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Helena
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What food is healthy enough for a SNAP pilot? It’s not a simple question
As congressional leaders now try for the fifth time to come up with a spending deal to keep the government funded through the rest of the fiscal year, they still need to work through a handful of thorny policy issues.
Two of those have to do with food. First, there’s the question of whether or not Congress will find hundreds of millions of dollars in additional funding to make sure the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, doesn’t run out of money and have to ration benefits later this year. As I wrote last week, securing that funding has been a huge challenge.
Second, there’s been a big ol’ fight over whether lawmakers will keep a controversial provision to allow up to five states to test restricting what foods you can buy with Supplemental Nutrition Assistance Program benefits.
Budget negotiations are still ongoing – the House and Senate just passed a short-term bill to keep the government funded for a hot second while lawmakers iron this out – but the latest word is that the eventual longer-term deal will include stepped up WIC funding (TBD how much). That new SNAP pilot program, however, may have been taken off the table. (Hat tip to Politico’s Meredith Lee Hill for first reporting this on Thursday.)
This is somewhat surprising, because just last week it seemed fairly likely that the SNAP language would survive. As I’ve previously noted, restricting what foods can be sold via SNAP has long been a priority for Rep. Andy Harris (R-Md.), who’s long pushed a bill to do just that. He’s currently chairman of the panel in the House that writes the ag appropriations bill (the bill that funds USDA, FDA and other related programs), and the current budget standoff is a prime opportunity for him to get a policy like this to the finish line.
So what happened? My sources are still mostly speculating, but suffice it to say that lobbying against the pilot concept has been intense. Retailers, food companies and anti-hunger groups have long been lockstep against cracking the door open to restrictions in SNAP. This nearly $120 billion program helps tens of millions of Americans afford groceries each month — and it also represents billions in sales for food companies and grocery stores.
The crux of the debate: Proponents for testing SNAP restrictions argue that it only makes sense to look at our largest food aid program as a potential lever for improving Americans’ diets. The U.S. is riding a tidal wave of costly and debilitating diet-related diseases, which not only reduce quality of life but also threaten the sustainability of Medicaid and Medicare.
Opponents, meanwhile, argue that it’s patronizing for the government to dictate what people can feed their families, even if the government is paying for that food. And the data shows that SNAP households don’t shop much differently from other households. Many people see this as another way to make the program more onerous and less appealing — a means of shrinking a safety net program without the bad optics of overtly cutting it.
What is nutrient-dense? Setting aside the debate about whether it’s a good idea to test these restrictions and study the results, the concept raises some interesting questions. The most pressing: How do you draw lines around which foods are in vs. out?
In the original language, backed by Rep. Harris, the pilots could only include foods and beverages that are considered “nutrient-dense” according to the Dietary Guidelines. Nutrient-dense might seem kind of straightforward on its face, but it gets complicated quickly. Here’s how the Dietary Guidelines define it:
Nutrient-dense foods and beverages provide vitamins, minerals, and other health-promoting components and have little added sugars, saturated fat, and sodium. Vegetables, fruits, whole grains, seafood, eggs, beans, peas, and lentils, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry—when prepared with no or little added sugars, saturated fat, and sodium— are nutrient-dense foods.
It’s easy to come up with a list of foods that many would consider part of a healthy diet that would not make this list: whole-fat yogurt, granola, white rice, many types of peanut butter (added fats), many types of canned beans (added sodium). I’m not even sure where exactly the line would fall on lean meats and poultry, but that could sure make shopping for something like ground beef super confusing for the average consumer. Condiments like hot sauce, soy sauce and pickles also seem unlikely to meet this bar.
Sen. Kirsten Gillibrand (D-N.Y.) on Wednesday asked Agriculture Secretary Tom Vilsack about the definition of “nutrient-dense” during a Senate Agriculture Committee hearing, noting that it wouldn’t include whole milk (because the Dietary Guidelines specify low-fat dairy) – a nod to New York dairy farmers, no doubt.
“If this appropriations rider were to pass tomorrow, how would you define nutrient-dense foods?” Gillibrand asked, further pressing on whether states or USDA would be charged with drawing the lines. “Will it make it harder for retailers to use the SNAP program? And what’s the impact on consumer choice and dignity?”
Vilsack replied by noting that it’s somewhat up to Congress to put parameters around what counts as “nutrient-dense,” though he suggested the food-level specifics would be left up to nutrition science.
“I don’t think we have many of the answers to the questions that you raised, which is why you have a pilot – to find out whether or not a system like this does work, or doesn’t. Does it create serious IT issues at the grocery store, or not? Does it create stigma, or not?”
“I will say we have found that incentives work effectively,” he added. “And increasing the nutrition [education] aspect of SNAP is always important.”
What’s next? Barring some other twist, the SNAP pilots seem unlikely to make it into the final deal for fiscal 2024, though we’ll know for sure when the negotiations wrap up (you know, if they ever do). Then it’ll be time for the ag appropriations subcommittee to start writing the fiscal 2025 spending bill for these same programs, with Harris still as chairman. I would not be the least bit surprised to see this issue come up again next year. The Maryland Republican has been talking about it for a very long time.
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What I’m reading
Certain types of ‘forever chemicals’ will no longer be used in US food packaging, FDA says (CNN). “Certain kinds of greaseproofing ‘forever’ chemicals called per- and polyfluoroalkyl substances, or PFAS, will no longer be used in food packaging in the US, the US Food and Drug Administration announced Wednesday,” per Brenda Goodman. “The FDA’s food studies have shown that food packaging materials like fast-food wrappers, microwave popcorn bags and take-out pizza boxes were a major source of dietary exposure to certain types of PFAS, hormone-disrupting chemicals that may persist in the body and the environment. PFAS have been linked to a variety of health effects including changes in immune and liver function, obesity, diabetes, certain cancers and lower birth weights.”
A ‘vaccine-like’ version of Wegovy is on the drawing board at Novo Nordisk (STAT). “New obesity drugs like Wegovy and Zepbound are currently taken once a week, indefinitely. But what if they could be taken once a year instead, like a vaccine?” writes Elaine Chen. “That’s a question that Novo Nordisk, the pharma company behind Wegovy, is exploring as it faces increased competition from other drugmakers aiming to develop similar GLP-1-based treatments for obesity. … [Chief scientific officer Marcus Schindler`] said the thinking on a vaccine-like drug is in very early stages and it’s too soon to say who Novo would target with such a molecule — whether it would be for people who have just lost weight to help them maintain the weight loss, or if it would be given to prevent people from developing obesity in the first place.”
Virta Health says it has the GLP-1 deprescription solution (Fierce Healthcare). “Telemedicine clinic Virta Health believes its members can achieve significant and sustained improvement in weight loss, even if a patient has stopped taking a GLP-1 drug, a newly released paper in Diabetes Therapy shows,” reports Noah Tong. “According to the company, it is a first-of-its-kind study offering an opposing viewpoint against clinical trials showing GLP-1 deprescription leading to weight regain. The results have potentially major implications for employers and plans looking to help its members improve health outcomes and fight obesity but that are concerned about rising costs amid increasing demand.”
New York sues beef producer JBS for ‘fraudulent’ marketing around climate change (NPR). “New York state Attorney General Letitia James sued beef producer JBS in state court for allegedly misleading the public about a pledge the company made to slash its climate pollution in the coming decade,” reports Michael Copley. “Prosecutors said JBS continued making deceptive marketing claims even after a consumer watchdog group recommended the company stop advertising because it didn’t have a strategy to achieve its climate target.”
Why the infant formula shortage is still a concern (Fast Company). “This month marks two years since the national infant formula shortage—when the United States could not feed its babies and was forced to rely on imported formula as an emergency bandage solution,” writes Laura Modi, CEO of Bobbie, a U.S. infant formula company. “Today, the shortage is over, but the problem is not: We still don’t have a resilient or diverse domestic supply, and the government has failed to make any significant progress to prevent a future crisis. We are still just one bacterium away from entering another tailspin due, in large part, to our inability to address the U.S. market failures.”
How Panera Bread ducked California’s new $20 minimum wage law (Bloomberg). “Billionaire Greg Flynn, who made his fortune running one of the world’s largest restaurant franchise operations, is getting a new boost from sourdough loaves and brioche buns,” report Daniela Sirtori-Cortina, Eliyahu Kamisher, and Josh Eidelson. “That’s because a California law that’s about to raise the state minimum wage at fast-food spots to $20 an hour from $16 offers an unusual exemption for chains that bake bread and sell it as a standalone item. Governor Gavin Newsom pushed for that break, according to people familiar with the matter. Among the main beneficiaries is Flynn, a longtime Newsom donor whose California holdings include two dozen Panera Bread locations.”
Reasons to avoid ultra-processed foods (The BMJ). “What can be done to control and reduce production and consumption of ultra-processed food, which is rising worldwide?” write Carlos Monteiro, Eurídice Martínez-Steele, and Geoffrey Cannon, in an editorial. “Reformulation does not eliminate harm, and profitability discourages manufacturers from switching to make nutritious foods. … [P]ublic policies and actions are essential. These include national dietary guidelines that recommend varieties of unprocessed or minimally processed foods and freshly prepared meals and avoidance of ultra-processed foods; institutional food procurement that aligns with these guidelines; front-of-pack labels that clearly identify ultra-processed foods; restricting advertising and prohibiting sales in or near schools and hospitals; and fiscal measures that make unprocessed or minimally processed foods and freshly prepared meals as accessible and available as, and cheaper than, ultra-processed foods.”
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