UC Food Blog
Pat Crawford, the senior director of research for the University of California Agriculture and Natural Resources (UC ANR) Nutrition Policy Institute. "The United States – along with Mexico – has the highest obesity rates in the industrialized world. With these extraordinarily high obesity rates, we are on a path toward ever-rising chronic disease rates including not just diabetes, but also heart disease and some cancers, increasing healthcare costs and reducing productivity."
"Even more alarming," continued Crawford, "is a little known fact that 23 percent of the adolescents in this country currently have pre-diabetes or diabetes as measured by actual blood tests in our largest national study of health (NHANES). Something is seriously wrong in a society such as ours where so many children are growing up with such a high risk of preventable disease.”
The UC Food Observer published an extensive interview with Crawford, who, prior to joining the NPI, co-founded and directed the Center for Weight and Health at UC Berkeley for 15 years. She is a UC ANR Cooperative Extension nutrition specialist, as well as an adjunct professor in the School of Public Health at UC Berkeley.
Crawford led the 10-year longitudinal NHLBI Growth & Health Study, an epidemiologic study on the development of obesity in African American girls and FitWIC, the five-state obesity prevention initiative in WIC. She is currently leading studies evaluating a wide variety of state and national nutrition programs and policies. An internationally respected researcher, Crawford served on the California Legislative Task Force on Diabetes and Obesity and chaired the Institute of Medicine's Workshop (IOM) on Food Insecurity and Obesity.
Following is the UC Food Observer's Q&A with Pat Crawford:
Q: You have worked very hard over several decades to inspire positive change in human health. Can you tell our readers a little about the nutrition politics and the situation that encouraged you to do this? What keeps you passionate about your work?
A: From the 1970s to the 1990s, I was involved in research studies measuring the health effects of children's diets and physical activity levels, with particular attention to racial and ethnic disparities. Over this time period, I saw clear evidence of the deterioration of children's diets, with a disturbing and widespread transition to convenience foods and snack-type processed foods. These foods were being sold and distributed in the very institutions where children learned and were cared for. They were widely advertised and marketed to children and were replacing more nutritious foods. New foods were often heavily fortified, deceptively making them seem like nutritious alternatives. While I was watching these dietary changes, I also began to see the rapid, unprecedented, shocking rise in childhood obesity, with accompanying implications for health. We learned that childhood diets characterized by excessive calories from low-nutrient foods could lead to negative population-wide health effects during childhood as well as during adulthood. Our processed and snack-food rich diet was associated with a tripling in the rates of childhood obesity and a new spread of type 2 diabetes never before seen among children. I knew I needed to stop watching the trends and start trying to reverse them.
What keeps me passionate is knowing that change is possible when high quality policy relevant research is conducted and communicated to decision makers and those who work with children. During the last decade we have seen early signs of declines in the rapidly rising child obesity rates. If this energy to improve children's health continues for 20 more years, I would expect rates of child obesity to return to those in the years preceding the1980s, thereby nearly eliminating type 2 diabetes and heart disease risk factors in childhood.
A: This new unit is in the systemwide UC Division of Agriculture and Natural Resources, rather than being located on a specific campus. This provides more opportunities for multi-campus collaboration on issues that are of statewide and national concern. Being located in UC ANR, we also expect to use a broader food systems approach with a greater diversity of colleagues and, of course, utilize the power and reach of UC ANR Cooperative Extension to assure outreach throughout the state.
Q: People of color generally have poorer health outcomes in America. What public policies could help us change that? You led a seminal epidemiologic study on the development of obesity in African American girls. How does that work inform your thinking about nutrition education efforts and public policies in that arena?
A: The 10-year NHLBI Growth and Health Study was one of the first studies to disentangle the effects of race/ethnicity and family income and education on childhood obesity. We found that poverty is a critical determinant of obesity. This finding has guided my subsequent work conducting research on WIC [Women, Infants, and Children], the School Lunch Program, and SNAP-Ed [Supplemental Nutrition Assistance Program Education, previously food stamps], all of which provide an opportunity to address the most at-risk individuals, including children.
We have seen dramatic improvements in the programs. For example, the WIC program, which serves low-income pregnant women and their young children, revamped their food package to include more healthful foods. Similarly, new school lunch guidelines are assuring more healthful foods are served to children. Most of the children who benefit from this are low income students who qualify for free and reduced-price meals. There is still plenty of work to do to improve the programs, to ensure all those who could benefit have access to them, and that the benefits provided are funded adequately, but I am encouraged by how much has been accomplished.
Q: The average person knows relatively little about how research can inform and shape public policy. Are there insights you'd care to offer?
A: Policy-making bodies at both the state and national levels are eager to have science-based information to make the best decisions possible. Policymakers want to positively impact the health of their constituents. And more policymakers than ever are aware that our country spends far too much on healthcare and doesn't have the best health to show for it. This focuses increasing attention on disease prevention, as we clearly must do more to promote population health and keep people from needing to consume healthcare. Dietary intake is increasingly recognized as a major factor in the prevention and reduction of chronic disease rates in this country. Therefore, providing decisionmakers with good evidence about ways to improve dietary intake and thus population health offers opportunities to do something that helps constituents—and ultimately may lead to improvements in the nation's bottom line as well.
Q: The Academy of Nutrition and Dietetics recently received a great deal of negative attention when its new Kids Eat Right logo landed on Kraft Singles. They've had to walk back this decision, in part, due to pressure from their constituent group and folks like you. Any comments or insight you can provide on this situation? Is the logo a damaged brand now?
A: The Academy of Nutrition and Dietetics recently embarked on a new partnership with the food industry. However, it is my understanding that the Academy's membership questioned the terms of the partnership, thus bringing into question the degree of separation of nutrition professionals from the influence of industry. Food industry sponsorship of speakers at annual meetings of the dietetics profession is another example of action that has begun to cloud the Academy's reputation. If the Academy does not change its approach, I fear it could become a damaged brand.
Q&A with Alissa Hamilton, who advocates for the replacement of milk as the suggested beverage with water. What's your take on this? What kinds of issues are likely to emerge as the Dietary Guidelines move further along in the revision process? What would you like to see? What do you expect to see?
A: The Dietary Guidelines Advisory Committee is an independent scientific body that reviews the evidence behind the nation's dietary recommendations. The current evidence on dairy supports its inclusion in the recommendations. Thus, in my mind, the issue isn't the need for replacement of milk with water, but rather the replacement of soda, energy drinks, and other sugar-sweetened beverages with water. Hopefully educational materials for the public, including MyPlate, can begin to include water as the beverage that is first for thirst. Free water should be available in schools, childcare centers, worksites, public buildings and all other venues that serve children and adults.
Hopefully, the final Dietary Guidelines, when issued, will reflect the recommendation by the Dietary Guidelines Advisory Committee that added sugars be limited to no more than 10 percent of the calories in a diet. We have had strong evidence of sugar's contribution to diabetes, heart disease, obesity and dental caries. Therefore, in order for consumers to estimate their added sugar intake, it would be necessary for the FDA to modify the nutrition facts label to include added sugar. Without this information the American public has no resources with which to determine the amount of added sugar in their diet.
I also support the Committee's recommendation to consider sustainability when making dietary advice, and their encouragement of a plant-based diet. We are just beginning to understand all of the ways in which our food system is connected. Ensuring an adequate and adequately nourishing food supply for the population in the future demands that we continue to move in this direction.
Q: You're a researcher, but you also exert a profound influence in food politics. A battle is shaping up in Congress over the Healthy School Meals Act, which is due to expire at the end of September. In addition, the SNAP program is under fire by some politicians. Can you talk a little about the dynamics of these situations? Ultimately, what do you think might happen?
A: The safety net programs are under fire by some who seek to reduce or shift priorities in the federal budget, but the data overwhelmingly support the need for these programs for low-income Americans. We are spending more money on safety net programs now because so many people need them. In California, for example, more than half of our public school students qualify for free or reduced-price school meals and most babies born qualify for the WIC program. Thus, our food programs are not serving a small segment of our population but, rather, are necessary to sustain the majority of our population. We need to fix our economic challenges. In the meantime, cutting these food assistance programs would increase the risk for poor diets and the resultant long-term chronic disease costs, which would then paradoxically actually increase budgetary expenditures. Thus, cutting these programs would be an example of action that is penny-wise and pound-foolish.
Q: Can you tell our readers a bit about your most current research projects?
Q: Fomenting change is risky. What keeps you going when things get tough?
What keeps me going is the realization that we, as adults, are not adequately protecting our children. For a long time, we bought into the mantra that children were to blame for not making healthy food choices. We now have overwhelming evidence that children will make unhealthy choices only if given unhealthy food options; conversely, children will make healthy choices if given healthy food options. Adults are responsible for the health, well-being and protection of their children and this means provision of healthy food choices and lack of access to unhealthy food choices. Healthy food consumption is the single biggest factor for preventing chronic disease risk in children. Healthy food for children is an investment in our nation's future as surely as is education.
Q: Many are using social technologies for movement building in your profession (the work of the SugarScience team is just one example).
Q: Your work has a strongly ethical aspect to it. Are there unique challenges that nutrition professionals face in a free market environment?
A: Nutrition professionals have to contend with the enormous power of large multi-national corporations in the food industry. The power of food companies to influence policymakers cannot be overestimated, particularly when it comes to changing nutrition policies for our nation's food programs or trying to establish new policies to limit consumption of products we know are contributing to ill health. Further, the food industry has enormous resources available to market and promote foods and beverages with little or no nutritional value to children. This overwhelms and undermines the efforts of the limited nutrition education that is available to educate them. The free market fails here — consumers aren't able to get the information they need to make good decisions, and the people who profit from selling ill health are not the same ones who pay the consequences. Thus, it is up to those of us working in this area to make sure we share good information and work to change the systems that currently enable selling ill health to be so profitable.
Q: With a proliferation of labels, many consumers are confused. Do labels help someone concerned with ethical and environmentally aware eating?
A: Food companies make claims for their products, both in advertising and on the front of package labels that are deceptive and misleading. For example, a product may claim to have no gluten or no cholesterol despite the fact that that type of product never included those constituents. Products that say “lower salt” are often still very high in sodium. Some products claim to provide energy when they are really only indicating that the product provides calories. Confusion is commonplace.
Access to information on the environmental impact of food production is sorely limited. Only recently has the selection of a diet good for both the individual and for the planet become a part of our discourse. For people who can afford to shop at specialty food stores or farm stands, there are some suppliers in the marketplace that try to sell better choices in terms of environmental impact. But we have barely begun to do what is needed to support wide availability of dietary choices that are optimal for human or environmental health.
Q: Everyone gets the drought question! The California drought impacts the nation and the world. What changes might it bring about in the nation in terms of thinking about where and what we produce? What might the future hold for California, and agricultural production in the state?
A: There is much we don't know. Climate scientists and agricultural scientists are working to identify and predict the impact of various aspects of climate change including increased CO2 emissions, warming, and drought on crop yields and nutrient composition of various commodities. What I can say is that if the yields of fresh fruits and vegetables drop considerably, as they may do, we will have a grave situation. Fruit and vegetable intake by Americans is already inadequate. Eating enough affordable fruits and vegetables is going to be harder than ever, particularly for low-income Americans. This is yet another reason why reducing federal nutrition assistance programs at this time, as some are proposing, is not wise.
Q: What keeps you up at night?
A: I'm most worried that some of the progress we've made on policies to improve the healthfulness of school meals will be reversed due to political pressures based on the costs of healthy foods compared to the lower costs of less healthy foods, and the resistance of some to accept change that is in the best interest of children, particularly when it affects the profits of adults. I am also worried that there will be enormous lobbying efforts on behalf of less healthy foods that have been excluded from the new regulations. School meals should be more fully supported in order to provide children with the foods they need to be healthy.
Q: What might it take to get the next generation inspired to be concerned about nutrition and food policy?
A: I'm really pleased that these issues continue to be in the public eye and in the media. I hope that food and nutrition education will be reinstated in schools with the knowledge that this type of education can be provided in a way that it does not negatively impact test scores in common core subject areas. Currently children in the United States receive an average of only four hours of nutrition education a year, similar to the amount of time students are exposed to junk food advertising in a single week. With even modest increases in annual hours of food and nutrition education, I believe the next generation will be more aware and concerned about the relationship among nutrition, disease and food policy. We are seeing that the millennial generation is more interested in food issues than the generations before them, and this I find very encouraging.
Q: What must institutions and groups do to effect change in the food system?
A: I am heartened by the increased attention being focused on the food environment, policy and systems. A complex issue such as the food system requires input on multiple levels from multiple stakeholders. An example of the kind of effort that is needed is already underway on the University of California campuses. Last year, President Napolitano began the Global Food Initiative to harness the expertise and resources across multiple disciplines the UC system to address healthy and sustainable food systems.
Q: We're faced with challenges on a variety of fronts that have strongly ethical aspects to them, such as climate change, environmental constraints, income inequality, and food access. How do we get groups to move forward together? And is this a movement? How does the work of professional nutritionists fit into the larger food movement?
UC Global Food Initiative, university-wide, is working to increase research and collaboration among all the campuses. The UC ANR Nutrition Policy Institute is working to train the next generation of nutrition researchers to expand their field of inquiry and include systems science in their work. The work of nutritionists can enrich and inform our understanding of the food system by providing the evidence linking factors within the system to food and health outcomes.
Q: I'm giving you a super power. You can change one thing about the food system with that super power. What change would you make?
A: I would level the playing field by reducing the influence of money to reduce the healthfulness of children's diets, both in the marketing of unhealthy foods to children, and in food industry lobbying of policy makers.
“This is a perfect example of what can happen when multiple levels of government and community organizations work together,” said Luis Chavez, a member of the Fresno County School Board. “This is a model that we hope to expand across the city.”
UC CalFresh, part of UC ANR Cooperative Extension, provides regular produce sampling and education in classrooms to encourage children to eat fruits and vegetables. UC ANR's Shelby MacNab, UC CalFresh program manager in Fresno, said the program is also committed to increasing access to fresh produce in the communities it serves. UC CalFresh staff will stand alongside the farm stand each Thursday to reinforce the nutrition lessons and offer nutrition class sign-ups to families.
"We are absolutely delighted to support the farm stand by providing nutrition education. Pairing greater access to fresh fruits and vegetables with nutrition education is an essential combination for transforming the health of our community," MacNab said.
On May 14, the school launched the program for 2015 with fresh cherries, oranges, jujubes, squash, green onions and baby bok choy. The produce came straight from the 10-acre Reedley farm of May Vu. The low-cost fruit and vegetables can be purchased with cash or CalFresh benefits (formerly called food stamps).
The farmer connection was facilitated by John Thao, project manager with the National Hmong American Farmers Association, another partner in the food stand effort.
“We're working to sustain the economic development of small-scale farmers,” he said.
For the community around the school, the farm stand addresses the woefully inadequate grocery shopping options. Liquor stores and fast food restaurants abound. A supermarket that stood at a nearby intersection for decades is now closed.
“We want to make the healthy choice the easy choice,” said Genoveva Islas, executive director of Cultiva la Salud, one of the community organizations involved in the partnership.
Theresa Calderon, principal of Vang Pao Elementary School, said the after school farm stand is popular with the students.
“The students bring a dollar and buy cherries, strawberries, whatever is in season, rather than going to the corner store and buying a slurpee and bag of cheetoes,” she said “It's what's best for the students.”
Farm advisors: They're the local hand on the long arm of the University of California Agriculture and Natural Resources (UC ANR). They apply cutting-edge research to problems facing their farming neighbors, often adapting practices and research results to local conditions. UC ANR Cooperative Extension advisors provide locally adapted science to local farmers.
So it might come as a surprise that some farm advisors got their start in agriculture nowhere near their backyards or their neighbor's fields. In fact, more than a few farm advisors fell in love with helping farmers while they were overseas.
Mark Lundy, for example. As the UCCE agronomy advisor in Colusa, Sutter and Yuba counties, Lundy works with farmers on field crops such as tomatoes, alfalfa, wheat, sunflower, beans, and an assortment of other vegetable crops. At a recent meeting for tomato growers, he presented about tools that might help farmers better apply fertilizers, with sensors adjusting recommendations for each individual field. Does it get more “local” than that?
But as a UC Davis grad student, Lundy traveled to Malawi for a few weeks to help extension agents there teach farmers modern tomato-growing practices — as part of a Trellis project with the Horticulture Innovation Lab.
Lundy wrote about his experience in Malawi recently on the Feed the Future website. He describes setting out, eager to put “book learning” to practical use, and eventually realizing how valuable local knowledge can be for agriculture. While in Malawi, Lundy worked with a local agronomist named Chimwemwe:
“Seeing Chimwemwe's extension program in action underscored to me that agriculture is simultaneously (even paradoxically) a global and a local enterprise. Many of the fundamentals of cropping systems do apply broadly across diverse agricultural landscapes, which is what permitted the productive conversations and collaboration between us. Nevertheless, there is no substitute for a nuanced understanding of the particular contours and constraints of any given region or farm.”
Though Lundy had years of formal education in agronomy, he witnessed how Chimwemwe's relationships and local understanding made him a “sharper tool” when it came to helping local farmers.
“Observing Chimwemwe in action inspired me to leverage the regionally specific knowledge I had gained about California agriculture during my graduate education and try to become a similarly sharp tool in my own backyard,” Lundy wrote.
You can read the rest of the article, “How a Global Trip Inspired this Californian to Focus Locally” on the website for Feed the Future, the U.S. government's global hunger and food security initiative. The initiative brings American ingenuity and expertise to bear in the global fight against hunger. Several agricultural research programs at UC Davis and UC Riverside fall under the banner of Feed the Future — including the Horticulture Innovation Lab, led by UCCE specialist Beth Mitcham.
Author: Brenda Dawson
As a graduate student, Mark Lundy (back, left) worked with Chimwemwe (second from right) and colleagues in Malawi on a tomato production project with the Horticulture Innovation Lab.
As the global demand for seafood booms, major food retailers are promising that soon all of the fresh, frozen, farmed and wild seafood that they sell will come from sustainable sources. However, finding such sustainable sources to satisfy the global appetite for seafood is easier said than done.
While many of the sustainability standards have been met by commercial fisheries in the developed world, a major challenge exists in fisheries overseen by developing nations, which account for about half of all seafood entering the international market. Unfortunately, only 7 percent of the fisheries that have been fully certified by the Marine Stewardship Council for meeting sustainability standards are developing-nation fisheries.
An alternative mechanism for achieving both sustainability and increased seafood supply has been developed in the form of Fishery Improvement Projects, which aim to get fisheries on a path to sustainability and potentially certification by the MSC.
These improvement projects are partnerships between fishermen and firms up and down the international seafood supply chain. They are designed to offer developing-country fisheries access to the lucrative international export market in exchange for promises to improve sustainable fishing practices.
“It is hoped that the projects will protect marine life and ecosystems in areas where local and national governments have not acted to oversee sustainable practices, while also satisfying the demand for sustainable seafood,” said Gabriel Sampson, UC Davis graduate student and lead author of the study.
In many cases, however, the fisheries are obtaining access to the international seafood markets without following through to make the required improvements in sustainability.
In a May 1 policy forum titled “Secure Sustainable Seafood from Developing Countries” in the journal Science, Sampson and colleagues conclude that Fishery Improvement Projects need to be fine tuned to ensure that fisheries are delivering on their promises for sustainability improvements. The related abstract and podcast are available online.
Such sustainable fishery management reforms should include data collection and ongoing monitoring, strengthening harvest and access rights to the resources, limits on the catch, and instituting traceability throughout the supply chain, the researchers say.
They predict that if access to the fisheries is not better regulated, the current efforts by retailers to secure sustainable, wild-caught seafood could stimulate a “race to fish,” and those fisheries with full sustainability certification could find themselves at a competitive disadvantage compared to the fisheries that have been fast-tracked into the international market without having first made sustainability improvements.
And that could trigger a “race to the bottom” in terms of sustainable seafood fishing practices, they say.
“The retailers and organizations involved with managing fishery improvement projects need to insist on progress toward reforms from the fishery as a condition for purchasing seafood from that fishery,” said James Sanchirico, a faculty member with the UC Agriculture and Natural Resources Ag Experiment Station, UC Davis professor and associate director of the UC Davis Coastal and Marine Sciences Institute.
“This would likely lead to more durable conservation and greater assurance for consumers that marketing claims of ‘sustainable' seafood are valid,” he said.
On a Friday evening in a San Francisco conference room, food and technology leaders – including nutrition expert Carl Keen, a UC Davis professor affiliated with the UC Agriculture and Natural Resources Ag Experiment Station – spoke to a mixed audience on the need for innovation in adapting populations across the world to changing food systems.
In the crowd, one inspired undergraduate student from UC Davis thumbed together some notes on his phone. The next day he stood in front of everyone at the event – more than 250 in all – and pitched his newly formed idea for a nutrition app.
It drew a small team: a Silicon Valley entrepreneur, a UC Davis nutritionist and a UC Berkeley student. Over the next 40 hours they developed a software application that matches safe foods to patient medications. With the final presentations Sunday evening, the judges announced the winners.
Their project, called Took that? Eat this., won first place at the 2015 Food Hackathon. They now have sponsors and are developing their idea into a real consumer product. They are also flying out to the World Expo in Milan, Italy, in September – the first devoted to food and where an even larger food-themed hackathon will take place.
Breaking down the silos
“It's powerful how much happens in such a short period of time,” says Bob Adams, innovation adviser for the UC Davis World Food Center and a mentor for the hackathon teams. “It was a great experience for all the UC Davis students who participated, because they don't normally interact in projects with students from other programs.”
With nearly 9,000 total hours spent in developing the 18 different projects, the hackathon was declared by the organizers a success and a testament to the power of crowd sourcing.
A group of passionate techies, foodies, scholars, investors and entrepreneurs shut in a room for two days pushed them like never before to apply their diverse expertise toward tackling some of the biggest problems facing food and ag.
A university connecting ag and nutrition
Research and industry leaders are looking to this model as one way to seed California's innovation ecosystem across the state's agricultural horizons. As another example, Mars, Inc., which co-sponsored the hackathon, is investing in a new type of university-industry partnership with UC Davis and the World Food Center by establishing the Innovation Institute for Food and Health.
“All of us win from these new and needed collective investments in innovation in food, agriculture and health,” writes Mars chief scientist Harold Schmitz in a recent Sacramento Bee op-ed.
Howard-Yana Shapiro, also a Mars chief scientist and a UC Davis fellow, sees innovative food technology projects like those crafted at the hackathon as this decade's biggest investment arena.
“The next, larger human generation will face food challenges ranging from climate change and water stress to growing demands for upmarket foods,” he wrote in a LinkedIn article. “But from what I saw at the hackathon, the next generation is on it.”
See the original story by the UC Davis World Food Center./span>