Tom Vilsack, then-secretary of the U.S. Department of Agriculture (USDA), gave a keynote address on the work USDA has done to combat obesity. The obesity epidemic affects “many, many Americans,” he began. “We’re particularly concerned about it as it relates to our young people. If you look at those who have obesity or at risk of having obesity, it can be as many as one-third of the youngsters in this country.” He stated that he personally and USDA devote considerable time and effort to the issue, and went on to describe the department’s major initiatives.
Vilsack began by observing that, early in the Obama administration, attention focused on improving the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which affects about half of all preschool children in the United States. USDA worked to increase the consumption of fruits and vegetables not only to improve nutrition but also to introduce preschool children to a broader range of foods. Building on this success, Vilsack reported, it also worked with school-aged children. The Institute of Medicine and other organizations had identified many problems with the meals children were eating at school, including too much fat, too many calories, too much sugar, and too much sodium. With support from the Healthy, Hunger-Free Kids Act, the administration sought to refocus the National School Lunch Program and School Breakfast Program1 by changing the mix of foods; reducing fat, sodium, and sugar; and introducing foods that would be both nutritious and delicious at school.
Many school districts had a difficult time shifting to healthier foods, Vilsack noted. In response, USDA created an initiative called Team Up for School Nutrition Success, which entailed pairing districts that were struggling and similarly situated districts that could provide them with a mentoring experience. In addition, chefs from local restaurants were invited into the schools to work with their food personnel, and school districts received grants for equipment that would enable them to do more scratch cooking on site or in centralized processing facilities. In addition, the National Football League and the dairy industry supplemented these grants with $5 million for small-equipment purchases.
USDA also worked with schools to change the foods available in vending machines, said Vilsack, “to make sure that we were sending a consistent message at the school.” He noted that many school districts were concerned because vending machines are a source of school revenue. “But it turned out that kids will buy what’s in the vending machines,” he said, “and they are more than happy to buy flavored water, low-cal sports drinks, low-cal sodas, and things of that nature that substantially reduce the exposure to calories, to sugar, and to sodium.” At the same time, USDA has been working with schools on the marketing that takes place in schools to ensure that advertising is consistent with the new standards. In addition, Vilsack reported, the department worked with university researchers to develop strategies for encouraging Smarter Lunchroom2 choices—“the way in which food is displayed, the way in which it’s named, who serves it, how it’s served, sharing tables, things of that nature designed to provide an
1 See www.fns.usda.gov/school-meals/healthy-hunger-free-kids-act (accessed January 12, 2017).
opportunity for school districts to look at innovative ways to make school meals more nutritious and more appealing.”
According to Vilsack, this work has contributed to a 16 percent increase in vegetable consumption and a 23 percent increase in fruit selection among students through school meals (Cohen et al., 2014). Today, 97 percent of school districts in the country are following the new guidelines (USDA, 2015).
Vilsack described another focus of attention: revising USDA recommendations for healthy eating. The department replaced the food pyramid with the My Plate icon,3 which calls for meals to consist of half fruits and vegetables and half carbohydrates and protein, with dairy on the side. “The MyPlate effort has been incredibly successful,” said Vilsack. It has given people “an understanding of what a nutritious plate looks like—and we’re seeing that being adopted. We’re seeing the visits to our website increase dramatically. We think it’s a much easier way of explaining to people precisely what a healthy plate looks like.”
The department then turned to the Supplemental Nutrition Assistance Program (SNAP). One issue it considered was whether incentives to encourage families to purchase more fruits and vegetables would work. A long-term longitudinal study in Massachusetts had examined whether extension of SNAP benefits could be tied to the purchase of more fruits and vegetables (USDA, 2014). “What we found from that study was that, in fact, incentives work,” Vilsack observed. In response, the 2014 Farm Bill included the Food Insecurity Nutrition Incentive grant program,4 a roughly $100 million effort to encourage SNAP beneficiaries to take advantage of the ability to buy more fresh fruits and vegetables. The department also worked with private foundations and nonprofit organizations to match its funding through “double buck” campaigns, whereby SNAP benefits are matched dollar for dollar by nonprofit assistance for specific purchases. In addition, USDA has invested in expanded Electronic Benefit Transfer systems to make SNAP benefits more available at farmers’ markets, “and we’re continuing to look for ways in which we can expand access for SNAP families,” Vilsack reported.
According to Vilsack, USDA has also been looking at the problem of food deserts—persistently poor or remote areas in which residents lack access to a full-scale grocery store. Addressing this problem involved work-
4 See www.nifa.usda.gov/program/food-insecurity-nutrition-incentive-fini-grant-program (accessed January 12, 2017).
ing with the U.S. Department of Health and Human Services and the U.S. Department of the Treasury to encourage the development and financing of full-scale grocery stores. USDA has mapped the country to gain a better understanding of where food deserts are located (through the Food Access Research Atlas), and is working with Congress to provide grants and incentives for locating grocery stores in these neighborhoods. Vilsack said he has also used his position as the secretary of USDA to ask grocery chains to consider their social responsibility for making nutritious food available.
Finally, Vilsack reported, USDA is working with stores to rethink what they stock and shelve. For some stores, SNAP payments constitute a significant part of their business, which gives the federal government an opportunity to help these stores stock a more nutritious set of foods.
Healthier eating requires that fruits and vegetables be available to the people who want to eat them, Vilsack observed, which in turn requires expansion of local and regional food systems. Investing in those systems serves multiple purposes, he said, and can respond to a renewed interest in specialty crop production. For example, USDA has been experimenting with offering microloans to create opportunities for people to engage in small-scale farming.5 As a specific example, Vilsack mentioned hoop houses that can extend the growing season in parts of the country with harsh winters. Such farming can be done “just about anywhere,” he said—in vacant lots, on roofs, in community gardens. In honor of President Lincoln’s 200th birthday, USDA converted an asphalt-covered parking lot at its Washington, DC, headquarters to an organic garden. “That has spawned over 2,100 gardens of that kind,” Vilsack said, “which are producing fruits, vegetables, herbs, and so forth that are now going to food banks.”
Vilsack also observed that an estimated one-third of food in America is wasted. “If we could cut down significantly on food waste,” he suggested, “there would obviously be greater supply.” He noted that one way to do so would be reducing portion sizes. “I’ve begun to say to the waiters and waitresses, ‘I know I’m entitled to fries, but I really don’t need five pounds of fries. I just need a handful.’ I’m happy to pay whatever I need to pay, but I don’t want to waste food. You make people more sensitive on that score.”
Vilsack acknowledged that international trade affects the supply of fruits and vegetables in the United States and that some U.S. growers are deeply concerned about market shares. But, he pointed out, the earth will soon have 9 billion people living on it. “To feed that many people,” he
5 See www.fsa.usda.gov/programs-and-services/farm-loan-programs/microloans (accessed January 12, 2017).
argued, “we’re going to have to increase productivity and food production worldwide.” He asserted that greater demand will mean many more people consuming fruits and vegetables, which will help stabilize markets and support production. USDA is also trying to create new consumers of healthy foods by acquainting school districts with what is being grown in their vicinities. Vilsack described Farm to School grants,6 which are making it possible for schools serving millions of children to purchase local foods and support local farmers, thereby creating closer links between rural and urban areas and a stronger sense of community.
Vilsack also cited immigration reform as a way to increase the production of fruits and vegetables. “There is a lot of acreage in this country today that is not being farmed,” he observed; “or if it is being farmed, it’s not being harvested; or if it’s harvested, it’s harvested at a very late stage because we don’t have a stable, secure workforce.” He asserted that immigration reform would help create a more stable and secure agricultural workforce, which would make it easier for farmers to ensure that whatever is planted is harvested. “With fruits and vegetables,” he pointed out, “if you don’t have the workforce at the time that the fruits and vegetables are ready, you’re out of luck.”
Technology programs implemented by USDA have the potential to empower people, Vilsack suggested. With SNAP benefits, for example, embarrassment at being identified and judged in a grocery line can be an impediment to the purchase of foods. Thus, Vilsack said, “we have made a concerted effort to try to bring everything together so that what SNAP families are doing looks no different than what the rest of us do with a Visa card or a MasterCard.”
Vilsack observed that research can also point to the information people need to make better choices. One research project, for example, looked at how to characterize the value of fruits and vegetables. Characterizing foods by portion size rather than calorie content can help people understand that fruits and vegetables are not necessarily more expensive, Vilsack argued, and thus can help them make informed choices (ERS, 2016). Additionally, recipes on the USDA website have been giving SNAP families the capacity to incorporate more fruits, vegetables, and whole grains into their diets inexpensively.7 Vilsack explained that the department’s SNAP Nutrition Education and Obesity Prevention Grant Program, informed by research,
6 See www.fns.usda.gov/farmtoschool/farm-school-grant-program (accessed January 12, 2017).
teaches people using or eligible for SNAP about good nutrition and how to make their food dollars stretch further.
Vilsack observed that, as other workshop participants had pointed out, “we’re beginning to see some small steps, small signs, that we’re beginning to have an impact.” Some obesity rates, especially among children, have plateaued, and for some groups of children, the rates have even declined. “If we give this effort a generation or so, we’re going to see, I think, significant changes,” Vilsack said.
Reauthorizing the programs that have been making a difference is critical, Vilsack asserted. He suggested that Congress has an opportunity to cement a better approach to nutrition in government. “We have a great advocate with the First Lady and her Let’s Move! initiative,” he said. “We want to make sure that we finish strong, if at all possible. We’re going to work with Congress to try to get that done before this administration is over.”
Vilsack went on to report that USDA is also working with a broad range of partners to encourage continuation of its successful programs. Food insecurity has recently declined in the United States, he observed, “and the good news is we’ve seen a particularly important decline among children.” “It’s at a record low this year. We’re proud of that; we want to obviously see that continue.”
Vilsack noted that in the 1950s President Truman instituted the School Lunch Program because he was concerned about the country’s ability to have enough healthy people to defend itself. According to Vilsack, “he felt that there needed to be more calories consumed by young people so that they would be physically strong to be able to defend the country.” Now, he said, military leaders are concerned about too few young people being healthy enough to participate in a voluntary army. In addition, he argued, better nutrition could prevent large amounts of unnecessary health care expenditures and lost productivity.
“We didn’t get into this situation overnight, and we’re not going to get out of it overnight,” Vilsack concluded. But, he asserted, “if we stick with it and stay with it, we’ll see more significant benefits over time.”