Fast Food Genocide

We consider it normal to lose youthful vigor in our 30s, carry 30 to 40 extra pounds, live with chronic illness in our late 40s and 50s, and live our last decades completely dependent on others. But this should not be considered normal. This is the result of a lifelong pattern of unhealthful living and misguided information. We should look forward to enjoying an active life into our 90s. This seems like an outrageous expectation because most people spend a lifetime consuming an inadequate diet. They have yet to make the connection that we are what we eat and that ill health in the later years of our lives is the result of our earlier poor choices.

On the banks of the Delaware River, across from Philadelphia—the city of brotherly love—lies Camden, New Jersey, a city with a population of about seventy-seven thousand. It is one of the most violent cities in the country. It suffers from extreme poverty, high rates of obesity and diabetes, and low high school graduation rates. The problems plaguing Camden, and other urban areas like it, have baffled experts for years because it is a problem that hides in plain sight on almost every corner: Most residents of Camden do not live near a grocery store. Instead, they are surrounded by small neighborhood stores stocked with cigarettes, lottery tickets, highly processed snack foods, and few, if any, fresh fruits and vegetables. Camden is recognized by the U.S. Department of Agriculture (USDA) as a food desert.

The USDA defines a food desert as “a low-income census tract where either a substantial number or share of residents has low access to a supermarket or large grocery store.”¹ When grocery stores, farmers’ markets, and other healthy food providers aren’t available, the corner store or fast food restaurant becomes the primary source of nutrition, particularly for people who don’t own a car.

The rate of diabetes in a neighborhood is a barometer of its neighborhood-level deprivation of fresh produce.² Residents in urban areas like Camden suffer from diabetes at rates twice the national average. The amount of vegetables consumed in Camden is one of the lowest in the country, and this low consumption of vegetables is especially noted during the teenage years, the time when the influence of nutrition on behavior is profound.³

Food deserts are predominately located in low-income areas where people typically don’t have easy access to transportation. People who can’t afford to drive the mile or more to a grocery store are forced to rely on corner stores, bodegas, and fast food joints that sell commercial foods that create health problems. Imagine going into your local corner store and finding that every item on the shelf is unsafe for prolonged human consumption. This is the stark reality for more than 29 million Americans and 8 million children.⁴

Obesity and Diabetes by Zip Code

A report commissioned by LaSalle Bank in Chicago and undertaken by Mari Gallagher Research and Consulting Group with the help of the University of Michigan School of Public Health is titled “Examining the Impact of Food Deserts on Public Health in Chicago.”⁵

Researchers gave each urban community a score called a Food Balance Score. They measured the distance from every block and community to the nearest grocery store and divided that number by the distance to the nearest fast food restaurant. The higher the number, the more out of balance healthy food access was.

They reviewed the death rates and age of death in those areas and were able to calculate the Years of Potential Life Lost (YPLL), which estimated the average years a person would have lived if he or she had not died prematurely. YPLL is a measure of premature mortality. As an alternative to death rate, this method gives more weight to deaths that occur among younger people. Death rate records deaths per 1,000 population at all ages.⁶

The results were shocking: The people who lived in areas with the worst food balance score were the most obese and had more than double the death rate from diabetes and cardiovascular disease compared with people who lived in areas with a better food balance score. The YPLL for diabetics in these locales showed that these people were losing more than forty-five years of life.

DIABETES IN CHICAGO COMMUNITIES
BY FOOD BALANCE SCORE

Food Balance Grouping	YPLL	Death Rate (per 1,000 population)
Worst	45.48	1.27
Middle	33.48	1.11
Best	25.36	0.56

CARDIOVASCULAR DEATH IN CHICAGO COMMUNITIES BY FOOD BALANCE SCORE

Food Balance Grouping	Death Rate	Food Balance Score
Worst	11.07	2.04
Middle	7.41	1.25
Best	5.72	0.87

People with limited access to produce and healthy food are not starving for calories; in fact, most of them consume too many. Urban food deserts have plenty of fast food restaurants and convenience stores, and the population is generally overweight from the addictive nature of the available Frankenfoods. The problem is the absence or shortage of the delicate health-protective antioxidants and phytochemicals found in a variety of natural produce.

We routinely overlook the problem because we do not fully comprehend the role of nutrition in shaping what happens from the neck up. Nutritional opportunity determines behavior and intellect. A visit to local corner stores in Camden or Chicago reveals shelves of processed, nutrient-void foods that impair the normal functioning of the human body and brain. Numerous studies have found that the price of food goes down as the added sugar and oil content goes up. Consequently, inner cities in the United States have the lowest cost, lowest nutrient, most dangerous food supply in the world.⁷

Commercial foods that line shelves in corner stores are designed to have a long shelf life, look good, and taste good, but they are not compatible with human genetics. This deception is completed by the addition of synthetic nutrients, which prevent short-term vitamin deficiency disease, while the body and mind are slowly destroyed.

The SAD now derives more than half its calories from chemicalized processed foods, but in urban food deserts, the amount of fresh produce eaten by the local population is less than 5 percent of calories.

It is hard to generalize about the country’s worst urban food deserts, as all these areas of concern are not effected equally; there are worse sections and better sections within the cities listed here. All have areas of poor access to fresh produce, with a heavy penetration of fast food restaurants and stores.

Only one supermarket serves an unhealthy populace in a city with one of the highest crime rates in the country.

In certain areas of Chicago with little access to large grocery stores, largely African American neighborhoods have twice the death rate from diabetes and heart disease compared with neighborhoods that have adequate access to large grocery stores.

Detroit is the world’s largest consumer of potato chips,⁸ and more than half the city is considered a food desert.

A 2010 Gallup poll revealed a startling 26 percent of people in the Memphis Metropolitan Statistical Area who could not afford to buy adequate food for their families.

Since Hurricane Katrina in 2005, the lack of healthy food options in the poorest areas of the city have become critical, though it has been slowly improving.

With healthy produce growers and farmers’ markets only a few miles away, West Oakland has fifty liquor stores and hundreds of fast food restaurants and convenience stores selling junk food, with only a few supermarkets.

It is well-known that the incidence of obesity and diabetes are common in people who live in food deserts. But rarely do we consider the impact of fast food–infiltrated regions on the unborn. Full-term babies born with low birth weights are the result of intrauterine growth restriction, a term that refers to the poor growth of a baby in the mother’s womb. Researchers have found that the farther an expectant mother has to travel to buy produce, the more likely she is to give birth to a full-term baby with low birth weight.⁹ Low-nutrient diets create a wide range of physical and mental problems that start early in life. Low birth weights have been directly correlated with future learning problems, heart disease, high blood pressure, and type 2 diabetes later in life.¹⁰

Low-birth-weight babies are also more susceptible to developing future behavioral problems. One study found that 9-year-olds who experienced intrauterine growth restriction had more cognitive impairments, including difficulties with language, creativity, and executive functioning. They also had lower academic achievement and a diminished ability to “self-regulate,” meaning difficulty in regulating attention, which leads to inappropriate behavior and academic problems, and difficulty in regulating negative emotions, which leads to irritability and aggressiveness.¹¹

Typically during famines women become thin and stop menstruating. They do not become pregnant because of the lack of calories. Those unfortunate to be pregnant when famine strikes produce offspring with long-term health issues, but the damage in these cases is limited, as fewer women become pregnant when food is not available. But Frankenfoods have changed all of that, tricking the body into thinking that it is living in a time of abundance. Junk foods increase birth rates while simultaneously depriving offspring of required nutrients for full brain development.

The diets of mothers powerfully affect their unborn children. The brain is built in a micronutrient-intensive process that requires iron, iodine, zinc, magnesium, DHA, and a variety of vitamins and other micronutrients that are in low supply in many regions. Researchers in rural India evaluated the maternal nutrition of 792 low-birth-weight babies and found no association between size at birth and maternal calorie and protein intake. Instead, intake of micronutrient-dense foods and greens was strongly correlated with fetal growth and normal birth weight. Green leafy vegetables, fruits, and even milk were directly associated with healthy offspring, even after adjusting for potentially confounding variables such as socioeconomic status.¹² In other words, the nutritional quality of the mother’s diet is critical.

Iron deficiency, the most common nutrient disorder in the world, also impairs growing brains. The effects of iron deficiency during infancy last a long time. In one study, children who had been treated for severe chronic iron deficiency in infancy still tested lower in arithmetic and writing achievement and motor function after treatment compared with children who had good iron status in infancy. The ratio of children who had repeated a grade or were referred for special education or tutoring was two to three times higher. The parents and teachers of formerly iron-deficient children rated their behavior as more problematic, with increased anxiety, depression, social problems, and attention deficits.¹³

Iodine deficiency is another major global problem. According to the World Health Organization, even mild iodine deficiency causes subtle mental impairment that leads to poor school performance, along with reduced intellectual and work capacity.¹⁴ Iodine deficiency results in a global loss of 10 to 15 IQ points at a population level and constitutes the world’s greatest single cause of preventable brain damage and mental retardation.¹⁵ In extreme cases, iodine deficiency stunts physical and mental growth in developing fetuses. This condition, called cretinism, is rare in the United States, even though milder iodine deficiencies are not. In fact, they are on the rise; consumption of this vital mineral in the United States has declined by 50 percent since the 1970s. Fast food is low in iodine.¹⁶

Fast food and micronutrient deficiencies don’t just promote infants with low birth weights and suboptimal brain function. The same foods are a major problem affecting all children throughout their developing years. Researchers tested two cohorts of children in Australia and Indonesia. The Australian cohort was well-nourished according to daily recommended allowances, while the Indonesian group was marginally nourished. Each child received either a placebo or multivitamin supplement that included iron, zinc, folic acid and vitamins A, B6, B12, and C, with DHA and EPA. Researchers found that supplements led to significant improvements in both the well-nourished and marginally nourished groups. In both cases, verbal learning and memory were increased in the test group compared with the control group.¹⁷

Though supplements have only a fraction of the micronutrient and phytochemical diversity of real food, this study was a testament to the essential role of nutrients in enabling our children to achieve their maximum potentials. A gradual but full spectrum of intellectual damage from mild to severe is occurring, and this damage inhibits fast food–eating populations from reaching their potential and achieving the American dream of prosperity and happiness.

Commercial food makers do not and cannot replicate the wide variety of beneficial ingredients contained in whole foods, with their complex assortment of micronutrients and phytochemicals. The average American consumes a diet that is only marginally better than the diet of residents in Camden. Consequently, the problems in Camden are a bellwether of problems that threaten the health, welfare, and security of all Americans. This abysmal diet affects all areas of the country, but in the inner cities and the Southern states, things are worse.

Revitalizing our cities and protecting the health of people in need not only involves building adequate housing, creating jobs, establishing adequate public transportation, and providing affordable access to medical care; it also must involve providing access to healthy food. A healthy population improves the economy, reduces demand for public welfare services, supports the tax base, and reduces crime; it elevates and supports all other initiatives to improve public good. This means that food policy and distribution must change significantly. People in impoverished communities and especially inner cities need produce, and they need public health authorities to encourage the consumption of produce through public health initiatives and messaging.

New York City is an example where significant improvements in food awareness, accessibility, and eating style have been made, resulting in improved health of the population in a relatively short time. Today, salad bars, chopped salads, vegetable bars, vegetable juice bars, and fruit and vegetable produce vendors can be found on the sidewalks throughout the city. More food markets are selling produce in lower income areas. The political discussions about reducing sugar and soft drink consumption and lowering salt intake initiated by former mayor Michael Bloomberg had a positive effect on the social climate and health of New Yorkers. It is encouraging and even amazing that Bloomberg had such a powerful influence on saving lives in New York City, even when many of his initiatives were unpopular and rejected by the legislature.

The dialogue that Mayor Bloomberg opened among New Yorkers with his message about food on radio, on TV, and in print positively affected the way New Yorkers eat today. Since he first took office in 2002, Bloomberg unleashed a tsunami of public health initiatives: He attempted to cut sodium in prepared meals; he ordered that menus in chain restaurants include calorie counts; he posted restaurants’ health department grades; and he worked to limit the use of tobacco products throughout the city. His first acts included a ban on smoking in restaurants and workplaces. In 2011, the restriction was extended to public parks and beaches.

Bloomberg’s proposed restrictions spurred a backlash of criticism. Among other things, he was called Nanny-in-Chief and Big-Brother-in-Charge. Many people thought he went too far and that trying to legislate better health choices infringed on people’s rights. Several of his efforts did not succeed legislatively. For instance, he tried to restrict the serving size of soda and failed. He also failed in his bid to get a soda tax adopted and to ban the use of U.S. government food stamps to buy soda. In their efforts to beat these proposals, soda companies staged rallies and gave millions of dollars to politicians and made other donations to hospitals to enhance their public image. However, the attention brought to these issues could not be silenced, and although the soda-tax efforts were defeated in both New York and Philadelphia, soda consumption still went down in these two cities by about 25 percent and has remained down in subsequent years.¹⁸

There is no question that the discussion raised about soda, sugar, and health in the media and government’s role in encouraging better food choices had a positive result and are two of the primary reasons that New Yorkers started eating healthier. From the time that Bloomberg took office in January 2002, the city’s smoking rate has dropped from 22 percent to just above 14 percent—one of the fastest declines in the country. Today, New York is most likely the healthiest city in the United States and certainly the healthiest large city because of what Bloomberg did and others have done since. A ten-year study by the New York City Health Department showed that New York’s death rate fell 11.1 percent and life spans lengthened by more than 2.5 years, to 81.1 years, during the study period, 2004–2013, which ended with Bloomberg’s third term in office. Premature deaths plummeted by 16 percent during the decade, and the racial gaps in death rates narrowed, according to the study.¹⁹

Mayor Bloomberg also started a program called FRESH (Food Retail Expansion to Support Health). Its mission is to help alleviate the lack of nutritious, affordable, fresh food in low-income New York City neighborhoods. This program offers tax incentives, density bonuses, grants, and loans to fresh produce retailers who open or expand in underserved parts of the city. Since launching in 2009, twenty-four FRESH projects have been approved. Thirteen new stores have completed their construction and are open to the public. These supermarkets are expected to provide more than sixteen hundred new jobs and represent a citywide investment of approximately $100 million.²⁰

Certainly other factors played a role that developed increasing public demand, but in the past five years hundreds of healthy salad-and vegetable-friendly fast food places have opened in New York City. It is common to see a healthy salad takeout restaurant that offers assorted healthy toppings, including beans, seeds, and nuts, throughout the city. For example, in 2017 Just Salad has twenty-one locations in New York, Chop’T has six locations, fresh&co has fourteen locations, and sweet-green has fifteen. Fast food establishments serving healthy options in New York City have exploded. And there are now many more small grocery stores that feature salad bars and offer a large selection of fresh produce.

New York City uses multiple strategies to improve the food environment, including enhancing access to and education on healthy eating. Green Carts is an important New York City innovation that helps vendors with mobile food carts offer fresh produce in neighborhoods that have limited access to supermarkets. The street vendor carts sell only fresh produce, including local vegetable favorites and tropical fruits. The program was launched in 2008 and since then, nearly five hundred vendors have opened Green Carts. Many of them have electronic benefits transfer (EBT) terminals (distributed for free to these vendors) to accept supplemental nutrition assistance program (SNAP) benefits. These efforts in New York have made a big difference.

It is interesting to note that Bloomberg’s attempt to limit soda consumption was not welcome in some parts of the country. Mississippi—whose 34.9 percent obesity rate is our nation’s highest, according to the CDC—passed an “anti-Bloomberg” law. Mississippi Governor Phil Bryant wrote, “It simply is not the role of the government to micro-regulate citizens’ dietary decisions.” But Bloomberg lashed back. “‘Saturday Night Live’ couldn’t write this stuff,” he said about Mississippi’s move. “How can somebody try to pass a law that deliberately says we can’t improve the lives of our citizens?” he asked. “It’s just farce.”²¹

As we improve the nutritional intake of our nation’s inner cities, we will also have long-term positive effects on reducing chronic disease, poverty, violence, and crime.

One of the goals of the “Let’s Move!” campaign led by former First Lady Michelle Obama was to eradicate food deserts by providing financial incentives to encourage supermarkets to open in these neighborhoods. Objectives of the program are to eradicate food deserts, fight childhood obesity, and encourage the consumption of fresh fruits and vegetables. Of course, what the national government can do is limited because of competing food interest groups and lobbyists (including the processed food industry), which derail the opportunity for dramatic changes and the ability to heavily influence food policies.

For example, on the Let’s Move! website you can get information about MyPlate, a USDA program whose sample menus include dangerous fast foods, such as puddings, pretzels, tub margarine, and pork tenderloin with egg noodles. You won’t see any raw nuts and seeds, no large salads with healthy dressings (made with real seeds and nuts), no bean chili or vegetable bean stew with greens, onions, cabbages, and mushrooms. It’s just more semi-dangerous SAD recommendations that are a bit better than the typical fast food diets many inner-city children now eat. What a disappointment.

To significantly improve the nation’s health, we must expose the truth about dangerous, low-nutrient foods such as white bread, pasta, and flour. Most importantly, we must share the latest nutritional science to showcase the necessity of eating greens, beans, nuts, and seeds. Government nutritional programs (if they continue to get funded at all) can be hindered by influential lobbyists. The government won’t take a stand on strong initiatives such as reducing meat consumption, or cutting out added sugars, or eliminating sweetened milk from school lunches. It can’t even support the basics, such as eating more fruit, veggies, and beans. It always purposefully confuses the message so as not to offend the food industry, especially the sugar, egg, meat, and dairy industries.

Though our national government is unlikely to advocate clear guidelines for excellent nutrition, these three are clear and well-supported by a consensus of nutritional scientists the world over. These three points need to be recognized everywhere, without confusion:

1.Eat more fruits and vegetables, especially vegetables of differing colors, beans, mushrooms, onions, seeds, and nuts.

2.Reduce or eliminate the consumption of fried foods, white flour, and sweeteners, including sugar, fructose, honey, and maple syrup.

3.Reduce all animal products to fewer than 10 percent of total calories, especially processed meats, barbecued chicken, and red meat.

Not thousands, but millions of people are dying needlessly every year in their 30s, 40s, 50s, and 60s, rather than living with good health into their 80s and 90s, according to the World Health Organization (WHO).²² WHO is a global organization that includes more than seven thousand doctors and scientists from more than 150 countries. Its primary goal is to “build a better, healthier future for people all over the world.” The findings and recommendations from this organization should be wake-up calls for the world.

Diseases linked to lifestyle choices, including diabetes and cancers, kill 16 million people prematurely (younger than the age of 70) each year according to a 2015 WHO report. This “lifestyle disease” epidemic “causes a much greater public health threat than any other epidemic known to man,” said Shanthi Mendis, the lead author of WHO’s Chronic Disease Prevention and Management report.²³

WHO supports banning the advertising of tobacco and alcohol and taxing junk food and high-salt fast food. In Hungary, a heavy tax on unhealthy components of various foods and drinks led to a 27 percent drop in junk food sales.²⁴ Heeding the call of WHO, the United Kingdom announced the introduction of a 20 percent tax on sugar-sweetened beverages in 2017. The U.S. food industry argues that members of the public should be able to take “personal responsibility” for choosing what foods to eat, deflecting the blame to the consumer; but the truth is that the public lacks knowledge and choice.

This is a critical point. Is it really a choice if the information, let alone the healthy food itself, is not readily available? And while the general population may understand the basic distinction between healthy and unhealthy, I argue that most people don’t truly understand the radical, detrimental life-altering and life-shortening effects of the highly processed, sugar-enhanced foods that they choose daily. This must change.

The costs of treating people who are sickly for years and then die in the prime of their lives are devastating. WHO has reported that $7 trillion will be sucked out of the global economy over the next decade by such premature deaths.

The current tactics of the sugar industry mimic how “big tobacco” was able to define its practices and promote tobacco use for years and years. Key in its strategy was paying scientists to plant doubt in the minds of the public, thereby confusing them, and financially supporting political allies.

New innovations and initiatives for supporting better food availability are happening across the country. In New York state, a program called the Healthy Food & Healthy Communities Fund has provided $30 million in financing for produce markets since 2011. This program, along with some in New Jersey and Colorado, was modeled after the Pennsylvania Fresh Food Financing Initiative led by the Food Trust, the Reinvestment Fund, and the Urban Affairs Coalition. The goal of all these programs is to make it easier to develop full-service food retailers. This can happen through better loan terms, subsidies, tax incentives, and a host of other financial packages. In Pennsylvania, the financing program approved funding for eighty-eight new and expanded markets in the six years of the program.

In New Orleans, a city program called the Fresh Food Retailer Initiative was part of the financing that helped open several stores in target areas during 2013–2015. These included the reopening of Circle Food Store, a local landmark in the Seventh Ward that was devastated by Hurricane Katrina. It was and is again a needed mainstay of fresh food. A Tulane University study in 2014 showed that the number of supermarkets in New Orleans in that year had returned to more than thirty, after having been less than half that number in 2007.

Emerging research suggests that introducing supermarkets into low-income urban communities can improve dietary behaviors. An important 2002 study that followed ten thousand residents in Maryland, North Carolina, Mississippi, and Minnesota found that local food environments affected dietary intake. Researchers reported that African American residents increased their fruit and vegetable intake by 32 percent for each supermarket in their census area.²⁵ A similar study in the United Kingdom measured fruit and vegetable consumption as a marker of healthier eating behavior and found that 75 percent of the population increased their produce consumption after a supermarket was introduced into an area of need, doubling their average intake of fruits and vegetables.²⁶ The evidence shows that if quality food is available at reasonable prices, positive health effects occur for people at high nutritional risk.

But opening more food stores is not enough. People have to buy and eat those healthy foods. We need a grassroots-initiated food revolution. Old habits, ingrained food preferences, and food addictions are hard to break. Supermarkets on their own will not be successful in changing the eating habits of people who live in food deserts, so what else can we do? Well, we need to educate individuals about healthy choices and provide creative incentives for them to buy healthy foods. And education needs to target both children and adults.

For example, in New York City, the Department of Health and Mental Hygiene distributes “Health Bucks” that people can use to buy produce at all farmers’ markets in the city that accept food stamps. Participants receive one Health Buck coupon for every $5 they spend at farmers’ markets using food stamps. In other words, they get more food dollars if they spend what they have more wisely.

Clearly, we need to couple educational programs with financial incentives that encourage people to spend their food dollars wisely rather than buy fast food and junk food. This has begun to occur in some areas of the country. For example, seniors in New York City with yearly incomes of less than $30,000 can get vouchers that they can redeem at farm stands. Many farmers’ markets will help collect produce and take it to food banks and pantries at the end of the market day. Tax deductions also can play an important role to encourage donations of produce to feed the hungry. The Good Samaritan Hunger Relief Tax Incentive Program allows farmers and small business owners to receive a tax deduction for donating food to banks, pantries, and homeless shelters. Look at Seattle: in 2008, seven neighborhood farmers’ markets donated 40,343 pounds of produce to local food banks.

We need an army of voices working with and within these communities to improve their health. Efforts have begun and it is starting to pay off, but it is a slow process that needs further innovation and support.

I have known nutritionist and educator Akua Woolbright for years, since she worked for Whole Foods Market on its healthy eating programs. We worked together to improve the health of Whole Foods Market team members and to set up educational initiatives for Whole Foods customers. Woolbright has a doctorate in nutritional sciences from Howard University. Today, she serves as the nutrition program director for the Let’s Talk Food initiative in Detroit, a program sponsored by the Whole Cities Foundation.

When Dr. Woolbright went to Detroit in 2012 to work in this low-income community, she hit the pavement running. That first year she spent most of her time taking our nutritional message to the community. She went to health care centers, church basement meetings, hair salons, senior citizen centers, mosques, high schools—any place that would allow her to introduce herself and speak on their turf. She went to two to three different church services on Sundays to meet people and speak to pastors, asking whether she could lecture on healthy eating and present healthy cooking classes. Her work has won a steady and growing following of enthusiastic people, and her experiences teaching people who live in low-income areas in Detroit offer keen insight into changing the health of our country. Her insights below, which she shared to be included here, are invaluable.

The biggest surprise to me that I learned in the years I have been working in Detroit is the incorrect perception coming from public-health and medical authorities and the universities, stating that this message of plant-based, superior nutrition cannot work in a place like Detroit and that black people in large urban communities will not be receptive to healthy eating. I was told, “You won’t make a difference, it is not worth the effort, and it is best just to prescribe medicine,” because “these people just won’t do it.” We should not be making these false assumptions of what people can and cannot do.

It is not my decision to decide what people can and cannot do; my job is to bring people the right information so they can decide what they want to do for themselves. And the response has been overwhelming, and people have been transforming their health.

It is my responsibility to present sound nutrition information. Period. As an African American nutritionist, I feel an even more pronounced responsibility to make sure this life-saving information reaches my community.

The second most important thing I have learned is that the language we use is often inadequate. Whether it’s New Orleans, Detroit, or Oakland, the people in these communities do NOT necessarily consider themselves underserved or disadvantaged and they may not like the term “food deserts.” It is important that community health professionals reach a deeper understanding of the communities they serve so that the messages and approaches they apply will be more appropriate and effective. I have seen that people across all demographics are willing to apply the nutrition information they receive to make bold lifestyle changes.

People living in neighborhoods across Detroit are working every day to make our neighborhoods better, and I am happy that I’ve had the opportunity to make contributions toward the health and wellness of the people who reside in this city.

A different vocabulary is needed to speak about these communities in a way that is uplifting and respectful, to acknowledge the good that is here, and to add to the good that is already happening. This helps the community see you as an equal partner, not as someone looking down from an ivory tower of superiority, but as someone who is willing to meet them where they are and walk the journey with them.

Every day I talk to members of the black community with different socioeconomic backgrounds, many of whom are living with some of the most serious health challenges and obstacles, and I work to help them get their lives back on track. Despite what some of my colleagues seem to think, this healthy eating message even works better in a community like this because folks have experienced and seen the negative effects of serious health conditions—the human tragedy that they are seeing with their own eyes every single day, so they are more ripe for a major nutritional overhaul. You don’t have to show them the statistics of ill health in this community; they see it every day with their own family, friends, and neighbors.

The people that come to my classes come back and share—“my night sweats are gone,” “I am sleeping through the night,” “my fatigue, joint pain, or my headaches are resolved.” This is only the first tier of results that people experience early. And they never thought their suffering with these symptoms was linked to food and diet. Of course their sinuses clear up, and chronic sore throats and indigestion go away. But then the second tier of results starts to come into play and their chronic diseases gradually resolve. They are able to first reduce and in most cases eliminate the need for medication for blood pressure, diabetes, and high cholesterol. At one meeting, a person stood up who lost 100 pounds; a couple chimed in that had lost 40 together—so many losing and really keeping it off, because they are maintaining the lifestyle they were taught. They learned to make a permanent change in the way they eat.

The beauty here is that this work is translatable to all these groups and populations; it crosses economic boundaries; it crosses race, cultural, and ethnic barriers. I am surprised that so much of what I learned in the university was wrong, and I found that cultural, ethnic, and racial differences were NOT an impediment to change—especially when [one is] given the opportunity to really spend time with and educate people properly. When [people were] given practical information and the lifesaving scientific information that supports it, so many were willing and able to change and not be helpless and frozen in their fast food habits.

I am talking to SNAP recipients; we have war veterans, single mothers, grandmothers, college students, government workers, auto industry professionals, office workers, and health educators who all attend my classes together, and that is the beauty of this movement—seeing the powerful interest that emanates across the entire spectrum. That has been the most important affirmation. If I had listened to the professionals in this field, I would have given up the first week. People everywhere and especially here want better for their families, and they want to enjoy the best quality health and happiness they can earn.

I have found that health practitioners must push the envelope and request more significant changes from their clients and patients. We have to go beyond portion control and moderation, which is not working. We have to get bolder in our approaches and expect more from people; if we don’t believe it is possible, we are already lost. It starts with us, but it ends with people making positive changes in their lives.

Akua Woolbright’s wisdom and work are critical for the future health of this country. The evidence is clear that good information and healthy food availability make a real difference in the lives of people in impoverished communities.

Voices for Healthy Kids is a joint initiative of the American Heart Association and the Robert Wood Johnson Foundation working to engage, organize, and mobilize people to improve the health of their communities and to help all children grow up at a healthy weight. Voices for Healthy Kids is dedicated to improving access to affordable healthy foods for children and families. They work to increase the number of healthy food outlets, grocery stores, supermarkets, and farmers’ markets in underserved communities by increasing governmental support for financing initiatives.²⁷

They are working on behalf of more than 1 million people in Alabama—including a half-million children—that live in areas without easy access to fresh and healthy food. That places Alabama among the top ten states in the nation in terms of a lack of access to healthy foods. But a group of health advocates under the leadership of Voices for Alabama’s Children is working to change those statistics by creating a healthy foods access fund. The state-based program would establish a revolving-loan program that would provide financial incentives to grocers and other food retailers to locate their businesses in communities that have low or no access to healthy foods. Voices for Healthy Kids has also launched healthy food access initiatives in Texas, North Carolina, Oklahoma, Louisiana, and Ohio.²⁸

The food and beverages and chain restaurant industries target children with intensive marketing.

In 2010, the food and beverages industry spent $40 billion lobbying Congress against regulations that would decrease the marketing of unhealthy food to kids and promote soda taxes. The fast food industry spends more than $5 million a day advertising sugary cereals, junk food, and fast food to children; and it’s working.²⁹ It has been demonstrated that exposure to these advertisements induces children to eat higher amounts of sugar, fried food, and sweetened beverages. Advertising brain-damaging foods to children is no better than advertising cigarettes, alcohol, and addictive drugs to them. It’s hard enough for parents to get their children to eat vegetables, but once they are hooked on commercial baked goods and sweets, it is, as we have seen, even more difficult.

Animals of all species will choose highly flavored, processed foods over real food and become highly addicted, obese, and sick when exposed to these food choices. In fact, animals will stop eating the produce they are habituated to eating in their natural environments and only consume calorically concentrated, highly flavored junk food when given the opportunity. Their palates and their brains can be captured to prefer high-tech, designer foods. Human children are no different. They don’t like fruits and vegetables because their taste has been deadened and hijacked by highly palatable processed foods.

Of course, parents are ultimately responsible for what their children eat, but until communities and school systems prohibit these dangerous foods in public places, even well-intentioned parents become conflicted with societal pressures to conform to the dangerous eating practices placed on their children. Schools have to make clear that bringing cupcakes, doughnuts, cookies, and other junk food into school for parties, birthdays, and even for regular cafeteria consumption is not permitted. It’s time to stand up to the big food companies and protect the health of our children. Advertising sweetened, processed foods to children is just not acceptable.

Policy changes are needed; agricultural subsidies foster poor health. For more than eighty years, U.S. farmers have been the beneficiaries of a medley of subsidies and price-support programs to elevate and stabilize crop prices and keep fields productive. Critics and scientists say these policies have led to more obesity and disease by favoring the production of only corn, wheat, and soybeans. These crops are for feeding livestock rather than people and for use as sweeteners and additives in processed foods. These policies are now entrenched in America’s heartland. They keep the foods fed to cows and pigs cheap and reduce the consumer costs of dairy and meat, thus keeping sugary, corn syrup–flavored fast foods cheap too, as well as corn oil, HFCS, soybean oil, and white flour. These policies primarily benefit huge agricultural corporations, fast food giants, and processed food manufacturers, not the family farm trying to grow fresh fruits and vegetables. While the overall price of fruits and vegetables in the United States increased by nearly 75 percent between 1989 and 2005, the price of junk food dropped by more than 26 percent during the same period.³⁰

Food subsidies are one reason that the cheapest, unhealthiest, and most fattening fast foods are the most available foods in poor neighborhoods. Inexpensive, dangerous, and addictive foods have become the staple of an overweight and sickly population that faces an explosion of medical difficulties and medical costs. And these cheap foods do not come cheap—they burden a stressed population with tragic medical difficulties and unaffordable medical expenses.

If the United States is going to subsidize agriculture, it should at least subsidize healthy foods, not unhealthy ones. Rather than subsidize sugar, corn syrup, and beef, we should subsidize mushrooms, walnuts, almonds, broccoli, and bok choy. Subsidizing fruit and vegetable growers instead of commercial corn, dairy, and beef concerns would do a lot toward making our population healthier. It may not make a huge difference in the price of corn syrup liquid drinks at fast food outlets, but it would encourage large growers to think more about farming diversity and growing options. And, it would be a factor in educating our population about the value of fresh produce.

The fact that fresh fruits and vegetables are more expensive than processed snacks is perceived to be a major impediment to eating healthy food for many, particularly lower income, families. This is an issue that the USDA has studied. Hayden Stewart, an agricultural economist with the USDA’s Economic Research Service, says that the USDA wanted to answer the question of how much it costs someone to meet fruit and vegetable recommendations. Her group found that an adult on a 2,000-calorie-per-day diet could satisfy recommendations for vegetable and fruit consumption in the 2010 Dietary Guidelines for Americans at an average cost of $2.00 to $2.50 per day, or approximately 50 cents per edible cup equivalent.³¹ Stewart and colleagues also looked at costs associated with swapping out snack foods for fruits and vegetables and found that swapping is, at least, cost neutral.

Certainly, if a family cuts out fast food and processed food from their diet and spends those dollars sensibly on produce, they can eat healthfully with little extra cost, but those are acquired skills that Americans need to learn. And don’t forget to factor in the costs of illness, chronic disease, excessive medical expenditures, and reduced work capacity that result from poor eating habits. The American College of Cardiology estimates that $22 billion in needless and excessive medical costs and $9 billion in lost productivity are related to improper eating in this country.³²

We can see that efforts are under way to improve the way Americans eat, and this is happening near to me in Camden. The New Jersey Partnership for Healthy Kids launched a Get Healthy Camden initiative, and a Camden Food Innovation Grant Fund was started. But we need to do much more because we have passed the tipping point of danger. We need better nutritional guidance, and we need millions of new adult role models of healthy eating. Adults have to model healthy eating behaviors and get rid of fast food in their diets before they can expect kids to do the same. The efforts to promote the consumption of vegetables, beans, fruits, nuts, and seeds need to involve citywide agencies, joined by all areas of political and social influence, with heathy eating promoted in hospitals, medical clinics, and all public places. We need an integrated effort that involves celebrities and influential athletes promoting the consumption of fresh fruits, vegetables, beans, seeds, and nuts. Health professionals have to walk the walk and talk the talk. For instance, we can’t continue to allow fast food restaurants in hospitals. Hospitals and public health facilities must remove white flour, pancakes, waffles, and other junk food from their menus. Every pebble of influence needs to come together to start and maintain an avalanche of good.

Imagine if we transformed America’s inner cities into zones of excellent nutrition that grow healthy bodies and healthy minds. Instead of food deserts, they could be hotbeds of creativity and business opportunity; they could be transformed into Blue Zones of slim, healthy people living well and long, and being proud of their accomplishments. Improvements have already begun to happen in some areas of the country. With many people working purposefully together, we can stop fast food genocide.