Article Content

NEWSBREAKS INCLUDE:

 

* Milk Consumption as Kids Get Older

 

* World Hunger May Be Going Up, Not Down

 

* Patterns of Child and Adolescent Obesity Are Linked

 

CHILDREN ARE DRINKING LESS MILK AND JUICE AS THEY GET OLDER[horizontal ellipsis] BUT WHAT ARE THEY DRINKING INSTEAD?

New government data show that water accounted for 43.7% of beverage consumption among US kids aged 2 to 19 years in the period 2013-2016, followed by milk (21.5%), soft drinks (19.9%), and 100% juice (7.3%). Other beverages such as coffee, tea, sports, energy drinks, and miscellaneous other products accounted for 7.6% of intakes. As in previous data sets, consumption of milk dropped significantly with age, with milk accounting for almost a third of beverage intake (32.1%) for 2- to 5-year-olds, but dropping to just 14.5% for 12- to 19-year-olds during the period. A similar trajectory applied to 100% juice, which accounted for 12.4% of beverage intakes for 2- to 5-year-olds, but just 4.9% for 12- to 19-year-olds. So what are kids replacing milk and juice with? As children move into the 6- to 11-year bracket, consumption of soft drinks rises the most strongly, whereas consumption of water and other beverages (energy drinks, coffee, etc) rises as they hit the 12- to 19-year bracket.

 

There are some differences in consumption habits based on gender, with girls drinking significantly more water and slightly less milk and fewer soft drinks than boys. African Americans drink more soda and less water and milk than other groups. However, the sharpest differences in beverage choices are based on ethnicity, with African American kids consuming significantly more soft drinks, slightly more juice, and significantly less water and milk than all other population groups, with 30.4% of their intakes derived from soft drinks compared with only 8.8% for non-Hispanic Asians, 17.5% for non-Hispanic whites, and 21.5% for Hispanics.

 

Asian children, meanwhile, consumed the most water (55.4% of intakes), the most milk (25.2%), and the lowest levels of soft drinks (8.8%). For all Americans 2 years or older, milk is the no. 1 food source of 3 of the 4 underconsumed nutrients of public health concern identified by the 2015-2020 Dietary Guidelines for Americans, namely, calcium, vitamin D, and potassium.

 

Source: https://www.cdc.gov/nchs/nhanes/index.htm

 

UN REPORTS THAT GLOBAL HUNGER CONTINUES TO RISE

New evidence indicates that the number of hungry people in the world is growing, reaching 821 million in 2017-or 1 in every 9 people-according to "The State of Food Security and Nutrition in the World 2018" released by the Food and Agriculture Organization of the United Nations. Limited progress is also being made in addressing the multiple forms of malnutrition, ranging from child stunting to adult obesity, putting the health of hundreds of millions of people at risk.

 

Hunger has been on the rise over the past 3 years, returning to levels from a decade ago. This reversal in progress sends a clear warning that more must be done and urgently if the Sustainable Development Goal of Zero Hunger is to be achieved by 2030. The situation is worsening in South America and most regions of Africa, while the decreasing trend in undernourishment that characterized Asia seems to be slowing down significantly.

 

The annual United Nations report found that climate variability affecting rainfall patterns and agricultural seasons and climate extremes, such as droughts and floods, were among the key drivers behind the rise in hunger, together with conflict and economic slowdowns. Changes in climate are already undermining production of major crops such as wheat, rice, and maize in tropical and temperate regions, and without building climate resilience, this is expected to worsen as temperatures increase and become more extreme. Temperature anomalies over agricultural cropping areas continued to be higher than the long-term mean throughout 2011-2016, leading to more frequent spells of extreme heat in the past 5 years. The nature of rainfall seasons is also changing, such as the late or early start of rainy seasons and the unequal distribution of rainfall within a season.

 

The report found that the prevalence and number of undernourished people tend to be higher in countries highly exposed to climate extremes. Undernourishment is higher again when exposure to climate extremes is compounded by a high proportion of the population, depending on agricultural systems that are highly sensitive to rainfall and temperature variability.

 

Poor progress has been made in reducing child stunting, the report says, with nearly 151 million children 5 years or younger too short for their age due to malnutrition in 2017, compared with 165 million in 2012. Globally, Africa and Asia accounted for 39% and 55% of all stunted children, respectively.

 

The report calls for implementing and scaling up interventions aimed at guaranteeing access to nutritious foods and breaking the intergenerational cycle of malnutrition. At the same time, a sustainable shift must be made toward nutrition-sensitive agriculture and food systems that can provide safe and high-quality food for all. The report also calls for greater efforts to build climate resilience through policies that promote climate change adaptation and mitigation and disaster risk reduction.

 

Source: http://www.fao.org/3/I9553EN/i9553en.pdf

 

MAKING SNAP HEALTHIER WITH FOOD INCENTIVES AND DISINCENTIVES COULD IMPROVE HEALTH AND SAVE COSTS

Poor eating is a major cause of illness, especially from cardiometabolic conditions such as heart disease, type 2 diabetes, and obesity later in life. These diseases generate large economic burdens for both government and private insurance programs. For individuals and their families, additional burdens come in the form of personal illness, out-of-pocket costs, reduced quality of life, and a shortened life span. These diet-related diseases and costs disproportionately affect low-income families in the United States. A new Food-PRICE study from researchers at the Friedman School of Nutrition Science and Policy at Tufts University and the Harvard T. H. Chan School of Public Health modeled the health effects and cost-effectiveness of 3 policy interventions to incentivize healthier eating in the Supplemental Nutrition Assistance Program (SNAP). The study, published in PLOS Medicine, estimated that $6.77 billion to $41.93 billion could be saved in healthcare costs over the model cohort's lifetime by incorporating specific food incentives, restrictions, and/or disincentives to improve food choices in SNAP. At the same time, up to 940 000 cardiovascular events and 146 600 diabetes cases could be prevented.

 

The 3 evaluated incentive/disincentive scenarios were (1) A 30% subsidy for fruits and vegetables (F&V), similar to the USDA FINI program available for some SNAP participants in certain states; (2) a 30% F&V subsidy plus removal of sugar-sweetened beverages (SSBs) from the list of eligible purchases using SNAP funds; and (3) a broader incentive/disincentive program including a 30% subsidy for F&V, nuts, whole grains, fish, and plant-based oils and a 30% disincentive for SSBs, junk food, and processed meats. This program, termed "SNAP-plus" by the researchers, was designed to incentivize healthier intakes across a broader range of foods while preserving participant choice (ie, not restricting any items from eligibility).

 

The impact on health outcomes, healthcare costs, and cost-effectiveness were evaluated over different time periods: 5 years, 10 years, 20 years, and lifetime. Of course, in order to do this, it was necessary to estimate what the authors considered to be the likely health effects of the interventions, and this is a matter that is difficult to predict. Assuming the reader is willing to take the authors' estimates as being realistic, it was estimated that, over the cohort's lifetime, the F&V incentive could prevent 303 900 cardiovascular events, add 649 400 quality-adjusted life-years (QALYs), and save $6.77 billion in healthcare costs. Adding an SSB restriction increased the benefits to 797 900 fewer cardiovascular events, 2.11 million QALYs gained, and $39.16 billion in healthcare savings.

 

The SNAP-plus incentive was claimed to yield the greatest corresponding gains: 940 000 fewer cardiovascular events, 47 million added QALYs, and $41.93 billion in healthcare savings.

 

To evaluate the effects of the 3 incentive/disincentive protocols, the research team used a validated microsimulation model (CVD Predict) to generate a sample representative of the US adult SNAP population. The data included observations from the 3 most recent National Health and Nutrition Examination Surveys (2009-2014), as well as data from national surveys, published sources, and meta-analyses that included demographics, food prices, diet-disease costs, policy costs, and healthcare costs. The research team constructed a data-driven simulation for the 3 incentive/disincentive policy interventions. Their analysis examined effects of such interventions on the number of cardiovascular events, quality-adjusted life-years, program costs, healthcare savings, and cost-effectiveness for the 3 scenarios, compared with the outcomes under the current SNAP program.

 

Source:

 

Mozaffarian D, Liu J, Sy S, et al. Cost-effectiveness of financial incentives and disincentives for improving food purchases and health through the US Supplemental Nutrition Assistance Program (SNAP): a microsimulation study. PLoS Med 2018;15(10):e1002661. https://doi.org/10.1371/journal.pmed.1002661.