markets often places specific quality and quantity requirements on them, which necessitate the use of those more advanced marketing skills in order to succeed.
  • Overall farm sales for farmers who sold only directly to consumers actually fell--by an average of 2 percent. That compares to a 20.5 percent growth rate for farmers with no direct sales.

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