Fighting childhood obesity: SNAP v. soda

In the mid 20th century, hunger was a major concern for America’s poor. To better support malnourished families living below the poverty line, the federal government created the Food Stamp Act in 1964 to help provide healthy food to people in need.

America’s nutritional landscape has changed a lot over the past 50 years. Malnourishment is still a big problem in America, but in a much different way than it was back then.

Because of their lower prices and mass availability, unhealthy foods and drinks have become a staple in the diets of millions of Americans. Obesity rates in this country have grown to epidemic levels, with impoverished communities being hit especially hard. In low-income homes across the country, overweight and obese children now outnumber underweight kids by a ratio of seven to one.

To combat this epidemic, many states are trying to change what type of items people can buy via the Supplemental Nutrition Assistance Program (SNAP-formerly know as food stamps). Because sugar-sweetened beverages have no nutritional value and have been closely linked with obesity, nine states, including Illinois, Nebraska, Texas and most recently New York, have tried to have these drinks barred from being bought with SNAP money.  In each case the US Department of Agriculture (USDA) has said no.

Limiting what people can and can’t buy using government assistance isn’t new. For years SNAP users haven’t been able to use their benefits to buy alcohol, tobacco, products not meant for eating (e.g. paper goods, pet foods, etc.), or hot, premade foods often sold in grocery stores. Still, despite a history for deciding what can and can’t be bought with SNAP dollars, the USDA denied permission for states to exempt sugar-sweetened beverages from SNAP benefits.

David Ludwig, MD, PhD

David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center and the Optimal Weight for Life (OWL) Program at Children’s Hospital Boston, supports state-sponsored pilot projects to revise SNAP benefits in the wake of the obesity epidemic. In a recent commentary in the Journal of the American Medical Association (JAMA), Ludwig says that proposals to eliminate sugary drinks from SNAP provide an opportunity to align government spending with public health priorities.

“The government spends $4 billion each year to purchase sugar-sweetened beverages for low income individuals – that amounts to about 20 million servings per day,” Ludwig says. “Research strongly suggests that consumption at these rates will adversely impact diet quality, cause excessive weight gain, and increase the risk for obesity-related chronic disease.”

Obesity and its related health concerns, like diabetes and heart disease, cost millions to treat every year. In many cases, American taxpayers provide the lion’s share of those dollars through programs like Medicare and Medicaid. Considering the burden obesity has become on the health and financial well being of so many Americans, it’s difficult to understand why the federal government continues to encourage consumption of sugary drinks through SNAP.

The USDA says it has several issues with regulation that would forbid SNAP money from buying sugary drinks. For instance, in New York’s case, the USDA says too many of the city’s retailers—especially the small and independent ones—aren’t prepared to adapt to any changes in SNAP rules. It also stated that a clear-cut system to figure out which products would be allowed and which would be denied wasn’t currently available.

Many sugar-sweetened drinks have no nutritional value and contribute to obesity. Should they be made available through government-funded programs?

In addition, the USDA says New York’s proposal lacked proof that such a ban would eventually reduce sugar consumption or improve health among the state’s 1.9 million SNAP users.

Siding with the USDA, anti-hunger groups and the American Beverage Association (ABA) have also joined the debate. The Food Research and Action Center, a leading nonprofit organization dedicated to fighting malnourishment, said adding limits to what people using SNAP can and can’t buy might make recipients feel stigmatized. The ABA, which names the Coca-Cola and Pepsi Beverages companies among its members, said that such a ban is “another attempt for the government to tell people what they can and can’t drink.”

Some of these concerns, though valid, could be addressed using straight-forward pilot studies of the new policy recommendations.  In addition, Ludwig says SNAP continues to serve a critical public health mission, and any policy changes must avoid stigmatizing recipients. Nevertheless, Ludwig says by using taxpayer dollars to buy millions of sugary drinks everyday, the federal government is actively contributing to the nation’s obesity problem, while undermining SNAP mission to “help put healthy food on the table” for the program’s 40 million users.