confounding role (income, socioeconomic position, race, psychological characteristics).

  • Greater use should be made of non-observational designs, which could help assess the causal nature of the association between food insecurity and obesity (quasi-experimental designs, natural experiments, reanalysis of randomized controlled trials that assess the effects of food supplementation).

  • Additional longitudinal research should examine the mechanisms through which food insecurity is associated with poor health—critical periods (which are the key developmental periods?), cumulative disadvantage, chains of risk.

  • Interventions and policies that aim to decrease hunger and food insecurity should be evaluated over the long-term, to test whether they contribute to improvements in health and decreases in health inequalities.


Elle Alexander

Johns Hopkins Bloomberg School of Public Health and

Global Health Policy Intern, PepsiCo

As a Johns Hopkins Bloomberg School of Public Health student and PepsiCo Global Health Policy intern in attendance at the Institute of Medicine Workshop on Food Insecurity and Obesity, I appreciated the presentations describing the current state of the research and the suggested solutions for food insecurity and obesity, but noticed the lack of discussion of several important factors. While several discussions focused on the negative contributions of food and beverage companies to overweight and obesity in low-income populations, conversation excluded the role of food companies as part of the solution. PepsiCo is taking important steps that should be noted:

  • Removing full-sugar sodas from primary and secondary schools by 2012 and encouraging schools to supply only products that meet nutrition guidelines set by the Alliance for a Healthier Generation;

  • Lowering sugar, salt, and fat in PepsiCo portfolio of products: sodium will be reduced 25 percent by 2015 in key global food brands; saturated fat will be reduced 15 percent by 2020 in key global food brands; and sugar will be reduced 25 percent by 2020 in key global beverage brands; and

  • Expanding the nutrition portfolio—including Quaker Oats, Tropicana, and Gatorade—from $10 billion to $30 billion in 2020, supported by the new Global Nutrition Group.

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