ARTICLE
Fifty years ago, President Nixon called to order the first and only White House Conference on Food, Nutrition, and Health. The conference grew out of the public's shock from Congressional testimony that there were malnourished children in the U.S. who were "hungry, weak, apathetic ... exactly what 'starvation' means.” Over the past 50 years, much progress has been made in eliminating hunger in the richest country in the world. However, challenges with food access, poor diet, and obesity remain. Equally important is ensuring the large federal investment in programs to reduce hunger and malnutrition in America are achieving those goals. Following the 1969 White House conference President Nixon directed that the pilot food stamp program established by President Kennedy be expanded nationwide. Over the next 50 years, the food stamp program (now called SNAP – the Supplemental Nutrition Assistance Program) grew dramatically, from serving fewer than 3 million needy individuals in 1969 to more than 36 million today. The National School Lunch Program and the School Breakfast Program were also expanded to provide both free and reduced priced lunches to needy children, and the Special, Supplemental Nutrition Program for Women, Infants, and Children (WIC) -- targeting nutrition assistance for pregnant and postpartum women, infants, and young children -- was established. Of course, the growth of these programs came with increased costs. In 1969, expenditures for the SNAP pilot program were $250 million; today, the program costs close to $65 billion annually. An even more important question is whether the federal feeding programs have had an impact on health over the past 50 years. Some programs with science-based nutrition guidelines, like the school meal programs and WIC, have made modest improvements in the diets and health of their target populations. In fact, from 2010-2016, there was a decline in childhood obesity rates among low-income children enrolled in WIC – one of the only groups to see a decline in obesity in recent years. In addition, after updated nutrition standards for school breakfasts and lunch were put in place, meals became more than 40% healthier. However, as an anti-hunger program rather than a nutrition program, SNAP has been unable to compete with broader failings in the population at large to eat healthy diets. This is evident by the increase in chronic health conditions tied directly to diet -- obesity, type 2 diabetes, cardiovascular disease, and some cancers, to name a few. Currently, 40% of U.S. adults have obesity, costing our country more than $147 billion per year. Over the last two decades, the average score on our government's diet quality index has remained dismally low -- currently a failing 59 out of 100. The USDA has been criticized in the past for allowing the SNAP program's rules to be controlled by the agriculture industry, and some critics unfairly equate the country's unhealthy diets to the government's feeding programs. But one cannot place the blame of poor dietary habits in the U.S. on the programs created to eliminate hunger. Multiple factors contribute, including a lack of nutrition training in our medical schools to changes in family structures and the environment in which we live. Understandably, busy, stressed families seek quick, convenient meals that often include ultra-processed, calorie-dense foods, and fail to find time to eat regular meals as a family. While the 1969 conference's goals of eliminating hunger and starvation in the U.S. has largely been achieved, segments of the population still struggle with food insecurity. Even more importantly, we have not been successful in eliminating poor diets, obesity, and preventable chronic disease. Common-sense policies are needed to put the "N" (for Nutrition) back in SNAP and improve diet quality among SNAP participants – and the population at large. Otherwise, the costs of poor diets population-wide, not just for the recipients of these programs, will haunt the public's healthcare budgets for the next 50 years. Source: https://www.medpagetoday.com/primarycare/dietnutrition/83688