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Food And Health: Health Affairs' November Issue

The November issue of Health Affairs contains a number of articles focusing on the relationships between food and health in the United States. Some of the topics studied include policies that can encourage healthier eating, the impact of food insecurity on overall health, and the cost of obesity to state Medicaid programs, among others.

This month Health Affairs launches a new DataGraphic feature, which will appear primarily in theme issues. This month's DataGraphic (excerpt below) provides a pictorial view of key facts about obesity, including data from several studies in this month's issue.
The November issue of Health Affairs is supported by the Robert Wood Johnson Foundation.
Obesity In The United States: A Look Over Time
Centers For Disease Control And Prevention (US Prevalence Chart And US Maps)
Restaurants With Calorie Labels On Menus Offer Lower-Calorie Options. 
In advance of the 2016 federal mandate to add calorie labeling to all chain restaurant menus, researchers evaluated the impact of restaurants voluntarily adding this information. Sara N. Bleich of Johns Hopkins Bloomberg School of Public Health and coauthors used data from 2012 to 2014 and found that restaurants that used labels had items on their menus that were lower calorie than restaurants that did not. In 2014, restaurants with calorie labels averaged 139 fewer calories per item than restaurants without labeling. Similar differences were found in 2013 and 2012. Study authors believe calorie labeling may have important effects on the food served in restaurants by compelling the introduction of lower-calorie items.
Obesity In Adults Costs State Medicaid Programs $8 Billion.
Obesity has tripled in prevalence over the past three decades, and yet the question remains: What is the cost of this disease? Y. Claire Wang of the Mailman School of Public Health at Columbia University and coauthors examined health care spending levels related to obesity at the state level and estimated how much of these expenditures were paid for by Medicaid. In 2013, nearly 11 percent (or $8 billion) of the cost to treat severe obesity was paid for by Medicaid, ranging from a cost of $5 million in Wyoming to $1.3 billion in California. Experts predict these costs will only grow as Medicaid eligibility is extended to more people following the implementation of the Affordable Care Act's Medicaid expansion, which also requires state Medicaid programs to cover more obesity treatment-related services than in previous years. To mitigate rising obesity-related health care costs, the study authors concluded that states need to identify and ensure access to effective obesity prevention and treatment services to people who are Medicaid-eligible and include obesity in the policy discussions around state Medicaid expansions.
Analysis: Healthier Eating Is Saving American Lives.
In what is believed to be the first study of its kind, researchers analyzed the diets of Americans to document the change in disease burden attributed to change in overall dietary quality over time. Dong D. Wang of Harvard T.H. Chan School of Public Health and coauthors found that, from 1999 through 2012, healthier quality of diet cumulatively prevented 1.1 million premature deaths. The difference in dietary quality between 1999 and 2012 resulted in a 12.6 percent drop in type 2 diabetes, an 8.6 percent drop in cardiovascular disease, and a 1.3 percent drop in cancer cases. Using the Alternate Healthy Eating Index 2010, the study authors found that out of an optimal score of 110, Americans' scored a 48.2 in 2012, with large gaps across socioeconomic groups. Americans' diet quality scored just 39.9 in 1999. The researchers concluded that while improvements have been made in the dietary habits of Americans, overall, Americans' diets remain poor.
The Impact Of Food Insecurity On Children's Health And Academic Success.
Researchers assessed the impact of transitions into and out of household food insecurity on the academic achievement, behavioral problems, and health status of children in kindergarten and first grade. Rachel Tolbert Kimbro and Justin T. Denney of Rice University used nationally representative data from the period 2010-12 for 6,300 children in the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11, with household incomes below 300 percent of the federal poverty level. They found that food insecurity negatively affected children's health status, as well as their self-control and interpersonal skills, among other behaviors. Food insecurity, however, did not have an impact on academic achievement. Taken together, these findings underline the importance of food security for children's healthy development.
Also of interest in the November issue: