Making Health the Default

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A recent article featured in the Robert Wood Johnson Foundation News Digest on Childhood Obesity highlights a simple strategy that can be implemented in restaurants and other venues to improve the food environment.

The innovative new strategy is to change the offerings on children’s menus to highlight the healthier options. One way to do this is to set the default side options for children’s meals to healthier items. The default refers to the items that come with a combination meal if you do not explicitly ask for certain items. Traditionally, the default side options for combination meals have been soda and french fries. Healthier options are items that are advertised as alternatives to the defaults, such as apple slices, carrot sticks,100% fruit juices, low-fat milk, or water.

Shifting the restaurant food environment in this way-making lower-calorie beverage options and fresh fruits and vegetables the norm-may help to improve children’s nutrition when eating away from home. This is significant, as the number of meals children eat away from home has been increasing in recent years. Offering healthier items as the default also changes the decision-making environment by facilitating healthy choices rather than requiring people to alter their own behavior.

This type of strategy has been dubbed “libertarian paternalism” by University of Chicago professors Richard Thaler and Cass Sunstein in their recent book Nudge: Improving Decisions about Health, Wealth and Happiness. A “nudge” is designed to steer individuals towards a certain behavior without taking away their freedom of choice. Read More >

Childhood obesity may have leveled off, but disparities are getting worse for adolescents in California?

A recent study published in the American Journal of Public Health, looked at obesity rates in adolescents comparing income groups and gender in the years, 2001-2007. What they found was potentially alarming. This study reveals that when comparing adolescents under the poverty line (<100% of poverty) and adolescents whose family income is greater than 300 percent of poverty, adolescents from low-income households show over double the obesity prevalence. There are many studies that have shown increases in obesity across all income groups. However, there is continuing speculation that obesity and income may have an inverse relationship, as incomes go up, obesity rates tend to be lower and vice-versa. There is no definitive answer as to why this may occur, but it is speculated that higher income families have more access to healthy foods, and that low-income families may make eating decisions related what foods provide the most caloric value for the money spent, often consuming calorically rich, but nutrient poor foods. There are, of course, many factors that help shape these trends.

The adolescent obesity gap increases.

The adolescent obesity gap increases.

To explain, in 2001 the obesity rate for California adolescents living under 100 percent of poverty was 17 percent and for those in households earning more than 300 percent of poverty, it was only 10 percent. That’s a difference of seven percent. However, by 2007, that disparity between income groups had over doubled to 15 percent; a 23 percent rate for low-income adolescents and an 8 percent rate for higher income adolescents. For a family of four, the poverty rate in 2007, was $21,203, so 300 percent of poverty is $62,609, hardly a king’s ransom for a family of four, but therein lays the disparity. Read More >

DC Healthy Schools Act

On Friday, March 26th  the DC Council listened to testimony from various concerned citizens and experts from the community on the DC Healthy Schools Act.  This bill represents a wonderful first step in improving the health of DC’s children and the role that schools play in the sustainability of our communities.   While the bill’s main focus is on nutrition and physical activity, the sustainability language is compelling.  See Washington Post article:

Councilman Catania made his opening statement, championing the advancement that DC has made in the health of children and putting his support squarely behind this bill designed improve the situation in DC’s schools even more.  He started by saying that in the last 5 years, DC had cut the number of uninsured children in half and that the present number of uninsured children is one of the lowest in the nation.  Additionally, the number of school with nurses has increased from 37% to 99% of DC public schools having full time nurses on campus.  As a former teacher in an urban school who never saw a nurse in my school, I can say that this is a major accomplishment.  He also laid out the bare numbers that DC must hurdle with regards to childhood obesity.  According to Catania, 43% of students are overweight and 26% are obese in the district.   Read More >

10 in 10: Ensure Every American Child Has Access to Healthy and Affordable Food: A “Gentle” Wish For a New Decade

10in101A new decade brings new opportunities and challenges. The interaction between diet and health received significant attention during “The Aughts.” What will we do during this next decade to respond to the call for action for a healthier and more sustainable lifestyle? This is the fourth in a continuing series highlighting 10 ways you can help this year.


Knowing that the obesity epidemic in the United States has some scientists predicting that for the first time in history American children will live shorter lives than their parents, my wish for the next decade is to see First Lady Michelle Obama, President Barack Obama and his administration succeed in their mission to ensure that every American child has access to healthy and affordable food. A recent gathering of Obama Administration officials invited to discuss their efforts to improve America’s food system left me hopeful that my wish will come true.

Courtesy: White House Blog

Courtesy: White House Blog

Last month in D.C. Kathleen Merrigan, Deputy Secretary of Agriculture, Dora Hughes, Counselor to the Secretary of Health, and Sam Kass, White House assistant chef and Food Initiative Coordinator for the First Lady each shared their goals for the next year during an event for the W.K. Kellogg Foundation’s Food and Community Program. Surprisingly it wasn’t their words that left me so inspired; rather it was the words of 10-year-old David Martinez-Ruiz. Kass shared with the audience a letter that the D.C. elementary school student had presented to the First Lady following his class visit to the White House Garden.

One of the things that I want to say about being at the White House was how gentle the feeling was. It felt surprisingly natural to be there. We planted on a warm day. The sun was out and there was a little breeze. The grass was beautiful and green. The people made us feel good. I liked the way the staff person who helped me was very gentle with the worms we found. I think about the garden as being gentle: gentle with nature, gentle to your body, and gentle with each other. Read More >