Raina’s Wellness: A not so new start for health policy in 2015

WUERKER © 2014 Politico. Dist. By UNIVERSAL UCLICK. Reprinted with permission. All rights reserved.BY RAINA GOLDSTEIN BUNNAG

The New Year is a time for a new start, and many of us hope to shed the drama and old news of the past year. Yet, 2014 was a big year for health policy issues and these topics certainly didn’t go away when the ball dropped.  Here I recap on some of the public health highlights I covered in 2014 and discuss the current status of the issues and what we can expect in 2015.
Then: In April I wrote about the 50th anniversary of the surgeon general’s report on the harmful effects of cigarette smoking and the progress our country has made since then.  Smoking rates are at an all-time low among U.S. adults and smoking bans are commonplace throughout the country.   At the time of my article, CVS had recently announced its plan to eliminate all tobacco sales in stores in an effort to further discourage people from smoking.  In addition, the fight against e-cigarettes by public health professionals and governments was starting to gain momentum.
Now: CVS’s ban on tobacco was rolled out one month ahead of schedule. On Sept. 3, 2014, they stopped selling all tobacco products in their 7,700 stores across the country. There are not yet any published statistics on whether the ban has hurt sales at CVS. However, they plan to make up for the estimated $2 billion in yearly lost sales through smoking cessation programs and increased partnerships with employers and insurance companies. Other large pharmacies that are tobacco free include Target since 1996 and Wegmans since 2008.
While tobacco rates continue to trend downwards, e-cigarettes are gaining popularity quickly, especially with teens.  The CDC reports that over 250,000 youth who never smoked a cigarette tried e-cigs in 2013. This creates new nicotine addiction and also increases acceptability of smoking.  E-cig manufacturers defend their product and maintain their safety. However, a recent study at National Jewish Health in Denver found that smoking e-cigarettes damages cells in healthy, young non-smokers. This study could pave the way to support further research and create tighter regulations.  In 2015, the battle will continue as many local governments are fighting for laws that prohibit sales to minors as well as e-cigarette bans in public places.
School Meals
Then:  In June I wrote about the major changes to school meals that were being introduced under the Healthy, Hunger Free Kids Act of 2010.   There was backlash across the country in schools and in Congress due to the strict regulation and monumental changes.  When I reported on the subject, the House and Senate had each introduced bills to make the guidelines more flexible and delay or eliminate certain provisions.  Public health organizations like the Center for Science in the Public Interest (CSPI) and Let’s Move! were fighting back against these bills, arguing that the guidelines, based on the most current science recommendations, are in the best interest of children’s health.
Now: The Omnibus Appropriat-ions Bill passed in December significantly loosened the school meal nutrition guidelines. The bill prohibits additional sodium restrictions in school meals until there is further scientific evidence to support them (remember that the original guidelines were based on the latest science). In addition, it allows districts to go back in time to the 2012 guidelines mandating that only 50% of grain products served must be whole-grain rich.  In the original legislation, 100% of grain products were to be whole-grain rich by 2014 and most districts had already implemented the new guidelines.
Students have been tweeting photos of particularly bad school lunches using the hashtag #ThanksMichelleObama, referring to the legislation spearheaded by the First Lady’s Let’s Move! organization. This is bringing increased negative attention and representing a biased view.  Fortunately, the hashtag #realschoolfood highlights school meal programs that have been serving great-looking lunches while following the same guidelines.  Hopefully in the coming year, hashtag supporters of all kinds will come together to share strategies and success stories to promote nutritious and delicious lunches in every school.
The results are in.  Recent studies have shown that school lunches are healthier than those packed at home.  A NY Times article by Jane E. Brody looked at several studies, two of which found that school lunches are healthier than those packed at home as they include more fruits, vegetables and whole grains, which have all been shown to be components of a healthier diet.  This review highlights the important role of school lunch and why the healthier guidelines are worth fighting for.
Food Labels
Then: In July I broke down some of the confusing lingo on food labels.  Labels often purposely confuse consumers by portraying a healthier or higher quality product.  I also wrote about the FDA’s proposed changes to the food labels to make products more transparent and labels easier to understand.  Among the many changes, the proposal focused on making serving sizes more realistic and labeling added sugars so empty calories can be kept in check.
Now:  The fate of the new food labels is still uncertain. The public comment period ended on Aug. 1,  and the FDA is now charged with reading and responding to comments before determining the final rules.  There is a hot debate between public health professionals, who don’t think the rules go far enough, and industry, who thinks the rules are too stringent.  Public health professionals, such as former FDA Commissioner David Kessler and the CSPI, are asking for labels that convey a clear message to consumers about the overall nutritional value of the products.  Other countries, such as Ecuador, use stoplight labeling so that consumers can easily identify amounts of fat, sugar and sodium in their foods.  A red light would indicate a high amount of fat while a green light could indicate low sodium.  However, the food industry in the U.S. is fighting hard against this system because it will deter people from purchasing certain foods (yes, this is the point).  They have invested millions of dollars into their Facts Up Front label. This label lists only numbers and percentages of nutrients which has proven difficult for consumers to understand.
By December 2015, restaurants and vending machines with over 20 locations will be required to list calorie counts for all food and beverage items on their menus or menu boards.  This means you can no longer feign ignorance of that donut’s caloric content because it will be staring you in the face.  This is a huge success as it allows consumers to make more educated decisions about their food choices.  It’s important to remember that calories don’t paint the whole nutrition picture. Added sugar and excess sodium are abundant in prepared foods and should be kept to a minimum as they are harmful to your health. Ask the restaurant to provide an ingredient list to be certain of what’s in your meal.

Raina Goldstein Bunnag has a bachelor’s degree from Boston University and a master’s degree in nutrition and public health from the University of North Carolina. She keeps abreast of the latest health news and will be addressing relevant wellness topics each month. If you have any questions or topics you would like to see covered in the column, please send her an email at [email protected].

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