Memorandum

Optimistic NYT piece concludes Americans are eating less, particularly sugar-sweetened beverages in children – July 29, 2015

Executive Highlights

  • New York Times recently published an article suggesting that Americans are eating less, according to data from NHANES, Nielson food purchase data, and USDA food supply data.
  • However, we are wary of the impacts of these changes in food consumption as higher BMIs continue to rise; Drs. Donna Ryan and Arya Sharma provide similar sentiments, highlighting the need for greater treatment within adults and the more severely obese.

An optimistic New York Times (NYT) feature article appeared over the weekend on Sunday’s front page, boldly concluding, “Americans Are Finally Eating Less.” The piece triangulates data from three sources to draw the broad conclusion including (i) NHANES data (self-reported diaries); (ii) Nielsen food purchase data; and (iii) USDA food supply data. The pros and cons of these data sources are well detailed in an accompanying article (“It’s Hard to Count Calories, Even for Researchers”), ultimately quoting highly regarded obesity expert Dr. William Dietz (George Washington University, Washington, DC): “They’re all convergent, and showing roughly the same trends.”

The calorie reductions depend on the data source used, ranging from a ~1% daily reduction based on adult food diary data to ~8% based on child diary data to a ~20% reduction in food purchases in households with children. Still, there is some potential noise here – for example, the adult diary and food supply data seem to be trending in the wrong direction as of their most recent data points back in 2010 and 2012, making it hard to know exactly what’s happening, especially in the past year or two (the most recent data point is in 2013 – we do understand it takes awhile to get and report data!). The piece emphasizes the progress in families with children, highlighting the most dramatic caloric reduction in sugar sweetened beverage consumption: -186 calories per day in children between 2004 and 2012. Many experts in the article link this to the public health emphasis on childhood obesity, including programs like the First Lady’s Partnership for a Healthier America (PHA) and Let’s Move! – for a throwback on this, please see our coverage from 2011 of Ms. Michelle Obama’s early initiatives on this.

This new data mark an encouraging trend for sure, though the author rightly points out that those at higher BMIs continue to see a rise in weight and waist circumference – unfortunately, these are also the individuals who need the most help and are the most costly, contributing the most to healthcare expenses. Notably, the author points out that the calorie reduction does not reflect an increase in consumption of fruits and vegetables (this was surprising and disappointing), so clearly more needs to be done on the front examining the quality of calories – for instance, we see this as a sign that we need to make the obesity prevention message more complex than just calling for less consumption of calories.

  • We were very glad to see the NYT highlight obesity, though found the piece to be a bit on the positive side – we felt overall, most reading the article would feel meaningfully more positive on the obesity front overall, and weren’t sure that was as the author intended. We hope that the piece sparks a number of questions:
    • How well are we doing as a country on fighting obesity overall, particularly in those with the highest BMIs?
    • How many funds are being spent on this front, compared to how many funds spent on treating complications emerging from obesity?
    • What are the most exciting ideas and pilots, and who is pushing them forward?
    • What is the potential for digital interventions combined with pharmacotherapy?
  • Obesity experts Drs. Donna Ryan (Pennington Biomedical Research Center, Baton Rouge, LA) and Arya Sharma (University of Alberta, Edmonton, Canada) similarly expressed cautious enthusiasm, pointing to specific needs for treatment in alleviating the epidemic.
    • Dr. Ryan called these new data “a good sign,” but noted that more multidisciplinary treatment of obesity will be needed to “reset the body’s set point” for adults. From these findings, she predicted that, “the impact in adults would be to stabilize rates and in children, would be to decrease rates” as youth have greater plasticity than adults in weight management. Thus, Dr. Ryan emphasized that approaches that work through biology are needed such as “medications, surgery, and constant vigilance around behaviors like lots of exercise,” ultimately noting that it is not time to “uncork the champagne quite yet.”
    • While Dr. Sharma acknowledged that “things are pointing in the right direction at a population level,” he highlighted that the impacts of this on the “health-cost burden of obesity” are unclear. He illustrated that the burden “increases exponentially at the tail end of the BMI bell curve” in terms of cost, health, life expectancy, and quality of life. Thus, he stressed that this “part of the epidemic is getting worse and will likely continue to worsen until we have better treatments for this chronic disease.” We agree that modifications to the built environment (surrounding food and physical activity) are absolutely critical for prevention, but that treatment must step up to address the increasingly important area of more severe forms of obesity.
  • Looking forward, we hope to see more public coverage of obesity, and more constructive ideas on the current state of affairs, particularly from large foundations that could make a real impact – the Robert Wood Johnson Foundation’s recent $500 million commitment to fight childhood obesity was extremely notable and the foundation has been on the forefront of intelligent thinking on this front, as has the Partnership for a Healthier America, run by the highly respected Mr. Larry Soler and chaired by the renowned Dr. James Gavin – please see our days #1 and #2 highlights from PHA’s most recent Summit. Overall, now is probably not the time for celebration as much as thoughtful consideration on what we should be doing much more and less of.

 

-- by Sarah Odeh, Melissa An, Adam Brown, and Kelly Close