June 28th, 2021

I have been frustrated by this annual reality for the better part of two whole decades. How can we continue to allow our elected officials to allow certain farmers, convenient stores and the healthcare industry to profit from making our children ill? The scourge of this country is and remains the constant access of our children to government funded low

quality foods in our school systems and SNAP, supplemental nutrition assistance program, in the guise of "feeding them". We have seen an exponential rise in obesity, liver fat disease, high blood pressure, diabetes and other diseases of over nutrition while no changes of meaningful value have occurred in the quality and or access to good food for the poorest children in America.

From an opinion article by Drs. Landrigan, Satlin and Boffetta, "HFCS was invented in the 1960s. Production increased dramatically in the 1970s, after the U.S. Department of Agriculture (USDA) ended controls on corn, wheat, and soy production and replaced them with a policy that encouraged — and paid — farmers to grow as much of these commodity crops as possible. Today, these subsidies total $19 billion per year. They have led to enormous increases in production of cheap corn starch. No subsidies are paid to fruit or vegetable farmers despite the clear health benefits of eating fresh fruits and vegetables."

Initial reasons behind the subsidizing of these staple and storable foods were obvious in the 1960's and 70's where food scarcity was more common. The financial incentives have been misaligned since the issue of food scarcity became a non issue in the American agrosphere over the past 40 years. Children are no longer missing out on meals or going calorically hungry. The opposite exists in full force throughout America especially in rural and inner city environments. "governments spend $570 billion annually on public support for agricultural producers; these subsidies are focused on achieving historical development imperatives, such as eliminating hunger and reducing poverty, rather than at incentivizing the behaviors that will achieve today’s broader vision for food systems." (McKinsey and Co. 2020)

The obvious answer to this problem is to stop subsidizing the wrong foods and in turn subsidize high quality fresh fruits and vegetables. Unfortunately, we are not only subsidizing the wrong foods, we are also allowing the purchase of these poor quality products with SNAP dollars for the poorest Americans. "About 20 cents of every SNAP dollar goes toward sweetened beverages, desserts, salty snacks, candy, and sugar, according to a report commissioned by the U.S. Department of Agriculture (USDA). Soft drinks, potato chips, and processed meats are among the top ten items purchased with SNAP benefits." (Rahman et. al. 2021) In the pursuit of good "feed the less fortunate" governmental policies, year after year different lawmakers double down by knowingly doing the opposite through subsidies and poorly placed policy.

In the world of pediatrics, we are stuck picking up the pieces of this realtime nightmare with governmental incentives to fight the obesity and metabolic disease epidemic through testing identification and education. Now we are living in the perverse world of antecedent government endorsed damage with no effective tools to help these kids while being told to do exactly that. We will check hemoglobin A1c's, lipids, and liver screening tests knowing that they will be abnormal with no chance of general health success when the deck is stacked against these children before we begin the process.

Dr. M

Landrigan Mt. Sinai Opinion Piece
McKinsey Article
Rahman Medpage Today