The USDA's Thintervention

On Monday, the United States Department of Agriculture and Department of Health and Human Services -- the guys responsible for the ever-evolving "food pyramid" -- released their national nutrition guidelines, which they update every five years. The basic message of the report: Eat less, make more of what you eat vegetables and fruits, and eat much less salt.

It's not advice we haven't heard before -- nor, however many times it's heard, does it seem to be making Americans any thinner -- but it does represent a government effort to provide food guidelines that are easier for consumers to understand and a frank acknowledgment of our growing obesity epidemic. Typically, the national nutrition guidelines lump foods into broad, technical categories like "carbohydrates" or "proteins" and focus almost exclusively on individual consumers' eating choices. This report not only makes individual recommendations easier to understand; it critiques the broader food environment that influences how and what Americans eat. Broadening the scope of the discussion about food is a marked shift from the past and exactly what many food-policy advocates have been arguing for.

Those advocates, from food writer Michael Pollan to nutritionist and columnist Marion Nestle, praised the report for giving more workable advice about what to eat and for targeting the unhealthy American lifestyle. "Eat less" isn't a message many thought we'd ever be likely to hear from the USDA, since that's also the agency responsible for promoting American food products. "I'm in shock. ... The new guidelines recognize that obesity is the number one public health nutrition problem in America and actually give good advice about what to do about it: eat less and eat better," Nestle wrote. But she did have some criticisms shared by other health experts: This report is specific, to an unprecedented level, when telling you what to eat; it tells you to fill half your plate with vegetables, for example. But when it comes to telling you what to eat less of, the report goes back to abstractions; it tells you to cut down on "solid fats."

Of course, what it should say is "eat less cheese, red meat, and ice cream," and the omission highlights some of the political problems the USDA runs into when crafting the guidelines: It steers clear of singling out particular foods we should cut down on for fear of upsetting particular food industries, which spend millions to lobby legislators every year.

Because the most recent guidelines didn't target specific foods that need to be reduced in the American diet, most industries took them in stride. The meat and poultry industries, for example, didn't bash them, though they want you to know that eating more seafood doesn't mean meat isn't part of a balanced diet. The salt industry raised the biggest objection, saying eating less salt is unrealistic. But these industries also know that the guidelines are just that -- guidelines -- and few people actually pay attention to them when they make their food choices, and the extent to which most individuals actually investigate their food choices is limited. Up to now, even concrete advice to eat more vegetables and drink fewer sodas has fallen on deaf ears. That's partly because the recommendations don't do much to change the abundance of cheap high-salt, high-fat foods.

Which actually points to the other big change in this report: It acknowledges that the environments in which people buy food matter and contains policy recommendations for improving them. The broader scope is an important acknowledgment that individuals' choices are shaped by the choices available to them. And it comes from an administration that has actually designed an agenda that crosses agency lines and is meant to improve health overall.

The report includes a section called "A Call to Action," which lays out recommendations not for individuals and families, as the rest of the report does, but for state and local governments and agencies. It identifies several societal-level barriers families may face in implementing its recommendations, including lack of access to healthful foods and places to exercise: "Interventions should extend well beyond providing traditional education to individuals and families about healthy choices, and should help build skills, reshape the environment, and re-establish social norms to facilitate individuals' healthy choices," the report says. This moves beyond the "individual responsibility" approach to nutrition to one that takes into account the food system as a whole. "This document is not just a road map for food manufacturers ... but it's also a road map for how we need to reform our farm and food policies," Scott Faber, vice president of the Grocery Manufacturers Association, said on The Diane Rehm Show Tuesday. "It's great to say people should have half their plate covered with fruits and vegetables; that's not possible for 10 percent of Americans because they don't have access to a grocery store."

The report urges governments to expand access to grocery stores and farmers markets -- making food available, affordable, and safe. (It doesn't, of course, detail how this should be done.) It also encourages the expansion of safe agriculture and aquaculture practices that bring food to all populations, but it doesn't really spell out what those are. And while it still encourages nutritional education, it calls for expanding gardening and cooking instruction, limiting unhealthful food in schools, reducing television and computer time for children, and cutting down on the number of ads they see for high-sugar beverages.

The Obama administration has already made some of these changes. First Lady Michelle Obama's "Let's Move" initiative, designed to curb childhood obesity, has already resulted in a childhood-nutrition bill that increases the amount of fruits and vegetables handed out for school lunches and removes junk food from school vending machines. On a broader level, the Departments of Transportation and Housing and Urban Development are on board, at least rhetorically, with policies that promote safe bicycle and pedestrian thoroughfares and transit-oriented development -- those promote physical activity, which is a key goal outlined in the report. But while the administration has increased funding for the National Organic Program and supported initiatives that bring local farmers and ranchers into school lunch programs, it hasn't fundamentally changed how the country produces its food.

The bigger problem is that these changes are slow-moving. It will be a couple of years before schools are serving entirely healthier lunches, and the time it takes to actually change the physical environments in which many Americans live, buy, and eat food is even longer. And even if the policy changes all fall into place, changing behavior is a bigger challenge than any one report can tackle. Those critical of the Obama administration on the left are often frustrated that progressive concerns seem to be the first dropped when the legislative ball starts rolling. This report at least shows that the administration is listening.

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