Editor’s note: Each Spring, attorneys Bill Marler and Denis Stearns teach a Food Safety Litigation course in the LL.M. Program in Agricultural and Food Law at the University of Arkansas School of Law. This specialized program for attorneys brings together those who are interested in our food system, from farm to table. As a final assignment, students are asked to write an op-ed or essay on food safety, with the best to be selected for publication in Food Safety News. The following is one of the essays for 2020.
By Ksenia Epanchina
After WHO declared the COVID-19 pandemic, people all over the world were told to stay at home under quarantine in order to reduce the spread of the virus. Stress, associated with cardinal change of lifestyle and daily activities has emotional consequences, and reactions to it can be different depending on numerous factors. One of the most common stress reactions is overeating, and particularly craving foods rich in processed carbohydrates and fats, to put it simple – junk food. Weight gain, as a logical consequence to increased food consumption may not be a significant problem for people with healthy body mass index (BMI), what can’t be said about those, who have already faced obesity and diseases, associated with it, such as type-2 diabetes and heart disease. Gaining weight for obese people can be life-threatening under normal circumstances, but experts found that obesity also increases the risk for more serious complications of COVID-19, and excess body weight significantly raises the risk of hospitalization for young COVID-19 patients.
Shift from healthy to “safe” foods.
The group of researchers from Columbia University Mailman School of Public Health noted that “As households stock up on shelf-stable foods, they appear to be purchasing ultra-processed, calorie-dense comfort foods. Our own experiences in supermarkets show that along with the shelves that held flour, rice and beans, the shelves that held crackers, chips, ramen noodles, soda, sugary cereals, and processed ready to eat meals are quite empty”. The researchers’ personal experience is confirmed by the data on sales increases of the foods they mentioned. Bloomberg reported, that by the middle of May 2020 the popcorn and pretzel sales rose almost 50%, the rise of potato chip sales was 30% compared to the same period in 2019. Breakfast food, cookies and crackers are also in demand, according to Mondelez International Inc. Those who tried to choose fresh healthy foods before pandemic, are now buying the food that makes them feel safe, such as potato that had been ignored because of low-carb diets and red meat, that, together with the processed meat, had been linked to cardiovascular disease.
Commenting on these numbers, Lisa Young, a New York dietitian, said that performing self-control is much harder when people are stressed, and eating comfort foods makes people feel good during stressful times, so she thinks that dieting is not a good idea right now. Dr. Quanta Ahmend believes on the contrary that “Now more than ever, getting into shape has become a matter of urgent national public health security”, because according to the recent data from NYU Langone, “body mass consistent with even early obesity in the setting of coronavirus infection makes a patient three times more likely to need intensive care medicine, suggesting a more severe clinical course”. Though the U.S. has been struggling with overweight and obesity epidemic for a long time before COVID-19, now its consequences are devastating, because “it is one of the biggest risk factors related to COVID-19 hospitalizations and critical illness,” researchers say.
Healthcare workers have to be careful.
Cousins Subs, LaRosa’s Pizzerias, Fired Pie, Jersey Mike’s and many other fast food restaurants have announced that they are offering free meals or special offers to help medical workers get through the crisis. Every Monday from March 30 through May 11, all Krispy Kreme drive-thrus will give a free dozen (!) of doughnuts to everyone in the medical community; McDonald’s was offering free Thank You Meals through May 5 to health-care workers; Subway will donate 6-inch subs to health-care workers at participating hospitals. It’s clear that COVID-19 crisis requires immediate response, and the community, including the fast food industry wants to thank and support healthcare workers, but donating junk food to hospitals in the middle of an obesity crisis can make the situation even worse.
Children are also in danger.
Experts warn that due to schools closures the number of obese children may go up, as they will no longer receive school meals and will have to stay indoors, deprived of school activities. Previously it had been noticed that children usually gain weight during summer recess, and extra pounds remain with them during the whole school year until the next summer when they gain even more weight. Now under quarantine kids will spend most of the time in front of the TV with its aggressive fast-food advertising or playing computer games, followed by snacking. It has been proven that an obese child will most likely be an obese adult: according to the Bogalusa Heart Study, 77 % participants, who were obese as children, remain obese as adults, while only 7%, who were at healthy weight as children, became obese adults. So, the government is now facing new challenges, because adequate response is required to continue to support healthy eating patterns and active lifestyle of children, who are under quarantine.
What has been done by far.
After it was discovered that the death rate from obesity is 80 times higher than from foodborne illnesses per year (400,000 v. 5,000 respectively), it became clear that ultra-processed foods and foods, rich in sugar and saturated fats threaten our lives even more than foodborne parasites, disease-caused bacteria, toxins, unapproved additives or allergens, traditionally associated with food safety, and that FDA’s policy in that area should include initiatives addressing the quality of the food we eat and its calorie content.
US policies and programs responding to obesity began in late 1990-s and addressed clinical, behavioral, or educational aspects, rather than environmental: the “Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults” by the National Heart, Lung and Blood Institute (1998), the Weight-Control Information Network by the National Institute of Diabetes and Digestive and Kidney Diseases (1994). The goal of these initiatives were to educate public on the obesity and weight control, using scientific, evidence-based research papers. In 2002 President George Bush launched the HealthierUS Initiative to stimulate the nation to start exercising and make healthy food choices through “President’s Challenge”, then USDA set up “Team Nutrition Program” to teach students to differentiate between healthy foods and foods making them obese.
The Nutrition Labeling and Education Act of 1990 (NLEA) required that labels on food packages bear nutrition information, including calorie information, but didn’t cover food, served in the restaurants “for immediate human consumption’’. In 2014 FDA published the final rule for menu labeling, that required restaurants provide in the menu calorie information of the food they serve, and the Vending Machine Final Rule, requiring that vending machines declare calories in a manner, that would allow consumers read calories before purchasing it. FDA explained, that the goal of the rules is “to provide consumers with nutrition information in a clear and consistent manner to enable them to make informed and healthy dietary choices for themselves and their families when eating foods away from home”.
The problem of child obesity was acknowledged by the government long ago, and several initiatives have been taken to protect children from the decease. In 2009 Interagency Working Group on Food Marketed to Children, established by Congress, developed a set of voluntary standards, according to which all foods marketed to children of 2 to 17 years old should contribute to a healthy diet and have minimal levels of added sugar, saturated and trans fat and sodium. So, the goal was to reduce unhealthy food and beverage marketing to children. Because of the food industry opposition standards were released by the Federal Trade Commission in October 2011 in a significantly weakened version, applying only to children who are 12 years old or younger.
In 2010 Congress passed the Healthy Hunger-Free Kids Act, developed by M. Obama, according to which fruit intake should have been 2 times increased, 50% of grains must have been whole grains, gradually turning into 100%, fries must have been served at schools no more than 2 times a week. Later, however, the USDA under the Trump administration published the final rule that rolled back Obama’s heathy food initiatives: the 2018 rule “Child Nutrition Program Flexibilities for Milk, Whole Grains, and Sodium requirements” allowed flavored milk, lowered the required amount of whole grains to 50% per week, provided more time to reduce sodium levels in school meals.
In January 2020 the Trump administration proposed new rule that alter provisions from the Healthy, Hunger-Free Kids Act: aimed at reducing food waste the proposal will allow schools to offer lunches for a la carte purchase, adjust fruit servings and offer more vegetable varieties. So, under the new rule schools will be able to purchase less healthy vegetables, and kids, having a la carte choice will obviously order burgers, french fries and other foods, high in saturated fats and refined carbohydrates.
Did the efforts work?
According to the National Center for Health Statistics, in 1999-2000 30.5% among adults and 9.2% and 4.7 among children were obese in the United States. In 2015-2016 the numbers grew to 39.8% and 18.5% respectively, and they keep growing – in 2017–2018 the numbers were 42.4% among adults and 9.2 % among youth. It seems that whatever the government is doing, obesity lives its own life. Experts say that because the food environment is a key factor leading to overeating and obesity, without radical changing it – stop mass marketing, selling ultra-processed foods, all other efforts will not work. Dr. Aseem Malthora, a London-base cardiologist, believes that failure to tell the public to change its diet and reduce the availability, affordability and acceptability of ultra-processed food now during COVID-19 crisis, when we have evidence that people with obesity are more likely to become severely ill, “would represent an act of negligence and ignorance”.
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